I think his point was that this WHO document used highly filtered patient reports, so it would be wrong to look at it and infer you were getting something representative of the distribution of patient outcomes. Which, purportedly, the NYT did so infer.
>Do you have *any* underlying unease at the extensive physical force and coercion, even prolonged imprisonment in psych wards, that is commonplace in Western psychiatry?
I'm guessing Scott has given it some thought along the way. One such post (but it has come up other times):
I don't think this is quite right - they describe themselves as the Hearing Voices Movement, not as the Schizophrenic Movement or whatever.
I also think it's fine to say there's a natural cluster of eg autistic people (which is obvious enough that things like "aspie" have entered the lexicon even though psychiatrists would kind of prefer that not happen) and that you can believe this and still be angry with people who think this cluster should be treated with powerful medication.
Hypertension is famously the "silent killer"--without a doctor's appointment and a trip to the syphgmomanometer no one would ever know they were hypertensive before they died of a sudden stroke. Yet the actual phenomenon of blood pressure is as objective, quantifiable sign as a person could ask for: it's the literal pressure of the blood in the vessels. You can quibble about at which exact point it becomes a concern (and no one actually believes that something magical happens when your blood pressure increases by 1/1 and you cross into the hypertensive category, the line is drawn because you have to draw it somewhere) but you can't argue that 121/80 is actually 128/10. It's a poor analogy to mental health conditions, which necessarily create symptoms that the patients are aware of, but which are very difficult to objectively measure, and which can be interpreted through any number of theoretical lenses which radically change the meaning of those experiences.
I agree with the thrust of your ontological concerns about mental health conditions but I actually think the HVM (which I'm not a part of) is coming it from another epistemic place altogether and so avoids many of those concerns. People in the Hearing Voice Movement are gathering around a shared experience that they would be aware of with or without professional intervention. People who are having certain kinds of auditory hallucinations might fret about whether they are truly "hearing voices", but if I understand them right I think the ethos of HVM is very much unconcerned with that kind of line-drawing. I mean, if you exist in modern society and have certain kinds of abnormalities of psyche, psychiatric concepts will have mediated some of your understanding of your experiences, but I don't think that's much of a gotcha for the people who have the abnormalities in the first place.
So what makes people believe they are different, abnormal in this way? The voice-hearing case is pretty straightforward, but I think you might be more interested in other examples. When it comes to autism spectrum, I think the subjective experience that many people who come to identify as AS are gathering around is a lifetime of inexplicable social friction and rejection. I think the gravity that holds those social groups together is less about meeting particular psychological/developmental criteria and more about whether being picked last on the dodgeball team over and over for reasons beyond your comprehension is something that resonates with you--and, you broadly fit the phenotype, so you can bond over the shared similarities. I mean, I happen to think AS is close enough to something of a real thing that it can explain why these people with this broadly similar phenotype are socially rejected over and over, but I don't think that explanatory framework is necessary for those folks to get together on non-hypocritical grounds.
" You can quibble about at which exact point it becomes a concern (and no one actually believes that something magical happens when your blood pressure increases by 1/1 and you cross into the hypertensive category, the line is drawn because you have to draw it somewhere) but you can't argue that 121/80 is actually 128/10."
Except when I was trying to find out about what exactly constituted hypertension, the information online was "we used to think 140/80 was normal but now that has been revised downwards":
“The risk of cardiovascular disease begins at 115/75 mm Hg and doubles with each increment of 20/10 mm Hg; individuals who are normotensive at 55 years of age have a 90% lifetime risk for developing hypertension,” the guidelines say."
I hope you all are rigorously maintaining 115/75 BP! And striving to lower it even more!
Okay, and why did they pick "120/80" or "120/70" OR EVEN LOWER as the new "normal blood pressure range"? What studies, what measures, what incidences of cardiac events and strokes at 140/80 versus 120/80?
Scientific American doesn't know, but it knows LOWER IS BETTER:
"The exact origin of the designation of 120/80 as the threshold for "normal blood pressure" is unknown. It may have come from the large amount of data available early in the 20th century from life insurance exams and what happened to these people as they aged, or it could have arisen from the beliefs of medical practitioners, as so much traditional knowledge has."
I do like the 'traditional knowledge' bit; yes, the ancient and venerable all of thirty years that 120/80 was considered normal BP!
Scientific American may be puzzled by this conundrum of the sphinx, but I know: Brazilian tribe in the rainforest, was the answer. Some study measured their blood pressure levels and found that they had an average of 120/80, so this was set as the new ideal:
"Four remote population samples (Yanomamo and Xingu Indians of Brazil and rural populations in Kenya and Papua New Guinea) had the lowest average blood pressures among all 52 populations studied in INTERSALT, an international cooperative investigation of electrolytes and blood pressure. Average systolic blood pressure was 103 versus 120 mm Hg in the remaining INTERSALT centers; diastolic blood pressure in these four population samples averaged 63 versus 74 mm Hg in the 48 other centers. There was little or no upward slope of blood pressure with age; hypertension was present in only 5% of the rural Kenyan sample and virtually absent in the other three centers"
I went "Dude, I am not a Brazilian tribesperson living in the Amazon, I kinda think personal circumstances and genetics might be a teensy bit different for what you are saying I should be aiming for?" I mean, sure I would *like* "hunt monkeys for two hours, then lie around in a hammock the rest of the day" lifestyle but that's not going to happen in the Western world, you know?
The European Heart Journal is as confused as I am:
"No wonder that many are confused at a higher level: what should we use in our daily practice? When we strive for truly normal blood pressure, we might look back at the days when humans still lived in their natural environment as hunters and gatherers. Of note, there are tribes still living today as our ancestors did thousands of years ago. For instance, blood pressure of Tsimane Indios who live in the Bolivian Amazon forest averages ∼116/73 mmHg throughout life. Interestingly, they also have rather low average cholesterol values of 2.4 mmol/L, much lower than Westeners of today’s world. Furthermore, they exhibit much less coronary calcification than age- and gender-matched US citizens. Obviously, they move a lot and hunt all day long in order to feed themselves and their family, and they eat fish, meat, and fruits; however, the downside of their style of living is an elevated C-reactive protein and eosinophils in their blood due to chronic parasitic infections.
The Yanomami Indios who live across the border in the Brazilian Amazon region, have similar blood pressure values throughout their life span. Finally, the Kuna Indios who live near the coast on small islands outside mainland Panama in the Atlantic also have blood pressure values of ∼100/70 mmHg throughout their life in spite of the fact that they eat a lot of salt, in particular, in addition to cacao plants which are one of their major nutrients. Of note, when they move to mainland Panama or to its capital Panama City, they do show the age-dependent increase in blood pressure typical for Western populations.
If naturally living people have lifelong blood pressures of 100–120/70–80 mmHg, are we all hypertensive? Why do we have so much higher blood pressures and a consistent increase in systolic blood pressure with age? Several factors might contribute: (i) genetic changes; (ii) increasing life expectancy; (iii) the obesity epidemic; (iv) sedentary lifestyle; and (v) the composition of our diet. Gene drifts and selection are a possibility, but hard to prove at this point. The increasing life expectancy may explain the marked rise in systolic blood pressure in the very elderly, but not in the population at large. Indeed, Indios reaching retirement age still maintain low blood pressures.
...What would be the appropriate management in the context of diverging recommendations for optimal blood pressure? Not all hypertensives are made equal; some may be younger and have just recently been diagnosed with elevated blood pressure, but are otherwise healthy. Others may already have end-organ damage such as left ventricular hypertrophy or intima media thickening of the carotid arteries, while others may already have coronary artery disease with or without diabetes. Finally, elderly hypertensives may be frail, have a low gait speed, and a risk for falls. Thus, hypertensives have quite divergent cardiovascular and safety risks. It is obvious that one cannot and should not treat all these hypertensives with the very same approach—we must treat a patient and not a risk factor."
I have never met these people who "insist [polyamory] is good for everyone". I think this is part of the problem: people are really bad at separating "please tolerate me when I do this" from "I think everyone should do this".
(not accusing any specific person, my guess is people on all sides have this problem - both the people making the requests and the people hearing them)
I think assuming someone saying, 'please tolerate me', means 'everyone should do this', is an easy jump to make when the person is saying something to the effect of, 'please tolerate me being more moral than you'. In fact, that is basically just taking them seriously. I think this is why so much vitriol gets spewed at vegans, for example.
I am pretty sure you know poly people who advocate that jealousy is silly (or, in your words, a paper tiger), and the throughline from that to moral superiority is straightforward; you are affected by negative emotion, but we poly people are not.
"when the person is saying something to the effect of, 'please tolerate me being more moral than you'"
Yeah, that's the impression I get from people advocating for poly who are often all "Jealousy? Oh we've solved jealousy!" and while they may not *intend* it, it comes across as "because we are superior to you monos, whose tiny brains cannot handle the work of feeling joy for your partner's happiness, but it's not your fault you are stuck on a lower evolutionary level than we are".
It's like the Bike Thief cartoon: it's a lovely *ideal* to have, but the *expression* of it makes me want him to get run over by his own bike ridden by the druggie who stole it to sell for his next fix.
Actually anti-anti-psychotics would be dopamine agonists like amphetamine, which can generate psychotic symptoms.
Those peak spiritual experiences are not at all promised in psychosis and tend to be rare and brief, not lasting states. It must not be especially energetically stable to be so blissful and all-is-one-y. And when you tumble off that peak you often land differently configured. some-is-nothing? who-is-not? etc. Takes a while to get back to this-is-this and that-is-that. Inducing these states via psychosis seems an especially dangerous route.
My recollection is that virtually everything in DMV (4 and 5) requires "negative impact on patients life" for a diagnosis. It doesn't require that the negative impact be worse than that of the drugs needed to solve the problem(for a diagnosis). Thus there are going to be diagnosed people who may well be better off untreated or at least chemically untreated...
This even-handed analysis is so needed -- and I think it also applies to the movement of people treating psychosis as a "spiritual emergency." Thank you.
I'd say that NYT-bashing is a bit excessive, if the goal is to reach reasonable people who aren't already part of this bubble. Like it or not, it's still the newspaper of record, and if your first experience with a rando blogger is their seemingly blind rage towards it, that's probably about as reliable a red flag as they come.
eh, Scott is perfectly allowed to write to his regular readers rather than trying to optimise for outsiders and sanding off everything that made the regulars follow him
Sure, but my impression is that he aspires to more. Like, the general idea seems to be that legacy media is largely discredited and teeters on obsolescense, and brave new solutions are all but ready to replace it, like, say, the Substack-osphere. But for this promise to be realized you actually need to consistently adhere to a higher standard than the legacy media.
If legacy _news_ media were able to go back to the way I remember them - when they had more reach and bigger budgets - I'd be a happy subscriber.
Substack isn't better, and it isn't even serving the same customer wants - nor, AFAICT, attempting to do so.
It also doesn't seem to me to be replacing Life Magazine et al., or Readers Digest, or much of anything that ever appeared on television.
Maybe substack is an adequate or better replacement for types of media I never consumed. (Literary magazines? High brow opinion journals?)
More likely, it's another example of adaptations to the way that modern technology too often makes it impossible for people to get nice things. ;-)
I.e. trad media aren't viable on an ad based model, with google et al taking the lion's share of the ad revenue. All we can get are the clickbait-oriented leftovers, controlled by an ever-decreasing set of oligarchs. Substack is little more than a workaround for one of the resulting problems. Plus, of course, an opportunity for some people to make more money than they otherwise would.
No,not reallt, because this blog doesnt make a claim to be "the blog of record" In fact,m one could argue that making such a claim, which was possible when there weremore limited media sources,is part of the problem and the thing should be acknoweldging whatevr perspectives and biases you may have and not try to claim yourself asthe "official"objective source for things.
I thought Scott was being tongue in cheek. Like he obviously doesn't have a great impression of them but I didn't take his lightly ribbing them as anything but him lightly ribbing them.
If it's *not* your first experience with this particular blogger, then the rage seems justified (albeit crass, even if it is a literary reference), and his behavior is on average consistently better than theirs.
A joke at the expense of a massive media corporation with a history of dishonesty is hardly a more reliable red flag than anything else that gives a "rando blogger" distinction from any other.
Should he also take out the knocks against religious people? Should he remove any mention of trans people, or should his mentions of trans people be more fawning and less skeptical? Those, too, are "reliable red flags" that could alienate outsiders.
"Should he also take out the knocks against religious people? Should he remove any mention of trans people, or should his mentions of trans people be more fawning and less skeptical? Those, too, are "reliable red flags" that could alienate outsiders."
Probably yes for both of those, since those comments generate far more heat than light. The actual topic of the article is controversial enough, why court even more controversy by bringing up two largely or entirely unrelated topics? It risks having any discussion on the article turn into an argument on religion or an argument on trans people, while the actual point of the article gets ignored!
Though I don't really care about the New York Times put-downs. Anyone who'd clutch their pearls about a blogger insulting a giant media conglomerate is probably unlikely to read this blog in the first place. But religion and LGBT issues are topics that quite a lot of people feel extremely passionate about, and while that doesn't mean he should never talk about those topics, it does mean that it's probably unwise to bring them up as casual examples or analogies or jokes in essays about other topics.
Right. Its definitely "culture war" territory, but theres definitely an issue where people utilize that "well,its an established thing" reputation of the Times and other institutions to see control of that as an important part of gatekeeping- the hysterical reaction to the possibility that Musk might buy Twitter shows that a lot of people are very personally invested in this and believe it on if not a conscious level at least a semi-conscius one, and I suppose as a rationalist whose seen this specific community attacked by dubious means(intentionally) its fair to dismiss that combination of "uses shady suggestive means to attack things that are not partof their gatekeeping while still trying to hold the image of journal of record"
It may not be necessary for x-rationalists to givesome special consideration to a media outlet that has attacked them not for what they actually believe but for insinuations that are based on a desire for controlof a "gatekept,this is the official view of reasonable people" paper, and the argument that people,especially rationalists, should stop treating the Times as anything other then a similar partisan news source as that acknowledgement of its "legitmacy" creates legitimacy.
For example., the times can be cited on wikipedia while ACT probably could not.Thats a problem if you're interested in an ability to understand information without first having to pass a certain political/cultural filter.
I thought there was a slight tongue in cheeksness about it given Scott's personal issueds with the times, and it was assumed readers would interpret it in that context.
There is totally successful "church, but for athiests"! I, and most of the practicing Jews I know, are atheists, love going to temple and singing, bar mitzvah our kids, sing praise to the lord, honor our traditions, and think that literally believing in god is infantile.
I'm slightly jealous of my friends who grew up Jewish or Unitarian for this reason - it doesn't seem likely to fill the need for someone who didn't grow up with it though.
This is a reasonable point. I think I meant that the thing where atheists try to create something where people go to church and sing hymns about science or liberalism, without even the slightest pretense of association with a previous God-centered religious tradition, doesn't work.
(this *has* worked for rationalists, but we also have some pretty kooky-by-mainstream-standard beliefs, which seems to be an irreplaceable element. For whatever reason, atheism isn't kooky enough, even when it's extreme atheism in an otherwise religious society)
I asked myself the honest probability of whether something like the God of the Bible existed back when I was in college and admitted the answer was epsilon... and I might not have been willing to do that if not for the fact that I was already sleeping in on Sundays once I'd moved into a dorm.
I love the morning, but going to church isn't one of my top 100 ways of spending it. FWIW, I'm probably one of the most anti-Marxist people around but Freddie, I'm glad you're in the world. You're a stand-up guy and refreshingly honest. I loved "The Cult of Smart". Well, except for the end, which didn't say much about undoing the Cult, just basically "enact everything Bernie says."
When I had my first religious experience, at age 14, my main conscious reason for not doing more with it was because I valued my Sunday lie-ins too much.
Then at 18 I had another one that I couldn't ignore so easily (but still went to evening church for preference). I still do prefer evening church and like lie-ins, but kids who get up at 7am anyway have made that a less-relevant factor.
(Of course, the rationalist credo of "I want to believe what is true" very much applies. If God is real, it's more valuable to believe he's real, even at the cost of Sunday lie-ins. I didn't see things that way at age 14, though.)
I've participated in some rationalist rituals and ceremonies, but personally, I've found them missing something essential that's common to almost all religious practices. That something is a genuine sense of reverence, the idea that a ritual should be designed to evoke sincere and heartfelt emotion, and then actually taken seriously. A lot of the time the rituals go through the motions of nodding to some kind of deep sentiment, but the participants tend to treat the actual expression as a joke.
Individual atheists may feel deep reverence for some things, but I don't think most of them have a shared sense that they ought to feel and express *shared* reverence in a specific thing, that the experience is made deeper and more significant to the participants if it feels like everyone is in it together and not making a joke out of it.
If you'd like to witness the Next Generation of hippies being inculcated into the faith, https://www.retreatfarm.org/ during food truck night is a good place to go.
Having grown up in a place that had lots of Unitarians, had a serious high school girlfriend whose father was one the most eminent Unitarian theologians of his time, etc....your first paragraph is pretty doggone close to what Unitarianism is.
(Nowadays anyway -- one thing I learned from the professor was that it originally had a stronger God-centering aspect.)
The jokes that we all learned [How does a Unitarian start the Lord's Prayer? 'To Whom It May Concern....'] were funny in part cause they were so close to true.
Secular Judaism of the kind described above and the modern UUs both are continuing orthopraxy (https://en.wikipedia.org/wiki/Orthopraxy) and ritualism rather than orthodoxy, and are the inheritors of a genuine religious tradition that they have cored out the "believing in supernatural stuff" but kept the rest, and the rest is thick enough with content to provide cultural capital for the unbelieving generations to consume.
How long that capital will last is another thing; I give Judaism a way better chance at surviving than the UUs.
"For whatever reason, atheism isn't kooky enough, even when it's extreme atheism in an otherwise religious society"
Except we're not living in an otherwise religious society. We're living in a secular society that has a non-religious basis for its social, cultural, moral, political, and legal norms. So in that regard, being an atheist is not very "kooky," because being a secular atheist doesn't result in any noticably different behaviors or lifestyles or values or non-theological beliefs than being a functionally secular theist. In that regard, being devoutly religious in a highly visible way is far more "kooky," even if being a nominal theist is technically the norm.
Being an "extreme atheist" might be seen as weird in an exclusively negative way, if "extreme atheism" implies an active and vitriolic hostility to religion. But that's less because of the belief itself and more because hostility towards other people's beliefs is seen as rude, belligerent, and antisocial.
I agree. I think atheists might have a better shot at having a religion-like thing in a setting where actual religious feeling predominates. Maybe it doesn't even have to predominate, they just have to plausibly believe that is the case (the reddit atheists of earlier in this century come to mind). Nowadays, it's very hard to pretend we live in very Christian communities, so they died out accordingly.
I think just being an "atheist" isn't enough to sustain any kind of movement because its just a "not" movement. It doesn't head towards anything it only heads away. After you've all finished congratulating yourselves for not believing in God, then what?
One issue is that Judaism isn’t a proselytizing religion and seems fairly ambivalent about welcoming converts (refuse three times, etc.). So to the extent that something like the Bright (lol) movement was intended to provide community while defanging the harms caused by most revealed religion, Judaism doesn’t really fit the bill. At times I’ve been lowkey jealous of secular Jews because of the dynamic you describe, but being insular appears to be a key part of making it work. Something like Mormonism for atheists would be great (family home evening!) but just hasn’t gotten any traction.
I was also thinking of music and dance communities. I grew up in an pretty intensely committed multi-generational folk music community with a charismatic leader that 100% served this niche. Even decades later I have only positive reflections on how the structure and values of the group influenced my life. Contra dancing scenes can have this dynamic as well. Toward more quirky, inclusive, and high functioning affinity groups!
But can a music subculture persist over multiple generations? I was in an intense music subculture in my twenties, but it kinda went away eventually as people got older.
I'm seeing a bit of this direction in Catholicism among people my age (late 20s early 30s). People who keep a lot of the traditions and rituals but don't really believe genuinely anymore.
That's interesting, because I've had the opposite experience. I was raised Catholic, and I think a lot of Catholics in my parents' generation did keep the traditions without really believing. I know my dad waffled in his beliefs while I was growing up, and the mother of one of my childhood friends didn't believe in the resurrection, but she still raised my friend Catholic and attended church with the family. But among people I know around my age who were raised Catholic, most have left the church, and the ones who stayed are actual believers who abide by the more difficult rules.
I think this just implies your peer group is at a later stage than GlacierCow's in the multigenerational process of dissolving strong religious bonds. Scott actually wrote about this on SSC in a post called The Ideology Is Not The Movement (Section IV-4):
I believe a critical mass needs to actually believe everything, though. In the Catholic setting, a certain subset of women come to mind.
Edit: arguably in most settings, since, as far as I know, women report more religious feelings in most of the world. But women were certainly very important for the early successes of the Catholic church.
Yeah I see a very similar thing with my friends at home with (rural, European) Catholicism. It is just part of the village traditions/customs, believing anything is not required, just proper protocol.
[And from a Catholic angle you are saved anyway by eating the bread at communion, so there is no need to really believe in anything ;) ]
(2) "Get saved" - this is a very American Protestant Evangelical term. First, and again this is a big deal for some of those denominations, Catholicism does not have 'eternal assurance/eternal security', it is entirely possible to lose your salvation:
Second, just receiving Communion will not 'save' you and indeed can damn you:
1 Corinthians 11: 27-30
"27 Whoever, therefore, eats the bread or drinks the cup of the Lord in an unworthy manner will be guilty concerning the body and blood of the Lord. 28 Let a person examine himself, then, and so eat of the bread and drink of the cup. 29 For anyone who eats and drinks without discerning the body eats and drinks judgment on himself. 30 That is why many of you are weak and ill, and some have died."
(3) "No need to really believe in anything" - this is also incorrect. I'd have to end up quoting the entire Catechism to you to refute this one, so have a snippet from this publication:
I swear, I have no idea how I turned into an evangelist, but whatever nit-picking module of my brain gets engaged when I read incorrect statements of doctrine kicks into high gear. I don't expect anyone to *believe* all this, but I would like if they could state the things they don't believe in correctly.
I remember having transubstantiation explained to me before my First Communion. “It really happens. It becomes the body of Christ. Don’t chew it. Swallow it quickly.” We were to fast from the previous day until we received the sacrament. My fourth grade teacher gave me a religious medallion to mark the occasion. Miss Kaye, nice woman, smart as a sack of hammers. I never could convince her that magnetism could pass through glass or that Mexican jumping beans have a larva inside.
That was in 1962. My autobiographical memory is weirdly reliable.
Oh it has changed *so much* since our day! Did you get the little lecture too about "what do you do if the priest drops the Host before you receive it in your mouth? No, you don't touch it! You *let* it fall to the ground, because lay people cannot hold the Host, their hands are not consecrated!"
And then communion in the hand came in decades later 😁
Fasting from midnight until you received at Mass - this was why people used to faint in church (I saw a couple of instances when I was a small child). Now it's only an hour's fast, and I wonder if even that is observed.
Yeah, the changes are pretty dramatic. As I understand it people don’t go to confession much anymore. There used to be a big line every Saturday evening to prep for communion on Sunday morning.
Dropping the host was an inconceivable event so we I never got that lecture. Even if it were to somehow happen an altar boy held a small gold plate under it so it could never reach the floor.
Hey, my remark was about 50% a throwaway joke, but thank you for responding still. Let me write out a non-joke reply.
(1), (2). English is not my native language (I even had to google what a chick tract is) and I have to admit I was too lazy to look up the translation for "Hostie" (which is "host"), so I just wrote bread. The point about me translating "getting saved" is super interesting though, I wasn't aware that this was such an Evangelical term, but I must have picked it up unconsciously from Evangelicals in the US.
I was thinking of "Sündenvergebung", meaning "forgiveness of sins", during mass as in "mein Blut was für euch und für alle vergossen wird, zur Vergebung der Sünden, tut dies zu meinem Gedächtnis".
(3) I'm not trying to refute my catechesis(?) here, I am giving an accurate (in my worldview) statement how Catholicism is lived in my home town, and closely connected to tradition and protocol.
------
Catholicism, or really any religion, is lived more differently than people think, even when they think there are regional variations.
For one thing, the German bishop conference does have a different focus and interpretation of the catechism. There are also over-regional practices that are common all over German-speaking areas, such as large easter fires (which are lit from a single bonfire in the church yard during easter night), that are, as far as I know, not common in other areas. These are definitely seen as "a Catholic thing" where I am from and there is no separation of "village tradition" and "religion".
I am not arguing that these are schism-level differences, people do agree on broad strokes, but I would argue the way they conceptualize the same words is different. I am also not saying this as a total outsider, I did spend a lot of time in church - as altar server during my teenage years. You have all these people coming to church, murmuring "Herr ich bin nicht würdig, dass du eingehst unter meinem Dach, aber sprich nur ein Word, so wird meine Seele gesund", because that is the proper thing you do, and the actual words don't need to have meaning. You are part of the community by coming and saying them and (in mine/their eyes, not necessarily the catechism), makes you a decent Catholic.
The google translation is not great, but I think good enough to examine various differences. For example, the German version explicitly mention that work is forbidden on Sundays and holy days. The suggestion to go to church every day, on the other hand, is omitted here, only requirements to go on Easter and in danger of death are mentioned. The bullet point regarding marriage is ommited completely. Assisting the church does not mention financial aid. Below the commandments is an interview with a guy who is explaining and further relativising them, saying that context matters and things shouldn't be taken too literally. Maybe you'd find this comparison interesting.
Hello again, and thanks for the reply. Let me take this in no particular order:
(1) I have a high view of the Eucharist, so I do get twitchy at terms like "bread" because they were part of Reformation polemic and because online atheists like to toss about terms like "crackers" when referring to the Host (and in part because of a stunt like this one back in 2008: https://en.wikipedia.org/wiki/PZ_Myers#Eucharist_incident)
(2) We're translating between English and German here, so linguistic and cultural differences ahoy!
(3) I would not be one bit surprised by anything you say about the understanding the ordinary Catholic globally has of the faith; the state of catechesis has been abysmal over the past few decades. I could do the usual "blame Vatican II" bit, but it has always been so, my father was an altarboy himself during the days of the Latin Mass, and he had been trained to just parrot off the responses but never told what they meant, so he had no idea what he was saying. Pope-Emeritus Benedict XVI back when he was still Cardinal Ratzinger also mentioned the likes about not having false nostalgia for the 'good old days', that even back then there were the bulk of Catholics in Germany who just went to church because that is what you were supposed to do but they had very shallow understanding and no real faith.
(4) You are not obliged to attend Mass every day, but you must atttend on Sundays and holy days of obligation.
(5) Yes, the words of institution which you quote in German are the same for the Mass in English; recent translation of Eucharistic Prayer I: "TAKE THIS, ALL OF YOU, AND DRINK FROM IT: FOR THIS IS THE CHALICE OF MY BLOOD, THE BLOOD OF THE NEW AND ETERNAL COVENANT, WHICH WILL BE POURED OUT FOR YOU AND FOR MANY FOR THE FORGIVENESS OF SINS. DO THIS IN MEMORY OF ME."
This is the acknowledgement of the saving sacrifice on the Cross which redeemed fallen humanity, but this is already turning into a theological tract so I'll keep it short. It's not "go up and receive communion and all your sins are forgiven even if you haven't been to confession and you will never lose your salvation" theology.
I have probably been arguing/discussing with American Protestants on the Internet too much, since they tend to have a much different view of salvation and the Lord's Supper, so I was interpreting your words in their sense. Sorry for that.
(6) Lighting bonfires outside the church door on Easter? Yes, that's the new fire - you extinguish all other lights and fires, kindle the new fire, light the Easter Candle from it, and in turn light all other candles from it so you have the new light. It was not alone a tradition but part of the rubrics until very recently; churches over here seem to have given up on it a bit but I am glad that your parish is keeping it up 😀
It's the incident mentioned in the Life of St. Patrick:
Regarding the new fire. Yeah, the core idea is Catholic, I am trying to say that the way people act and interpret it can be very different. I really mean a bonfire, here is an example: https://www.youtube.com/watch?v=aIIrnrmdFJg&t=249s
(You see them coming up to the bonfire at about 4 minutes with candles coming from Easter mass.)
I know some people like this as well. But for myself, I can’t bring myself to see the point of restricting how I eat or how I spend my time, given that I don’t actually believe in the underlying belief system.
I suggest not following the rules that seem pointless, but asking people around you if they go to a church, synagogue, mosque, or other temple that they absolutely love (especially if there is good music), and checking it out. Most people who think of themselves as following the rules are super inconsistent and intellectually lazy about it anyway -- you're doing what they do, but just being more honest about it.
I hear you, but lots of Jews aren't even very ethnically Jewish. My kids are less than 1/4 Jewish by ancestry. Everyone just adopts the identity they want, you can too. You can just show up, sing along with the singing, disagree somewhat with the sermon, go home, read a Dilbert and go to bed.
There's no Jewish card. You just start going to stuff. I guess some Jews are annoying about ancestry or whatever, and the official policies of the state of Israel are designed to exclude people, but just find a temple with gay couples and I promise it'll be cool and not annoying about if you're Jewish enough. As with most of the world history of the last 200 years, places that treat gay people well are safest and best
It's ironic how atheists get more obsessed with religion than the religious. It's also interesting to me how many atheists seem to latch on to Abrahamic stereotypes, especially Christianist stereotypes, when they argue against the existence of god and religious practices in general.
Not all religions require a belief in a particular god or gods. Buddhists, for instance, can get along quite well without a belief in a god or gods (Buddhists can believe or not believe as they wish deity-wise, and it makes no difference for their practices or how they're regarded by their fellow Buddhists). Likewise, Marxism displays many of the beliefs of millenarian religion without a godhead—but they substitute historical inevitability for god's will—and True Communism for the rapture. And in extreme sects of Marxism, a god-like cult is built up around a leader and large-scale worship rituals are promoted and enforced.
Meanwhile, (many) US atheists who think the worship of god is infantile stand for the Pledge of Allegiance (though they might remain silent or mumble "under god" part). And even without the "under god" component, Jehovah's Witnesses long ago sussed out that American flag worship is a bizarre cult where the US flag has become an idol. Their refusal stand for for the pledge is because they see flag worship as violating the 1st and 2nd Commandments, and the enforcement of flag worship rituals in US society as a violating their 1st Amendment rights (BTW: we owe the Witnesses a lot for bringing and *winning* many free-speech 1st Amendment cases before SCOTUS).
But most atheists seem to be as ignorant of religion as Christian Fundamentalists are of science.
3. Many people who claim God is talking to them are, at best, misinterpreting their experience.
4. It would be nice to have some basis, experience, or expertise for claiming there is no God. As someone I respect once said, "That God you don't believe in? I don't believe that God, either!"
"Born again Christians are constantly having what would normally get classified as psychotic experiences - I have asked a bunch of evangelicals who say “God told me to X” whether they actually heard God in a, you know, hearing God type way, and they usually say yes"
Regarding that, the Catholic Church is very "hmmmm" about people claiming to be hearing the voice of God directly communicating with them. (Yes, all the Reformation Protestants will now chime in about putting intermediaries between God and man).
There is a distinction between the voice of conscience, the promptings of Providence, and God Almighty speaking directly to you, and some of that distinction may have been lost in the more enthusiastic denominations in the USA. So you might say "I know Bill is perfectly genuine and sincere, but I don't believe God spoke to him" and I would agree, but not on the grounds that "of course not, God doesn't exist, Bill is just hearing voices".
" -The natural conscience is no distinct faculty, but the one intellect of a man inasmuch as it considers right and wrong in conduct, aided meanwhile by a good will, by the use of the emotions, by the practical experience of living, and by all external helps that are to the purpose.
- The natural conscience of the Christian is known by him to act not alone, but under the enlightenment and the impulse derived from revelation and grace in a strictly supernatural order.
- As to the order of nature, which does not exist but which might have existed, St. Thomas (I-II:109:3) teaches that both for the knowledge of God and for the knowledge of moral duty, men such as we are would require some assistance from God to make their knowledge sufficiently extensive, clear, constant, effective, and relatively adequate; and especially to put it within reach of those who are much engrossed with the cares of material life. It would be absurd to suppose that in the order of nature God could be debarred from any revelation of Himself, and would leave Himself to be searched for quite irresponsively.
- Being a practical thing, conscience depends in large measure for its correctness upon the good use of it and on proper care taken to heed its deliverances, cultivate its powers, and frustrate its enemies.
- Even where due diligence is employed conscience will err sometimes, but its inculpable mistakes will be admitted by God to be not blameworthy. These are so many principles needed to steady us as we tread some of the ways of ethical history, where pitfalls are many."
"It is a misconception that the church is quick to accept mental illness or drug abuse, such as schizophrenia or hallucinogens, for private revelation and demonic activity. The church is skeptical, and only accepts private revelation after discernment, because it is "the pillar and bulwark of the truth" and because it has a long history of dealing with fraudulent visionaries."
"all the Reformation Protestants will now chime in about putting intermediaries between God and man"
Now you are putting an intermediary between me and my "Yes, but!" comments. Typical Papist!
Anyway, a large number of canonizations happen exactly because people claim to have seen an intermediary like Mary or a saint in the sky or whatever. And not metaphorially seen, but seen the same way a cloud or sun is seen in the sky.
The Catholic church, while ostensibly ruled by the Pope, is in a constant tension between very serious Jesuits and wacky superstitious Mexican abuelas. The superstitious abuelas are always getting visions, the very serious Jesuits are always saying that this kind of thing doesn't happen, and occasionally they agree to compromise.
Sounds very similar to Eastern Orthodoxy. Lots of woo-woo from babushkas about visions, reincarnation, basically anything mystical, that often contradicts basic biblical tenets. Hopefully it's not just from the Russian state media's ability to obliterate critical thinking from its populace.
Catholicism is weird along a lot more vectors than that. I was raised Catholic, but I didn’t realize how weird it could be until I went to Europe. Sure, 600-year-old relics of saints’ body parts are easily written off as “back then”, but at Fatima there is still a huge oven for burning wax effigies of body parts and human figures as offerings. You can buy a wax breast and throw it in as an offering with prayers for someone with breast cancer. My Catholic mother would have screamed “Witchcraft!” at things still done by Catholics in other times and places.
If you spend several hours a day for ten years visualizing your meditation deity, it's very likely to appear to you (it did for me, and it scared the shit out of me). Rather than seeing it as dissociative, a better rational explanation for phenomena like tulpas would self-hypnosis through ritual focus (although I think that explanation is also facile). But it suggests to me that the mind is much more flexible in what it can perceive than standard rationalist dogmas allow for.
I didn't want to say the actual reason I posted the above but now that I'm seeing your comment, might as well: I have a comparably long personal practice of meditation and have seen a similar thing happen with a different sort of a visualization. AFAIK, it can be done via hypnosis and faster as well. It didn't quite change my beliefs on the mind though: it seems that if you imagine a sufficiently elaborate entity while in a certain state for long enough, you can make the idea loop and become self-sustaining... Dreams where one talks to imaginary convincing people are a common phenomenon, this must go in a similar vein, or at least so I keep telling myself to stay sane. :)
Dissociation, however, might be related to how one might do such a thing unconsciously.
This occurrence didn't become self-sustaining for me, and I'm happy it didn't. After it left, I realized that I had forgotten an important instruction from my first meditation instructor — "don't undertake meditation practices without the supervision of your teacher". Later in an informal seminar on Buddhism, given by Robert F. Thurman, he echoed that dictum with the codicil, "because you might find yourself in a mental space you'll find very frightening or one that's difficult to escape from without assistance."
Silly me for not taking these warnings seriously.
And this is why I'm against teaching meditation in schools. Are people still pushing that stupidity?
It was more or less an attempt to remember a deceased relative over multiple longer sessions. I don't even know whether that's something one is supposed to do at all, but, well, when that unexpectedly happened, it felt like talking to what I best remembered of them and then the image went away after a while, it was self-sustaining in the sense that I stopped feeling like I was focusing at some point. Never did it again, but at least I gave them remembrance one last time, figment or not and found out just how terrifyingly realistic tulpas of the familiar may seem.
While you definitely can do damage with deep meditation, standard mindfulness stuff might be alright? I'd also assume the Zen approach is built around safety, though that's not what I did and I'm not really familiar with it, so it's just a guess. I stuck with the practice for far longer than most should just as at first it helped me learn to tolerate chronic pain better than prescription meds in terms of not slowing me down, then I kept doing it out of habit as I saw it more as focus training than a rite. Schoolkids are unlikely to practice since it's really easy to get distracted with any other hobby over it unless you have a very good reason, but I've never seen that idea brought up somehow. Wonder if they already do it in any country?
But if you suddenly start realizing what some of the normally silly sounding terms in something like Tantric Buddhism might mean to your own surprise, yeah, I'd really stop joking around and find an expert to talk to, as at that point you might be 'painting' with mixed psychiatric failure states to some degree. I didn't even figure what exactly I was doing at first and still can't be 100% sure either. I think the specific intention 'saved' me from longer term consequences there.
Nothing here I intrinsically disagree with. Not familiar with "the order of nature". I would quibble pretty seriously with "derived from revelation and grace...." I think that may be true, but it's not clear to me that the person operating with "natural conscience" is aware that they are operating under revelation and grace.
Yes, I asked an evangelical I knew well if she actually heard God's voice, and she was quite clear that yes she actually heard it. It was an actual auditory experience, just like hearing me talk -- but she knew it was God's voice. She was not the least bit crazy. I just do not know what to make of it. I wouldn't exactly call myself the sanest of the sane, but I have never once heard a a piece of actual audible speech from someone who was not there -- except when in bed, on the verge of sleep, & I'm pretty sure auditory hypnogogic hallucinations are common and normal. I keep thinking that she must have just *thought about what God would say,* and rounded that up to actually hearing a voice, because direct communication with God was regarded as normal in her community, and in fact was highly valued. And yet she was an extremely honest person, in fact one of the most honest I have ever met. About most other things she would tell me the actual, literal truth, even if the truth was embarrassing, socially undesirable and made her look foolish. So why think she was lying about hearing God's voice?
Re "bell curves all the way down", how would tinnitus fit into this? Very high prevalence (on the order of 10% of the population). A high pitched hum doesn't suggest an alternate reality... Does this count as a hallucination or as a sense organ problem? There seem to be something like nine different theories of the cause
I think it's a common phenomenon with multiple causes which can both be independent and coexisting. I have tinnitus, it varies, it seems related to physiology more than psychology.
Many Thanks! Certainly there could be multiple causes (e.g. analogous to type I and type II diabetes). It would be nice if the possibilities could be disentangled as definitively as e.g. checking insulin levels distinguishes those.
FWIW, for me it correlated very strongly with experienced stress. Once I realized that, i took steps to reduce stress externally (people and situations in my environment) and internally (meditation, counseling). I got an immediate drop of 30%, and now I'd say on most days about 70% less than at the peak. I'm also taking a diuretic, which seems to help, too.
I have something that might be tinnitus, but it's subjectively extremely quiet; I can only hear the tones in extremely quiet settings or if I plug my ears with something.
It's perhaps too complex to go into here, including the nature of evidence. IMHO, there's plenty of evidence. There are many credible reports of experiences of the divine-some more or less replicable. To assume that the mundane, untrained experience of quotidian reality is accurate is as ungrounded as assuming that a person lacking the appropriate training can understand AI or string theory. And to be clear, there are many false claims for the existence of God-I'm not arguing against that assertion. Perhaps a rough analogy: at some point, there was no evidence for virii or bacteria. That didn't establish their non-existence. At the least, agnosticism seems a more reasonable stance.
I'm agnostic, with respect to both God and the photon. Both seem like useful ideas, even if hard to nail down. Truth may not be as important as utility.
The Saturday Morning Breakfast Cereal a few days had "running the arguments for god in reverse". It puts some rigor in arguing for that default, and end up making it look more than a little ridiculous.
What is this Saturday Morning Breakfast Cereal you speak of? And why should I consider that a bowl of soggy corn flakes has any insight to the existence or non-existence of god? The image of eating Froot Loops from the Holy Grail came immediately to mind, though. ;-)
OTOH, I can't stop chuckling over the idea of breakfast cereal arguing over the existence or non-existence of god. Do they have religious wars—Kellogian's vs the Postians? In my younger more slovenly days, some bowls of breakfast cereals became science experiments, but none of the evolved consciousness let along became a philosopher of religion.
It is straightforward to prove that there is no God that likes people and is able to verifiably communicate: observe that all communication that appears to be from God is via unreliable channels, and there are things He should have been saying but didn't, such as various practical medical things some thousands of years ago.
The other options are a God that dislikes people or is unable to communicate. Nobody seems to believe in those much, for emotional reasons. Loki is on the Disney channel because hardly anyone believes in him, but Loki seems like a more plausible deity to me than the others I come across.
3. You, obviously, aren't capturing all claimed communication from God.
4. "Should have been saying" has too many assumptions buried into it to address in this forum. That said, for instance, it seems to anthropomorphize God.
5. Again, it's less that God is unable to communicate than that humans are unable to hear, so to speak. For instance, to understand, oh, say, bio-neurology n a deep way takes, I'll arbitrarily say, a Ph.D. and a post doc--call it 6 years? I'm positing that it takes at least that much time, in the equivalent of a good Ph.D. program and post doc, to communicate with God. At least for most folks.
6. There are factors in the human being which interfere with the ability to "hear God"-fear, shame, anger, impatience, ego (in a negative sense), etc. These have to be cleared out of the way for communication to occur. Otherwise it's like trying to talk with a friend at 120db+ rock concert.
>You, obviously, aren't capturing all claimed communication from God.
Okay, you are saying that you know of claimed communication from God that came through reliable channels. What would that be? If it actually is reliable, we should have a talk with Him (or Her, or Them). Which God do you have in mind?
The best lead I currently have is a bald assertion from some stranger on Astral Codex Ten. I would be happy to accept a videoconference projected in the empty air, or letters written on the sky, or a chat with some guy who demonstrates He can walk on water so long I can verify that the water doesn't have transparent objects inside and He doesn't have ridiculous buoyant shoes. There are many other reliable communication channels that could be used so should we assume that part of the problem is uninteresting? A God Who made the universe doesn't have to be subtle, and He is claimed not to be subtle in many holy books.
>"Should have been saying" has too many assumptions buried into it to address in this forum. That said, for instance, it seems to anthropomorphize God.
Seems like you are withdrawing from the conversation abruptly. Okay, fine, but that's not consistent with "It would be nice to have some basis, experience, or expertise for claiming there is no God." If you think it's nice to have a such a thing, you ought to be open to a conversation about whether you already have it or not.
We're calling this thing a God, and as a consequence I am assuming that this God has recognizably goal-directed behavior. I posit that that is part of what we mean by "God". As a non-example, a God that behaves exactly like the laws of physics is the laws of physics, not a God.
>Again, it's less that God is unable to communicate than that humans are unable to hear, so to speak.
>There are factors in the human being which interfere with the ability to "hear God"-fear, shame, anger, impatience, ego (in a negative sense), etc. These have to be cleared out of the way for communication to occur.
I could read letters written on the sky describing a cure for aging. More generally, humans can communicate with each other, a God can do more than humans, therefore a God can communicate with humans if He chooses to and He actually deserves to be described using the word "God". Subtlety is not required or useful.
Not withdrawing more than from anything else given the heavy demands on my time at work and at home, and in groups I'm involved with.
Let's try this: What do you think are the characteristics of this God? God can do everything that humans, can do, and more? I disagree with that. The customary line is that God is omniscient, omnipresent, and omnipotent. Where I disagree with that is with respect to omnipotence. My understanding is that all potency is God's but it is not all exercised by God.
Again, what do you think the characteristics of this God are? Like a human being, only God can do anything? God wants what human's want? I mean, no insult intended, the concept you seem to be arguing against is sort of the same general Christianist all powerful hairy thunderer Father in the skies. That's not what i'm talking about. What are you talking about?
The argument gets to the conclusion that God doesn't exist if we assume God likes people, is able to communicate reliably, and knows anything useful to people that He obviously chose not to communicate to them. "God likes people" is also implicitly assuming that God is purposeful enough to be said to like people.
If He is omnipotent and chooses not to exercise that for the benefit of the people He allegedly likes, that implies either not liking people or not being omnipotent (and therefore not being God). I don't care which.
He only has to be omnipotent enough to be able to communicate reliably, so the amount of omnipotence required depends on the communication channel. I will leave out the tradeoffs there because I hope they are obvious.
This conversation seems repetitive. Now I doubt that you really want to "have some basis, experience, or expertise for claiming there is no God". If you did, you would have defined your terms by now instead of making me repeat my best guess about what you mean.
My definition of omnipotent is different from yours. In my understanding, "omnipotent" means that all potency belongs to God, and some of it is delegated to human beings. It doesn't mean that God can do anything.
And, again in my understanding, God isn't "conscious" in the way you seem to be thinking. It's more like God is dreaming, and it's the role of the completed or completing human being to be part of God's awakening.
It seems reasonable to me that if someone is claiming there is no God, that they define what it is that they are saying does not exist. I'm not trying to have you guess what I mean; I'm trying to you to tell me what you mean. You don't seem to be doing so, instead saying things like "God likes people, is able to communicate reliably, and knows anything useful to people". So those sound like aspects of God, or characteristics.
Lastly, I would say that "communicate reliably" is trying to do too much work here. I'd argue that God is trying to communicate all the time, but just because a person breathes, eats, eliminated, and can read a blog doesn't mean that they have done the preparation to communicate reliably with God. You seem to think that if God is omnipotent (and I think I disagree with your definition, as I understand it), that God can communicate to anybody, any time. The record shows that's not true. The record also shows that some people have made credible claims to communicate with God- one could start with Ibn Arabi, or Rumi, or Jesus, or Shefa Gold.
OK sure, but I'm thinking about a different kind of god. God on a meta level, so there is no 'real' god. But the idea that there is a god, which mostly just means you should behave nicely, 'Do unto others as you would have others do unto you'. Is actually a pretty good first guess on how to behave in the world. At least that's my experience. I'm not sure I believe in god, but I like the idea of a god. And so, on some meta level, I guess I do believe in god... I believe that the idea of a god is a good thing, and I want to hold onto the idea, that I don't have to believe in any specific god... Christian, Buddhist, or otherwise.
I don't understand how you got the premise that "there is a god" means "you should behave nicely". (I agree that behaving nicely is a good thing, if we could figure out a definition for it, and I even believe that describing it is feasible so I'm not accusing you of being uselessly vague here. The connection with god is the part I'm missing.)
I can imagine god perhaps wanting all sorts of things. Many holy books describe gods who want things other than behaving nicely, so apparently the people who wrote those books could too. Maybe you are unaware of this (unlikely) or you are doing wishful thinking (much more likely), but my dominant hypothesis is that you're having thoughts about this that I can't anticipate.
"if you’re desperate enough to join the KKK or your university’s Black Student Alliance"
This is too tasteless for a throwaway "murder arson and jaywalking" joke, too short and off-topic for a serious "what are the implications of some races having much better options than others" digression.
Yeah, this was, in Scott's words, pretty cringe. I immediately wondered whether Scott thinks that you have to be desperate to join a campus Hillel group.
Joining a group based on shared religious activities and beliefs does seem to be a step up from joining a group based on shared melanin levels. Even joining a group based on shared ethnic background makes more sense to me than joining one based on race alone. But then I married a foreigner so maybe race matters less to me than normal people? Still, I would at least aim for "shared hobby" group membership before race.
People join racial affinity groups because race correlates with shared culture, shared experiences (of discrimination _and_ of other things), etc. I think the Hillel comparison is very apt. It's not just melanin.
I don't know about that. I am not sure a black student from Brooklyn would have more in common with a black student from Botswana than with a white student from Brooklyn. I agree there is probably some common "black culture" in the USA that is somewhat distinct and maybe shared across regions to an extent, but seems a very weak thread compared to religion or hobbies and other interests.
Like I said, maybe I don't identify super strongly with my own racial group compared to other group markers, and that makes me strangely unable to see the appeal, but shared race seems like the lowest common denominator to use to meet friends.
That's because "race" doesn't exist outside of the shared social context in which it is defined/enforced. Two "black" people from Brooklyn have "race" in common with each other but not with the Botswanan. Botswana certainly has its own "racial" or ethnic identities but they will be wildly different. If the Botswanan moves to America and spends significant time within the sociocultural context, they may well "become" a different "race" than when they arrived, despite the fact that "race" is nominally something you are born having.
Isn't the reason that there is a Black culture in America that a lot of ex-slaves had been disconnected from their national cultures, so they made one to fill the gap? So there is a genuine culture there that is primarily linked to melanin levels because that determined who needed it, whereas everyone else had their national culture still and didn't need a skin colour based replacement?
Also, the assumption that members of Hillel have shared religious beliefs is wrong. I'm Jewish. I'm also an atheist. In my experience of secular, American Judaism, this is more common than not.
Black people in America are obviously not a monolith, but they do have shared ethnic background(s) in much the way that American Jews do.
I don't like woke-ism, but I do have a hard time associating myself with anti-wokeism when it comes with opinions as dumb as yours.
I thought about pulling my punches, and then I thought otherwise. Usually I agree with what you're saying. In this case, I don't. I think it's completely relevant to point out that Doctor Hammer's comment is not only wrong but also that it's insanely, idiotically glib and ignorant. It is an incredibly dumb opinion.
It's also dressed up with the kind of pseudo-high minded condescension that characterizes a lot of this kind of dopey commentary. Oh, look, "race matters less" to this person. He obviously isn't infected with the kind of base tribal impulses that cause his lessers to want to associate with their co-melanists.
Sometimes it's worth puncturing this kind of arrogance and pointing out that the person with the terrible opinion really isn't very clever.
I have a different opinion on this, maybe you can help me understand it. Race strikes me as a categorically different quality than one's skin pigment. A Hadza hunter, a Caribbean farmer, and a Portland professor might all have functionally identical levels of melanin, but I can hardly a imagine a situation in which it is appropriate to say that they are all the same race. Is that your position?
"Black people in America are obviously not a monolith, but they do have shared ethnic background(s) in much the way that American Jews do."
Really? Genetically and linguistically the ancestors of afroamericans are probably much more diverse than those of jewish americans. So the shared ethnic background refers to slavery and some generations of afroamerican cultures? Is the ethnic background of american jews considerably less shared?
Thanks, I also found it wildly offensive, bordering on evil. One is a group dedicated to perpetrating oppression and the other is built around the shared experience of being on the receiving end of that oppression (among other things). Maybe it was a joke (?), but if so, it landed very very poorly.
The KKK and its affiliates and offshoots has obviously murdered more people than has Black Lives Matter and its affiliates and offshoots. The effect of the KKK on American policy and culture has also obviously resulted in more death, destruction, and misery than has the effect of Black Lives Matter and its affiliates.
Amen to this. It turns out that anarchy and mob justice don't magically solve all societal problems just because it's "oppressed" people doing the anarchy and mob justice instead of "privileged" people. Who knew?
I think a one-dimensional concept of "oppression" that justifies everything is both superficial and causes a lot of damage, but I don't super want to get in a fight right now.
Interesting that you would read oppression justifying everything into my comment. I only stated the obvious, that the two are very different. Something does need to be desperate or wrong with you to join the KKK. Nothing needs to be wrong or desperate in you to join a black student union. I'd be very disappointed if you thought otherwise.
Regardless of whether you think that you would be interested in joining the Black Student Union if you were black, lots and lots of nice, normal, well-adjusted Black students join Black Student Unions. I've had several black students who were involved with our college's Black Student Alliance, and none of them were Black Supremacists, antiwhite racists, or anything of the sort.
I haven't met a lot of KKK members, so I can't speak from experience, but my strong suspicion is that most of them are racists, and most of them are losers.
I think basic respect for other people should mean that if an organization like a campus BSA draws a bunch of nice, normal, well-adjusted people, onlookers should consider that it might have some value for such people. You might even want to talk to some people who have been part of such an organization before deciding it's the equivalent of the KKK.
And if you've never been friends with someone who was a member of a Black Student's Association, or an Asian Student's Association, or something similar, maybe your own social life is more identarian than you imagine.
You might find it bordering on evil, but I think the double standard in who may or may not join race-based groups is itself bordering on evil. Either we say that race should be de-emphasized and other, less immutable shared characteristics should take precedence as the basis of group identity, or we say that people can and should feel pride in their race. Saying that everyone except white people can and should be proud of their race is rapidly becoming exposed as a cynical double standard used by some (not necessarily minorities) to silence and dominate others.
The problem is that, as was pointed out above, indigenous black Americans (American descendants of slaves) are an *ethnicity*, not a race. They possess a genuine shared culture and history.
A Black Student Association is therefore much more like Hillel (which accepts non-religious ethnic Jews) than it is like a hypothetical White Students' Association.
EVEN IF you believe that BLM and the KKK are morally equivalent (which, living in an area where there's still KKK successor groups and having known an ex-Klansman before the ex part AND having known people involved in BLM activism, I'll inform you the former are more dangerous), the BLM and black student orgs certainly aren't equivalent. I don't see many Black Campus Republicans marching around chanting Black Lives Matter.
Thanks for this comment; I was going to post something like "really, Scott????" but you said it better. I almost stopped reading at that point (but I'm glad I didn't because this is a really interesting piece otherwise).
I've stopped being surprised at this point. The race takes on this blog are really bad, as a rule. I'm just disappointed that they've started showing up in otherwise-unrelated posts.
He's doing what he said in the body of the article: trying to get people to read his article by aggressively signaling he's anti-woke so that anti-woke types will listen to him. I just wish he didn't feel the need to do it every time he writes about politics.
No, there are a handful of wokes in the comments who are mad that their sensibilities are not being especially catered to every post, but pretty much everyone else is fine with it.
I was honestly surprised to see anything like this reaction in the comments. There is a threshold of time past which historical groups which committed heinous acts cease to be regarded with reflexive horror. I think of (as a previous commenter said) the Huns, or the Inquisition. I suppose I underestimated the extent to which other commenters associate the KKK (largely a relic, current membership 3000-6000) with broader recent white supremacist violence in the US. In retrospect, this was probably a pretty stupid assumption by me.
I think the saliency of the KKK disproportionate to current membership is primarily the result of recency; burning crosses and child murders are in living memory still. Surely "exit living memory" is a necessary condition for the threshold of time passed.
As Sourdough points out, "the crimes and victims thereof exiting living memory" is a necessary element of the hatchet-burying. I doubt many people are eager to cast the Holodomor or the Holocaust or the Cambodian Genocide or the Rwandan genocide into the "forgive and forget" categories alongside their enactors quite yet.
Many people are completely willing to deny that the Holodomor, the Cambodian Genocide, or the Great Leap forward were all that bad IF they happened at all, and really even to mention them is an act of gaslighting in defense of White Cishetereopatriarchy and its corporate arm, the GOP.
You contribute less than nothing to this conversation. Those people are rightly considered to be politically-braindead ghouls. Even pretty hardcore leftists think tankies are mouth-breathing imbeciles.
This is being debated as if it were not a joke. Obviously it is a joke, so the debate should actually be "can you joke about this?" You can be super woke, and also be OK with irreverent humor. Can't you?
I'm not super-woke. I thought it was unfunny joke in extremely bad taste. And if you look at some of the other responses in this thread, you can see the type of mouth breathers this type of "humor" brings out of the woodwork.
Here's a pro tip: if you want to make the case against wokeness (which I think is a worthwhile thing to do), you're not going to win a lot of converts to your side by drawing equivalences between the KKK and Black campus groups.
This is obviously well covered by now, as I come to read it, but I'll add for the record that I thought Scott's line here was neither true, necessary, nor kind.
When it comes to the trans point, one stab toward a compromise:
Part of the question is "how broad is the funnel for prompting intervention" and I *do* think it's too broad. The good-faith reason to talk about introspecting on your gender, framing it as common to be fluid/trans is that you think it *is* common, that introspecting doesn't become a dysphoria-cycle, and that it's better to catch GNC kids early, so they don't encounter stigma/big dysphoria.
Whereas I'd rather offer help to kids who have an issue that is sustained, and they feel meaningfully and negatively impacts their lives. I want to avoid inviting people into the funnel if they're tomboyish or butch lesbians (I'll use Alison Bechdel as my example, since she is a butch woman who thinks she might have identified as trans if she were little now, but likes her life as a butch woman!).
An advocate will be frustrated that I am saying people should suffer a bit to rise to the level of an intervention, but that is the tradeoff I favor (just like I favor not offering routine mammograms to low risk women before 50).
The funnel is ever broadening. A 7th grade Health textbook was submitted to my kids school district for review (not chosen, but in use in other districts/states so some kids learn in school and then others through social media) that specifically stated that gender is a spectrum, and then used stereotypical examples such as a boy who likes to cry, and that such a boy would not be just all boy on the gender spectrum.
Sorry, but no, females have lower pain tolerance than males even a few hours after birth. And even if the reason women cry more is because of socialization, how do you explain the fact that human societies across the world, from primitive hunter gatherers to ancient Romans to Information Age city dwellers, socialize their people in the same way, unless you invoke a biological reason for the socialization patterns?
Which cultures normalize crying for men to the same extent as for women? If a man saw his child get slaughtered in front of him, of course nobody would call him weak for crying, but the range of situations in which it is acceptable to cry is much smaller for men than for women. Is there any culture where the opposite is true?
Yes, baby boys and girls are similar in how much they cry, which does weaken my point about pain tolerance. But baby boys and girls also look similar and have similarly sized breasts. Does that mean the physical differences between post-pubescent boys and girls are due to socialization? Crying behavior begins to diverge around puberty, just like all the other differences between the sexes: "From the age of 11, however, differences in crying proneness and frequency begin to emerge (van Tilburg et al., 2002)."
The same paper shows (in Table 2) that women cry 3 times as much as men, and that a similarly enormous difference occurs in all 5 of the countries they studied. Thailand, with its more traditional gender roles, actually has a less lopsided ratio than the Netherlands and the UK.
I agree with you that keeping emotions under wraps is often psychologically harmful, but I think there's a reason why "suck it up, be a man" is a universal attitude across cultures. If a man cries often, he is likely to be perceived as weak. His enemies will bully and attack him at every opportunity. His comrades are less likely to trust him to perform well in battle. Women are less likely to be attracted to him. He will be lower status, less successful, and less likely to find good sexual partners. So "suck it up, be a man" might be disastrous to perpetuate, but the alternative of "cry as much as women" is probably far worse.
Men emoting is absolutely frightening if they turn violent, and disturbing if other people are looking to them for reassurance.
There are ways to be in touch with your emotions as a man, but they're difficult to figure out if you have no role models to learn from. Most settle for either stoic dissociation or, less commonly, letting their impulses throw them around.
I'm just waiting for someone to say I'm not a woman because I like math, so I can rhetorically punch'um inna mouf. On the other hand, if math caused menopause, I'd make time for it every day.
The problem with a "you must suffer this much" sort of approach to transness is two-fold. First, the gatekeepers are often misinformed (for example, your assumption that every GNC person is seen as a transition candidate by doctors/activists) and that sort of environment also makes it easy for unscrupulous conversion therapists (like Dr. Kenneth Zucker) to string people along for ages and put them through all sorts of crap. Second, it's a pretty common experience for trans people to look back after they've transitioned and realize that they were way more dysphoric pre-transition than they thought. When you grow up with it (and since it tends to increase gradually over time, barring more abrupt changes like puberty), it's hard to notice the effect it hasuntil it's taken away or dramatically lessened. So you have people who don't feel like they're suffering, might even deny that they're suffering, but who nonetheless end up benefiting greatly from transitioning because they were suffering, and putting up a "you must be this dysphoric to be a real trans" sign will mean many of those people will just silently suffer (evidenced by the number of people who transition quite a bit later than they initially wanted to because of being told exactly that, but are nonetheless helped greatly by transition).
"Second, it's a pretty common experience for trans people to look back after they've transitioned and realize that they were way more dysphoric pre-transition than they thought."
I would not discount the potential for hindsight bias here.
Oh hindsight bias is part of it. But some things really just smack you in the face when you think back over them in a way that hindsight bias isn't sufficient to explain.
My initial reaction to this would probably get a warning from Scott. Suffice it to say that no, there is pretty good evidence that trans people are genuinely happier and in better mental health post-transition. The reduction in suicidality alone is pretty indicative.
It seems plausible to me, since "transgender" has only recently spread to the mainstream and therefore I would expect a lot of people had the experience of "I felt something weird and wrong about my body, but I didn't know that "dysphoria" was the word to describe that feeling." Kind of like how people with chronic pain sometimes say they didn't know that feeling pain throughout their daily life wasn't normal.
Exactly this. Until pretty recently only a very specific type of sympathetic trans narrative was ever really publicized, the "I've known since I was three and I was always extremely gender-nonconforming and homosexual with respect to my birth sex, and have very severe physical dysphoria about my genitals" narrative (and doctors tended to kick you to the curb if you didn't fit that narrative or pretend to). If your experience didn't fit that you not only might not realize you were trans in the first place, if you went to a gender specialist there was a good chance that they would say you weren't really trans after asking a bunch of questions about your childhood and masturbation habits and perhaps criticizing you for not presenting sufficiently stereotypically feminine or masculine. Also rather like the experience of many people with chronic pain, now that I think about it, particularly women.
The statements like "I might have identified as trans if I were little now" are extremely prone to typical mind fallacy. We read reflection of transgenders on their journey and our mind automatically tries to find similarities between their experiences and ours in order to understand them. And then we can think something like that:
"Wait a second, I too felt not fitting in, not satisfied with the gender roles society tried to impose on me! But I found a way to deal with it without hormones and surgery. Maybe these people didn't need all these things too!"
We imagine that what binary transgenders mean by not fitting in is the same things we mean by not fitting in, because we have no other way to grasp the concept. But this is very much not the case! Just the imperfections of our language and our way of understanding things.
If we look at the dynamics of detransitionings the rate is pretty low. And more importantly, the major reason isn't the sudden reveal that the person wasn't actually trans, but pressure from the family. I think it means that the funnel isn't too broad. Of course it's extremely important that physical transition wasn't the only available option for GNC people. We do need communities of tomboys, butch lesbians and all kind of queer people so that everybody knew that there are other options and could choose the best suiting them.
This isn't especially relevant to your post, but I despise the term "queer" and believe it encourages narratives of being "improperly LGBT", as well as the usual massive dose of academic pretension which shouldn't be allowed to get anywhere near real issues.
Sorry to hear that, I've never seen it in a gatekeeping context. I like this term because it was successful reclaimed from being a slur, it allows to describe a broad category of people by a one short word and I personally identify with it.
If you consider LGBT+ a subculture then it's mostly membership in it, yes. But there is also a notion of not wanting to label yourself in a specific narrow way. Like you see that existent categories are not actually a good fit for your experience and inventing new words isn't helpful. For me, personally, it echoes with Kafka's quote:
"I never wish to be easily defined. I’d rather float over other people’s minds as something strictly fluid and non-perceivable; more like a transparent, paradoxically iridescent creature rather than an actual person."
Right, but what I mean is, I don't see myself conforming to rigid gender norms imposed by traditional culture, but neither do I like LGBT+ worldview and aesthetic. Does this qualify me as queer?
Exactly. I have found it very difficult to successfully explain to cis people the internal experience of being trans and having gender dysphoria without reference to stereotypes/tendencies or in ways that they can round off as you describe if they are so inclined. It's like trying to explain sight to a someone who's been totally blind since birth or why you absolutely hate chocolate to someone who loves it. Gender dysphoria is not something that cis people ever really experience except if they are forced to or decide to pass as the opposite gender for quite some time. There's an interview with Amanda Bynes about her experience playing the protagonist in "She's the Man" and she describes, without giving name to the feeling, a perfectly typical experience of gender dysphoria as she recounts some of her mental health struggles during the filming of that movie. She might actually understand some of what us trans people experience but for the vast majority of cis people the inferential gap is huge and very challenging to bridge.
+1 on tomboys (and their genderflipped equivalent) being at risk here.
My generation had a lot of "non gender conforming" people who felt no need to transition, socially or medically. They did what they want, gave no fucks, occasionally encountered social resistance but mostly grew up well adjusted (and still not quite gender conforming). I think every single one of them would at least be tempted into declaring themselves trans if they grew up in 2022, with massively worse outcomes.
Is what you've described different from what happens in practice now? I know that (at least about a year ago when I looked into it) not very many of the patients who sought help for gender dysphoria ended up getting surgical or even pharmacological interventions. The guidelines recommended letting those patients explore gender through social transition and similar, giving time, and reviewing. Those who, after exploring other options still had significant impact on their lives from dysphoria were recommended the pharmacological interventions. Assuming those guidelines are followed in practice, it sounds a lot like what you propose above, to me.
The whole "Hearing Voices Movement" seems like a different take on the same phenomenon that people with "Dissociative Identity Disorder" ("plural systems") are describing. Is it?
When you hear voices, you are still clearly yourself, in control of your brain, but you hear voices. These voices probably aren't other full agents, but even if they are, they never get control, they just talk to you.
In DID, people claim that other agents sometimes take control of their brain and affect their actions directly.
I think people conflate the two because of Hollywood depictions of "multiple personality disorder," which combine the most extreme form of DID (an alternate personality taking control of their thoughts and actions while the core personality is unconscious) with elements of psychosis (during times when the core personality is still in control, they'll hallucinate the alternate personality as a separate being interacting with them). I don't think there's a single recorded case of this hybrid disorder ever occuring in real life, but that hasn't stopped movies/shows like Fight Club, Secret Window, and more recently Moon Knight from portraying "multiple personalities" in this way.
This portrayal makes sense from a storytelling perspective, since it lets the writer pull off a twist wherein a character who was believed to be a separate person is revealed to actually be the protagonist's alternate personality, and also allows for dramatic confrontations between the core personality and their alternate self. Unfortunately, some people have started taking it as an accurate depiction of DID, which is pretty far from the truth.
And, if the story is made into a play or screenplay, it lets the actor or actress portraying that role exhibit several different personas in a single performance (the opposite of typecasting?).
What do you think of the online "tulpamancy" movement? It seems to be in an interesting space between different ways of thinking about consciousness, and yet it seems to be a very real phenomena (in the sense that there's clearly *something* going on)
I once created a tulpa by accident. During an LSD trip I suddenly had the realization that if I wanted to pay close attention to the environment, all I had to do was imagine someone else was sharing my eyes and senses and wasn't from this universe and for whom I was the tour guide. And to be a good host I just had to pay close attention and talk to them non-stop about it.
And it worked. It was fantastic. I could just sit on a long bus ride, rapt in the act of paying attention. And they started feeling real. Not like I didn't know they were just in my head, but like there was someone following me, watching stuff over my shoulder. Holding my hand while I walked. Thinking problems through with me.
Truth be told my main view on the experience is that the Unitary Self doesn't actually exist beyond a way to think and model ourselves, so I think of a tulpas or plural systems as just having a different story we tell ourselves, whether consciously (or accidentally) cultivated, or through some variant in experiences. Probably being in a culture or community where different stories about self are common makes them more accessible.
I heard of that movement for the first time today and am a little curious about it. My impression so far has been that brains sometimes fail in providing the experience of single individual agency, like in third man syndrome, hallucinogen trips, spiritual practice.
The notion of being in control of your brain is an interesting one. What does it actually mean? It feels like there's a spectrum here: I don't ever feel like I'm 100% in control of my brain.
Have you lost control of you brain if:
1) You can't empty your head of thoughts to get to sleep at night
2) You can't stop distractedly thinking about something you read in the news
3) You're asleep and dreaming, but acting as a semi-rational actor in your hallucinated world
4) You're asleep and dreaming, but acting in ways that you would never do in reality
5) You're participating in a pain-tolerance study, but can't bring yourself to administer another electric shock to yourself, even though rationally, there is a large positive net reward payoff
What are the capabilities required of the "agent" part of your brain that determine whether it is in control or not?
The idea that any person actually has agency is, at best, speculation; right?
I'm a lucid dreamer, so I'm used to have mixed control of other entities in my mind. I've been two entities at once.
I have dream characters who have depth that is superficially similar to their real life counterparts(friends,family,etc.). These characters sure aren't my friends or family, but they aren't me either. I'm not interested in whether or not they have agency, I'm interested in what actually makes "me" different, if anything.
This reminds me of the Steven Wright joke about how his girlfriend got poison ivy on her brain and the only way she could scratch it was by thinking about sandpaper
The traditional response to this question is "No, schizo-spectrum neurotypes are different to multiple personalities, the idea that they have anything in common is a Hollywood meme". In practice, everyone I've met who can split their psyche up like that is either clearly schizospec or clearly borderline, and "clearly schizospec" and "clearly borderline" are not non-overlapping categories. If you're one or both, it can be easy enough to trigger the experience that you do it mostly by accident! I've described tulpamancy as "if you roleplay while schizotypal it'll start talking back to you" before.
(On the object case of the post in general, I'm vaguely sympathetic to HVM and this post made me more sympathetic to it.)
"Alcoholics Anonymous makes an interesting comparison: they’re solving this problem in their own way, by being more conservative and unforgiving than the psychiatric establishment would like.'
A number of recovering addicts wrote to me to tell me that this was the most important part of the recovery culture: that unlike with Hearing Voices, the perspective on twelve step programs is very explicitly that your default/instincts are NOT okay, not healthy, not to be humored or sugar coated. The disability rhetoric that has spread from autism to the broader world of mental health insists that you're fine the way you are. AA and similar say, no, you have to change.
As somebody who is "on the spectrum", with a couple family members formally diagnosed, the important insight for me was that while "how I am" may be "perfectly OK" in some sense, the fact that it's not, like, _morally bad_ that my brain doesn't process social cues the same way as the brain of the majority of humans isn't actually relevant. If I _want specific results_ that come from accumulating social capital, I'm going to have to put in the damn work to learn to mimic social behaviors in a way that the majority of humans (or at least the ones I have to deal with) respond to positively. And so I did, and I ended up as a "high functioning" aspie type -- I'm economically secure, with a job as a senior engineer at a highly respected company; I have an appointed position in my town government where I derive meaning from trying to improve the world for people in general by way of making land use rules less dumb; I have friends and a spouse; etc.
So I guess my question about the Hearing Voices folks would be: Are they helping people _get what they actually want_? And to the extent that they're causing people to _change_ the definition of "what I want", is it in a way that reduces suffering and is generally pro-social, or actually encourages people to be anti-social while feeling good about it?
I do think the worst thing was folding in Asperger's Syndrome to autism and instead making it all a 'spectrum'. Really bad autism is nowhere near "I have trouble with social cues", it's cases (again, from social housing) where a family with two teenage autistic sons were looking for a grant to build on an extension so when the kids needed individual alone time, they would have a special room to go to.
It needed to be a padded room, because of the 18 year old who had to wear a motorcycle helmet 24/7 due to his constant attempts to literally beat his brains out against the walls.
People forget that if it's a spectrum, that means you start on the lighter shades and move to the darker shades, and some shades are very dark indeed. I'm now working in an early years intervention service (and here I take the opportunity to wave the flag for early intervention for physical and mental needs for children, the earlier the better - it's fantastic, it's necessary and it makes one hell of a difference) and we include children on the autism spectrum. The aim is to support the families, help the kids, and get them into mainstream education when they turn 5. Most of our kids do go on that path, but some don't, they will instead go on to special schools. They'll have lives and a place in society, but they are never, ever going to be the quirky autist software engineer of pop culture mythology.
Public outreach is full of cloudy tactical decisions and trade-offs and I don't pretend to grasp them, so maybe it is good to focus first on getting people to understand that autism comes in degrees (from a-bit-quirky to chews-own-fingers-off). But, I found this slightly more sophisticated model to be quite illuminating: https://neuroclastic.com/its-a-spectrum-doesnt-mean-what-you-think/
Thanks, I haven't seen this perspective before. However, while spectrum isn't gradient, for practical purposes there does exist a gradient of how debilitating the condition is, and that's what people mostly care about when discussing questions like how to deal with it.
I was thinking about this recently, and I sense that high functioning people on the spectrum are just doing a more explicit and specific version of the kinds of social learning I did as a kid. Which, given what I know about autism, makes perfect sense! I had my own issues in elementary school, but I remember very clearly having the epiphany “My behavior is going to cost me things that I really want. I have to stop being a pain in the ass before it’s too late.” And I changed, and it worked.
Exactly. I felt this way when I got diagnosed with ADHD as an adult (I am also likely mildly on the autism spectrum). I'd interpreted my issues as a moral problem, to be fixed by "caring more" and "getting organized" and the way my parents treated it reinforced that. Both of them have sub-clinical attention issues which they've been able to handle without medication, so they sort of rounded my experience off to that since I wasn't bouncing off the walls as a kid like the stereotype. There wasn't really a sense that I could be inherently categorically worse at all this stuff (especially given how intelligent and capable I was in other areas) and have it not be somehow my fault. Figuring out what was up let me forgive myself. I still put in the extra effort I have to do to remember important things, be on time, and so on, because that benefits me and other people even if it's a lot of work, but I stopped beating myself up emotionally if the occasional thing falls through the cracks. And medication obviously helped me actually manage to keep on top of things, and gain the skills I hadn't really been able to learn previously.
It is a Jacqueline Carey reference, yes. When Scott made the initial post mentioning Elua way back when I decided to go read the books and really enjoyed them, despite them being very much not what I expected.
We live in a world where Slack is chronically low. I'm not surprised people turn inward instead in order to release some of the constraints they operate under, but I'm disappointed that the rewards for negotiating in good faith with society-at-large are so small it seems worthwhile to drop various pro-social acts.
I see this happening with anorexia and associated eating disorders too. There's a lot of "reduce the stigma" rhetoric that tells sufferers that they're doing great, and that everyone's body is different, and that we're all on different schedules.
But the way I got better was to quit giving into my tendency to self-starve. I improved my life was by changing, not by learning that I was fine all along. If I'd been listening to the "you're taking your own path" stuff, I would never have actually recovered.
I fear that there's a background conversation going on that more or less takes for granted that we've removed all objective truths about the human condition, therefore "better" or "worse" have no meaning.
I happen to believe that there are objectively better and worse ways to live, and that even just consequentialist approaches easily find them (and obviously religious ones even more so).
If you do remove objective "better" then the only thing left is subjective, at which point anything that people feel better about ("I am happy about the voices" "My lived experience is the most important") becomes the ultimate. Unfortunately, this thought process is doomed to failure, and can only exist in societies with huge surplus levels of wealth. If we had a true downturn, or in places where people don't have excess wealth, then the consequentialist results hit hard and make people more miserable than if they had tried to fix their problems and contribute to society. I can't imagine that "I hear voices" or "I'm not going to medicate my obviously debilitating condition" stand up too well in 3rd world countries, no matter how hard someone might try.
You might think it'd only happen in societies with huge wealth surplus, but a lot of subsistence societies have traditions of spiritually exalting some of those who might be afflicted by states modern medicine can more-or-less control.
The odds that an afflicted person dies an ignominious early death could be higher than the odds of achieving spiritually-exalted status, but it does mean people from these cultures can be resistant to medicating their loved ones in the typical Western way when that medication finally becomes available.
The Marian apparitions at Fatima, Portugal, beginning in 1916, were reported by children working as shepherds, hardly indicating excess wealth. From what I understand, the children's families weren't supportive, but evidently somebody was.
I, too, would expect the reaction of financially-struggling families to a family member believing himself "too special" to be medicated would be, "Shaddup already and take yer goddamn pills" for as long as they could afford medication. But that's not always what happens.
I think that there could be multiple reasons that a person doesn't take medication or seek help, but I'm focusing on one that I think is both new and novel. That is, a postmodern expectation against universal morality or norms. I don't think that this new reason can exist absent a surrounding society that chooses to support it, even if it's an incomplete society (like the social community Scott's talking about here).
This is interesting. I had heard about the rigidity of AA's approach, as Scott mentions above, but not this balancing principle. Do you have an example of how an AA participant has established a good way of life by keeping in mind both the official rules and this balancing principle?
This is how one of my close relatives, an alcoholic who last year had his first serious relapse in a long time, participates in AA on and off. He is a thoroughly secular person but speaks highly of AA a useful tool for his situation.
The problem for “highly functioning” autists is that practically no one will tell them what they need to change. Simply saying that one should not be a dork and understand social cues are not helpful. They need very specific instructions and deeper analysis of situations which most people are not even aware of because they learned them instinctively. Whereas for autists you need to be very explicit.
I got that from a truly excellent therapist, who I worked with on and off for the better part of a decade, starting when I was around 12 or 13 and severely depressed, right on through most of college. Lots of long conversations trying to analogize systems I _did_ understand to social dynamics. (I was really, _really_ into the idea of psychohistory at the time. Boiling messy social issues down to math would've made life _so much easier_. Math, I can do!)
I am glad that you were able to receive such guidance and explanations. We need more such therapists that understand highly functional autism. That's the way to go!
Yeahhhhh.... the thing is, when I was a child and into my teens, I had delusions. It wasn't hearing voices, but it was something in the same general area and I'm not going into more detail.
"But I thought it would be helpful for him to have people he could talk to about his situation who wouldn’t think he was crazy, or try to get him locked up."
While I too do not want to be locked up, sorry but I *am* crazy. Having [delusions of that type] *is* nuts, bonkers, insane, loopy, lunatic, whatever other term would make the Hearing Voices people need a fainting couch. That's why even when I was having them, I *knew* they weren't real and I told nobody at all about them, because yeah you bet that would have got me labelled as crazy. I sort of trained myself out of having them, but it would be easy to slip back in.
And a movement like Hearing Voices would be the worst possible thing for me: a sympathetic group egging me on to continue and indeed expand having my delusions? That I was special and wonderful for having them? That everyone from doctors to the dogs in the street who said I was a nutcase was wrong and evil?
I would have gone so far over the edge that I would have indeed ended up involuntarily committed in our local loonybin. For some people, who have it together and aren't extremely unbalanced by what they are experiencing, then maybe a movement like this is helpful; whew, I'm not the only one out there with this going on.
But for other people, it would be like handing an alcoholic a litre of vodka and slapping him on the back encouraging him to chase it down with this naggin of whiskey.
Sometimes when everyone says "this is nuts", it *is* nuts.
EDIT: I suppose the snarky part of me is going "Interesting how when the NYT is interviewing people about hearing voices, it's this nice middle-class group of presentable, articulate people and not the homeless person smelling of urine ranting on the street, huh?"
Psychosis seems to be a many-splendoured thing, and people who are not psychotic do hear voices. I imagine lists of symptoms are "the most common things everyone reports" so that while some people don't hear voices, more people do so they whack that down as "Symptom of psychosis".
Our paranoid schizophrenic client when I was working in social housing didn't hear voices, but other staff had anecdotes of dealing with clients who, for instance, used to report that they could hear people talking about them in circumstances where 'no, that is definitely your mental problems' was the reality.
I think people talk about voice-hearing a lot because it's one symptom that's easily relatable to the non-psychotic. When you hear voices, it's exactly what it says on the tin: you hear sounds in your head that don't come from the external world. But to my mind, delusional thinking is very hard to capture and convey to someone who hasn't experienced it. "Having strongly held false belief that's immune to evidence" is just not an adequate picture of what's going on. Many interesting descriptions have been attempted but they don't make very good memes, and negative symptoms just aren't very exciting at all. Hallucinations are just easier to wrap your mind around than delusions, are probably more interesting to the non-psychotic, and voice-hearing is far and away the most common form.
I've actually wondered if you might attempt the kind of description of psychotic thought processes that would get across some felt aspects of the phenomenon to the uninitiated.
My own pet loneliness is that no one talks about the experience of catatonia, and that catatonic people are often talked about like they aren't "in there," which just isn't the case.
Is it really hard to explain? Like a lot of people, I have enough delusional tendency that I think I've learned to explain it to myself.
Delusions are getting stuck on a bad narrative. Everyone else is doing one narrative, and this person is stuck doing a different one.
I think it only gets recognized in one of three ways. First, retroactively. Second, by recognizing the looping property, following your tracks so many times you realize you are circling. Third, by having a rude contact with reality (or, if you're lucky and not paranoid, by having contact with someone you really trust).
Absolutely everyone has lived through this. Severe delusions are a major difference of degree, but not a difference of kind. The difference is not "I have X experience that you could never understand", it's "I have X experience, just like you, but it was very strong and had ruinous consequences".
> That's why even when I was having them, I knew they weren't real and I told nobody at all about them, because yeah you bet that would have got me labelled as crazy.
On the one hand, this is where some sort of an acceptance movement for people with delusions would be useful: so that the next generation's Deiseach doesn't have to suffer in silence, and can instead go to the psychiatrist in the same way she'd go to an ophtalmologist or a cardiologist or something. On the other hand, the current iteration of the Hearing Voices movement appears to be moving in some orthogonal direction, at best...
> EDIT: I suppose the snarky part of me is going "Interesting how when the NYT is interviewing people about hearing voices, it's this nice middle-class group of presentable, articulate people and not the homeless person smelling of urine ranting on the street, huh?"
The modal person who hears voices is in fact middle class and presentable, because benign voice hearing is more common than the psychotic illnesses that also cause voice hearing, and even then, most people with those illnesses are not "smelling of urine ranting on the street". But since that's the image that's conjured up when someone thinks of a voice-hearer (which again, not the same as psychotic illness) I rather think the Times doesn't need to bang that gong any louder.
That's basically how psychiatrists treating me have described it. Having some strange audio pareidolia where running water or wind or other noise sounds like a huge choir singing words I can't make out? Not normal, but not psychosis.
The fixed idea (I won't call it a delusion because I could always reason myself out of it) that everyone can secretly read my mind? Surprisingly common psychosis.
I think these things might be on a spectrum. I have some patients who, at the very beginning of a psychotic episode, will interpret wind as music more (but have few other symptoms) and then further on in the episode they'll hear genuine voices.
For what it's worth, mild sleep deprivation (i.e. several nights little sleep, one/two nights no sleep) will cause me to interpret white noise like sounds as music.
Latest I've had is the shower making me convinced I'm getting a telephone call.
(Of course this is just my tired brain going into over pattern matching mode, similar to when using certain drugs or a sensory-deprivation tank. So maybe in itself this is just mild schizophrenia that occurs only when exhausted?)
Daaaaamn – I've experienced both auditory and visual hallucinations like this when I'm sleep deprived. But I wouldn't think even just a single night of no sleep is _mild_ sleep deprivation; maybe only sleeping for a few hours instead.
But I also notice my brain/mind 'falling into' "over pattern matching mode" a LOT anyways. I'm not sure that everyone doesn't experience that pretty regularly, ex. "Oh, I thought I saw X.".
Annoyingly, I also experience mood-lifting from 'acute' sleep deprivation sometimes, so I don't reflexively respond or adjust to it, e.g. by taking a sick day from work.
Wait, the audio pareidolia is not normal? I had enough conversations about similar perceptual distortions, with different people, that I'd at least expect it to be widely distributed...
My mom heard voices. She was encouraged further by the local Catholic parish, who recognized them as apparitions, and... well, that didn't go so well in the long run. I *don't much like* this Hearing Voices thing.
This is exactly why the authorities are supposed to take a sceptical view of such matters and have them investigated. Lay people are more inclined to be a lot more enthusiatic and credulous - see the moving statues in Ireland, bleeding statues, visionaries of all sorts, turning up to see images in glass, etc.
I hope your mother is doing better, if she is still alive?
If it's not too sensitive a topic, would you be willing to elaborate on the internal experience of having delusions that you know aren't true? It never occurred to me that that was possible, it naively seems contradictory.
I suppose it rather runs along the lines of 'madness need not mean losing your reason'. It's the split between the reasonable mind, which is telling you "you know this is not real, right?" and the - hmm, I need a term here, let's invent 'the experiencing mind' which goes right ahead with what it's doing.
Something along the lines of 'when you're having an anxiety attack at three in the morning, your reason can be telling you that no, you are *not* really dying but that cuts no ice with the emotional experience of how flippin' awful it is'.
I had a lot of little rituals which I brute-forced myself to break since I knew if I continued in them, they would only get worse (and I could see them getting worse anyhow) to the point that they would grievously impact on my ability to function.
An example of what I mean by delusions - and it is really hard for me to type this out as I feel like such an idiot - believing that pictures/photos could see. If there was, for instance, a photo or a picture of a person on the cover of a book or a magazine or wherever, that they could see what I was seeing. As if a real person was in the room with me.
So, for instance, if I was getting dressed and there was such an image in the room, I would cover it so it couldn't see me. Absurd and delusional, but my reason telling me "this is nuts" didn't help. I believed my reason, of course, and I knew it was correct, but I still did it. From around late pre-teens to early teens, then I finally (as I said) brute-forced my way out of it because I knew it was crazy and the fear of insanity is a good motivator to 'stop doing crazy things' (if you can get there early enough and it's not too severe). I used to look up the physical copy of the Encyclopaedia Britannica in school and wonder "Do I have hebephrenic schizophrenia?" https://en.wikipedia.org/wiki/Disorganized_schizophrenia
I've never been able to get that kind of willpower going to break other bad habits, so I suppose I really need the lash of terror about being declared insane to motivate me!
> It's the split between the reasonable mind, which is telling you "you know this is not real, right?" and the - hmm, I need a term here, let's invent 'the experiencing mind' which goes right ahead with what it's doing.
Something along the lines of 'when you're having an anxiety attack at three in the morning, your reason can be telling you that no, you are *not* really dying but that cuts no ice with the emotional experience of how flippin' awful it is'.
Yes! There's a lot more going on in like capital-P-psychosis but that's the essence of the split--see my comment to James above.
> An example of what I mean by delusions - and it is really hard for me to type this out as I feel like such an idiot - believing that pictures/photos could see.
That's a great example to illustrate the point, way better than my rose thing. It's the difference between thinking "this photo can see me" and experiencing the actual feeling that you get when a person is looking at you when you look at the photo. Hence the insight continuum(s?)--how much you are aware that the feeling is just a feeling, and how much the feeling is commanding reality. That kind of experience is common on the lower end of the psychosis spectrum, I bet a lot of people who've overindulged on Adderall, weed brownies, or all-nighters could relate.
I'm glad you decided to share this piece of your history, it's honestly fascinating to me, and I really really hope you will take it as a compliment if I say that your writing (an 8000 horsepower engine bedecked with lit sparklers) paved the way for this development.
Thank you for the compliment about my writing, from this end it feels more like a creaky, rusty tricycle powered by vitriol! 😁
I'm glad it was helpful for you. I wonder if a lot more people have these kind of experiences than we ever hear of, because they keep them quiet (due to "I don't want to be marked as crazy") and these experiences are not severe enough to render them in need of treatment, or they go away on their own/with effort to suppress them.
Considering all the Nazars in use and these studies with the eye pictures, there seems to be a hardwired tendency in a lot of people to consider oneself watched whenever anything resembling a human eye is around.
I chalk it up to the modularity of the brain. Think System 1/System 2 but I'm not committed to that theory, I'm just gesturing at it for intuition. There is a kind of two-track awareness though, which parallels those observations loosely.
Picture a red rose. When you encounter an object like a rose, several things are immediately apparent. Not in the sense that they occur to you quickly; in the sense that you perceive them directly. They are practically the constituents of reality itself--the redness of the rose, the curls of the petals, the contours of the stem--immediate roseness of it all.
Imagine that, when you encounter a red rose, with the same immediacy and pre-conceptuality as the redness and and the stem, the idea the person you love in is mortal peril seizes you. That meaning inhabits your perception of the object as much as its physical properties, is processed as quickly, and is equally unassailable. Someone might convince you that the seeming red rose you're looking at is actually blue, because you're under powerful hypnosis or it's been painted or some such, but they could never make you see it as blue, and neither could you yourself. I think most people feel on a gut level that they would be resistant to psychotic delusions, that they're too smart or reasonable or normal, that they wouldn't succumb. But no one sees the rose as red, no matter how cleverly or carefully they've deduced its blueness. Psychotic delusions don't live in the realm of the mind that's amenable to that kind of reasoning--they live in how you the world smacks you right away, and what it compels you to do.
You can retain propositional awareness of facts like "I am experiencing psychosis" and make predictions about the world based on that, like "no one else is thinking that my love is in mortal peril so I should not act like it is the case right now and run out of the building". Instead of "deep down, you know that's not true," it's more like "way up high, you know that's not true". Deep down it's like, truer than true. At least some psychotic people spend a lot of time pretending not to be psychotic, because they have enough of their higher cognitive functions in tact to figure out how to do so and to care enough about goofy mortal concerns like not get arrested, killed, or expelled to do so.
The actual blood-and-sinew experience of it is so hard to describe/remember--if you've ever tripped on hallucinations, you know all that ineffable, profound feelingness that frustratingly wilts in the light of day, and the differences between psychosis and ordinary cognition have that property as well.
Right, that distinction between apparently direct experience and deliberative reasoning is helpful. I think I could implicitly see how that distinction could be applied to hallucinations, which are sensory in nature, but I hadn't thought about how thoughts can also have that quality of immediacy of perception.
Section 8 explains so many of the pathologies of our culture…I’ve had thoughts along those lines before, but this really crystallized things. I’d be interested if anyone has any pushback.
I agree. I might build on it by saying it seems to be related to the internet and social media generating a competition to be interesting and get attention. If you only have access to a couple hundred people in real life, it is easy for many to be different in interesting little ways; when you have access to thousands of people suddenly you have to be really unusual to stand out. For people who want attention and approval, or need to join a group based on who they are as opposed to what they like, that really ups the ante on how strange your profile has to be to stand out from being "just another ____."
Very good point: the beauty of the internet is that it allows weird people to find one another and create communities (of a sort), the ugly is that people in weird communities need to become extra weird in order to "stand out".
the way I would paraphrase this section is "People who do/have done more novel things are more interesting and enjoyable to be around than people who do/have done fewer novel things." I understand Scott's point that there seems to be more shaming of people with minimal quirkiness, but I also understand Scott's mom's concern that he would be socially stunted if he spent all of his time doing one minimally quirky activity.
I want to talk to the woman who went to China to learn arcane tofu recipes more than the woman who did all of the same things as the first woman, except for that.
Even if they can be a great place for mild cases (edit: and I'm not convinced they are, see Deiseach), their misguided policies will lead them to take in some severe cases who need medical care, not a support group. Violence will result which could have been prevented.
I don't think that their treatment model is applicable to everyone; I think they think it is; this is likely to have dire consequences. HVM is not ready for what will happen when one of their members tries to kill another, is not even engaging with that as a possibility.
I think they've had a lot of members now without this happening. Even if it does happen tomorrow, it will mean they have some very low but nonzero murder rate, just like most other things (would public schools be too tasteless an example today?) I think shutting the whole thing down over one murder per few years would be a disservice to people who are well-served by them.
I agree they should have policies in place to escalate people they can't deal with to a higher level of care, and I agree that potentially their ethos will make this hard for them. Hopefully if something ever goes wrong they'll bite the bullet and get those policies. I don't want to accuse them now, partly because I don't know what their policies are, and partly because AFAIK nothing has gone wrong.
I think I agree. Shutting them down over it will probably be an overreaction. But it's the predictable overreaction that will happen to them. When the family of the murder victim sues them for wrongful death, they'll have a case. "our son was in your care. you let his killer in? you let them stay after hearing them express murderous intent? you failed to refer them to care or authorities?"
And that family will have a point. HVM needs to have a policy of referring people to care and authorities. Per the article, HVM is precisely dead set against having such a policy, meaning they're not engaging with reality in a way that might destroy them.
The analogy to public schools is also very apt here. Nobody blames the school system for the shooting... until and unless it comes out that they ignored the warning signs, kept the clearly dangerous kid in school, and swept the potential for catastrophe under the rug. That's exactly what there's potential for here.
Public schools are so profoundly dysfunctional as institutions that promote human thriving that I think you could use virtually everything they do as negative examples.
Yeah, you make a good point, I just...kind of hate optimizing for lawsuit avoidance. I've seen the results of this taken to an extreme, and it's not pretty. If you go through the mainstream psychiatric system with any kind of violence/psychosis history, then to a first approximation you get treated as a lawsuit risk with arms and legs, rather than a human being. I think part of the advantage of Hearing Voices Movement over the regular psych system is that they avoid doing that, and so (eg) you don't have to be strip-searched before attending meetings, and if someone wants to say "Oh, that sounds hard" when you give your tale of woe, they don't have to imagine a lawyer saying "The defendant ADMITTED the patient had a hard life, but refused to escalate them to a higher level of care!" Places where they optimize entirely for maximal lawsuit avoidance REALLY aren't good places.
I think you could tell a story where the entire advantage of Hearing Voices over a mainstream psych ward is that Hearing Voices is too poor and scrappy to be worth suing, plus judges would be sympathetic to them, so they don't have to err as far in this direction.
As a former lawyer, I also hate optimizing for lawsuit avoidance. Everyone treats it as being prudent, but I think there need to be people who are willing to put themselves out there, especially in situations where they don't have much to lose, and say "I'm going to do what I think is right to make the world a better place, and I'm going to trust that other people will act in good faith and not attempt to sue me into oblivion if something bad happens."
I think there's a dynamic where people optimize for lawsuit avoidance because they don't trust people, but the act of optimizing for lawsuit avoidance decreases trust, both by making the optimizer more worried than they should be and by making everyone who interacts with the optimizer feel like they're being treated like a potential attacker. I think one of the easiest ways to increase trust is for people to make themselves "vulnerable" in obvious ways and sometimes the only way to do that is unilaterally by doing something like *not* optimizing for lawsuit avoidance.
Institutions are paranoid about avoiding lawsuits because the least-cost avoider actually at fault is often "judgment proof", so our legal system goes after the nearest deep pocket.
I'm not in favor of Hanson's proposal. One of the options under it is:
"To convince them you are a low risk, you could show them many things about yourself, and even let them continually monitor you in many ways."
By privatizing law in this way, we would lose the constraint now on the government:
"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized."
Yeah, taking lawsuit avoidance as your highest value sucks, and god knows plenty of places are doing that, which might make this seem refreshing. But you need at least some pragmatism... and you need to value protecting those in your care. At some point, you've got to face reality.
Uh, consensus reality. Pragmatic reality. Fuck, you know what I mean.
Realistically that's true, I just don't know how you avoid optimizing for lawsuit-avoidance in this climate without having a strong culture of being against that, and strong cultures aren't the best at stopping at pragmatic stopping points.
The NYT magazine article also highlights another organization - Israeli-originating "Soteria Houses" - which, if the article's summary is accurate, seem to strike a far better compromise. Doctors can impose medication and escalate care, though it is not too frequently necessary; and they occasionally reject people as security risks. And apparently, insurance in Israel is now covering stays in them and programs like them.
A better balance seems possible! And what's more, it's necessary if people are going to succeed at building an institution that can last.
I strongly oppose the Hearing Voices movement, but I don't see why they'd let in someone expressing murderous intent. Did they say anywhere that they would? If they just let in people who hear voices but don't express murderous intent, it's hard to argue that they're responsible for anyone's death, given that everyone joined the group with the understanding that everyone else in the group hears voices.
Yes, it's very clear from the article. "Afiya house", which is the shelter "run by the alliance", took in the protagonist of the article when she was hearing voices telling her "they're going to kill us" and "we have to kill them." The article quotes its director as saying "Here, we have people express that they want to harm someone. These are all normal thoughts. But people train themselves to believe that they’re not. Giving space to express these things, to have these conversations, that’s the healing thing, that’s the magic here. When we don’t allow that space, things get bigger."
Again, there may be people for whom space and opening up is the best approach even if they are hearing voices urging violence. But there will also be people with severe cases who act on their delusions if not medicated, and Hearing Voices and Afiya are not being realistic about that or prepared for it. It certainly looks like they're failing to protect the people in their care from one another.
I think it's much more common to hear voices telling you to kill people than to be anywhere close to killing people. I find I sometimes (mostly unconsciously) mutter "die die die die die" when I'm really angry, but I'm not going to commit murder or suicide.
For what it's worth an emailer tells me that the article leads the reader to believe that the Afiya is a bigger deal than it is. It's a small program that treats a tiny percentage of Israel's psychotic population.
Yeah, like tutoring, it probably doesn't scale. The model relies on someone (an intern playing the role of "melavim", companion) being there to listen to each person at any given time.
(btw I assume you're referring to Soteria - that's the Israeli one, Afiya is the "peer-run respite house" in Western MA run by Hearing Voices.)
To be cynical, there's probably a natural filter in place. The type of person who ends up at a Hearing Voices group that gets written up in the NYT is your functional computer programmer with a successful career and the same social background as the other members, not the part-time worker as a supermarket cashier who is always losing her job because the voices interfere with her ability to function.
When and if we get groups for the people in threadbare cardigans and worn-out shoes, we're getting down to the level of 'severe cases who need medical care' and that is where the possibility of violence will arise, but those groups may in fact be better placed to recognise and deal with that possibility, because that is the reality of life for its members.
Interesting to hear your perspective on peer specialists. I’m about to start a practicum placement on a psychotic disorders unit with a few peer specialists, so I’m curious to see how the dynamic among the treatment team plays out.
Re the pressure to be quirky: I think it exists in parallel with the pressure not to be quirky, maybe in disjoint filter bubbles. Just the other week there was a dating advice thread on DSL where some posters were advising people to be bland and normal and not have any weird hobbies. I spent my teens trying to pass as normal, and am now comfortably weird in a bubble of other weird people, but I still feel intense social pressure to hide it whenever I step outside that bubble.
I think there might be what logicians call an omega-inconsistency here. It may be that there is pressure towards "there should be a quirk that you have" and *also* pressure towards "that particular quirk is one that you shouldn't have", for every single quirk.
But I also think that as you say, the different aspects of this have different strengths in different social bubbles. And it could be that the social bubbles that pressure people not to be quirky are the "dark matter" bubbles that make up the majority of society, but that don't interact with people like Scott or me at all (as described in section III here: https://slatestarcodex.com/2014/09/30/i-can-tolerate-anything-except-the-outgroup/)
Is beauty omega-inconsistent, or am I understanding the term wrong?
People whose faces are flawless in every respect look boring. People whose faces have lots of flaws look ugly. Having one or two facial features outside the normal range of variation might be a kind of sweet spot.
The strict definition of omega-inconsistency is for a theory of arithmetic.
A theory that proves "there exists a natural number x such that P(x) is true" but also proves "P(0) is false" and "P(1) is false" and "P(2) is false" and so on for each particular number is said to be omega-inconsistent. This theory is not actually inconsistent, because it can't even state the claim "every natural number is either 0 or 1 or 2 or ...", and since it is not inconsistent, there is some formal set-theoretic model that satisfies the theory. However, any such model must include some objects other than 0 or 1 or 2 or ... among the "natural numbers". Since "omega" is the name set theorists use for the actual set of natural numbers {0, 1, 2, ...}, the theory is said to be "omega-inconsistent", because it is consistent, but inconsistent with the model actually being omega.
I was applying the concept a bit metaphorically to the idea that society says "you should have a quirk" but "you shouldn't have quirk 0" and "you shouldn't have quirk 1" and "you shouldn't have quirk 2" and so on for every single possible quirk.
But I think once we try to apply it more concretely as you suggest, something about the analogy breaks. It's not that "you shouldn't have that flaw" it's something like "most people shouldn't have that flaw, but if it's the only flaw, then you absolutely should".
The signalling theory of quirkiness would be this: all quirks are status-negative. A high-status person adopts quirks in order to countersignal that they're so damn high-status that they can afford to take these status hits. A person with no quirks is signalling that they're sufficiently insecure in their status that they can't afford to step outside the lines at all. Then you have low-status people who don't understand the game, adopt quirks, and lower their status even further.
But the "countersignalling boosts status" thing is sufficiently well understood by humans (at least subconsciously) that you can't appear to be adopting quirks _just_ for the purposes of boosting your status, you need to actually appear to naturally enjoy them.
You can define quirks as status-negative, but I think that's not reflective of common use. Someone whose hobby is learning new languages is quirky, but that is status-positive. Other examples are easy to imagine.
I was getting ready to say something about Scott's take on transgenderism, but your comment is so on point that I think I'll just leave mine as a reply to yours.
There is definitely cross-pressure from the general culture and from the various subcultures all of us inhabit, and I think this is relevant to issues of trans identity. Scott's "switch" theory is interesting but I don't know how it could be confirmed or disconfirmed in our current social environment. There's enormous pressure from Society Writ Large not to express a nonconforming gender identity, but there's also pressure from specific social environments (especially for young women, I think) to embrace such an identity on what might not be the strongest grounds.
So if more people nowadays identify as trans, where does that leave us? Is it a case of "we must protect people from the subcultural pressures, otherwise their switch will flip and they'll be forever miserable because of counterpressure from Society Writ Large?" Or a case of "thank goodness subcultures are helping to cancel the pressure of Society Writ Large, because now more people are embracing an innate condition they otherwise might never even have interpreted correctly"?
Scott's main argument against flipping the switch is that it should be avoided because Society Writ Large still makes trans people miserable. That strikes me as less plausible than the standard trans-skeptical position, which is basically "there is no switch; some people are just temporarily confused and we shouldn't let them make irreversible body modifications, at least not until they're a little more mature".
Rightly or wrongly, the underlying assumption there is that people who transition too early may end up being unhappy *with themselves*. If there is a trans switch, however, then people whose switches are flipped won't have any internal problem with being trans; it's Society Writ Large that may have a problem with them. That's an argument for changing society, not for worrying about the switch.
"Scott's main argument against flipping the switch is that it should be avoided because Society Writ Large still makes trans people miserable. "
This is part of it, but I think an important amendment here is that I think even with zero social pressure, it's harder to be trans than cis. Cis people pass effortlessly and never stress about it; from my experience of trans people, they pass intermittently and stress a lot. Hormones, surgeries, etc are expensive and unpleasant. Some people never manage to pass even when they try very hard, and then feel bad about it. It's hard (though not impossible) to have children as a trans person. None of these problems are so big that they make it a bad idea to transition if you've already got the switch-flip, but I think in general it's much easier to be cis than trans for reasons not related to discrimination. I think most trans people implicitly agree with this - they wish they had been born a cis person of their preferred gender, and not just for discrimination-related reasons.
Fair enough. I was dubious because of the parallel with the ridiculous, obviously circular argument that anti-gay people used to make ("we should stigmatize homosexuality because if we stop doing that, more people will turn gay and then they'll be stigmatized"). But identifying as gay or lesbian doesn't require surgery or affect your capacity to have children, so... yeah.
But is there any evidence for the switch hypothesis?
My impression is that sexuality is different in men vs women. Homosexuality in males seems to be robust against quite a lot of pressure. But the largest shift in sexuality in recent decades has been among women, who were never really the primary targets of things like laws against homosexuality, and they tend more to be bisexual than obligate homosexuals.
I think that has been shown true in so far that bihacking and conversion therapy on men is quite hopeless. Once determined, male preference is set in stone (or very hard wood at least). But we'd have trouble knowing if a specific cultural environment itself can make more men gay when they grow up. There's more openly gay people than ever before. Assuming that 100 years ago, we'd have the same relative number of closeted gay men may be true, but it's unfalsifiable and should not be unduly priviliged as a hypothesis. Identical twin studies point towards some degree of malleability.
Evidence for the switch hypothesis for gay people: Identical twins separated at birth can turn out with different orientation suggesting a switch.
Also we haven't found evidence for a purely genetic explanation either, to my knowledge (no gay gene or polygenic gay score so far).
In practice, gay people have far fewer children and that cannot be blamed entirely on persecution. Also growing up with an avoidably smaller dating pool could be considered a potential harm to your child. Gay men also have a far higher STD risk, I believe. (and STDs are externalities, too)
I would say that arguing for persecution in service of hoping to prevent switch-flipping would therefore only be partly circular, the degree depending on a variety of unknown factors.
Fundamentally I am against having opinions on things I cannot directly affect. Please don't fight me, because I am not disagreeing with you, just pointing out perceived flaws in your epistemic position as a matter of... entertainment. (I should get back to work now, sigh)
I'm not sure that it does not appear to be culturally induced. What would a world look like, where culture/upbringing/education had nothing to do with it. You think it would look exactly like ours? I think there actually is some progress on genetic explanations.
And aren't there ethnic differences, too? (though disentangling those from culture is hard)
Doesn't mean that Cochran's gay-germ theory must be entirely wrong either. Iirc, 10% of ADHD cases come from a specific prenatal neural infection. (though it may be that those should have their own taxon, if we could reliably know that cause being present)
So my current model is that "being gay" is some kind of program/attractor state/mode/taxon that the brain assumes, that multiple causes can push one into.
Hmm, my understanding is that transwomen usually have unending difficulties passing, unless they were lucky enough to never go through male puberty - but transmen generally pass easily, with hormones and "top surgery", in any situation where they can keep their pants on.
Yup. Zinnia Jones, who blogs at GenderAnalysis.net and (in addition to being trans) knows a shitload about endocrinology and other stuff, has written up research on this topic. Basically: the human brain is conservative and demands lots of cues before identifying another person as female, but requires just a few cues to label someone as male.
I have absolutely no expertise in this field but the policy implications seem pretty straightforward. Puberty blockers for trans-identifying minors are good and they're especially crucial for natal boys who identify as female, because otherwise natural puberty may leave them permanently androgynous (which is what some trans people want, but not all). Surgery and positive hormone therapy are more questionable interventions for patients under 18--and especially for natal girls who identify as male, since the social factors in gender dysmorphia may be stronger in those cases.
How much of this anxiety about passing is a result of (fear of) discrimination, though? If all cis people accepted trans women as women, I think a lot of trans people would cease to be so desperate to pass.
I don't mean that desire to pass is a result of fear of being violently discriminated against, e.g. beaten up for being trans. What I mean is…
Like, it upsets a trans women to be thought of as men. Anxiety about passing is based on a fear that people will think of them as men despite their best efforts. Being recognized as a trans woman, instead of "passing" for a cis one, is a failure mode because of the risk that ordinary people will mentally think of a "trans woman" as a kind of man, rather than a kind of woman. To be clocked is to be misgendered, more often than not.
But in a society that was widely supportive of trans people, it should matter a lot less to the same trans woman if people notice that she's trans. The bystanders would just think "cool, a woman, specifically a trans one". No one's getting implicitly-misgendered, and the trans woman can save herself a lot of worry about her jaw size or whatever.
(Reasonable minds may, of course, differ on how much this sort of internalised, society-wide acceptance is achievable, in the foreseeable future or at all. I'm just making the point that if *for the sake of argument* we remove all transphobic sentiments from the world, then I do think a lot more of the anxiety associated with trans people's day-to-day lives evaporates than you suggest.)
I don't know. There are some medications that give men breasts. If I took them and developed big breasts, I would be sad. I wouldn't expect anyone to mistake me for a woman, I just would...clearly be failing at having an ideal male body (without succeeding at having an ideal female one).
You can always go further and say "well everyone should agree to stop having beauty standards", but that's a stronger ask.
I don't dispute this! But wanting to look feminine (or masculine) feels different from wanting to *pass* in the sense of wanting to be genuinely hard to tell apart from a cis person. I thought the anxiety you were talking about was the worry some trans people retain about things that hormones and surgery *can't* alter very much (e.g. facial bone structure) even after successful undergoing transition in other respects.
I don't think you understood my post. The whole point was to draw a distinction between the scenario "ordinary people are unable to tell a trans woman apart from a regular ('cis') one", and the scenario "ordinary people, when clocking someone as a trans woman, readily think of her as nevertheless a woman". The latter depends on changes in social attitudes/descriptive linguistics, not on surgery getting improbably good.
What I meant (as I thought was clear), in other words, was a hypothetical where everybody genuinely thought of "trans women" as "a type of woman" rather than "a type of man" or a weird in-between — not just mouthed words to this effect out of sympathy or duty, as I think many "trans-supportive" people do, but genuinely updated their mental definitions to this effect. A lot of people in very progressive, or simply very LGBTQ, spaces are there already, so it's not an absurd thing to wish for, even if I think we won't see such a shift in intuitions in the wider population in our lifetimes.
(It's worth noting that ordinary people, when we abstract away LGBTQ stuff per se, are perfectly capable of acknowledging the idea that a person might be a "woman" because she thinks like a woman, looks feminine even if she doesn't look like a biological woman, and has a female name.
Namely: outside of sci-fi that explicitly tries to make it into a trans allegory, no one looks at robot girls in fiction, who don't have chromosomes or uteruses or any such thing, and say, "no, this is a sexless entity that *defines* themself as a woman but they're not biologically female, so we shouldn't call them a 'she' however much she asks". If we can accept a sentient piece of software might be female if she says so, despite lacking *all* human biology, I don't think trans women not having a complete female biology is the insurmountable semantic hurdle you make it out to be.)
> [readily thinking of transwomen as women] depends on changes in social attitudes/descriptive linguistics, not on surgery getting improbably good
I think you're understating how hard it is to "genuinely think of 'trans women' as 'a type of woman' rather than 'a type of man' or 'a weird in-between'." Treating a non-passing transwoman the same way you'd treat a cis woman is a difficult thing to do (even if it's a worthwhile one).
Sure, linguistic changes, like respecting people's pronouns, are easy to do, and a matter of basic respect. On the other hand, "social attitudes" are hard to hack, even in yourself. People behave differently towards men and women. For example, when a (cis or passing) girl walks into a room that has previously been all guys, the dynamic changes. Why is complicated, there are probably many evolutionary biology stories you could tell - but whatever the reason, people behave differently towards and around men and women, and it happens mostly unconsciously.
What happens when a non-passing transwoman enters a previously all-straight-male conversation? The dynamic also changes... but in the same way as when a cis woman (or passing transwoman) walks in? I don't think so. At least, not without sincere, difficult, intentional effort by the other participants in the conversation. It's a rare person who is aware and sensitive enough to mock up their attitudes that well. As a matter of "social attitudes", I think it's downright impossible for transwomen and women to be treated the same when there are very noticeable physical differences.
So fossil's point has some validity... even well-intentioned people who respect pronouns and philosophically agree non-passing transwomen are women will fail to *actually treat them the same way*. Which implies that at current levels of surgery, being a transwoman is a dysphoric, stressful, depressing, emotionally taxing experience, even in the total absence of discrimination or ill will.
The female robot analogy is interesting, especially since a lot of straight guys would be up for trying sex with a “pleasure-bot” but would balk at trying sex with a trans-woman.
Why is an "in-between" a problem as a category (in the absence of persecution)? If e.g. a transman has XX chromosomes and testosterone levels typical of a man, what's wrong with just noting "This is a trans person, a bit unlike either the central example of a cis-man, or the central example of a cis-woman". (And, except in situations where the transman is a plausible sex partner, or in medical situations where their steroid levels or reproductive organs are relevant, what difference does it make? )
I'm a retired programmer. I've seen _lots_ of situations where we tried to describe alternatives with a single bit, then found that we needed a richer description with more bits and more alternatives.
How many of the "trans women are women" crowd really think it, without playing semantic games? That's just... not how the instinctual process of categorization works.
They can aim to fall in an "androgynous person of unclear gender" category, demanding anything more is a pointless exercise in doublethink.
Oh, as I said, I absolutely do agree a significant number of people who quote the slogan don't actually believe it, in that deep sense of "believe" I mean. I'm saying that trans people *wish* more of them believed it. Further, I was arguing that if more people did, this would be sufficient to alleviate most trans people's passing-based anxiety (as opposed to the view that only successfully passing for cis would do the trick). But in practice, sure, it's not realistically going to be something the general population grok, any time soon.
Still can work on the individual level, though, as an aim for people who *want* to be more welcoming to trans people to try to shape themselves towards, and as something for trans people to try and get from their immediate circle of friends/relatives instead of attempts to be treated precisely like a cis person — since the latter are, especially in the case of people who knew you pre-transition, usually unattainable.
I also agree the aim being "falling in an 'androgynous person of unclear gender' category" is a good realistic target to begin with. It's serviceable even if the cis observers can't or won't think about it deeper than that, in the sense that what's upsetting to a trans woman is "being thought of as a man", much more than "not being thought of as a woman, exactly". Also, it's a good first-approximation of the more sophisticated mental-category-shuffling I described elsewhere in the thread, which we might summarize as "form a bespoke 'trans woman' category and get into the habit of thinking of it as a category of 'female', distinct from 'cis woman' but closer to it than it is to the 'weirdly-dressed man' category".
I've heard it expressed at different levels of literalness, some of which sound very much like "literally exactly the same as cis" and others closer to your definition.
What does it mean to be "includ[ed] in the broader social category of women"? What would that entail, and how would it be achieved?
If having the switch flipped makes them unable to live happily without invasive surgery and disruptive hormone treatments that they otherwise wouldn't need, then I think it's fair to say that's a worse outcome. Regarding your follow-up comment, I don't think there's much evidence either way; note that Scott called this a "steelman" which probably means he thinks it's the strongest form an argument he doesn't agree with.
Ah, okay. I don't think I understand "steelman" (or "motte and bailey") despite having read the definition a couple of times. Why does having opinions have to be so hard?
I nearly lost my mother last winter due to post-surgical infection following a double-mastectomy for medical reasons (cancer). About a year ago I lost my step-father due to post-surgical infection following heart surgery. Surgery is dangerous. It is expensive and painful and people can die. Take away all of the social stigma, and trans surgeries are still expensive, painful, and dangerous.
There's "acceptably quirky" and "unacceptably quirky" and those differ for different groups. As per Scott's example, for some people 'going off to China to learn to cook rare varieties of tofu' is acceptably quirky, while for others that will be "Mother of God, it must be nice to have more money than sense" territory (I couldn't imagine being *jealous* of that person, because my 'they must have little to be worrying them' reaction over-rides any 'ooh, if I had a hobby like that, I would be so cool and not have to cultivate being interestingly odd to fit in with our boho social circle!' reactions).
For the "tofu is acceptably quirky" crowd, 'I went to the megachurch in that blue-collar neighbourhood for a year and participated in all the events and services' is unacceptably quirky, unless you can portray it as an anthropological quest or finding ammunition to subtly mock those types. Doing it sincerely? What are you, some hick from the sticks?
I think you are right. Much of these sorts of issues seem to be an attempt for people to form smaller tribes and communities to center on. Such groups are always going to focus on "like what I like, but don't like what I don't like!" thinking to create the community's boundaries. Perhaps this is the emergence of dispersed subcultures replacing the geographic/regional subcultures that dominated 50 years ago?
The boundary enforcement is more aggressive because there isn't a default area to base it on. So you can't say "we Lancastrians do X, and those Lititz people do Y" is wrong so far as it is based on what the people living in the areas do, but if you are basing who is in the sub-culture on who does certain things, then what people do becomes a question of wrong or right. More like religion than regional subculture.
Sorry, thinking in type, but it is an interesting question of how those bubbles interact!
> Just the other week there was a dating advice thread on DSL where some posters were advising people to be bland and normal and not have any weird hobbies.
Different things impress different kinds of people. Do you want to date nerds or normies? Nerds are more interesting, but normies are more numerous.
Maybe the advice is more about the direction than about the desired end state. If you are a normie, you should probably get a hobby. If you are a DSL reader, you should probably tone down your weirdness.
Disagree -- as a normie (well, an aspiring normie), I find nerds pretty boring. Unless you happen to share their particular obsession, they don't have anything else to say.
Whereas normies, they can engage in conversation on a wide variety of general-interest topics. Did you just come back from Uruguay? Great, tell me about that!
As an autistic nerd, this doesn't map on to most nerds I know. Maybe I just know a lot of highly-sociable nerds by pure happenstance, but even the most stereotypical one I know (obese, mildly agoraphobic, loves comic books and video games) can talk about a wide variety of topics with some confidence.
I think part of you is creating a very flat stereotype to beat up to countersignal here.
It's a derivative community from ACT, which Scott links to near the top of the blog under the name Bulletin Board. IMO, it's freakishly insular and intolerant of liberal language. The community is mostly a coalition of libertarians and religious conservatives. But the most uniting force in that community which does bring some moderate Democrats to the table is a passion for fantasy, D&D, sci fi and comic book heroes, All political division are forgiven if you love Lord of the Rings or Star Wars or Heinlein or the X-Men. That's what really holds that group together, even though it mostly pretends to be about conservative politics
Actually, it's an anagram of Slate Star Codex (no N, and it's "secrets" so there's the extra S). Figured I'd ask, though, since I remember someone on here (like, almost a year ago?) who claimed linking to DSL was bad due to the nature of the userbase.
This is very true. I often feel as though I'm neither weird enough nor normal enough, if that makes sense. Or maybe I'm weird in the wrong ways (the ways that don't make for interesting New York Times articles or instagram posts).
I think "quirky" is the wrong term. In fact, it's the opposite of quirky that people are looking for. They want you to assist in creating your character for them, by providing them with convenient handholds (to stick with the rock-climbing idea) to understand your personality. They need you to tag yourself with the various topics and stereotypes that apply to you.
Here's my take, which is similar. Assume that you have no internal drives - that you are doing everything to appear maximally attractive to others. Your strategy should be to ensure that you have many labels, and that you inhabit them in a way that a bad novel would have a character inhabit them.
For example: If you are a straight white man, you have the most options.
The first is to become a "straight white man." This means that you need to watch a mid-afternoon sitcom and become the husband. Exactly. In every way. Watch sports, drink Budweiser, wear the wardrobe you see in the sitcom, and treat women like they're ineffable.
"But people hate those guys." No, some people hate those guys, and some think they're great. The "straight white man" is a concept that it's easy to form an opinion on, which is what we're trying to do here.
You could also choose a straight white man subtype: Get really into politics, closely aligning yourself with one of the two parties. Make sure that if you're conservative you have wraparound shades and a pickup truck. If you're liberal, a hybrid car and a twitter account. You could be a workout guy: Get into working out, and make sure there's protein powder involved.
You could choose a mild mental disorder. This works better for women, but you can make it work if it's the way you'd see a mentally disordered man act on TV.
There's lots of other ways to do it, but the point is - adopt the character that you choose completely. Do not, do not, do not, have contradictions in your character. With advanced techniques you probably should have some surprising labels: e.g. "Yeah, I'm a conservative but I support gun control." That's the kind of thing that makes characters more interesting. But those should be very well-defined exceptions to a very culturally recognizable rule.
Everyone these days is on a script, and when you make them go off script it's a very bad experience for them. Don't do it.
This doesn't quite work for me. I think people would be unimpressed with someone who played video games and did nothing else, and more impressed with rare tofu guy. I think we have a mental bin for "person who plays video games and nothing else" and less of a bin for the tofu thing, so I don't think this is just mental binning.
That's fair. I'm tempted to say two things in defense of the mental binning hypothesis:
First, that people in my social circle might be unimpressed with someone who plays lots of video games, but they'd definitely be *more* impressed by someone who plays lots of video games and does nothing else (and adapts video-game-player attributes) than they would be by someone who plays video games, watches lots of sitcoms, and doesn't adopt any clear "character."
Second, in my mind, rare tofu guy is a pretty recognizable character. Not because we have a bin for "rare tofu guy", but because when you say "spent several years learning to cook rare varieties of tofu in China" I can imagine a whole character in a specific kind of prestige TV or novel. I can imagine the audience for that novel, and suspect the audience for that novel would find him attractive and interesting. Because we're discussing a genre, the tofu and China has nothing to do with it. It could just as easily be a dog breeder in France, or New York Socialite learning candle-making in Appalachia. The bin is <person> goes to <unfamiliar culture> where he learns <highly specific, unusual skill>. The key point is that you know the genre, and therefore all the characters. You picture locals as being less "sophisticated" but wiser, you can play the role of visiting person from hometown, etc. There's still a script.
With that said, this theory is coming dangerously close to being unfalsifiable. I suspect I just spent too many formative years reading Edward Teach stuff :P.
people always say ‘spend your weirdness points wisely,’ like it’s a budgeting exercise, but maybe it’s more similar to investing—a good investment (or short) gives one license to amplify their natural mix of weird/normal, and ‘successful’ investors are hedged enough across different contexts they can take more risks in ‘being themselves’ or whatever in new/bigger contexts.
...maybe the halo effect is something like ‘trading on insider info,’ etc....
Would you be more or less likely to express your quirkiness if criticizing your expression was considered 'ableist' and grounds for ostracizing the person being critical?
I think that's something the article overlooks; certain quirks are heavily protected (at least in large parts of society), and if you can cast your quirk as one of those, you can take advantage of those protections.
I think that would only work in the social circles that already tolerate or encourage quirkiness. In those that don't, that argument would be met with either confused incomprehension or hostile derision.
I imagine this post will get a lot of excited responses.
It doesn't feel as balanced to me as it does to you. Of course that may mean that it is balanced, and people on all sides of the relevant issues will be equally certain it's imbalanced, aka doesn't privilege their particular positions. Or then again, it may not.
My experience biases me towards the camp that sees various DSM conditions as often better handled without pathologizing them. I'm personally somewhere on the autistic spectrum, and connected with religious communities prone to ceremonial possession, aka channeling. (They don't just hear voices; they provide a mouthpiece for the speakers, variously conceptualized as mostly benign non-embodied entities.)
I'm also in the weird place of supporting the agitation against Autism Speaks, while at the same time knowing a person who works for them.
For those who don't know, there are two issues with Autism Speaks. First of all, they are a group of do-gooders lacking any autistic representation, which claims in their name to speak for autistics. (They understand us better than we do ourselves, at least in their own opinions.)
Second, they appear to claim that we *all* need to be "cured" and favour a wonderful (sic) treatment called ABA (Applied Behavioural Analysis(?)) which according to autistic activists basically involves "curing" the autistic person by punishing problematic behaviours until they stop. Done sanely, that might be a last resort, used only for dangerous behaviours - such as physical violence. Done by someone desperate to make autistics normal, it's likely to involve punishing a lot more, up to and including everything the autistic wants to do, enjoys, or has available as methods of self-soothing etc..
With humans involved, and the tendency of neurotypicals to project their needs and desires onto everyone else, not to mention the tendency of parent to want their children to be just like them, I'd be sure the bad version happens regularly, even without having encountered people who claim that it happened *to them*.
It's a mess, and I don't know how to solve it. Some people are messed up enough to benefit from help that has really noxious side effects. Or they are sufficiently dangerous to others that there's good reason to restrict their liberty, e.g. by treating them against their will. Others just need people to stop using their kind of person as a bad example, or demanding that they pretend to be a cookie-cutter example of normality. Most need strategies and tools for improved living, whether or not they are considered to have a psychological disorder - but the tools that will work for them won't be exactly the same as those which work for others, and while knowing what they see as problems may help select good tools to offer, a diagnosis is likely to be helpful in selecting tools, as well as in proactively suggesting tools to address problems they might not have mentioned.
If people were rational, those people could get useful-to-them help whether or not we called them "psychotic", "autistic", etc. - i.e. however we defined condition boundaries. But human beings generally aren't rational in that way; we over-simplify any category we define as Other, and thus tend to try the same things for a violent non-verbal child and a somewhat socially awkward child nerdy child that's fascinated with dinosaurs. And when we reclassify the nerd as non-autistic, we then try to treat them the same way as their sports mad, social butterfly classmate.
I agree that the seizure disorders need to be cured, though I suspect the 30% number isn't based on the whole group the American Psychiatric Association chose to consider autistic in 2013, with the World Health Organization registering their agreement in 2021 (Technically, autistic people all "have autistic spectrum disorder"; AFAIK, "autistic" is otherwise meaningless).
I'm not clear that autistic spectrum disorder, per se, needs to be cured in all cases. The analogy that comes to mind - suppose there was some morbidity that affected 30% of males. (I can't think of anything that approaches 30%, or even 3%, mind you. But OTOH a greater proportion of males than females generally die at all ages.) Should we cure their maleness? Should we selectively abort male fetuses, keeping just enough to sire a new generation, so as to increase overall life expectancy? (Females live longer, on average.)
Clearly, my analogy is a reductio ad absurdum. But my autistic symptoms give me very few problems, except to the extent non-autistics make trouble for me because of them. My prospognosia - another thing more common among folks on the autistic spectrum than in the general population - has been a lifelong nuisance, and when I was younger it would have been great to get rid of my general clumsiness. But other than those two things, I'm glad no one came along and "cured" me when I was too young to give informed consent, and wouldn't take a cure if it were offered today.
But is it medicine e.g. to tell an autistic child that many people get upset if you don't appear to be looking at their face when speaking to them, but you can avoid the (common among autistics) stress of meeting their eyes by looking at their mouth, or their eyeglasses, and they'll never notice you aren't meeting their eyes.
There's a lot that's interesting in your comment, both as a specific mental health treatment issue, and as one example of the perpetual struggle to figure out how useful social categories actually are. I hope Scott and others engage with it in a way that's beyond me, at least at the moment.
Right now I have a specific question.
>[The Autism Speaks activists] appear to claim that we *all* need to be "cured" and favour a wonderful (sic) treatment called ABA (Applied Behavioural Analysis(?)) which according to autistic activists basically involves "curing" the autistic person by punishing problematic behaviours until they stop.
So far I have read little about Autism Speaks, or any rival autism activists, although I think I grasp the outlines of the debate. Can you link to an Autism Speaks publication which specifically addresses high-functioning autistic people, as well as undiagnosed people who see themselves as similar? What I would like to see is confirmation that Autism Speaks activists are actually including such people when they talk about how to treat autism. The alternative is that Autism Speaks may view such people more as a distracting phenomenon of misdiagnosis, e.g. along the lines of Freddie deBoer's recent post (https://freddiedeboer.substack.com/p/the-gentrification-of-disability).
That's a really good question. My impression has been that Autism Speaks doesn't address autistics much, if at all - it primarily addresses parents of autistic children, generally in ways that seem to presume the parents are nowhere near the autistic spectrum themselves.
But I haven't read much of their literature myself, and none at all recently. (Frankly, I got sick of reading rants about them every time I went near any online Asperger's Syndrome support group.) I don't know how or whether their literature changed when the terms "Asperger's Syndrome" fell out of favor.
So I popped over to their website, and looked at their page linked as "what is autism" at https://www.autismspeaks.org/signs-autism. It pretty clearly refers to mild as well as severe autism - given the symptoms listed, and their prevalence among those previously referred to as having Asperger's syndrome.
They've also improved somewhat - not all of the page is addressed to "parents or caregivers" of children who might be autistic; there's a small section at the bottom addressed to adults and teens who suspect that "their feelings and behaviors involve autism".
Their page about "Interventions for Autism" at https://www.autismspeaks.org/interventions-autism lists Applied Behavior Analysis (ABA) first, but since the list is in alphabetical order that probably doesn't mean it's their first resort.
Their page on ABA at https://www.autismspeaks.org/applied-behavior-analysis makes it clear that the goal is to change the subject's behaviour, not to teach them coping skills or make them happier. The page stresses _positive_ reinforcement. But being cynical, and given the past controversy, when I see "Positive reinforcement is one of the main strategies used in ABA." I wonder what the other strategies are, and whether they could equally well say "Negative reinforcement is one of the main strategies used in ABA."
Overall, there's nothing flagrantly wrong with what I'm reading on the site, other than the badly chosen organization name. There are some inconsistencies and gaps, such that I feel as if a not-so-competent job was done of adding material relevant to (a) higher functioning autism and (b) people old enough to read the site themselves and investigate whether they are themselves autistic. I don't have a copy of their site as of when I first encountered them, but I suspect that material simply wasn't present at that time.
There are some unfortunate leftovers. E.g "Autism’s severity scale reflects how much support a person needs for daily function." from https://www.autismspeaks.org/what-are-symptoms-autism The implication, at least as read by a literal-minded person (many autistics) is that *all* people on the spectrum require some support for daily functioning, unlike healthy/normal individuals.
But overall, if they had called themselves "resources for parents of autistic children", and included things I'm seeing now, but don't remember from before, they probably wouldn't have become such a negative symbol among high functioning autistic teenagers and adults.
You're right that a literal reading of that reference to the severity scale implies that all people with autism need support for daily function. But if very few or none of these activists have autism themselves, and then there's less reason to take them literally. ;-)
My impression from the website is that Autism Speaks activists are not discussing the phenomenon of mental health directly. They are discussing the burden on themselves and other parents/caregivers, with reference to its cause. If a parent of a high-functioning autistic person said to them, 'Sure, my child is puzzling, but not in need of special support', I expect Autism Speaks would have little further to recommend.
This is in some ways how I feel about my bipolar disorder. I am well aware that for some people even the THOUGHT of mania is terrifying, that it's a life-destroying monster that comes in and wrecks their finances, relationships, career, everything.
I'm not unmedicated, but I'm lightly medicated. I had problems finding psychiatrists who wouldn't consider anything on the high end, no matter how marginal or seemingly stable, a serious problem. They'd say "If normal people go from four to six, every time you come in here you're at a 6.5 or 7." and want to start monkeying with my medication. It felt like to their mind living /under/ the norm was better than living /over/ the norm.
And this really bothered me. I didn't want to go WITHOUT treatment, because I wanted the ability to know when something was a bad idea to actually work. And to have a bit more stability and not be at risk of falling into a mixed state. And to not have to act increasingly squirrelly because I felt like people just walking down the sidewalk were talking about me, then awkwardly apologize with "Sorry, I'm having delusions of reference." But I wasn't willing to live in constant brain fog and dysthymia either.
It's one reason why I'm so keen on the idea that psychiatrists should be expert consultants on making people comfortable, happy, and effective in their own minds. And why I think a transhuman viewpoint is kind of the best way to think of it. (I like many details of how I think and feel. I don't like all of them. My ideal self isn't 'normal', but it's not my unmedicated self either.)
But I KNOW people who've had their lives destroyed by the same condition I have. Even if I decided I didn't want medication, there's no way I would jump on the 'Medication is bad!' bandwagon. This is just another one of those ways where I happen to benefit by dumb luck and I have no business chastising others who have a harder time of it. I don't even think I could give them techniques to try, beyond "If you have good insurance, time, and your life is sufficiently together, shop around for doctors and don't be afraid to fire treatment providers who aren't helping you or you feel don't listen to you or share your priorities."
You make an interesting point about the relative severities of different peoples' hallucinations. I can admit to having had a couple of them in my life. They were so ridiculous that I knew immediately they were hallucinations. It's absurd for one's dog to walk up and say "Hello."
Knowing I'd had an hallucination was, well, troubling, but it's not as though they have come with any frequency or regularity. They were many years ago, many years apart, and my dog hasn't said a word since. Perhaps it's still upset that I didn't engage it in conversation.
I wonder whether hallucinations may not actually be more common than is generally assumed. Are we just wired to ignore things that don't conform to our expectations? I've seen that film clip of a person in a gorilla suit walking through a basketball game. Nobody ever seems to notice him until he's pointed out.
Now I don't know whether to feel happy or sad that my dog may never talk to me again. It could have been chatting with me all this time, and I just wasn't paying attention!
The White Christmas Task shows it's pretty easy to induce a musical hallucination in people by asking them if they hear the tune "White Christmas" on what's just a recording of white noise. From what I understand of predictive processing, it's reasonable for people's minds to resolve white noise into a familiar tune if someone suggests they'll hear it.
Among musicians, hearing music that's not physically present must be completely normal, "not even a hallucination" (because hallucinations would be weird and bad?) normal. It's normal for musicians to be briefly fooled into thinking the music is "coming from outside the house" if they're in a situation where they hallucinate music in a setting where they really might be overhearing someone else's music, but you usually realize pretty quickly it's just your own imagination, and it's not weird.
I once asked a psychological expert whether hearing voices singing counted as "hearing voices". He said, no, it didn't — that you don't describe hearing imaginary voices as hearing imaginary voices unless those voices are harassing you or telling you to do bad things. Or at least, you don't describe it that way to mental-health professionals.
"They were so ridiculous that I knew immediately they were hallucinations."
That's interesting, since IIRC normally with schizophrenia at least hallucinations/delusions seem to override whatever mental filters the brain usually has to separate reality from delusion, no matter how much you know you're schizophrenic.
Cecilia McGough, founder of Students With Psychosis, experiences visual hallucinations. One of her most common hallucinations is of spiders. If it's a giant spider, she's relieved because she knows those don't really exist and it must be a hallucination. It's smaller spiders that really bother her, because they might be real.
The short answer is that insight is a spectrum, and it tends to fluctuate along with the intensity of other symptoms. It varies from person to person but especially over time if someone's condition is active and they are experiencing psychosis. If they're well, deteriorating insight might be a warning sign. It's interesting that reality-ness isn't an either-or proposition. (This is sort of a nomenclature thing but someone with schizophrenia could have intact insight while they are well. It's psychosis, the active symptomatic event that is shared with other conditions, that is better thought of as blocking insight, and I think is what you intended anyway.)
Questions: is psychosis identical with diminished insight? Alternately, are diminished insight and psychosis causally related but not identical - i.e. does diminished insight cause psychosis? Or vice versa? Or is the relationship between insight and psychosis merely correlative, i.e. does psychosis have, among its many possible symptoms, diminished insight? I'll go out on a limb and predict that the answer is "nobody knows", but I though I'd ask anyhow.
> Or is the relationship between insight and psychosis merely correlative, i.e. does psychosis have, among its many possible symptoms, diminished insight?
That's closest to my experience. Insight and psychotic experience are neither identical nor uncorrelated; I would think of them as loosely tethered.
There's a difference between hallucinations (non-real sensations) and delusions (irrational, unshakeable beliefs).
Delusions are essentially defined as beliefs that aren't logically derived or amenable to reason, so it's tautologically true to say that they override one's ability to determine what is real.
Hallucinations do override one's ability to determine reality in the very weak sense that knowing they're not real doesn't stop you from seeing them/hearing them/etc., but they're frequently recognised on the higher, conscious level as being non-real.
It is, of course, possible to delusionally believe that a hallucination is real, but even in schizophrenia there isn't perfect co-occurrence.
Delusional belief also is carefully distinguished from beliefs that would be understandable to have for a person in their cultural context. You can have a belief that is not rationally warranted and it not be considered a delusion. Catholics aren't experiencing a potential psychotic symptom for believing in transubstantiation. This allows us to not start declaring each other's cultural views, and especially religious ones, as meeting a diagnostic criteria for a psychotic disorder.
Sometimes this gets fuzzy. Religious delusions are common in psychosis, for example, and you as a clinician get placed in a role of deciding from the broader context if this "counts" as something a person can fairly think or is delusional. You sometimes have to end up making calls like, "It's Ok for people to unreasonably think God is speaking to them, but not like *that.*"
I think that hearing voices is perfectly normal. What's wrong is when you think it's someone other than yourself talking to you.
ISTM that wherever I read or write I hear voices saying what's coming in or going out. And I frequently hold discussions with myself about why this or that song is running through my head. If this didn't work, then Mantras wouldn't work at all. (They don't work that well, but they do affect my thought patterns.)
Just sitting here considering what to write, I find myself wordless until a voice in my head starts suggesting the words I should write (and revising itself).
So. Most mental things are gradient in nature. I would propose (without reading any of their literature) that these "Hearing Voices" people are a rather extreme form of the same experience that I have. The problem comes when they stop owning the voices as a part of themselves. Religious history tells us that that can lead to severe problems. So I strongly agree that your suggestion of the Family approach is worth following up. Actually, anything that will get a dialog going should help, but ideally they need to accept the ownership of the voices. This, of course, requires accepting that they aren't just their conscious mind...but I don't know of an author that believes that. (Consider the problem of writer's block.)
I wonder what, in this context, would you think of the tulpamancy movement? They don't have any relevant psychiatric diseases to start with, but they self-therapy into hearing very well-defined and agenty voices and consider that to be totally normal and accpetable. They certainly don't want to be "treated".
An obvious fact but one worth repeating is that psychosis isn't just "cleanly" hearing voices, which as described in this post seems like it would often be fairly manageable if that were the only symptom. There are lots of other aspects -- seeing patterns where there are none, trouble reasoning and using language, paranoia, etc.
And the diseases that can cause psychosis also have lots of other bad symptoms.
I have insomnia and sleep apnoea. These occasionally combine to make me very sleep-deprived.
In that state, I hear voices (I last did a couple of years ago, before that was the time my CPAP broke down in 2015). Usually my mother's voice as she sounded when I was about ten years old (not as she sounds now). Usually just asking if I'm OK, or telling me to go to sleep, or scolding me for not going to sleep - in many cases, resulting in it being harder for me to sleep.
This is not a problem for me; I know that the voices aren't real; I know they are caused by lack of sleep; I am usually lying in bed trying to sleep at the time I hear them; they are not telling me to do anything other than sleep. Sometimes I wake up later on, unsure if I heard voices before I went to sleep, or if I had a dream after I did. Other times, I am more clearly awake and hearing voices.
But, as Scott mentioned, I have very carefully avoided mentioning this to anyone involved in my work or family or medical practice, because I am scared that the result will be antipsychotics from the medical people and family, and losing my job from the work people.
This sense that there are versions of all sorts of psychiatric conditions that are basically just a personal quirk and there are versions that are utterly debilitating - and all points in between - is one I think really matters; I would feel a lot safer talking about hearing voices if I could rely on other people treating them as a minor quirk rather than as a serious medical condition.
Maybe it's because I'm old, but I personally find "quirkiness" irritating. I could spend hours listening to a person passionately expounding on the history of Australian Aboriginal flute-making techniques, or something to that extent -- because I like learning new things, and I admire passion when it is coupled with competence. But if that same person says, "I've read all about Australian flutes ! Tee-hee !", my only response to that is "STFU". I don't care about things that make you feel special; I care about things that make you actually special.
I think this is part of the problem, though; it's too much trouble to distinguish real specialness from fake specialness, so a demand for specialness increases both. I actually don't care if you know lots about Australian flutes! I don't like Australian flutes! I'm not against you learning, and I hope you have a good time, but I am not going to increase my estimation of you as a person just because you know stuff about them.
I realize this is kind of an unstable signaling equilibrium and it does show *some* positive things about a person if they're willing to have a nonstandard hobby, but I think I err on the side of not caring.
I that, for me, the difference between "you're an interesting person" and "STFU" amounts to competence. I don't really care about Australian flutes either, but I can respect someone who put his heart and soul into studying them in great detail; has published articles about the flutes; is currently involved in a bitter academic rivalry with his nemesis who believes that long flutes are superior to short ones and not vice versa; etc. Even though the flutes themselves do not interest me, the mindset of such a person would. On the flip side, I cannot respect someone who puts an authentic Australian flute up on the wall for an extra 50 quirky points. That person hardly has anything that qualifies as a "mind", IMO.
> That person hardly has anything that qualifies as a "mind", IMO.
This is too much. You're jumping from 'this signal is empty and tedious' to 'this signal allows me to diagnose the sender as a barely-human moron'. I know you might not mean it entirely literally, but I think that being so willing to write off other people for making inept moves in the signalling game is a real mistake. Just about all of us have some combination of empty pretensions and genuine depths.
edit: maybe you don't see those signals as 'inept' so much as unjustifiably successful? If you see society at large actually assigning the quirkiness points in exchange for the empty signal, I get the frustration. But, if anything, that probably makes it harder to write the flute-hanger off as mindless; they're just seizing an opportunity to score cheap points in a harmless way.
Leaving aside the truth or falsity of your assertion, that seems a fairly bleak and isolating worldview. In the ocean of social signals that surrounds us, some non-trivial percentage are undoubtedly empty. Do you feel like you’re surrounded by morons?
There's a series from around forty years ago called "Hands", made by our national radio and television service about craft traditions of Ireland.
This particular episode is from 1983 and the workhorses of Dublin. The narration is irritating because it's done in the style and accent of one of the "Professional Rale Ould Dubs", but the historical interest is engaging. This is the 80s in Ireland, in our capital indeed, and this is how we were living. The 80s were a time of very bad recession in Ireland, whatever about the rest of the world, and high emigration levels. This is the period and the reality in which I grew up.
I have friends whose parents immigrated from countries like China and India, and they've mentioned that the difference in material standards between their childhoods and their parents' is hard to fathom. I also had a childhood friend whose mom immigrated from a part of Ireland that has historically been poorer than Dublin, so I imagine she experienced something similar. But I think children growing up in the same country as their parents and experiencing such a gap in living standards in one generation is probably a pretty rare experience. The only other examples I can think of are modern China, South Korea, and Singapore, but maybe there are other cases I'm unaware of.
I find the narrator's voice absurdly soothing. I find the fact that Ireland still used coal to heat individual apartments in their capital absurdly terrifying.
Poland is in process of banning such practice. Capital of Poland, Warsaw, legislated such ban a week ago.
It starts in 2023 (unless it is legislated away or stopped by courts).
Kraków, Poland banned coal and wood burning in 2019, with exception for municipal heating plant. This was done after someone managed to block earlier attempt due to some legal trickery. It remains legal outside city limits, resulting in massive smog during winter.
Also, it is common to burn lower quality fuel than coal.
Wait, did they ban all wood burning, period ? That's going too far, IMO. I have no problem with people having outdoor barbecues or campfires in the woods or whatever. I was just extremely surprised that Irish citizens had to rely on coal as their main heating solution as far as the 80s.
I think responding to someone enjoying the fact they enjoy something with active hostility is one of the only things that make me want to tell people to shut the fuck up (along with unnecessary destructive criticism).
"The worst failure mode is people who handled ... their condition without medication, ..."
This line touched a nerve I have been poking for a while, so asking for advice on the internet. ¯\_(ツ)_/¯
In the last ten years, I have been in psychotherapy thrice, a few months each time, all of them CBT to my knowledge. The first time was very effective, the second was in hindsight ineffective, and the most recent one (TEAM-CBT) seems effective for now. During the last one, I learnt some tools and techniques, but I am starting to have doubts as to what extent and how effectively I can apply them on my own in the future after I will have already forgotten most of the experience.
I have explicitly avoided having to take any medication aka going to a psychiatrist. Mainly because I personally know zero people who had successfully done that -- I personally knew zero people who were in therapy as well but it felt less risky (even at the cost of being ineffective) -- and I worry about some sort of dependency/addiction/side-effects. I agree it is irrational, as I don't think that way about doctors/medication treating physical ailments.
Since Scott has been writing a lot on this subject: has he already written something to address questions like this? Like a primer about psychologist vs psychiatrist, and ways to find one? Thank you.
I'm surprised you manage to know zero people who have successfully seen a psychiatrist for social anxiety. How many people do you know who have unsuccessfully done so?
If you saw a psychiatrist for this and asked for medication, you would probably get put on SSRIs, which are not addictive in the classic sense but can produce dependency after a while. They would have a 30-50% chance of making you feel less anxious in general (higher if you count placebo) including with social anxiety. I've written up my thoughts on SSRIs at more length at https://lorienpsych.com/2020/10/25/ssris/
If you wanted to do this, you could ask your primary care doctor if they were willing to do it (about half are). Otherwise you could ask them for a referral to a psychiatrist, or ask your insurance for a referral (they collect information on which psychiatrists in their network have openings). If neither of these sources was helpful, you could look around on psychologytoday.com, which has a psychiatrists classified section.
I knew a handful of people in India who saw a psychologist/psychiatrist. Not idea about the actual diagnoses, as people are very private about such matters. Other than extreme cases (which needed some in-patient care), the couple of instances where someone was prescribed medication, they had discontinued the course on their own as they felt it made them dizzy/lethargic.
Based on news and the internet (your blog included) it appears to be comparatively vastly more common to seek help in NY/US. But I have never run into conversations where someone I know openly talked about their experience. I am not very social, so I mean this to say, "I don't know whether X has so-and-so and is getting help," and not, "I know X doesn't have so-and-so condition".
Thank you for the links, and for your writing in general.
I need to determine if I have ADHD, get medication if true, but also talk to someone about life issues involving long term depression and anxiety, while likely not taking anything prescribed for those. Psychiatrist sounds ideal for first but psychologist for second. No GP due to no more insurance because of these issues (guess I'll pay $). Who do you recommend?
You'll occasionally find psychiatrists who do therapy, but this is very expensive (psychiatrists bill more per hour, and usually you avoid getting hosed by only seeing them for the short amount of time it takes to discuss meds).
More likely, you'll have to do both at the same time. I think the easiest way to do this would be to start with the therapist, ask them about the ADHD, and if they also think this is important/needs treatment, see if they can recommend a good psychiatrist (most of them will have people they work with and know well). But you could also do it the other way around, start with the psychiatrist, and see if they can recommend a therapist.
There are a few large clinics that have both psychiatrists and therapists at them and handle the coordination for you. My old employer https://www.pcpasf.com/ is an example.
You know, I want to ask you a straight question. I've had dealings with a psychiatrist and he was a bit of a hypocrite when I was quoting his own hospital site that about the rates of SSRI success and claimed that he knows nothing about it, never heard of it and he knows SSRI are effective blah blah blah.
I mean if your pacients ask do you give them the straight answer that this stuff helps - sometimes. Or you give them fake hope?
It's all about regulating your nervous system. Work with a professional who understands this approach and healing will probably work better for you, like it did for me and does for so many others. The medication will regulate your nervous system for you or you can learn to regulate it yourself. It sounds like you're in no level of distress that would require medication to stabilize while working on a long term plan.
Just my very personal take on a little part of this:
In school they taught we'd be peer pressured into fun things like drugs, drinking, sex. The only form of peer pressure I've ever consistently received was pressure to identify in ways that made me easier to label.
For years I was encouraged to seek psychiatric help, specifically to get a diagnosis. This was... ultimately good, and I think some people spoke from a place of genuine concern. But I remain convinced that a lot of that pressure was that people had no idea what to do with a person who didn't have a good label.
Likewise, I continue to be encouraged to take on some LGBT+ moniker. To be clear, I am unquestionably a dude with a boring, conventional sexuality. I'm not stereotypically masculine but I've never felt that I'd be happier identifying as some other gender or "refusing" a gender label by labeling myself non-binary. Frankly I just don't consider my gender an important part of who I am. The same is true of my sexuality. I think people just need that crutch to know how to relate to folks, even when I just objectively do not belong in that community.
But this pressure has significant downsides! When I was first diagnosed with ADHD I was added to all kinds of support groups on social media, got all kinds of positive reinforcement from my friends, and my symptoms became objectively worse. I did not "consciously" decide to play up my ADHD symptoms to get positive attention. I just spent a lot of time talking about ADHD and thinking about the positive attention my ADHD symptoms got me, and somehow, "unaccountably" I found myself acting more ADHD. I brought this up with my friends, and they celebrated it, saying that I'd been masking before, and could finally act in accordance with my nature.
It would be so easy to take that road, without even consciously choosing it. Deferring responsibility, inhabiting a stereotype, and helping the people around me feel better about choosing their most superficial traits, or even their weaknesses as their entire personality.
Eventually I'd get accommodations from a job that feared lawsuits, and they'd quietly note to themselves that I probably shouldn't get promoted or get the good assignments. My wife and daughter would learn to accept less from me. I'd quietly replace all my object-level goals with superficial identity politics. I could enjoy all the benefits of being raised an upper-middle-class white man, while still claiming discrimination and oppression. Ultimately I could replace everything real in my life with words, and spend the back half of my life bitter that those words can't shape reality.
I should have been more careful in my initial comment and I'm going to try to be more careful here: There are, of course, lots of people who *actually do* have mental disorders/are actually LGBT/etc. I definitely would not advise a policy of "never tell anyone or seek treatment" for mental disorders or a policy of "never form a community to advocate for your interests and seek mutual support" for minority groups.
But label culture brings out the worst part of the dichotomy between self-acceptance and self-improvement. It doesn't want "uniqueness", it wants "quirkiness": a well defined set of behaviors allowed for people who have the same labels as you.
There is a difference between being "a person with ADHD" and "The ADHD guy." A person with ADHD struggles with attention, emotional regulation, executive function, but in an uneven way, while working towards other goals (probably too many other goals :P). "The ADHD guy" is a hypothetical guy whose every behavior is defined by their ADHD. Nobody is really "The ADHD guy" all the time, and I probably exaggerated a bit in my first post.
But in the weirdly asocial culture of the present, people think in abstractions more than they do in terms of complex human beings. They understand "The ADHD guy" who cannot succeed because they *are* their ADHD. That person is worthy of sympathy and compassion because the abstract concept of ADHD is worthy of sympathy and compassion.
People have a harder time with a person with ADHD who tries, sometimes succeeds, and sometimes fails. It's the social equivalent of losing disability because you tried to go back to work.
Probably everything in the last paragraph would not really happen to one person in the same life time. But definitely it happens a little to everyone.
It's human nature to want to believe you have power over every circumstance in your life, and it's also human nature to want to avoid responsibility for failures. We all know people who fall off that dichotomy into either crippling self-pity/learned helplessness, or delusional over-exertion. That's a hard problem, both as a reality modeling thing (almost certainly we don't have as much control over our success/failures as we'd like to think) and as a self-actualization thing (probably it's better if we think we do).
I'm not really talking about that personal struggle though, I'm talking about what happens to your efforts to deal with that struggle when everyone in a peer group is more concerned with their own Quest To Have The Right Opinions than with interacting with each other. Then suddenly the less agency you have, and the more you appear to be the archetypal "struggling person" the greater their opportunity to demonstrate their compassion and understanding. You don't need conscious effort for either of those things to happen. Just a bad reinforcement loop.
That loop can exist independent of this weird "prove your quirkiness" labeling culture. In college we had a very troubled friend who attempted suicide, and who was so moved by the outpouring of love and support he received, he did it a few more times. I don't think he consciously thought "I should attempt suicide to get attention." He just somewhere deep down inside knew that he felt bad and also knew the steps to feel good again.
But a culture where nobody is willing to make judgments for fear of being a "stigmatizer", and where people are just a collection of labels instead of a person with agency is a good petri dish for that dynamic to grow in.
> When I was first diagnosed with ADHD I was added to all kinds of support groups on social media, got all kinds of positive reinforcement from my friends, and my symptoms became objectively worse. I did not "consciously" decide to play up my ADHD symptoms to get positive attention. I just spent a lot of time talking about ADHD and thinking about the positive attention my ADHD symptoms got me, and somehow, "unaccountably" I found myself acting more ADHD. I brought this up with my friends, and they celebrated it, saying that I'd been masking before, and could finally act in accordance with my nature.
I'm really curious about how common this is for ADHD. And for autism. How often is "unmasking" actually clearly good for someone? To what extent is it natural vs a result of social pressure?
I can't speak intelligently about autism. To the best of my understanding, attempting to "act normal" is both possible, and literally physically painful for some autistic folks. If the idea is to make the people around them more comfortable (which is unfortunately sometimes the aim of autism treatment) you could easily teach an autistic child that it is right and proper that they live their entire life in agony for the comfort of others. That's...probably not good psychology.
For me, I can say for sure that it's extra stressful to meet deadlines, take an interest in the conversations of others, plan out a responsible day, stick to a schedule, sit still in meetings, etc. etc. That's tiring, and I'm grateful to have friends and family who are willing to give me time to, y'know, not do that.
But also, I want to meet deadlines. Doing good work is important to me. It makes me feel good. I like my friends to feel supported in their interests and concerns. I'm willing to make extra effort to listen to them. I know if I stick to a schedule I'll feel happier and healthier (I don't *do* it, and being kind to myself about failing to do it is probably better than not, but still).
I'm not willing to allow the people in my life to lower their expectations of me because I have my own stuff going on. It's my thing, I'll figure it out. Probably you can put up with me fidgeting in meetings though. Meetings are dumb.
>If the idea is to make the people around them more comfortable
Yes, this is the general idea of being able to coexist with other people. If autists aren't so lucky as to afford to live in comfortable isolation from society their whole life they probably need to learn social interaction for their own interest, and then presumably to calculate the tradeoffs with how much agony they are willing to tolerate for engaging in it. It sucks, sure, but what is the realistic alternative?
I think that's where the anti-stigma and "neurodiversity" movements are useful, to be honest. We could, as a society, become comfortable with a greater variety of non-harmful behaviors without incurring much cost. Sure, if someone is literally dangerous to themselves or others, does not do the things they promise to do, is consistently rude or hurtful in their speech, that's always going to be socially maladaptive.
But do we really need to stigmatize stemming/twitchiness, for example? If we know someone for whom holding still and staying silent for long periods is physically agonizing, wouldn't the compassionate thing to do be to just ignore/accept the fact that they're going to move and make an occasional noise?
The question of which behaviors someone with a mental disorder should control themselves, and which should be accommodated is obviously non-trivial. But for sure, unless you're willing to declare all deviation from the norm to be disordered, there's some element of meeting people half way. And IMO the point of therapy is to help people find a way to exist that works for them, not to make them shut up so the rest of us don't have to deal with them. It's a little adaptation/coexistence, and a little self-acceptance, and a little support from friends/family/society. Nobody ever said it was easy.
Indeed, somewhat changing the society no longer seems to be that unrealistic, at least for some subsets of it, as the ongoing apparent success of the trans movement indicates. It would be interesting to see where the halfway ends up.
It's mostly a risk in echo chamber environments. IMO in an ADHD case it's more just giving yourself permission to be a little bit ADHD. The adaptive version is designing your life/ living space around the fact that you are like that (examples - i have lots of containers, many of them disposable, because realistically I won't be able to wash them every single time and also I tend to lose them. I have lots of socks and underwear, probably 4x the average person, because I will forget to do laundry and giving me more allowable time between loads of washing helps. Vacuuming doesn't necessarily always happen as often as it should. That's okay).
The maladaptive version is changing nothing and complaining that life is hard. This is where I often have my annoyances with a lot of ADHD based communities, but understandably a lot of people are burnt out from trying to do things "the hard way" and not being allowed to use more adaptive routines. And yeah, I've occasionally been the latter, when I'm just too damn tired to life hack my way out anymore. But I feel no one is permanently the latter, because generally speaking it's not really... Tolerated long term except in very specific circumstances.
This comment shows that whether somebody is or is not "consciously faking it" is not a particularly illuminating question to ask. As Randall Collins says, sincerity and sincere belief are social products. It is unnecessary to posit a biological trigger for gender dysphoria, just as it is unnecessary to posit a biological trigger for Red Guard / Cultural Revolution type behavior.
> Frankly I just don't consider my gender an important part of who I am. The same is true of my sexuality.
I've heard this described as "cis by default," which seems as good a label as any to me. Like, apparently some people *do* have strong intuitions that they're a man and would be unhappy if that changed, but it doesn't seem to be a universal experience.
I don't know what you mean by "encouraged to take on an LGBT+ label." Like, have people seriously gone up to you and said you'd be happier if you identified as gay or trans? That seems pretty weird and rude, even by Bay Area standards.
AH! That's where the "+" in LGBT+ comes in. There's tons of ways to identify as "queer" while having an entirely conventional sexuality.
For instance, there's a nasty trope in not-that-old sitcoms of trans women "tricking" straight men. This pretty clearly grows out of discomfort with how arbitrary attraction is. If a person has feminine features and signifies feminity with dress and mannerisms, it's entirely normal for a straight person to find them attractive. In an extreme case you can imagine a person in public who has a penis (which obviously you can't see) but otherwise displays all the characteristics of a woman. Or you can imagine a non-binary person, born assigned female, who presents as very masculine. Or an intersex person with attractive features. The list of incredibly specific, incredibly rare exceptions to our understanding of "straightness" is long.
The mainstream progressive party line to all this is "uh, yeah duh. The only reason you thought this was a challenge to straightness to begin with is that our culture is rampantly homophobic. Also trans women are women." And that line is entirely correct. End of discussion.
But if you're seeking ways to both have a conventional sexuality and also take on a Label Of Oppression you could always identify as a demi-romantic gynosexual, which means that you're attracted to female-presenting people, and that you only develop strong romantic feelings to people you have a close personal connection with.
While I've never had a relationship with anyone other than cis women, and, to be honest, I'm rarely attracted to trans women, the fact that I think in principle that it would be possible for me to find someone other than a cis woman attractive given a circumstance where I didn't know she wasn't a cis woman is enough for people to urge that kind of labeling. It all strikes me as mostly harmless, but very very very silly.
This is exactly why I'm an atheist, and why, despite Scott declaring atheism to be no longer cool, I still think religion is harmful to society. There is such a thing as reality, and such a thing as truth. Magic talking unicorns don't become real just because you, a schizophrenic, hear them threatening to kill you. Gays should not be killed simply because your Bible or Quran says so.
Men do not become women simply by declaring themselves as such and coercing everyone to go along with the absurd falsehood. The world is the way it is, and although I'm certainly not the ultimate arbiter on truth, I don't appreciate being forced to agree to absurdities, because as Voltaire said, "those who can make you believe absurdities can make you commit atrocities".
Thanks for pointing me to that post! Despite our disagreement, I wanted to say that I'm a fan of your work and I appreciate that you took the time to reply to my comment.
In terms of your position, I disagree that "the Zambezi River is full of angry hippos" is a brute fact while "this person is a man" is negotiable. In fact, I'd argue the latter is more of a brute fact than the former. The former is only a brute fact if everyone agrees on the meanings of the words "Zambezi River", "full", "angry", and "hippo". The latter is a brute fact if everyone agrees on "this person" and "man". Every human who has ever lived can easily tell a man from a woman on sight, and they don't need to look at the sex chromosomes, because those chromosomes are nearly perfectly correlated with obvious physical characteristics and behaviors. Meanwhile, most people throughout history had no idea where the Zambezi River is or what hippos are. I'd go as far as to say that "this person is a man" is among the most brutish of brute facts that can ever exist, because how many other statements can get near-universal agreement across all cultures, religions, and ethnicities, and across all of history and prehistory?
Even if I grant that "this person is a man" is negotiable in the same way as the border between Turkey and Syria is, a negotiation is not an ultimatum, and the counterparty has the right to say no. Yes, the border between countries does not arise from some fundamental law of the universe. But what would happen if Syria declared 1 km^2 of Turkish territory to be Syrian and started treating the territory as if it were really Syrian, including sending military and police to occupy it and bureaucrats to administer it? What if it then declared that it was going to shame, fire, ostracize, and jail anyone who dared to continue calling the territory Turkish, including the residents of that territory? In such cases, almost everyone would agree that Turkey is justified in resorting to extreme measures to defend the pre-existing categorizations of "Turkish territory" and "Syrian territory", including the killing of Turkish soldiers and deportation of the Turkish bureaucrats and their families. No Syrian cries of "borders are just negotiated categories, not brute facts!" or "but 1% of my ultra-nationalist population would be really really sad if this territory isn't Syrian!" would get them any sympathy. Turkey would be well advised to respond forcefully despite the small amount of territory taken, because if Syria sees it can take an inch without pushback, why would it not take a mile? Why would it not make itself master of Anatolia?
And that's where I stand. The woke want to coerce me to use the language they invented five minutes ago and are still in the process of inventing, instead of the language of my childhood and my cultural heritage. They demand that I abandon the gender categories recognized by most human society since time immemorial, categories that reflect a fundamental facet of our humanity. I say no. I flatly refuse. I do not agree to the deal, and I will strongly resist all attempts to unilaterally enforce it. The transgender can call themselves whatever they want, and just like with all mentally ill people, I wish them the best and treat them respectfully. But the moment they try to force me to call a spade a hippo, under penalty of losing my job and even my freedom (e.g. https://www.cbc.ca/cbcdocspov/features/canadas-gender-identity-rights-bill-c-16-explained) if I don't, is the moment I lose all sympathy.
Give me a video and we can talk. It's often possible to make a trans person pass in a still picture, for the same reason that a Madame Tussaud's wax figure can pass as a realistic human (male or female). When a person is moving, and especially when they're talking, is when it's much harder to pass.
Or consider Nikkie De Jager, of Nikkie tutorials fame. She runs a makeup YouTube channel with _14 million_ subscribers, and had been running it for nearly a decade when just a few years ago, to the entire worlds surprise, she revealed that she was also trans.
Contrary to whatever you've been lead to believe, trans people don't want to destroy the meanings of words. In fact we mostly agree that "a woman" is a real specific thing.
But if your definition of "a woman" doesn't include Kim Petras or Nikkie De Jager, you're the delusional one.
I can confirm the rock climbing thing, one major reason I did it was because I wanted a funky activity to put on my dating app bios. Incidentally it's a pretty fun hobby that's deceptively easy to get into and with a surprisingly good gender ratio.
I worry that when both men and women are performatively picking up hobbies they don't actually care about just to appear interesting to each other, Moloch is winning.
I did this for my martial arts training, apparently, but unconsciously. I stopped those classes once I had a girlfriend and never went back. I couldn't put words to why, but the timing was so perfect that it seems hard to avoid the conclusion that I was doing it to appear interesting to women.
I've been rock climbing for years now, but I just wanted to do it. (It's very fun!)
But I'm also trying to psyche myself to join some dating apps and this makes me want to avoid doing that at all because what the fuck could I share with anyone that wouldn't be perceived as some kind of 'quirkiness signal'?
If it makes you feel better all human activity is fundamentally mate-signaling behavior so no matter what you're doing, why you think you're doing it, or how you express it you can't win
I'm somewhat sympathetic to the view that "drugs suck and psychiatry is bad". I wouldn't express my view that way, but I do think that psychiatric drugs are more harmful than is generally believed (and no, I'm not a Scientologist). My views are based partly on the unfortunate experiences of people who are close to me. But I've also been influenced by the work of Robert Whitaker, and especially his book, "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America". Whitaker admits that anti-psychotic drugs have a place in treating schizophrenia, but he advocates using low doses over relatively short periods of time. Whitaker's thesis is that psychiatric drugs may possibly work in the short term, but they can have paradoxically negative effects if used over longer periods of time (i.e., they worsen your condition instead of improving it). Here's a link to the Amazon page about the book. Whitaker is a journalist, not a clinician or a researcher, but I find his critiques to be convincing. https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing-ebook/dp/B0036S4EGE
I have to go further: I don't think that taking long term courses of drugs that affect the most complex organ in the body just based on them reducing the symptoms is a good idea in general. Antipsychotics seem to just make the brain into a stable soup for a bit, hopefully halting or breaking apart whatever malignant process was in motion. In the longer term you just habituate to the soup state. But then psychiatry can't explain what the full cognitive consequences even of taking SSRIs might be - till we have a comprehensive understanding of the brain, and yet routinely hands those out like candy while having no clue what they may make someone miss out on in their internal experience in exchange for the calm. Chemical treatment for personality issues should be the last resort scenario IMHO.
Say, 'anxiety' can be seen as a medicalization of something natural, and I'm saying this as someone who has had severe problems with people at one point. 'Give a man a fish vs teach them to fish' etc It's hard to distinguish what's the product of a real disorder and what's nonstandard personality or a quirk.
But then, most drugs have relatively clear impacts by comparison. For psychiatry not even the metrics of success seem to be sufficiently clear.
I can guess at why lithium is used in epilepsy, I have my hunches about how serotonin is used by the body for regulating attention modes and why antipsychotics might freeze an erroneous connection in the process of being formed, except all of those might happen due to dissimilar underlying factors, each can happen due to a myriad of different reasons - metabolic, or let's say computational, so it appears like the treatments are akin to hitting the car with a set of broad purpose wrenches, all of which may or may not have wider reaching consequences. But I can't tell what consequences are for making the actual HT whatever A signal even out uniformly and how that impacts your perception when it's unclear how much information the spikes carry. You're not going to get to see the exact impact of most of these in a petri dish, and just try understanding say what exactly the fractional anisotropy changes subjectively stand for on the scans.
Knowing that dopamine correlates with OCD doesn't let you understand how messing with it long-term will do for a specific personality type but it still may force the rest of the machinery to adjust in subtle ways along with it.
I'd rather not add entropy to the one organ that generally carries around the reasons we live for if that's avoidable. Funnily, I don't even have that trouble with nootropics(since you can take many of those only once in a while) or most illicit substances(despite the e.g. permanent openness increase factor for some) since it's generally not expected they be taken in courses - you'll forget how you normally feel sober by the time an SSRI kicks in, antipsychotics are _meant_ to strip awareness away from you, et cetera, so: it's just a fundamentally different matter when the drugs you take also affect your ability to judge their effects critically, day after day, to the point where Ship of Theseus applies. Risperidone is all too common and yet it turns off what, 16 receptor types indiscriminately while also affecting hormone regulation? It's carpet bombing where you can't even be sure whether the problem went away or just stopped being noticed on some level. Cancer drugs will tend to be more accurately targeted than that, I reckon.
At the moment, certain branches of machine learning probably have a better general idea of what the organ does than the people who service it medically and I'd rather not accidentally sacrifice self-awareness for comfort when there exist incentives to overprescribe.
But, eh, figure out futuristic brain implants that can record all the activity changes and let you compare and contrast the states directly somehow and you'd probably have my inner transhumanist approval. Plus, some number of psychiatric disorders seem to be resolved by just talk.
9. I’m adding my two cents to the discussion about transness. The teen years/puberty were dismal for me. Gender has a trajectory; as far as I could tell, “female” meant “will eventually have the process of Olivia Newton-John’s character in Grease,” ie, a socially-mediated larva-cocoon-butterfly experience ending in oneself capable of performing as butterfly.
I could tell that wasn’t happening for me but couldn’t tell why. It was long before the verbiage of gender was common. I stumbled on “Stone Butch Blues,” read it in my 20s, thought “that’s kind of like me” and proceeded to do nothing whatsoever about it. I still did not do “butterfly” very well so did self-destruction instead and wrote tortured poetry, some about gender and expectations.
Would medical transition have helped in my late teens? I think social transition, or better understanding of being non-binary, could have saved years of damage. Medical? Not sure. Pregnancy was terrible but I’m glad I had kids. And as a parent of two boys, one of whom is very, very cis-het, bless his heart, I realize there is a whole fabric of experiences of bodily maleness that I don’t & wont share. The whole crossing the legs versus the testicles thing? Just the beginning.
I think non-binary people with a uterus who date men can track a quasi-straight-female role for a while and have it work fine. I think there’s a lot of value in the lived experience of being outside important categories. I’ve had my nose rubbed in being different so many times I have no belief that that can be erased; I think “trans men are men” erases a whole stage and genre of experiences that are valuable. To society and to self. Am I ever transitioning medically? Doubtful. Should I transition more socially? Maybe. I got called “sir” last winter in a grocery store and then pitched my voice high and the poor kid freaked out. He apologized at least four times and I thought it was adorable. Long way from the days when seeming trans meant getting beaten up, which fortunately I never experienced myself, only saw. But I can’t get on board with the erasure of the outside ness and the transitionality. I don’t expect an Olivia Newton-John moment in any gender at this point. Medicating the kids will medicate away the gray area, which we need. Those of us in the gray need to describe and communicate about it more. I think a broader social recognition of a gender range is really important. Using medicine to group everyone at either end is a mistake. Plus yeah all the weird lifelong side effects. Also what “masculinity” I have is not due to high natural T; it’s right in the middle for a biological female.
Awakening to one’s transness should not devolve automatically into injections. Letting the first switch flip shouldn’t automatically trip the other ten. Gender is being mediated in sociocultural ways that we ignore at our peril if we make every little kid medically transition.
One of the most male-passing people I ever met maintained her very feminine name, never took T, dated men & had multiple kids. These are all real and valid choices.
I identify with a lot of what you're saying in this comment. Back in the 90s I adopted the term "tomboy" because that was the only way to vaguely describe my 'gender role' to people (and I was always eager to accurately describe myself to people, so they would not end up with unpleasant surprises where they expected me to have particular, say, interests). The whole trans conversation hasn't changed me, but it's given me much better vocabulary to describe myself, which I really appreciate.
It follows that I *personally*(!!! i.e. I am not saying others need to have this attitude) don't care very much how other people describe me - my interest is in communicating honestly about myself, what others do with that information is 99% up to them. Lots of people close to me still refer to me with she/her every day and that's a-okay; indeed, I'm actually glad I'm evidently not adding to their cognitive burden. But I am even more glad that I have the vocabulary to explain more of my subjective experience to people.
I don't have dysphoria and I don't want a body other than the one I have now for any other reason (well, maybe one with a better-functioning gut, I suppose, but otherwise I'm happy for it to be identical). But I'm into dinosaurs, computers, science-fiction, astronomy, I hang out on IRC and have happily coded in Assembly, and you'd have to pay me a lot of money to get me to put on a dress, any make-up whatsoever, or ride a horse, and an *obscene* amount of money to make and raise a child. (Yes, these are stereotypes (fortunately ones that are getting increasingly outdated), but that's more or less what gender roles consist of. It's possible to talk about them in other terms, but this way is easy, and I didn't want to waffle on forever. :) )
You have completely misunderstood the transgender divide.
The actual truscum argument goes as follows: there are two groups, one group of real trans people and a second group of social-contagion sufferers. There is no similarity or overlap between these groups, no "switch" that toggles individuals between the two. The second group is delusional, and it would be nice if they could be prevented from pursuing medical transition in their teenage years...after that, whatever...you be you.
Is the distinction mild vs. severe, or is it hallucinations+disordered thoughts/delusions+catatonia vs. just hallucinations? Hearing voices is the marquee symptom of psychosis, but also seems like the most manageable.
Thanks for writing this, this is the kind of article where if I'm late to work because I read it then it is worth it! Some killer quotes. One omission from the discussion of the group thing is Nationalism, but people don't do that like they used to, in the well off West at least who would identify them selves by country of origin in their three word bio on this site? But Nationalism is pre Diamond Age (Stephenson reference), the Phyles he talks about in that book always fascinated me. Partly because there is unlikely to be a country that I'm really in sync with values wise, but there could be a Phyle.
Stephenson was right on about clothing patterns coming back in fashion after HD TV would prevent them looking crap.
On transgenderism, I think you've misunderstood the divide. There is a group that seems genuinely (I say "seems" because outside perspective can't ever be sure, but I do not doubt it's true) repulsed by their own body and sex, and really wants to change. This has been in existence for quite a while, quietly in the background of society. Estimates put the frequency at 1/X,XXX or less of the population. Recently, riding the coattails of the LGBT movement, far more people are identifying as trans than ever before. This isn't universal, but there are subgroups where the prevalence is around 1/20 (female teens in the UK) or more. That's two orders of magnitude, or higher, more common than any reputable estimation of transgenderism.
To me, it looks very much like the current generation's Goth or Emo. Which meets the criteria that teens are often looking for - not approved by their parents, cool to peers, different from normal. Lots of teens look for that stuff. There are some other elements making it even more enticing, in that you can get adults at school and other locations to call you by whatever name you choose, and often treat you better than they might otherwise. In terms of teens following fads, it's not overly concerning, and most people move on from it as they develop their own identities and become more comfortable with the person they are. The only issue I see with this is that many parts of society want to encourage real trans individuals, and not allow any discouragement (lest they feel even more miserable than they often do already). This impedes the normal process whereby these individuals move on to other styles, but that's more minor. What is a really big deal is that some individuals who are not really trans are convinced that they need permanent surgery and life-altering medications. Then, they have no option to ever really go back. This would be a problem if the incidence was 1/X,XXX, but it's a massive problem if the incidence is 1/XX.
I feel like we need to put gatekeepers back on the process, which used to be standard, and weed out those individuals who are merely confused and quite likely to change their minds later. I doubt that psychiatrists did a great job of this before, but surely better than 1/XX of teenage girls being pressured to get permanent surgery and told that they really are boys and should accept themselves as boys, even if we know that can't possibly be true (at that level of frequency).
All of the evidence I have seen says 1/X,XXX or fewer, until very recently and then it's a mess to figure out.
Are you suggesting that dysphoria can be caused by outside factors? I'm not opposed to that idea, though I would think the pro-trans side would have a lot to say against that. Because women have been treated very poorly in pretty much all societies in all human history, and did not become trans, that seems to imply something new, possibly related to egalitarian ideals, that would cause this? I'm not sure what else you could be saying. I would consider it laughably false to say that women are treated worse now than in previous times in history.
Genuine question (not a "gotcha" or anything)—have you ever sat down with a transgender individual (either irl or online) and talked about what being transgender means to them? I'm asking because your description does not sound like what I've heard described in conversations with my trans friends, who when pressed, often describe something like an experience of phantom limbs—they sometimes literally feel a physical (or psychological) sensation in locations outside their bodies where sexually dimorphic body parts would be. Those I've talked with who have gotten surgery have also described it as being incredibly helpful, almost completely removing their prior sense of dysphoria, which in some friends used to be so bad as to make them suicidal. While having "the option to go back" would be *nice*, I don't think that that downside is so bad that those who want surgery shouldn't be able to get it, considering this.
EDIT: It sounds like there are some people who actually do fall into the "I'm doing this to be cool" category. I don't live in an area where being transgender is considered cool at all, so I cannot really speak to that. My intuition is that those people still make up a very small minority compared to "sincere" trans people, if Scott's friend group is anything close to a representative sample—one friend knows one person who does it to be trendy (out of ~10% of Scott's total number of friends), and this is in the Bay area!
Yes, I've had both in person and online discussions with trans people. That's why I started with agreeing that they seem genuine.
My problem is two-fold. First, the frequency of individuals identifying as trans is clearly significantly higher than ever known, to the point that there's no plausible scenario where this has been the historical norm. From my viewpoint, the frequency can be explained in only two ways, 1) You can convince someone into becoming trans, that would not otherwise be trans (obviously bad for the individual and for society), or 2) You can convince people into claiming they are trans (potentially bad for the individual or society, but maybe not, depending on what they do with it). Secondly, there is a non-trivial percentage of individuals (I have heard high and low estimates, but really don't trust the numbers on either side of the question at the moment) who formally desist. They claimed to be trans, went through all the normal stages and said all the right things, and then later changed their mind. I know people personally who have done this, including at least one who went through irreversible stages of transition prior to desisting, and several who were at least taking hormones before changing direction (girl -> boy -> non-binary or similar) or fully desisting. I've read a number of first hand accounts of people who got pressured into getting surgery, then changed their minds, filled with regret. I get why trans individuals are encouraged to get puberty blockers and surgery as soon as possible, but the timing is very poor for other reasons - namely that teenagers frequently have no idea who they are or what they want out of life, and that often changes by the time they get into their 20s. I fear we're going to have a generation of people, especially young women, who regret some big decisions that they can't ever reverse. We may not know this for another 10-15 years, after many thousands or hundreds of thousands of people have made those decisions. The dysphoria they would feel at that point could be much worse than they felt if they had just waited, and could potentially be larger (or at least more numerous) than if we denied the choice to real trans individuals totally. I'm not in favor of that last option, but hopefully you can see the point that if 10s of thousands of individuals desist after surgery, and 10s of thousands are happy after surgery, we haven't resulted in any net improvement in happiness at all!
I think we can definitely agree that if the majority of people desist after surgery, that would be pretty horrible! May I ask at what desistance percentage you would say that medical transition is almost certainly an overall good? It might be possible for us to come to a testable crux here, which I like doing when possible.
That's hard for me to say with certainty, but I'll give you some of my thoughts about it. Obviously different levels of transition have different levels of cost (both for the individual psychologically, and also the actual cost in money, time, resources, etc.) If someone is happy with just hormones, or even better, happy by wearing different gendered clothing, that's going to be much less problematic than full surgery and lifelong hormone treatment.
To try to keep it apples to apples, I'll try to only look at full transition verses full desist. Because there are costs to surgery (as above), and also surgery is not 100% able to perfectly change a person's sex, the number is certainly less than 50% desist rate to be considered medically good. How much below 50% is too hard for me to say, because I cant estimate how much dystopia a person might feel even after surgery, due to it being imperfect. If surgery could perfectly transform a person into their desired sex, including functional reproductive systems, the number would still be less than 50%, depending on how much cost we consider relevant - a notoriously hard thing to value, happiness verses the cost of medical intervention, especially one that can be considered elective (which I also get that some people consider it life-saving, and would not therefore consider it elective).
Okay, fair enough. Calculating this sort of thing is very hard, and it isn't unreasonable at all to simply say "I'm not sure".
It should be pointed out that *every* medical procedure has some amount of desistance—I can think of plenty of people who deeply regret taking chemotherapy for example, even when they know it saved their life! So desistance existing in a very low percent of cases isn't too worrying to me, the problem only comes if that percentage is sufficiently high. Personally, I'd say if it's above 10-20% I would strongly consider putting more restrictions on access, though from the (admittedly imperfect) studies I've read, it seems to be closer to ~1%.
If I had to put a number on it, I would have said 10-20% might be where I would draw a line as well. It's nearly impossible for an outsider to even guess at how strong a feeling of dysphoria someone else might be feeling, but if dysphoria were stronger or weaker, I might want to move that higher or lower.
As I said before, trying to get an actual answer to the question of desisting is nearly impossible. I've heard ranges from your ~1% to a clear majority. It appears that the topic is so central to the culture war that nobody studies it for disinterested reasons, and therefore every number is suspect.
Desistance alone doesn't deal with the possibility that someone could be mistaken about whether transition was a positive. We can't run the counterfactual of if they had never adopted the identity to begin with. If I had transitioned in my youth and grown to accept that outcome I couldn't have known that I would have grown up to be a well adjusted many otherwise.
It's good not to ignore possibilities, but I don't think this one has the evidential weight you suggest. The feeling that "the grass is greener on the other side" is pretty common, but that counsels against making it easy for people to transition in various forms, given the costs of transitioning. No?
The critique is to the experiment. Just because someone doesn't desist doesn't mean that transitioning wasn't a net negative for them. Because they may have naturally improved without transition. I think this is most important for kids put on blockers, because going all the way through puberty could have actually been the thing that would have cured their dysphoria.
This concern and others like various cognitive biases downstream of the sunk cost fallacy is why I don't think we can naively use desistance rate as a measure for how good our diagnostics tools are and thus measure the net good.
For a trivial hypothetical imagine that every single person who is diagnosed for blockers as kids would have grown out of their dysphoria but after going on blockers and adopting the identity as "trans" with the associated bucket of "transphobia" to place all their problems they go on to transition and struggle for the rest of their life with the various issues trans people have but within their memeplex aren't able to consider de-transitioning or even think of it as a betrayal to their identity and ingroup. So none of them desist. That world would imply that transitioning is always a net negative but yet we'd see very few detransitioners making the above proposed experiment yield a false positive.
Minor (admittedly improbable) comment on: "First, the frequency of individuals identifying as trans is clearly significantly higher than ever known". For all I know, there might be a _biological_ cause for this (perhaps analogous to the odd increase in obesity - presumably _something_ is changing set points). Maybe a weird effect of a contaminant, maybe (unlikely!!) a weird effect of pervasive fluorescent lighting, maybe even a weird side effect of ameliorating some subclinical deficiency. Lots of possibly-biologically-relevant factors change over decades.
I would not be surprised if we learn this is the case in the future. I know that there are easy-to-perform experiments in which one can effect the “gender presentation” of animals like mice and frogs, though I have no idea how transmissible to humans those effects are.
Good point! I confess to a (frankly, terrifying) suspicion that persistent year over year reductions in testosterone levels and sperm counts likely correlate with incredible amounts of polymer contamination in every conceivable part of the biosphere, particularly given that we've known that certain classes of polymer are powerful endocrine disruptors since the 1920s....This is also my pocket explanation for the obesity increase given that AIUI it's been observable in non-human animals and not just humans since the 1970s.
Relatedly: can we please take plastic contamination more seriously as a society? Surely if it's actually having tangible effects on increasing gender dysphoria that's a BFD (not that obesity and testosterone decline weren't enough already).
" From my viewpoint, the frequency can be explained in only two ways"
The third explanation, the one trans activists use, is that as societal pressure against being trans weakens more people realise they're trans, and that eventually the number of people identifying as trans per year will become a straight line, as happened with left-handedness.
While that's certainly a possibility, it seems beyond reasonable to think that the increase could possibly be so dramatic as what we've already seen. At least, if those who now identify as trans feel as strongly about dysphoria as the historical cases. If a significant percentage of those now identifying as trans could have been fairly to significantly happy without identifying as trans, and would historically neither identified as trans nor had significant negative effects from not so identifying, that has different implications for the discussion.
AFAB non-binary-ness and classic male-to-female transness are really different phenomena with totally different causes and shouldn't be limpoed together as the same thing. I hate the total lack of nuance forced on this discussion.
Also as someone in the trans and LGBT community, and the medical industry, I've never encountered many desisters. Nor have the surgeons who perform these surgeries.
Trust me, surgeons at the University of North Carolina Hospital absolutely would not perform surgeries that has a substantial likelihood of resulting in desistance. (And they aren't especially gate-keepy)
I managed to get myself to feel a phantom tail after enough time imagining one, so it seems reasonable to me that an individual who desperately wants and imagines any body part long enough could feel such phantom body parts.
I also recovered from intense gender dysphoria caused by self-hatred, so I know experientially that there can be similar (or even identical?) dysphoria caused by non-trans experiences. In my case I hated myself so much that the idea of becoming a new person thru gender transition was a very appealing answer. It was easy to convince myself that my self-hatred arose from being trans, rather than vice versa. I felt disgust at my body and intense physical sensations of wrongness.
I believe there are sincere trans experiences, 100%. But I also had the personal experience of having dysphoria switched on by social contagion and depression, and later switched off by treating the depression and self-hatred. I haven't felt gender dysphoria in 7 or 8 years.
I've talked to a pre-teen 'girl' that – AFAICT – is convinced that they're non-binary because "I like doing boy things.". That seems potentially very terrifying (and an ironically vicious defeat of 'feminism' too).
Why is that necessarily bad? It’s certainly a very different way to think about gender than you may be used to, but I highly doubt they’re going to get permanent surgery as a result (almost no non-binary people do, as far as I’m aware), and if it gives them a sense of community and self-definition, I don’t see what’s the harm.
The 'I must be non-binary because I like to do some stereotypically boy/male things' is sad enough on its own. Where did they get the idea that anything in particular is a 'male thing' versus a 'female thing' or that being a girl and enjoying a 'male thing' has anything to do with transgenderism?
It sure _seems_ like kids are learning really grotesque stereotypes of sexes/genders that, until very recently, would have been considered 'harmful' themselves. (I still think those stereotypes are, for individuals anyways, very 'stupid'.) I'm pretty sure they're picking these ideas up from school. I'm also pretty sure no one is intentionally pushing kids to be non-binary or transgender, but I also think kids are picking up on the obvious subtext that non-cisgender is 'better', if only because of the obvious, visible, and significant effort by the relevant people to 'be inclusive'.
If they were – 'naturally' – non-binary, or transgender, or anything else, even cisgendered and heterosexual; that'd be fine. Dysphoria seems generally bad tho, so I wouldn't choose that for them myself. But I still find modern ideas about gender confusing, so I'm skeptical that kids this young, or the adults teaching them whatever it is they're hearing or seeing, have a better, coherent, or consistent understanding of it either.
But, yes, I admit the chance that it will lead to permanent surgery or even, e.g. hormone therapy, is probably pretty small. But I also don't think any resistance to that idea at all is socially acceptable and just the fact of a child that young jumping to that conclusion (that they're non-binary) on such weak evidence is mildly frightening.
It's astounding how retrograde a lot of modern liberal discourse is. It used to be that if a girl liked to play with trucks, she was still a girl and should be proud of it, don't let anyone tell you who are!
I agree this is a good statement of the trans-skeptical position.
I haven't met anyone who clearly falls into the "just the equivalent of Goth" bin. But some of my trans friends say they have, and I trust them, since their incentive is to say the opposite. And I don't know a lot of actual teenagers. I'm sure there are nonzero examples of these people, since there are nonzero examples of everything. But I could believe they're 10x more common than real trans people, 10x less common, whatever. I think these would imply pretty different levels of gatekeeping.
I'm in a weird situation, which is that I'm in the Bay (maybe trans capital of the world?) and the rationalist community (autistic people are trans at 10x normal rate, draw your own conclusion). Even though I don't select for trans friends and am known to be Problematic, about 10% of my friends are trans. As far as I can tell, all of these people are in the "really real trans" bin, which makes me wonder how vast a supply of fake trans people there can be out there compensating for this.
I am sometimes asked to gatekeep trans people. I want to admit here, down in the comments section, that I am terrible at this. Psychiatrists don't have special creepy mind powers to figure out when people are lying (except sometimes forensic psychiatrists), and a person who's pretty smart, Googles "what do you say if you're trans?", and is able to cry convincingly would probably fool me. The only real filter you can use to block these people is to make transition a kind of miserable and drawn-out process which nobody would do unless they absolutely had to, which was the standard ten years ago. But unsurprisingly, this did make a lot of trans people miserable.
Hopefully we'll have more data on this in a few years when all the teenagers grow up and have a chance to decide whether or not they regretted their actions. I predict most of them won't, but I'm up for being proven wrong.
I feel like in the context of talking of transness as a trend we should also talk about the rising phenomenon of self-identified trans people refusing medical transition. "I hate my body with a burning passion and literally feel like there's something else between my legs than there is" is not the dominant narrative anymore, at least not on tumblr, afaict. Strong dysphoria is not considered a prerequisite to transness in those circles. So if falsely identifying as trans is indeed a thing (I think it might, but I will not make a guess as to which degree) then what seems to follow *isn't* "teens transition and then regret it" but "teens experiment with pronouns and fashion" which isn't really any different from any time before.
I don't think it should matter, but I am five years into hormones (testosterone), yet have no surgeries planned, because I do not feel a strong drive to do so. I sometimes wonder whether I should stop T, because I don't desperately *need* it, I just kinda wanna, and have most of the time for most of my life.
And as an aside, most people who detransition seem to do so for ideological reasons, not because their feelings changed.
seconding your latter comment—there's a great study I read a while back (can't find it offhand) which interviewed ~100 trans people over ten years, and those who de-transitioned universally described having a friend group that didn't support their descision.
I agree that gatekeeping would be very hard to get right.
I do know a fair number of teenagers, including some who strongly appear to be the Goth equivalent for trans - going back and forth, changing their name multiple times. I know one who's gone by at least four names and 3+ different genders since January. Exploring who they are can be okay, but if they decide (or get pressured) into non-reversible surgery, that could end up as a major problem. Even hormones can be a big deal - weight gain, body changes, etc. that very likely will stick with them for a long time, if not permanently.
What you're talking about is gender-fluidity, which is a mindset/philosophy that I don't think is at all likely to lead to permanent medical surgery. The idea is more of viewing gender as a presentation or even public performance, and that some days you might want to present yourself to the world through differently-gendered lenses. They are often explicitly and consciously doing it for the "aesthetics," (though this is not the case for everyone, naturally) and I don't think there's any real potential harm or danger in that, as long as they act responsibly. Everyone knows that surgery is not really reversible, and no sane person is going to commit to that if they know they're likely to continue experimenting with their identity—it's something you do only once you're quite certain it's what you want for the rest of your life (though even still some people may be mistaken, of course).
I agree that performance is generally pretty harmless. It also reminds me a lot of Goth/Emo performance, which is why I started this conversation with that observation.
I think it's important for society to push back enough, and curb some of the more radical tendencies of the pro-trans movement, to make surgery and permanent/semi-permanent changes less accessible. We wouldn't want to get into a situation where a performance carried out for a few months or a few years gets conflated with someone living with significant dysphoria and both end up with surgery or irreversible choices.
Are you absolutely certain they're really as accessible as you think?
As a "really-real" trans person or whatever, having been this way for about a decade, in a liberal medical bastion in the US, even though I'm smart, fairly well off, and better than average at navigating beauracracies, I _still_ _constantly_ run into hurdles even just getting hormones, not to mention surgery. It's a year long process at absolute best with like 4 different doctors I need to see.
So from living it it's just so hard for me to imagine this being too much access? And scares me that people want to make it even harder.
What happened to people owning their bodies and informed consent? Why shouldn't an adult have access to surgery if they want to, for literally any reason?
I don't have an issue with adults getting surgery or otherwise making these decisions. My concerns are entirely about children, who often lack the context or psychological capacity to understand the gravity of a lifelong decision.
I'm not totally convinced that HRT is totally irreversible. I mean, we have HRT treatments that go both ways. It stands to reason that you'd just dose the reverse if you changed your mind.
It's also, at the moment, a moot point - in most places the most dramatic thing a trans minor can get is a puberty blocker. At the moment, gender affirming surgery is definitely inaccessible enough, and some would say far too inaccessible.
Hormonal treatment can lead to permanent effects, including infertility. This is especially true if taken early in life. Puberty blockers definitely have permanent effects, even if only to change body type (that's the point...).
Thank you for this blog. As always, well reasoned and informative.
I found the NYT piece highly upsetting. Encouraging psychotic people to abandon their medication is immoral and irresponsible.
A “caring” therapist convinced my very ill sister to give up her medication early last year. She’s spent the last 12 months in and out of private and state institutions- her admissions have been both voluntary and involuntary. It has been a traumatic and costly journey. Made so much worse by the fact that no one would have been put through this trauma had her therapist not been so irresponsible.
The journalist who wrote the NYT piece and the editor who approved it should have spent time with the families of the people they hold out as examples of people living without their medication - I’m sure their families have a very different story to tell.
Heard a joke once. Man goes to the doctor. Says he has anxiety. Says he can't even work. Asks doctor about a cure in a week. Doctor says: "Medication does not work in one week, however Great Inspirational Speaker Pagliacci is in town giving a speech about how he overcame anxiety. Go and see him. That might work." Man bursts into tears. Says: "But doctor.. I am Pagliacci."
Great article but there really is no reason to be so even handed. Psychosis is not equivalent to other differences people may have. Psychosis is equivalent to, for example, having a broken arm -- something in the brain is not working correctly.
1. Almost invariably there is neurodegeneration with untreated psychosis -- MOCA scores fall, SPECT neuroimaging shows a brain getting worse and worse, even structural MRI which is less sensitive will pick up a brain that is in decline
2. The above #1 does not apply to people who may have this or that belief, ie, to the differences between people -- it applies to psychosis.
3. Patients sometimes say things that could be diagnosed as hallucinations but they really aren't (e.g., "my mind keeps saying to check this again two time or else" eg in OCD)
4. Psychosis seems to occur only in humans -- not in other mammals. (Similarly full causal reasoning seems to occur only in humans, not in other mammals.) It is most probably a design flaw, i.e., occurred because of a tradeoff, rather than a typical disease, hence seems to involve not one but thousands of genes.
As a European, this extreme hunt for quirkiness that you describe seems alien to my experience. Is it an American thing? A Californian thing? Or is it happening in Europe too and I was simply lucky or inattentive enough to not notice?
It's certainly a Cali thing. I sometimes suspect that it's a form of conspicuous consumption within a culture which has tried to stigmatize explicit conspicuous consumption as 'classist.'
Yeah, I suppose it's possible that the conspicuous consumption in CA has gone so crazy that something even crazier was required to break ties among really rich teenagers with materialistic, competitive parents.
It's primarily a suburban and West Coast Upper-Class thing. Most other people in the US have some kind of regional culture they can plug into to have a sense of identity, but the WCUC never managed to cement a coherent identity (although I'd argue things like rationalism are an attempt) and suburbs are inherently designed to strip humans of their identity and replace it with a cardboard corporate McSelf.
I mean, you can find pockets of it anywhere if you turn the sensitivity high enough- turn it up to max and you can describe every aspect of human behavior not essential to survival as an attempt to be quirky. I consider quirkiness-as-personality to require that pathological component where there seems to be little genuine interest in the hobby beyond a surface attempt to augment the personality- not out of hesitancy, but out of some bizarre reflexive detachment or vapidity.
I wondered about this as well, coming from New Zealand, but then I haven't ever done the Dating Scene(TM) thing, so I wouldn't put too much weight on that.
"The DSM says that you can’t diagnose a psychotic disorder if someone’s in a cultural context when they’re expected and encouraged to hear voices - which sure does sound like the experts think cultural context can affect whether you hear voices or not."
This sounds a lot more like the DSM being culturally relativistic and not wanting to tell cultures their sacred traditions are actually the result of mental illness, plus the usual "well if it's not upsetting the patient, we can't call it mental illness". I don't think it says anything about whether or not anything is actually mentally different.
> I don't think it says anything about whether or not anything is actually mentally different.
I'm not sure about that. The purpose of this piece of the diagnostic criteria is to say ok, given that someone is hearing voices, how much does this increase the likelihood that they are psychotic? It's not the only diagnostic criteria so it's one consideration among others.
We can translate this to a familiar cultural context, though. If someone is proclaiming they've heard the voice of God, and you are trying to predict whether they are psychotic, it matters whether they are a devout evangelical christian who believes in speaking in tongues and the whole nine, or if they were an atheist just yesterday. It matters because it seems to be the case that when an evangelical hears the voice of God, they're a lot less likely to be having a corresponding complete mental decompensation.
As to the very specific neurological thing that is happening when someone has an auditory hallucination, it probably looks similar whether it's the evangelic case or the atheist (who is in the throes of psychosis) case, for that narrow phenomenon alone. But the phenomena it exists in concert with would look very different. It might have a different proximate cause and immediate effects. The global picture would be different, and that's what the criteria attempt to assess.
More specifically, the purpose of the DSM is to provide consistent guidance as to whether one is or is not hampered by a particular disorder. Every diagnosis requires "yes" to X of the following Y questions (eg yes to 4 of 7) plus "is this causing them problems in their life." We wouldn't want make it easier for members of certain cultures to receive positive diagnosis. Additionally, I would guess that if you are experiencing audio hallucinations due to schizophrenia, you are probably getting more variation than just God providing guidance/moral support.
So you write a whole bunch on how the DSM is very focused on whether or not something is actually causing problems for someone, but completely ignore how different cultures are going to change whether or not something is causing problems for someone.
I do not think the DSM would label someone psychotic but not mentally ill. Furthermore, I strongly doubt that this is merely just them trying to find the precise cause, and I definitely don't think it provides any proof for social contagion.
If you command Barack Obama to come to your birthday party, and he doesn't, that doesn't prove he doesn't exist. He's a very powerful person, and he's in charge of what parties he goes to, not you.
However, if you don't believe he exists, and he shows up at your birthday party, you'd have to be deliberately ignorant to keep on not believing in him.
So I'm one of those Christians who has heard God. Hi! Just popping in to say that there are a lot of us and we are the way we are because of being unwilling to deny things that have actually happened to us.
1. Internal. 2. Probably? Same as being unable to "hear myself think" because of distraction. 3. No, no, yes. 4. & 5. See #1. 6. I suppose I could be confused as to whether it's God or my own thoughts, but in practice, I don't think I ever have been. How to tell the difference is a matter of deep theology and spiritual practice.
7. The mark of something living is that, as it grows and unfolds itself along various dimensions over time, structural complexity is revealed that was not evident at first, but, after the fact, shows itself to have been necessary all along. As the DNA in a seed unfolds along many dimensions to reveal the structural complexity of the adult plant, which ends up having been the necessary unfolding of that specific DNA all along. Or how the ending of a great novel or film makes all the seemingly-unrelated information from the beginning "snap" into place, so that, although you couldn't have guessed the ending, after getting there, you see that it was the only ending possible.
God hasn't spoken much to me, in my life. What he's said has been grammatically simple, but had much, much more of this living quality than I'm able to produce, myself. I don't think that quite counts as linguistic; but he certainly has communicative capacities that I don't.
Oh, yeah, definitely different things. I haven't read the Jaynes book Scott mentions (although I have a copy somewhere!), but as far a I can tell from my own life, the experience Christians have of hearing God usually has little in common with a psychotic experience.
Do you think that if someone performed a study comparing the proportion of the Christian, Muslim, Tenrikyo, Mormon, etc, population who claim to have personally heard God, Christians would come out ahead? Why or why not?
I think evangelical christianity (baptists and the like) would beat most other sects of Christianity, Buddhism, and Judaeism, because they have a tradition of hearing from god. They would probably come out behind any religion that used drugs (spirit walking type stuff), and more radical religions like radical Islam.
Also, are mormons not considered Christians?
EDIT: I also think an important thing to consider is what threshold people put “hearing from God” at. Among agnostics (which I am), assumedly 0% have “heard from God,” because if they had, they would stop being agnostic. But I have had a dream where, if I wasn’t already agnostic, it would’ve probably been coded as “hearing from God.” And honestly I don’t think I’d have even needed to be in a religion with a strong tradition of such things to cross that threshold.
Generally only mormons consider themselves Christians. It's usually delineated by sacred book additions everywhere else. Judaism = Torah. Christianity += New Testament. Islam += Quran. Mormons += Book of Mormon.
I would consider them Christians, as they also believe that Jesus Christ is the son of God, died and was resurrected, etc, etc, but if they're right all the other Christians are wrong in a way that is not equivalent to how if the Catholics are right, the Protestants are wrong.
The Quran has an account of Jesus being born of a virgin, but notes that creating things is easy for god, and that this doesn’t make Jesus a deity in his own right. It has an ambiguous account of the crucifixion, implying that something supernatural happened but the Christian account of Jesus’ resurrection isn’t accurate. Also, the doctrine of the trinity has never been accepted by Muslims, who believe that there is 1 and only 1 god, and 3 does not equal 1.
> They would probably come out behind any religion that used drugs (spirit walking type stuff), and more radical religions like radical Islam.
In the books I've read about Islam, hearing Allah's voice does not happen, and any Muslim's claim to the contrary would be heresy. I think one book explicitly said this, but I can't recall which. I'm referring to mainstream (i.e. non-Sufi, non-liberal) versions of Shia and Sunni Islam, whether 'radical' or not. (The category of 'radical Islam', although not meaningless, seems to be more political and sociological than theological.)
This is a question that's pretty easy to map to the "powerful person" framework. You could ask, "Do you think that if someone performed a study comparing the proportion of the Democrat, Republican, Libertarian, Socialist, etc, population who claim to have personally talked to Barack Obama, Democrats would come out ahead? Why or why not?"
Democrats would probably come out ahead, but maybe not. Because Obama is a powerful person, he could talk to lots of Libertarians or Socialists, if he wanted to. And if a Democrat got mad because Obama was talking to a Libertarian, Obama could very properly say what God says in the book of Job: "Who are you to tell me what to do?" [chapters 38-41, Matt's paraphrase]
Also, you would expect all the different political groups to have really different ideas about Obama's character, because they each have a different (and complicated) relationship to his power. His power makes the relationship complicated and subjective. And the different ideas of the Republicans, Democrats, Libertarians or Socialists who had actually met and talked with Obama would be founded--legitimately, in their own minds--on first-hand evidence, talking with the man himself. And yet, despite inspiring different descriptions, Obama really does have a specific character, and some of the descriptions are more accurate than others.
(Edit: And, of course, some people lie about Obama, or deceive themselves about his character. Because he's powerful, and they have a subjective relationship to that power. If God is like a powerful person, you would expect to encounter a lot of widespread lies and self-deception about him, too.)
I can imagine how you would convince a skeptic that Barack Obama showed up at their birthday party, but not how you would convince a skeptic that you are hearing God's voice. At the worst, you can bodily push the skeptic into Obama, but you can't let them into your head to listen. If the skeptic keeps insisting that they haven't bumped into anything, you know that's false. You might try to take the same line with God's voice - say that they are hearing the voice but are stubbornly refusing to listen - but you can't provide any evidence that the skeptic is hearing the voice, because you can't let a third party into the skeptic's head any more than you can let the skeptic into yours.
Yup! That's why the thought experiment is about evaluating evidence that you've received yourself, not convincing a skeptic you have evidence even though you can't show it to them.
It's not intended to convince anybody that God exists. Mostly it's just a window into what things are like from our end. But I think it could also serve to debunk a certain flavor of proof that God doesn't exist.
"if someone had been willing to do this to the original hippies we might have saved ourselves several decades of weird art and dumb politics."
I'm sensing this is lighthearted, but still. Why denigrate the hippie movement like this? There is a major war going on right now and the hippies were the ones whose politics were trying to prevent the US from the Vietnam and Iraq wars. I guess I've got too much love for people who thought they were on a breakthrough of the human condition, only to grow up unable to prevent the sad realities, on their deathbed seeing Trump trying to overthrow US democracy. Basically proto effective altruists.
I genuinely think the hippie movement has been really damaging. I'm grudgingly okay with Hearing Voices, but I think there are versions of the same tendency (eg Thomas Szasz, Gregory Bateman) which are entirely about denying mental illness, and that those groups have done a lot of damage. I think there's a clear line between that and "Defund The Police" style social initiatives that say if we just stopped trying to treat problems and make them better, they would go away of their own accord - this definitely isn't true and has made many things worse. I think the anti-nuclear movement set technology back 30 years, and various anti-science forms of hippieism (including but not limited to blank slatism) set the social sciences and some harder sciences back 30 years.
I agree they were right on war, and directionally right on some non-nuclear parts of environmentalism. I guess this goes back to a question of whether, in the absence of ideological movements whose ideologies do bad things, everyone would just be rational and do good things, or if you need them to counterbalance other even worse ideological movements. I'm not sure. I still wish someone had tried to knock some sense in the original hippies and tone them down 50%.
Does the "defund the police" movement actually say that "we should stop trying to treat [police-related] problems and make them better"? I think their steelmanned point is much closer to "police are a cost-ineffective partial solution to the problem (or may even contribute to the issue), and we should be spending those same resources on something more effective". That isn't *necessarily* denial of effectiveness, though in practice it can often bleed into it.
"Steelmanned" is an attempt to deal with the argument on its own grounds. It is not (necessarily) what they are actually saying, which is "defund the police".
We should at least do them the courtesy of believing them.
I feel obligated to say that I'm yet to find a 'defund the police' person who doesn't immediately tell me three other things the money could be spent on, usually including housing and poverty aid and trained mental health professionals deployed on front lines.
I'm in ideological agreement with you, except in that you ascribe these negative things to Hippies far more than their stronger link to more positive things. Polyamory and drug experimentation are directly descended from the bravery of the hippie generation to be the first to significantly contest the conservative traditional way of life for a thousand years.
I'm not aware of any link to anti-nuclear, other than that the Bay Area is the cultural descendant of hippies and is at the forefront of pushing forward nuclear in the US today.
I guess I'll just reiterate that, in spirit, EA / rationality has the same countercultural forward progress view (it's not coincidence they're based in the same area hippies were 60 years ago), and that EA / rationality will get some things wrong, and hopefully not roasted over the coals because of it like you're doing with the hippies.
Bias: my aunt and uncle are actual "summer of love" Bay Area hippies in contrast to the rest of my family.
I'm sorry but that's just absurd. People have been sleeping around or engaging in complicated non-marital affairs for centuries (read eg, the memoirs of Casanova for plenty of examples of people living what we would now call polyamorous lifestyles), and people have been taking drugs for millennia. The prohibitionist drug war started by Nixon is new and weird, not traditional culture for 1000 years. Plenty of cultures had stuff to say about alcohol at various points in history, but plenty freely allowed it too.
Name me a modern polyamorous culture. Niche groups throughout history that didn't become prevalent are a historical dead-end. That hasn't happened with hippies. Same thing with drugs. People have indeed been taking drugs for millenia. War on drugs isn't just Nixon, it's in every conservative culture from India, China, Japan, Russia, etc. I'm not talking about alcohol here, that's clearly a global traditional drug. Our modern use of Cannabis, Psilocybin, LSD, MDMA, PIHKALs and TIHKALs are directly because of hippies. I'm actually amazed this is an unorthodox view here when the rationalist core, and the reason for this very blog, live 50 ft. down the road from UC Berkeley and Sasha Shulgin. Computers, drugs, polyamory, civil rights, human progress, charity, eccentrism; it's not a coincidence, it's a direct lineage.
This analysis surprises me; I was a young adult around 1980, and if the remnants of the hippies were anywhere, it was in the anti-nuclear (both weaponry and power plants) movement.
This is interesting. I always thought about rationalists as partially descending from hippies - I mean, you are in the same place, and some similarities are apparent (e.g. polyamory, drug experimentation, moral universalism)
It's a little concerning that for all the rationalist hoo-rah about getting to the bottom of things, they must be so concerned with the future, that they haven't even realized why they're centered in Berkeley in the first place.
Unfortunately, "Those who do not learn history are doomed to repeat it."
I wonder if it's that "uncanny valley" / tribal proximity issue, where peoples who are very similar, but not quite, end up very focused on the ways they're different, and go to war with their neighbors over it, unaware or uncaring how they're actually most related to each other and far more different than the rest of the world.
On your take on transgender individuals: I'd like to offer some counter-evidence to the idea that being transgender is necessarily a cultural phenomena. For one thing, many (if not most?) transgender individuals describe voicing confusion about their gender when extremely young, for some around the time that they start speaking in coherent sentences. If you want specific examples I'd be happy to provide. This does not seem to be the case with anorexia (and other plausibly culturally-induced disorders), which tend to appear later in life, often during teenage years, when most susceptible to cultural influence. Yes, many transgender people "come out" as trans when teenage, but a number of my trans friends tell me that they tried to tell adults beforehand, but were dismissed/laughed at until they found the right words to describe their experience to others. I know of multiple(!) trans folk who didn't realize that other people *didn't* desperately wish to be the opposite gender, and discovering that was shocking. I think the closest analogue here is left-handedness, which appeared on paper to become vastly more "popular" in the 20th century, but which was mainly due to the stigma against it being removed. For a long while, people were "coming out" as being left-handed later in life, but this was not an internal development on their part! They simply weren't able to share that fact about themselves until they were older and in an environment where it was safe to do so.
(This is tangential, but on a personal note, I grew up without once hearing the word "gay" until I was fourteen or so, having grown up in a fairly insular religious community. This did not stop me from being bisexual, but it did stop me from having *words* for my experience until I was much older.)
For another thing, the majority of trans people I interact with online grew up in *transphobic* households, and in fact most are still not "out" to their family members. This is may be due to small sample size (around 10), but it does suggest that being transgender is not strongly correlated with being in a transgender-friendly environment—while publicly *expressing oneself* as being transgender is.
I have some other thoughts, but this comment is getting long, and I need to go to an event, so if you're interested in hearing more when I have the time to continue, please let me know!
Thanks for this. I wrote on the subreddit that I'm about evenly divided between "people feel more comfortable coming out", "social contagion" and "endocrine disruptors or something" as the explanation. But let me try to get into more depth on what I think "social contagion" and "switch-flipping" might mean.
There are a lot of psychosomatic conditions that start with some minor weirdness, then some kind of focus on the weirdness, and then the focus becomes all consuming and takes over your life.
For example, consider the statement "you are now consciously aware of swallowing, and your swallowing is weird and awkward". I think most people, asked to meditate on the statement, will find that it's true. A few people will go further - I remember when I was a teenager, I suddenly noticed my swallowing was weird and freaked out for a few hours thinking I might have some kind of throat disease. There's a condition called "globus hystericus" where exactly this fear takes over people's lives, although it's pretty uncommon nowadays.
If for some reason one of your throat nerves fires wrong, or you have some minor irritation in your mouth, this causes a focus on swallowing. If you're naturally prone to this kind of thing, then that focus itself then makes you feel worse, and sustains itself until it burns itself out somehow (or sometimes until you get psychiatric help).
This is also a common cause of panic attacks. A typical pattern is that they start when someone is on a drug, and something is very wrong with their bodies. They panic over this, which causes something to be even more wrong with their bodies (panicking puts you in fight or flight mode), and then they have a panic attack. Then they might get sensitized to the idea "the slightest feeling of wrongness = panic attack" which causes them to freak out when they get slight feelings of wrongness, which means they will get panic attacks all the time from then on.
Or consider chronic pain. A typical problem is something like "their arm hurts for a little while, much the same as everyone's arm hurts sometimes for mysterious reasons". They focus on this so intensely that it causes their pain-gating system to get wonky and now their threshold for noticing pain in their arm is so low that it *always* qualifies as having pain.
I think the steelmanned social contagion theory of transgender is something like: some small number of people (let's say 1%) will have massive irresolveable differences between their gender identity and natal gender that will bother them forever no matter what. Some much larger amount of the population, let's say 50%, has some minor mismatch which might be easy to ignore. If you're in a society that thinks that makes no sense, and that obviously sex == gender, then they'll ignore that feeling and it legitimately won't bother them in any way (or will nag at them every once in a while). If you're in a society that focuses strong attention on it, then you'll get sensitized to/obsessed with it, think about it all the time, and feel very unhappy until it's corrected.
In this model, you're completely right that you "didn't have words for your experience", but in some sense this actively made your experience less real and less anxiety-provoking. There's a decent amount of evidence suggesting that in some cases, telling people mental illnesses are real and biological makes them worse; I think telling people transgender is real and biological might have the same effect.
Ah, okay, that seems like a plausible theory, thanks for clarifying! One possible way to test this would be to see if we can find a way to measure reported well-being before and after someone is exposed to the "trans meme" (such "unexposed" people still exist, as I can personally attest). My personal prediction (based again on anecdotal experience) would be that we'll find people who are "out" as transgender* (*and are in a relatively supportive environment) will report greater happiness, but I'd be willing to concede to the social contagion theory if this is not the case.
EDIT: Thinking about it more, social contagion might still be the correct theory even if my prediction is correct, though in such a case it would be weird to call it a "contagian" if getting infected makes people feel better about themselves. I think we can still round this out as a fairly good test if it's possible to operationalize it?
[By the way, for me personally, not having the words for it made my situation *way, way worse*. In retrospect, I would have given just about anything to know that other people like me existed, and weren't deviant evil people. That being said, I also found that being diagnosed with POTS (postural orthostatic tachycardia syndrome) later in life was one of the most helpful things to happen to me, even without having a good treatment plan until a few years after that. For me, knowledge that I'm not alone, and access to a supportive group environment where I can learn from others dealing with similar issues is positive enough to outweigh any potential harms, like increased awareness of pain. I get that the calculation may be very different for others though.]
Sociologists have been writing about "social contagion" for a long time. It's called that because of how it spreads, not because every contagion is harmful like a disease. Similarly, on the internet something can "go viral", but that does not imply it is killing healthy cells.
Can you think of any words that mirror the meaning of 'social contagion' without the negative connotation?
It's my experience that connotations can have a profound impact on the direction of a discussion; even in a community that is willing to stringently clarify meanings and intentions.
I think that memeplex is better than 'social contagion' for sure.
I feel like 'meme' is overused however. I find it hard to separate meme/memetic from the concept of internet memes, and I imagine that would be the case for many internet inclined people.
If we're reaching in the bag for new words/combinations, we might as well grab something fresher. A foreign word perhaps.
I'm thinking something like 'thought implant', but 'implant' feels like it adds an implication of intentionality to the idea.
Maybe something like "thought pollen" would be better. I think I like the pollen metaphor, firstly because any plant can be beautiful or ugly; beneficial or invasive. Secondly because pollen spreads in proximity and without intention, which is pretty similar to the sort of memetics were are talking about.
My guess for the social contagion part is that it has two dimensions: society's knowledge/tolerance of transgender people, and society's tolerance of gender non-conforming behaviour. Under this theory, societies or groups where being transgender is unknown or stigmatised but gender conformance/enforcement is low would see the fewest transitions, but you'd expect the most in a society that both awards extra good-kind-of-unusual points for being trans and bad-kind-of-weird points for being gender non-conforming but not trans.
Another post mentioned a school textbook with "stereotypical examples such as a boy who likes to cry, and that such a boy would not be just all boy on the gender spectrum". I find this a terrible example in many ways but it shows both dimensions at work: we're perfectly accepting of you crying sometimes, as long as you don't claim to be "all boy".
There is a blog post called "Toward an End to Appropriation of Indigenous “Two Spirit” People in Trans Politics: the Relationship Between Third Gender Roles and Patriarchy" which as you might guess from the title is from a radfem author, but the post makes a factual and falsifiable claim that deserves to be treated by looking at the argument rather than the author. (I won't link it, but searching for the title should bring it up.) If the facts are true, and I have no way of verifying myself, then it's interesting as it's as close as one gets in the wild to a randomised controlled trial.
The author claims that in pre-Columbus northern America, Apache children had a "very non-gendered upbringing" because there was constantly some kind of war on so everyone needed all the same "home front" skills they could get. The Iroquois meanwhile had a comparatively peaceful society which was largely gender egalitarian. Neither of these peoples had any "two spirit" people of their own, even though they knew about the concept (presumably through trade with other peoples). In contrast, the Sioux and Dene had a very gendered and, in the author's words, a very patriarchical upbringing of children - and had two-spirit people.
Someone with more knowledge of the facts than me is welcome to check them, and if they're false then the whole claim is of course dismissed. But if the facts are true, then they support the hypothesis that the prevalence of transgender people is influenced by intolerance for gender non-conformance as well as tolerance for gender diversity.
"Someone with more knowledge of the facts than me is welcome to check them, and if they're false then the whole claim is of course dismissed. But if the facts are true, then they support the hypothesis that the prevalence of transgender people is influenced by intolerance for gender non-conformance as well as tolerance for gender diversity."
This mostly matches what I've seen. I expect the trans population per capita will top out and decrease as society grows more androgynous.
This theory sort of ignores anatomical reasons for transitioning however. Part of the reason I transitioned is due to my dislike of experiences that are mostly caused by testosterone(greasy skin,acne,anger,libido,especially spontaneous erections). That is to say, I partially transitioned because being a man is inconvenient in and of itself, regardless of society's stances on gender expression.
1990s actually, but that's because we needed a non-offensive English word. The Apache, Sioux etc all had their own words, there is definitely evidence of the "phenomenon" before 1990.
Pre-90s, I believe the English word people used was berdache, but that had gained connotations and so a new term was needed, just like the originally value-neutral "retard" became a slur and had to be replaced.
"My personal prediction (based again on anecdotal experience) would be that we'll find people who are "out" as transgender* (*and are in a relatively supportive environment) will report greater happiness, but I'd be willing to concede to the social contagion theory if this is not the case."
Huh, the experiment that most immediately came to my mind was: are people from conservative backgrounds with a slight tendency towards transgender but completely repressing it, happier or less happy than people from liberal backgrounds with a slight tendency towards transgender who haven't yet transitioned but are thinking about it?
I guess these are both true, mine for the epistemic question and yours for the utilitarian one.
A counter to the idea that exposure to the idea of trans people being normal and right necessarily makes people more likely to transition: I grew up in a fairly conservative culture, then met various queer people in high school, and later some trans people in my 20s. This prompted a lot of discussion and rumination on gender. The conclusion I drew was that I had a minor mismatch between my AGAB and my internal identity, but I didn't really weigh gender in my self-image highly enough to go through the effort of transitioning. I experimented by asking one of my friends to refer to me as "they" and on net I'm not sure I noticed the difference.
Conversely, if I wasn't able to calmly examine and dissect this part of my identity, the wrongness could have grown more uncomfortable over time, eventually driving me to take action, who knows. I would say I greatly benefited from my acquaintance with trans and non-binary people, despite not transitioning at all!
"Or consider chronic pain. A typical problem is something like 'their arm hurts for a little while, much the same as everyone's arm hurts sometimes for mysterious reasons'. They focus on this so intensely that it causes their pain-gating system to get wonky and now their threshold for noticing pain in their arm is so low that it *always* qualifies as having pain."
I think it's worth pointing out that "focus[ing] on this so intensely" often isn't under conscious control where chronic pain is concerned, but something our brain does "for us" at lower computational levels whether "we" want it to or not:
"if the brain believes there’s a threat, you’re going to hurt, no matter how pointless it is or how intensely you focus on trying to have more reasonable and rational sensations. It’s mostly just not up to you. But that doesn’t mean that we’re completely powerless. Mind has some influence over brain" though it's indirect and can be counterintuitive.
For example, the "no pain, no gain" school of physical therapy for chronic pain is still quite popular. Sometimes it works, other times it might make things much worse.
"Pain is a warning system, and central sensitization is therefore a disease of over-reaction to threats to the organism — a hyperactive warning system. When physical therapists, massage therapists, and chiropractors treat chronic pain patients too intensely, they may trigger that alarm system, potentially making the situation worse.
"Central sensitization is bad news, but worse still is how few health care professionals are aware of the neurology and make things worse with careless or even deliberately rough, no-pain-no-gain treatment... With tragic irony, the most likely victims are also the most vulnerable and desperate patients, patients going through the therapy grinder, their hopes leading them right into the hands of the most intense therapists."
Stoic minimization and attending away from pain isn't enough, by itself, to convince the brain there's no threat present, especially if there is some underlying physical problem present (even if the brain is blowing it out of proportion — which might become pretty easy for the brain to do when someone has an underlying physical problem dismissed as "merely" moral or psychological) or therapy is repeatedly painful.
If conscious focus is so ineffective at directly controlling pain perception, I wonder how effective it is at ignoring marginal feelings of gender mismatch in an environment bringing them to the fore, or other social expectations, for that matter. On the other hand, since having legitimate concerns shut down is pretty threatening, and threat tends to make discomfort worse even when you're as consciously chill about the discomfort as possible, maybe rigid policing of gender norms sometimes turns tolerable discomfort with natal presentation into intolerable discomfort.
"If you're in a society that thinks that makes no sense, and that obviously sex == gender, then they'll ignore that feeling and it legitimately won't bother them in any way (or will nag at them every once in a while)."
This, as well as some of the comments above, confuses me. (Or did you mean '=/=' Scott?) I'm (sorta) "trans-skeptical", but that's because I think there's a strong distinction between sex and gender. Sure, gender is fluid, there can be many different types of gender expressions, people of one sex might identify more with the (main) gender associated with the other sex. Gender non-conformity is fine, I kinda dig it. But being a man or a woman has to do with sex, not gender: a man is a male adult human, a woman is a female adult human, just the way a stag is a male adult deer and a doe is a female adult deer. (I mean this just as a linguistic claim: we have terms for referring to things by their sex (rooster/hen, bull/cow, etc. etc.), it would be astounding if we lacked such terms for humans, and if we have such terms 'man' and 'woman' are obviously them.) Part of why I'm (sorta) "trans-skeptical" is that it seems like* the pro-trans movement elides the distinction between sex and gender: if you "identify with" the masculine gender, you must actually be male (a man), etc. I'm happy to be polite and let girls play with the boys etc. in most contexts, but it's reached a point where if you think there are any contexts (jails, shelters for abused women, etc.) where we should be separated by biological sex you are deemed a bigot. Which just seems ridiculous. (Maybe worth adding: I don't deny thing there are some people who genuinely feel like they were born with the wrong sex, I just think that there are many more that identify with the "opposite" gender and become convinced that they are trans, which I don't think is good for various reasons.)
*But maybe I'm wrong about this? I honestly have trouble understanding what the "standard" position is.
Sorry, I don't follow. The claim is that 'man' refers to male (a sex) adult humans, as opposed to masculine (a gender) adult humans, just like 'bull', 'rooster', 'stag', etc. refer to the adult male members of their respective species. Obviously, the part about being human is important!
> many (if not most?) transgender individuals describe voicing confusion about their gender when extremely young, for some around the time that they start speaking in coherent sentences
I'd love to see some studies on this. IMO, "most trans people were confused about their gender from a young age" sounds like the sort of belief that's pretty susceptible to confirmation bias. (I expect the trans people who experienced confusion/dysphoria from a young age are much more likely to speak up on this topic, and the trans people who *didn't* are much *less* likely to speak up.)
I know a lot of trans people, and I don't personally feel convinced of this.
It also seems plausible to me that this could've been true in, say, 1990, but false in 2022. (Since being trans is less socially costly than it used to be, so people with relatively less dysphoria may find it more worthwhile now.)
It can be hard to tell if someone naturally would have expressed dysphoria in childhood. As a young boy, I expressed femininity in a number of ways that were pretty much immediately shut down. I ended up dropping any behavior that wasn't deemed acceptable. You're just taught not to act like that.
Ultimately, I didn't express much femininity during my later adolescence. However, I was known for not being very manly, and people made note of it. I wonder if this would have manifested differently in an environment that was less hostile to male femininity. Even for me, it's hard to parse through, given the fact that none of these things happen in a vacuum.
"Whatever your criteria for a mild case are, there will be someone who fits those criteria, but says the condition ruined their life and you are dismissing their pain. Whatever your criteria for a severe case are, there will be someone who fits those criteria but is thriving and living their best life and accuses you of wanting to imprison them in a hospital 24-7. "
Couldn’t the absence of suffering, absence of endangerment of yourself and others and the ability to manage your life autonomously be criteria for mild cases?
"Absence of suffering" is a strong claim. Being rich causes nonzero suffering (doing your taxes gets much more complicated), but it's still overall a good thing. "No excess suffering on net" would work better, but at that point it's almost tautological.
As psychotherapists once told me, or as I understood their explanations, Leidensdruck is a criterion for whether some behavioral trait should be given therapy. As far as I understand it, the word can be translated as level or degree of suffering, psychological stress or strain. Of course we do not have a sufferometer, but I guess a therapist should be able to give orientation, such that the patient is able to judge whether s/he suffers so much that s/he wants treatment.
In this whole context and similar examples, it seems to me that the more complicated question is whether the affected people have a moral entitlement that society behaves in a way that they do not suffer and if so, to what extent. The easy part is tolerance. But at some point qnd in some context, people started saying that tolerance is not enough, instead we need acceptance. But what does this include? In the extreme, it implies second-guessing everybody else's personal preferences including on ways to talk or not talk about something.
So the degree of suffering depends on the society you are in, and possibly that is also true for the other criteria. That is what makes them debatable, not their inherent fuzziness.
"People hate admitting that some cases are mild, and others are severe."
They don't hate it: they are incapable of comprehending it. It's an instance of being able to keep multiple incompatible thoughts in mind. It's anti-memetic: they literally forget there is a scale involved right after they admit there is a scale involved.
And when we encounter some new concept in mathematics, we tend not to master it just by reading the explanation several times. We master it through practice problems.
Maybe people would benefit from some form of practice at applying the idea 'a scale is used differently from how a category is used'. The goal would be transforming this comprehensible, yet totally abstract, idea into something we might actually succeed in applying next time we encounter a scale.
This very good article also highlights something that should be obvious without even reading the article to anyone not writing this at 2am, like I am, but yet often overlooked: the metaphor about how transgenderism is something taken up by people, is not a deep part of "themselves" in some kind of metaphysical sense, and yet is very much an extremely important part of who they are, and definitely not something they could walk out of if they wanted to, etc., makes me think that a reason why sociology, even when done by people who acknowledge that they are biased, still makes a lot of people feel uncomfortable, is that people actually believe their own culture, the same way people who took up trans culture really are trans, and certainly feel like they are. Yes, it really is very obvious, but I’ve seen quite a few sociology professors who are at a complete loss when it comes to understanding why laypeople won’t listen to them, and I myself had mostly stopped at "it’s because you make me sound like a crazy conspiracy theorist, you fool!" without understanding it as clearly as this article puts it.
Sorry for the clumsy phrasing and uninteresting content, as I said, I’m writing this half-asleep.
Also, are there people who actually do not bother to want a personality apart from being honest, kind, and the like? I’m sort of almost autistic, and I often feel like that on a superficial level, could people with actual ASD actually be that way, or think they are? And would they be fooling themselves in thinking so?
Re: 1st paragraph: You have definitely scrambled the 'culture war' script by comparing transgender people to socially conservative commonfolk, and gender-critical commentators to academic sociologists.
Re: 3rd paragraph:
> Also, are there people who actually do not bother to want a personality apart from being honest, kind, and the like?
Sometimes we have conflicting values and need to maximize one. For example, kindness and honesty can point to different actions. Aren't the decision criteria (conscious or unconscious) which we use in these situations themselves the core of our personality? If so, then not wanting a personality would mean not wanting a way of deciding, in a particular context, between honesty and kindness.
I have low confidence in this understanding of what the core of personality is, and will gladly read any counterarguments.
But I will say that the aspiration you indicate, even if I can't work it out in theory, sounds virtuous.
> The DSM says that you can’t diagnose a psychotic disorder if someone’s in a cultural context when they’re expected and encouraged to hear voices - which sure does sound like the experts think cultural context can affect whether you hear voices or not. Born again Christians are constantly having what would normally get classified as psychotic experiences - I have asked a bunch of evangelicals who say “God told me to X” whether they actually heard God in a, you know, hearing God type way, and they usually say yes.
Related book recommendation: TM Luhrmann, "When God Talks Back: Understanding the American Evangelical Relationship with God." Her book is explicitly about how religious people cultivate the experience of hearing (or otherwise perceiving) God respond to their prayers. I thought it was quite good.
Love the post. One thing I will push back on, I think the demand for quirkiness or special snowflakeness depends on your environment. My impression of San Fran is that it is the city of quirkiness. When I lived in DC, quirkiness wasn't important, instead it was connections. Now that I'm in Florida, no one care about quirkiness. Obviously Florida has plenty of quirky people, but more people are happy to just confirm and live a relaxing life. These kind of groups seem to be created in San Fran, then slowly move across the country, with Florida being one of their last stops.
I think you are just defining quirkiness based on what you see in California. Is not boat or motorcycle owning and hunting and gun collecting(edit or golfing) the same type of behaviors(quirks)? I don't know what you mean by connections but if you feel the need to share the existence of these connections with people you meet, then that feels pretty quirky to me...
I think that quickly evolves into describing every aspect of a human personality besides working a job as "quirky", and I think once you've condemned the entire human soul to the garbage as pretension (or, more generously, that everyone should just do their hobbies while hiding under a blanket and a dark room and feel shame about it) you shouldn't be listened to.
I'm not sure how you read "We shouldn't write off people's hobbies as vapid status-seeking just because they exist" and got "Fuck Californians".
Some people do, of course, engage in vapid attention-seeking, but I think most people have hobbies because they like the hobby and not because of Teachian Dynamics.
Exactly the point of my previous comment (to which you replied) where I was saying that our use of quirkiness as possessing interesting attributes applied equally well to DC and Florida.
In other words, my rock climbing and coffee roasting and wrenching on cars (all of which started in California) are no more or less quirky than someone hunting, BBQing, golfing and boating in some other part of the country. That "Aristides," if he was defining quirkiness as only applying to Californians, was doing so because he found Californian hobbies "unusual."
(And this was what I meant by you taking my reply to "Aristides" out of context)
There is an awful lot to unpack here. I hadn’t read the Times article initially so I had to give that once over. I watched Freddie’s response too.
I’m going to have to re-read Scott’s article before I give any opinions. Probably going to need to read Saul/Paul’s account of the events on the way to Damascus too.
This disagreement comes about because we have a weird system where some people who get mental illness diagnoses truly suffer from their "illnesses" and find them unrelievedly bad, while some people who get mental illness diagnoses truly do not suffer from them at all. And many people probably see both pros and cons in those characteristics and experiences that get labeled mental illness.
It might make more sense to save the label "mental illness" for only characteristics/experiences that are distressing or disabling, but that's not the world we live in. We don't really have a way to talk about people who are very weird without labeling those characteristics as an "illness." And yes, it is possible to get a mental illness diagnosis without being distressed or disabled by those characteristics. I don't think Freddie gets this. Some of us had diagnosis thrust upon us, and those people are naturally the ones largely driving Hearing Voices, neurodiversity, autism pride, and critical psychiatry in general. But it isn't that those people don't recognize that disabling and distressing mental illnesses exist—but the culture already pays enough attention to them. For everyone who glorifies mental illness and trash talks psychiatric drugs, there are 100 people who think that anyone with a mental illness diagnosis is dangerous and unstable unless they are on drugs and in therapy at all times.
>But the opposite of this are the people who think psychosocial interventions and acceptance are the only possible solution for anything and trash talk the meds every chance they get.
Who are these people who think no one should ever use psychiatric drugs? Cause I've read a LOT of critical psychiatry stuff, and I have literally never heard anyone say that no one should ever use psych drugs. This seems like a straw man. People do point out that these drugs have often very large downsides that don't get discussed or acknowledged very often in most doctors' offices or in the culture at large. (When I asked a doctor about the side effects of an SSRI, her sole response was "eh, you might get drowsy.") But the vast majority of critical psychiatry/Hearing Voices people acknowledge that people can legitimately and reasonably choose to use psych drugs after being informed of their risks and benefits.
Peter Breggin is a very prominent anti-psychiatry voice who does explicitly believe that psychiatric medications are bad. He's been an expert witness in hundreds of trials. The website Mad in America is also a thriving home for people who express this sentiment. They exist.
> It might make more sense to save the label "mental illness" for only characteristics/experiences that are distressing or disabling, but that's not the world we live in. We don't really have a way to talk about people who are very weird without labeling those characteristics as an "illness."
Based on your comment and a number of others, I've been attempting a scale. Affected people might move in and out of these 4 (for now) semi-arbitrary levels over weeks/months/years. After each level is a sentence or two on what sort of community I would expect.
'a pattern of thinking and behavior which differs from the norm, sometimes to the point of mild social distress'. This level is sufficient for appreciating Buzzfeed listicles and other in-jokes. Few affected people consciously seek out similar people.
'a pattern of thinking and behavior which differs from the norm to the point of moderate social distress'. This level is sufficient for bonding among affected people involving a mix of recrimination against social norms, and relief at finding an oasis from those norms. Medication and/or therapy are sometimes suggested.
'a pattern of thinking and behavior which differs from the norm to the point of clinical significance in THIS society, but probably not in a plausible alternative society'. Medication and/or therapy are often advised, but not if the affected person successfully orchestrates a lifestyle as if they were part of a plausible alternative society. This includes e.g. the Hearing Voices Movement, or working in a workplace which is sufficiently autism-friendly to feel more like 'Right Planet' than 'Wrong Planet'.
'a pattern of thinking which differs from the norm to the point of clinical significance in ANY plausible society'. Medication and/or therapy are highly advised. A community of affected people would most likely either reinforce medication and/or therapy, or else harm its members.
>Some of us had diagnosis thrust upon us, and those people are naturally the ones largely driving Hearing Voices, neurodiversity, autism pride, and critical psychiatry in general.
To overgeneralise a little, autistics usually do appreciate the diagnosis. This is because a layperson will easily notice that an autistic is different but extremely-often "misdiagnose" the problem as malingering, as sociopathy, or as being a serial/spree killer - all much, much worse things to be labelled.
I appreciated this discussion. I think as a culture we have become too tolerant of deviant behavior in public places while at the same time demanding excessive conformity in opinion in offices and educational establishments. The dividing line on medical coercion has to be based on behavior and whether it is harmful to the person himself or to others around him. It's not an easy line to draw but denying that many harmless people hear voices or see visions which don't need to be medicalized is almost as harmful as failing to provide restraint to those who are dangerous.
Excellent piece, but as I read it, mentally copy-edited this sentence: "Study after study has shown you will be happier if you go to church." Shouldn't it read like this? "Study after study has shown people who go to church are happier."
Actually, neither is correct. I'd bet large amounts of money that while the *average* churchgoer may well be happier than the *average* non-churchgoer, there exists at least one churchgoer who is more unhappy than at least one non-churchgoer.
More likely, there also exists at least one churchgoer who is more unhappy than the _average_ non-churchgoer, and at least one non-churchgoer who is more happy than the average churchgoer.
One should note that even the weak version is only true in the US.
Or put differently, it's actually "people going to church are only happier in poor countries, but are not happier in rich countries. The US are an outlier."
I have also heard the version that it depends on how important religion is in the country. What I seem to recall is that in countries where religion is still very important (the US, Poland) church-goers are happier. In non-religious countries they are less happy. But I didn't fact-check this version.
Yes, a lot of the effect is probably 'people with more community ties tend to be happy'. For poorer countries, it means having an extra support network, and there might be some impact on values related to work ethics.
I have Aphantasia, meaning I have no mind's eye. When I read a book, for example, images do not ever pop into my brain and indeed until I learned about Aphantasia it never occurred to me that reading text could possibly cause a human to picture anything other than the text. Hearing voices that are not there seems remarkably like seeing things that are not there. Why is the former considered a sign of mental illness while the latter is not? I guess the obvious but unsatisfactory answer is that "the majority is always sane".
Has anyone studied if seeing images in your mind's eye harms you? I can imagine that it distracts you when driving, increases rage (as you picture the thing you are mad at), makes you more confident in false believes (as you picture what you think is the truth) and increases post-traumatic stress disorder as you vividly remember the bad happening. Before I learned about Aphantasia I could never understand why adults worried so much about kids seeing violent or sexual images as it never occurred to me that the kids could continually revisit the images in their mind's eye.
Although it's impossible to compare in any rigorous sense, I would say I have someone with a very vivid 'mind's eye'. I would say yes! I've mostly derived pleasure and aesthetic benefit from it, but am certainly haunted by chilling images intrusively recurring at times, and do indeed (exactly as you say) have more rage when I start imagining a frustrating/bad thing happening and then can't help myself from 'watching the rest of the movie', so to speak. That's a very interesting observation!
There is an unmistakable distinction between imagined visuals in my mind’s eye, and actually seeing something. Likewise for imagined voices and actually hearing something.
I don’t think I am skilled enough to describe the difference to someone without the experiences, but it’s like they live in two completely different places. My understanding is that most people who hear voices or hallucinate also draw some distinction between hallucinations and their normal use of imagination.
I think one way of giving an inaccurate-but-possibly-still-informative impression of this might be to say: Look at a shining lamp for a few seconds. Now look at the wall. You can see the retinal burn of the lamp, but you know it's retinal burn and not a feature of the wall.
The mind's eye isn't like this (most strikingly, it doesn't obscure actual features from your sensory input), but it *is* comparably separate in a way that is subjectively obvious.
Yes, speaking for myself, I can turn them on/off at will. More importantly, I always know what is a real thing that I'm looking at, and what is a visual fantasy. Strictly speaking, sometimes unwanted visuals do pop up, but I can choose to dismiss them/turn my attention away from them.
A combination of "the majority is always sane" with the fact that hearing voices often (though not always, as in the case of the programmer I talked about) correlates with other kinds of crazy behavior. If you weren't hearing voices yesterday, and then you started hearing them today, decent chance you're about to have a bad time.
Also, I think you're overestimating what other people mean by "not being aphantasic". Having a mind's eye feels very different from visual hallucinations. It feels like the images are in some kind of nonspatial location separate from the ordinary sensorium. At least it feels that way to me. I can go "Oh, that image is in my mind, not in the physical world". Also, I only see the images when I choose to / when I think about them - there's some complicated subtle sense where this isn't true, but to a first approximation it's true.
Wait, actually? Now I want to see wider polling on this. I have about as much control over my internal monologue as I do over my mental radio (like a poster above, I have music playing in my head most of the time, but it takes some effort to 'turn the knob', so to speak). It's not intrusive or anything, but also definitely not under conscious control most of the time.
I have a "conscience" which speaks up and makes me feel bad about stuff I probably should feel bad about. It is somewhat of an internal monologue and tells me upsetting things that I need to hear. If I ignore it long enough, then I guess it turns into what you could call negative self-talk. But again, it's because I am acting poorly in a pretty specific way, like lying, causing harm, or ignoring something important. When I stop acting poorly, the negative talk stops.
I wonder if this is an appropriate way to think about negative self talk. Some people don't listen to their conscience and as a result have a lot of unresolved and intrusive monologues. Others have a poorly tuned or impossible to please conscience, and no matter what they do, it will never stop.
I also have unwanted/negative anxieties that kick in, but they are purely "felt", with no monologue.
“Right now, our society demands you be a Special Snowflake. Women who aren’t quirky enough are “basic bitches”, men who aren’t quirky enough are “yet another straight white dude”. Just today, I read some dating advice saying that single men need to develop unusual hobbies or interests, because (it asked, in all seriousness) why would a woman want to date someone who doesn’t “stand out”?”
There’s empirical backing for this. In “Don’t trust your gut”, Seth Stephens-Davidowitz writes:
“The mathematician and author Christian Rudder studied tens of millions of preferences on OkCupid to learn the qualities of the site’s most successful daters. He found—and this was not at all surprising—that the most prized daters are those blessed with conventional beauty: the Brad Pitts and Natalie Portmans of the world. But he found, in the mounds of data, other daters who did surprisingly well: those with extreme looks.
Think, for example, of people with blue hair, body art, wild glasses, or shaved heads. Why? The key to these unconventional daters’ success is that, while many people aren’t especially attracted to them, or find them plainly unattractive, some people are really attracted to them. And in dating that is what is most important.
In dating, unless you are drop-dead gorgeous, the best strategy is, in Rudder’s words, to get “lots of Yes, lots of No, but very little Meh.” Such a strategy, Rudder discovered, can lead to about 70 percent more messages. Be an extreme version of yourself, the data says, and some people will find you extremely attractive.“
Is being "a very successful okcupid dater" what you want? It presumably means you're able to get dates, but not actually able to turn them into long-term relationships. (Or else you're poly, which is another kettle of fish and no doubt strongly associated with blue hair and body art).
The really successful okcupid users are the ones who show up for a couple of weeks, find someone they really like, and then never log in again.
I agree that this set of incentives for attention-getting is problematic, especially at the societal level. We need a fairly large amount of fairly standard “boring” relationships to multiply and replenish the Earth after all.
I had an interesting experience with a mushroom overdose (described in several of my blog posts below) and it gave me interesting auditory and visual hallucinations for a while (which I have now fully recovered from), so I think that I have an interesting perspective to add to this discussion.
In hindsight, I realize that those were just another aspect of my personality that "split* from my ego, and needed to be reintegrated through discussion and understanding. Now that I'm fully recovered, I don't need to talk to myself out loud, because I've reintegrated that aspect of my personality into my core persona. Nevertheless, it would have been EXTREMELY damaging to my mental and emotional health if anybody had overheard me and attempted to put me on any sort of psychiatric medication against my will. In fact, I would go so far as to say that if anybody HAD tried that on me, I would want to kill those people - not only at the time that they were doing it, but also now that I am fully recovered. (Granted, while I was going through that traumatic experience I would probably have wanted to torture them to death slowly, and now that I am fully "myself" again I think a quick death by firing squad would be more appropriate, but GENERALLY speaking my feelings about this have remained the same.)
I don't think that there's ever any need to medicate somebody for being "weird." As long as they're able to obey the law and their condition is not a danger to themselves or others, society should have no business interfering with them. "Making sure other people feel comfortable" is never a good reason to exercise state control over somebody else's personhood, and people who feel otherwise are simply evil human beings. Nobody has an inherent right to feel comfortable, certainly not at somebody else's expense.
I don't find interviews to be an interesting format. Either I have specific pressing questions for Freddie or not. If I did, I'd ask him. If not, it feels kind of fake to pretend I do.
Generally, I agree with you. I don’t listen to interviews of or by any of my favorite substack authors. But ... I’d make an exception to listen to you and Freddie talk with each other about psychiatry. You each have very distinctive takes from very different perspectives. But I understand your preference.
Interesting. Wouldn't suggest you do start doing interviews, but consider this as a way of changing perspective: did you have all the blog topics you've written in you innately and/or in response to circumstances, or did the act of writing cause you to dig deeper and generate more topics of interest? I would guess the latter.
I think a good interviewer learns the habit of searching for interesting questions, often to good effect.
I have no pressing questions for Nelson Mandela, but I'd like to think that if you gave me a dinner with him, I could find a few good ones. For starters, "aren't you supposed to be dead?"
"People need personal mythologies. “I am a guy who works a McJob and is bad at it, and that is all I am” isn’t going to cut it psychologically. “I am a guy who works a McJob by day, but my hallucinations give me a higher level of insight into the problems of the world than all these people who are superficially more successful than I am” is just healthier, as long as it doesn’t get taken to a grandiose extreme."
This phenomenon is nothing new. Henrik Ibsen's famous play, from 1884, The Wild Duck, examines exactly this topic. There is even a supporting character, who is said to be "daemonic". We never really learn what this means, but it's dark and mysterious and he is apparently proud of it. I imagine him as the 19th century equivalent of a Hearing Voices member. At the end, we learn that one of the main characters, who is a doctor trying to help people in any way, encouraged his pride in being a mysterious daemonic figure:
"What the devil do you mean by daemonic! It's only a piece of gibberish I've invented to keep up a spark of life in him. But for that, the poor harmless creature would have succumbed to self−contempt and despair many a long year ago. "
They actually have a word for this in Japanese. 'Chuunibyou'. Basically, it's this type of delusion, and it's usually associated with middle schoolers, thus the name(Eight Grader Syndrome)
It's a very common trope in anime and manga to have a 'chuuni' character.
I've been thinking recently about DID systems, and how the people who experience a non-singular life may be better suited for thinking through concepts that are difficult for a persistent individual ego.
To that end, I was wondering if it would be beneficial to group many such DID systems/tulpamancers into a society, where they could live in a way that was compatible with their internal experience. In human society, it's basically mandatory that you structure your life around a single ego, even if you have to fake it(SSN,Bank account, Passport,Lease, Etc). What observations would these people be able to make if they could live life in a way structured around multiple egos, where they wouldn't have to act as chameleons half of the time? I bet they could come up with some interesting stuff.
What I have in mind is something reminiscent of Castalia from 'The Glass Bead Game'. A class of thinkers sponsored by the state to maintain, advance, and disseminate a tradition of knowledge. A similar example from fiction would be the Keepers from dath ilan. Honestly, I think the benefit of such a society would far outweigh the costs, even if it only ended up providing insight into these mental states.
The cases on the edge are interesting. We no longer consider synasthesia a form of hallucination and instead view it as a sensory quirk. I hear music in my head all the time which is intense enough that I sometimes have telling whether there's music playing in the next room or it's coming from inside my head, and differentiate by checking if I can control the music at all, which I can moderately if it's coming from inside my head but not at all if it's external. In practice it's much more common that music which I assumed was all in my head was actually playing than that I thought something was there which actually wasn't. I don't identify this as hallucination. I think of it as simply intense imagination. But something which was either more intense or happening to a person who wasn't completely clear that the music was imagined might unambiguously qualify as hallucination.
If you've ever used DMT, it seems to become obvious that the human brain can easily 'rephrase' any sensation or idea to fit through entirely inappropriate bits of its architecture - including 'entities' that seem to be formed from plugging random abstract categories into whatever machinery you normally use to model the behavior of other people or animals. Some portion of the contents of our dreams may be similar to that phenomenon. Which makes me believe that at least some of the 'voices' cases stem from disrupted connectivity between other regions whose traffic simply ends up accidentally rerouted through 'hardware' responsible for speech recognition. Mild cases are probably a lot more humane to leave alone rather than treat with antipsychotics, smashing that channel as well. Makes me wonder whether if this were better understood it could be that trying to restore the original connectivity via something like repeat directed TDCS along the intended pathway would be seen as the proper thing to do rather than damping every single connection in the brain to get at a single glitch.
All hallucinogens do is demonstrate the effects of sudden connectivity changes - typically long-distance potentiation - across some type(s) of receptors, which tends to be considered to be more conducive to general introspection than not, just rather confusing, yet many of those states seem to have semi-synesthetic qualities. So, formally: no, it's not definitive proof, but raises the prior on at least some types of hallucinations being long-distance miswirings for different reasons.
Very minor tangent. I have never other than here seen the word “woo” used to refer to (I take it) new age nonsense or the like. Is that usage, which is different from the ordinary meaning of attempting to obtain reciprocal romantic interest, (a) a common meaning that I have just missed, (b) a regional meaning from the west coast, or Michigan, or wherever, (c) a meaning that is distinctive to the “rationalist” community or some other group, or (d) an idiosyncratic usage by Scott?
I think a? I seem to vaguely remember having seem people in the "skeptic" movement unconnected to Scott or rationalism use it, and I don't *think* they were all from a particular US area. I think (not certain) British skeptics use it?
RationalWiki (not always a reliable source but probably fine on this) claims it originated in the 1990s. I associate it with the likes of James Randi but I'm not sure who actually invented it. https://rationalwiki.org/wiki/Woo
It comes from the "woo-woo" sound made by a stereotypical spooky ghost.
Thanks NYT, for without you I never would have found this blog!
It is so amazing these days to meet a truth-seeker, who in good faith tries to investigate two sides of a contentious and polarized subject, and tries to reconcile them (not for one, but for two contentious subjects!). Thanks, Scott.
I was seeing a psychiatrist a few years ago. After 10 sessions or so, to my surprise, I was the one who brought up meds, not him. We had a discussion about several options, I choose one and have been taking them ever since, and they make my life better. I don't like to put some chemical into my body daily, but hey, what can you do? Life is a game of trade-offs...
There are some great pieces I'd normally want to dig into, but overall this article is simply to uncohesive, uninformed and tasteless around a sensitive topic.... My tipping point was when Scott called IFS "woo-y" whilst speaking in a myraid of other assumptions and rather absolute statements.
This is your blog and your perspectives are yours Scott, and mine include using IFS and acupuncture to recover from severe physical and mental developmental trauma without medicine, and then become a mental health professional to help other patients find their path to healing. I'd be curious to talk about mental health when your perspective has been informed by a broader set of perspectives... or can at least hold back on the callousness that was in this article.
Scott, like most rationalists in my estimation, blends together an incredible amount of sympathy with basically zero empathy, and I'm afraid it's something you're going to have to get used to.
Well put on sympathy vs empathy and the rationalist perspective. I'm not sure what you mean that "it's something you're going to have to get used to". I hear something I disagree with and comment my dissenting opinion authentically. I am used to disagreeing with people and continuin to listen to them and engage with them. Most of the time I find Scott's manner of communication to be quite effective, but in this particular post I found it to be brash and underinformed. That is fine, it's not my blog and it would be less interesting if it was!
I don't expect anyone to change for me, but I also recognize that people can't change without experiences that expand their perspective. Scott could screenshot my comment and send it to a friend and say "Look at this chump!" and I don't care. It's all about living authentically and making peace with what happens around you. I spoke up as I wanted to and that's good enough for me :)
In my experience, people just become more and more entrenched in more twisted and extreme versions of their mindset no matter what you do, and it happens faster if you try to push back. This is why I've basically given up on meaningful discourse and am bordering on giving up on communication (at least online) entirely. IMO humans are entirely irrational and any "reasoned thinking" we do is just post-hoc fluff to justify what we were going to do anyways.
re-reading my message, I hope I was clear I don't think Scott's post is like a college application essay. Just his point that rewarding quirkiness begets more quirkiness makes me think of how college applications are similar (and a lot of life), and not always in a good way.
Kay Redfield Jamison approaches this question in 'An Unquiet Mind' (1994), and 'Touched With Fire' (1996). She recommends a combination of chemicals and therapy for symptoms. I believe she's a therapist. So, no magic bullets there, but she does cover the idea that quashing a little madness may also arrest any savant-ish 'genius' that often comes with it.
Civil service agencies frequently acknowledge 'personal' days, in addition to sick days, only obliquely suggesting they might be important. With all the disinformation, war, and disaster in play, we really need to recognize that mental health is physical.
>My starting point for any discussion of this, which I feel like it’s really hard for a well-informed and well-intentioned person to disagree with, is that at least some large subset of transgender people aren’t consciously faking it. That is, they genuinely have the experience of feeling like they are the other gender, they’ll be absolutely utterly miserable if forced to live life as their birth gender, and telling them “no, just snap out of it” will not work, at all. I think it’s hard to know transgender people closely without coming to this conclusion, unless you have some kind of really galaxy-brained take beyond my ability to even imagin
>So what’s left for the people who believe transgender is a “social contagion” or about “special snowflakeness”? If I had to steelman their position it would be something like: there’s some switch that can be flipped by social pressure and wanting to look cool. Once the switch is flipped, you’re transgender in some pretty real way: you’re not faking it, and you’ll be miserable until you’re allowed to gender transition. Still, being transgender makes people worse off on net, so society should try to avoid flipping that switch.
This is not a good steelman I don't think. It's difficult to distill the issue I have with the trans movement into one argument because the trans movement is really four or five different and mutually incompatible movements in a trench coat. When I try to steelman the trans movement I end up with something reasonably close to what I believe was called transmedicalism, the idea that there is something akin to body integrity disorder that some people unfortunately have where they experience extreme dysphoria at certain body parts and desperately want to modify those to reduce their pain. I find that steelman pretty strong and difficult to go after but it's a motte to a "Gender bailey".
In the "Gender bailey" we go from the fairly difficult to mis-selfdiagnose symptoms like a terrible urge cut off parts of your body that feel wrong to some fairly squishy claims of some essential soul like feature that people have access to which informs them of their proper social role, and these social roles seem suspiciously like sexist caricatures. My issue with trans social contagion/snowflakeness is that when I put myself in the shoes of a kid today, or just my own shoes from a couple decades back, and I try to seriously answer the question "am I transgendered?" I can't see how an answer either way can be falsified. Even taking the assumption that there is a thing to "feel like a man" or "feel like a woman" we are each only endowed with one of those states and have nothing to compare our state to in order to categorize it. So kids are going to fall to second order things to answer this question. Many kids who are going through those awkward puberty times who would have gotten through and been better off for it might take the totally ordinary confusion and angst as evidence that their problems are caused by their gender.
Kids make stupid things their identities all the time. When I was very young my family went to a restuarant that normally served chicken tenders that I loved but for whatever reason they were not able to produce them. So my parents tried to get me to have a burger instead. In the petulant way of children I, being quite cross at not getting my favorite meal, declared that I hated burgers(which I had never had before). And for many years after not liking burgers was somewhat of an identity marker that I, to my embarrasment today, took seriously. Kids will latch on to anything as an identity, if you give them one that comes with a community and a tool like being able to call anything against you 'transphobia' I don't see how kids aren't going to fall hard into that identity group. I'm almost certain I would have as I had my own feelings of not fitting in with the other boys. And that's really where my objection to the trans kids phenomenon lies, I'm absolutely terrified that if I was a kid today I would have fallen down that rabbit hole and I worry for all of the kids like me today who are going to end up permenantly altering the course of their lives.
My father has been involuntarily and continuously in a psych institution since I was 8 and he was 36 in 1993. Schizophrenia with Christian-themed hallucinations that he thinks are real. He thinks he can channel the spirits of Jesus, Joan of Arc, Leonardo da Vinci, etc. He complains of his freedom of religion being violated by the institutionalization. Every time I see him he asks me to contact celebrities or congressmen to pull the right strings to get him out of there. Often he's too medicated to even get out of bed to see visitors, but when he does get out of bed he's doing elaborate rituals to combat demons and hatching plans to get out. Once in a while he gets better enough to go to a sort of on-site halfway house, and then relapses and goes back to the psych ward. He still beats all the staff at chess.
He had an acrimonious divorce from my mother in 1990 and then made a good living flipping houses for a few years. He went to some sort of convention for "clairvoyants" in 1991, which sounds like a predecessor to the Hearing Voices movement. He met his second wife there. The details of how he got committed in 1993 are still unknown to me, but it involves being convicted of arson. He complains of his second wife being possessed by demons shortly before the episode, which probably means they got in an argument or something. No idea if the arson was intended to hurt anyone or was just an anti-demon ritual or an insurance fraud. The cultural context that told him his hallucinations were real and important spirits probably made him a lot worse through making him not want to take his medication properly and more likely to act on the hallucinations. (He probably also got some chemical induced brain damage from repainting / remodeling many houses.) Being his biological son gives me a ~10% base rate of getting schizophrenia but since I'm 37 years old with no sign of it yet that updates down to below 1%.
The half-dozen times I've smoked weed over the years I've experienced what I believe is much like schizophrenia: what starts as my interior monologue quickly shifts into a slightly different voice which I realize I'm not in control of, and it scares the fuck out of me to discover that my interior monologue "isn't me". The moment I realize I can't control that voice a new interior monologue begins overlapping the previous one which is now another voice, and then that interior monologue turns into another voice I can't control, and another starts, and so on and so on for hours. It terrifies the shit out of me. The voices don't tell me to do bad things, but they terrify me because it feels like someone else is doing the thinking in my head, not me.
Luckily, the cure for me is to not smoke marijuana. But I feel massive sympathy for those who can't control voices in their heads.
This spurred a thought which is a small sidetrack - Effective Altruists have a self perception that not only are their ideas are weird, but that they themselves are personally weird. In my experience, EAs are not really that weird? My picture of the median EA is someone who dresses in casualwear, needs a haircut, works a 9-to-5, gives their money to charity, tweets about current events, goes to little houseparties where talking takes precedence over music, and gives a bit of side eye to those rationalists they get lumped with (who are some real weirdos, let me tell ya). When everyone else is jockeying to stand out by being weird, EAs seem to be the weird ones out for trying to move in the opposite direction! Or, maybe it's easier for everyone in a social circle to all pretend we're all unusually weird together so nobody has to admit that none of us are actually that weird, in which case we'd have nothing to bond over. In that case sorry to fellow EAs for blowing our cover.
I would agree! Most effective altruists are pretty aggressively normal, people except for the extremely unusual beliefs that 1) The suffering of people far away is actually real, and 2) Some of that suffering is at least partially solvable in some surprisingly cost-effective ways.
> Still, being transgender makes people worse off on net, so society should try to avoid flipping that switch.
Says who? Besides you could use this same logic about LGBT people to justify abhorrent laws like Don’t Say Gay in Florida. And in fact, that is exactly what’s happening. I’d argue that trying to prevent the switch from being flipped is far worse on net, leading to a host of concrete terrible outcomes for transgender and LGBT people. If a few guys who wouldn’t have become a girl, become a girl… that’s the price of freedom. That’s what I’m told after every school shooting so gun nuts can keep their weird hobby. At least transgenders don’t massacre crowds of people on a regular basis.
Scott's responded to this elsewhere in the comments - transition therapy currently has a pile of downsides like the expense and danger of surgery, plus the usual sterilisation. It is clearly worse to be a transitioned transsexual than a cissexual; the argument for transition is when the alternative is *not* "cissexual" but rather "untreated transsexual".
"We can admit that you don’t need a “personality” beyond being responsible and compassionate."
A passionate secular "Amen!" to this!
Re. the man who wanted to overcome his anxiety in a week, I think that if he was coping with his anxiety enough to be functional, he should have given a talk on how he coped with his anxiety without overcoming it.
Re. Scott's transgender dichotomy, there is another dichotomy in play. Last year, I was picked up at a party by a trans woman who didn't tell me she was trans until shortly before we reached her bed. We had a long conversation then, and she said, with sadness and bitterness, that she avoided the trans community as much as possible. She had been born intersex, and lived as a man for a while, but decided (partly because she could never match the masculinity of her macho older brothers) to become a woman.
She actually wanted to be a woman, and /worked/ at becoming a woman. Then in comes the contemporary trans activist community, saying (for the most part) not that men can become women by taking on the female gender role, but that gender roles aren't "real", and so a man can identify as a woman without bothering to act out female gender. A lot of what she saw in the new trans community was former men who had felt like failures as men, and didn't really want to be women; they just didn't want to be men anymore. But they thought that not being men meant they were women. They didn't know that being a woman is more than having a woman's name and wearing pink.
In other words, they felt that being a man was hard work, but being a woman was not. And she felt like this was shitting on all the work she had done to learn femininity after adolescence, and insulting all women, cis and trans, as being nothing but inferior un-men. She cried while telling me this.
So where Scott describes a dichotomy between trans people who are happy changing genders and people who probably shouldn't change genders, she saw a dichotomy between people who actually change genders, versus people who identify as a gender without adapting that gender role, and really want to destroy the concept of gender. They want to stigmatize the gender performance and personality she had worked so hard to internalize and embody.
And I wonder how highly correlated these two dichotomies are.
Wow! I wonder what she thinks of people who don't have a strong gender identity in the first place, and would prefer not to be required to perform any gender role.
I would guess that she think they should say they have no gender identity, rather than identifying as women. Saying "I don't want to have a gender identity, so I'll just be a woman" sounds to me like an insult to women.
This is relevant to a few comment chains above, but it's also relevant to the main post and it would be a bit obnoxious of me to post it 5 times, so I'll put it in a top-level comment.
I'm ex-trans, and in the full sense of "had gender dysphoria, full phantom-limb, and it has gradually but almost completely abated".
So I'd go further than Scott's steelman and say "it is possible to be gender-dysphoric and honestly want to transition, and yet for transition to be a bad idea that won't help".
EDIT: If there's one thing that would really clear up the mess, it's a full RCT of transition therapy. That is, you take 5,000 people who say they want to transition, transition 2,500 of them, tell the other 2,500 they're just confused and should get over themselves, then follow up in 20 years and check life outcomes and happiness. Good luck doing that these days, but RCTs are the only way to avoid Aslan's old dictum that "no-one is ever told what would have happened". You'd probably want a bunch of pre-registered subgroups so that you could verify, after the study, that X criterion is actually relevant to whether transition is warranted.
People should not be put on risperidone for having spiritual experiences and wanting to tell people about them. At all. I don't know why you thought that was a reasonable thing to say. Please do not put people on risperidone for having positive experiences that are meaningful to them.
If any other crazy people are reading this, please know that Scott, although better than average at respecting the humanity and self-determination of people who seem crazy to him, still will throw you under the bus like this.
> please know that Scott, although better than average at respecting the humanity and self-determination of people who seem crazy to him, still will throw you under the bus like this
I presume it's from assuming that the first two-and-a-half paragraphs of section 5 (reproduced below) are how Scott makes forced-treatment decisions as a psychiatrist. I think this might be a bit harsh a reading, given the "but" immediately following this passage, but I can see how you'd get to that conclusion.
>Imagine that you go to the top of a Himalayan peak, take some obscure Ecuadorian psychedelic, sink deep into meditation, and have the most profound experience of your life. You see God approaching in the form of an arrow of pure light, which splits open your head and then blossoms like a flower, and this makes you realize that your whole childhood was [and so on in this vein].
>You try to explain this to someone, and before you even get three words out, they tell you that you’re crazy and God doesn’t exist and you need to take risperidone 2 mg daily until they tell you to stop.
>This is probably the right response, and if someone had been willing to do this to the original hippies we might have saved ourselves several decades of weird art and dumb politics.
Believing in spiritual experiences is bad. Telling people about your spiritual experiences is bad, especially when there's a potential of spiritual memes:
(I could have written the last article, except about my grandmother who died slowly and horribly from a skin cancer that has a 99%+ survival rate when treated on a reasonable time table.)
While I think indulging in spiritual belief is always a bad idea, I was also being performatively strident and overly simplistic, in response to the OP's tone.
If the alternative to indulging in spiritual belief in death, I do not think it's a bad idea. If I had not "indulged in spiritual belief", I would not be here today. I found genuine faith at my lowest point, and it gave me a path back to life where medication couldn't.
How do you know faith was the *only* possible intervention saving you from death?
Plenty of people are bumped out of low points by things that aren't adopting (explicitly spiritual / fantastical) faith. Psychedelic drugs, being badly frightened by a near fatal event, meeting someone who helps/inspires them to get better, getting arrested, etc.
And faith in what? Because some faiths have a lot more potential to do toxic harm than others. If your faith motivates you to survive so you can practice jihad or get abortion banned or deny your children medical care...well...you adopting a faith is really not a good outcome for other people.
I had an actual answer for these, but I realized I actually don't think your opinion is rational or even discussable and that nothing good for either of us will come out of this conversation. I can say "Yes, some people are saved by other things, but others are saved by religion and I think it is grotesquely unfair to say those people shouldn't have been saved", but you will not listen. I can say "you literally just said that you think faith is always bad, so me saying that you think faith is always bad is not strawmanning" and you will not listen. So I will not speak any further.
I don't understand how Essex is straw-manning: if indulging in spiritual belief saved him from death, that's decent evidence that it's not always bad, which is what you claimed. I'm also not sure how the fact that other things *could have* saved Essex from death is supposed to be relevant. (I'm honestly trying to understand.) Compare: A: "Group X isn't all bad, one of them saved me when I was drowning." B: "But someone in another group could have saved you." A: "??"
I hadn't noticed it was part of a series back then: 'Lives Restored: This is the fourth article in a series of profiles about people who are functioning normally despite severe mental illness and have chosen to speak out about their struggles.'
I kinda assumed that as it becomes more mainstream more people will "catch" being trans but that doesn't seem so bad. Yes, gender dysphoria seems bad, but I figure that as it becomes more common and appealing it will start to simply blend into a general kind of non-conformist sexual and gender expression. I mean, when I first started running into people who were trans they were almost all fully medically transitioned. Now, I seem to run into far more people for whom being trans seems to mostly be about hiding their breasts or otherwise refusing to conform to gender stereotypes in a way that's frankly pretty mild but for the name.
And I'm hoping that this will moderate out the whole thing. I can't prove it, but my hope is that not only does this create greater acceptance for those that would feel deeply out of place in their birth gender regardless, but, also, by making it less of a big deal with basically make being trans kinda like being goth/punk/whatever (while also reducing the focus on medically transitioning).
--
I'm much more worried about the rhetoric about how it's innate and the implications that they have the other gender brain. Not because I even disagree (I'm skeptical it's that simple but don't know), but, rather because it creates an excuse that's the one special reason we have to be compassionate to people who are different in this one way but don't have to do so for all the other weird people.
If by “trans” you mean “quirky teens that use various non-binary or genderqueer terms to describe themselves but are otherwise just standard quirky teens that are vaguely gender non-conforming”, then fine I guess.
But if by trans you mean “start taking medications and getting surgeries with permanent and life altering impacts, including at basically a minimum high likelihood of reproductive issues”, then no, that’s a very bad thing for people to seek out as an answer to general teen awkwardness.
I think almost every teen is a little dysphoric - puberty is weird, adolescent socialization tends to suck sometimes.
It would be very bad if physical gender transition became anything like a first line treatment for that. At least until we’re at the point where seamless and infinitely reversible gender transitioning is technologically feasible.
I understand the idea behind maximum compassion and all that, but I am looking at this picure and I can't shake a feeling it makes no sense:
1. If you feel that your neighbor have been replaced with a hostile alien robot, you get medicated and maybe compulsory hospitalized
2. If you feel your left hand has been replaced with alien computer that serves as a beacon for alien invasion, you get medicated and doctors try to do their best to dissuade you from cutting your hand off and throwing it into a volcano (how else would you destroy an alien computer?!)
3. If you hear voices that instruct you to do things, you are medicated (or at least told to get medicated). Unless you either hide it or proclaim you are a member of an official religion and the voices are voices of God, in which case you are lauded and considered blessed.
4. If you feel your body is of a wrong shape and you need to stop eating until it is shaped correctly, you're anorexic and need to get medical help to start eating again.
5. If you feel your genitalia are of a wrong shape and need to be cut off or reshaped, you are stunning and brave and any doctor that is not rushing to help you to cut them off or heavily medicate you to "affirm" your feelings - even if you're a pre-pubescent kid whose opinion has zero value in any other case but this one - is a nazi bigot who should lose their medical license as soon as their bigotry became known. Also, anything less than enthusiastically embracing the fact you already *are* of the gender you feel like means the non-believer is a violent nazi who should be shunned, shamed, fired, and probably physically beaten or shot if one can get away with it.
Did I get any of it wrong? If not, should it make sense to me?
I mean, in none of these cases people are "faking" it - they may be genuinely believing it, even if the environment, as Scott pointed out, may have triggred the specific form of expression. But in some cases we think it's a medical issue which has to be dealt by professionals - with maximum care and attention to the patient, of course, and all that Scott mentioned - but as medical issue. And in other cases it's a public civil rights issue where holding a wrong opinion about it gets you physically attacked and societally destroyed. How does this work?
As a point of fact: I would call "physically beaten or shot if one can get away with it" (i.e. vigilante action) a fringe position among SJers (though not unheard-of), and as I understand it TERFs get a *little* mercy.
The rest is mainstream, though, and "imprisoned" and "disenfranchised" are entering the Overton Window. "Hound them, impoverish them, exploit them, imprison them, just *do not kill them* and you are God's noblest of men."
"Get away with it" part plays a role here. For 1000 people thinking "it'd be nice if somebody beaten him up really bad" there may be would be one who is inflamed enough and insane enough to actually do that, in normal situation. Of course, if you're in antifa-occupied territory like Portland, the calculus may change.
As for murder, it is true the Western left (Chomsky excluded) aren't ready to embrace the killing fields for their enemies just yet. Violence is already ok, but outright premeditated murder is still rare. But I don't see them mellowing out anytime soon.
My impression's been that mainstream SJ doesn't actually approve of antifa - it just doesn't particularly want to talk about them because admitting there are thugs on one's side loses face (cf. I Can Tolerate Anything Except The Outgroup, paragraph on beheadings).
(I was glossing over a bit by saying "disenfranchised". What the Greens want to do is institute a requirement that all elected legislators uphold SJ positions and condemn the far-right - in other words, ban the far-right parties from contesting elections. I figure that the literal ability to vote is of little use if a group's preferred candidates are not allowed on the ballot.)
> My impression's been that mainstream SJ doesn't actually approve of antifa
Do they disapprove of them, or do they say ritual formulaic things about disapproving them when they have no other choice, but secretly wish there would be more of them and may be even fantasize how they could be one of them if they weren't afraid of consequences?
Because I see great reluctance in prosecuting violent Antifa or denouncing even the worst excesses - even when there's no particular loss of face in admitting there could be one or two criminals among the comrades. In fact, I hear a lot of politicians approve or justify their actions, as maybe exaggerated, but just reaction to the wrongs of the world. I do not see a cultural rejection there.
> What the Greens want to do is institute a requirement that all elected legislators uphold SJ positions and condemn the far-right
This is essentially how major parts of academia has been operating for years. And now, through mandatory DIE trainings, which pretty much always are prepared by those coming from that academia, the capture of major business proceeds apace. So, we have a pincer maneuver here - from one side, the wrongthinkers are getting cut off from the "polite society" and its economic and status opportunities, from the other side, in the inpolite society, they are allowed to be physically attacked and their property destroyed with impunity. Of course, if they try to defend themselves, the whole giant force of federal, state and other law enforcement would be thrown at them immediately.
We used to have separate water fountains for white and colored students in schools. And furries, like trans people or psychotics, are a group of people with different mental states that might equate lack of acceptance with overt discrimination.
I was trying to express that I feel like the battles for acceptance and against discrimination move along the axis from serious to less serious and eventually to trivial as the low-hanging fruit is picked. But the seriousness of the issue of the day is always portrayed as the same as slavery or Jim Crow.
I'm reminded of an episode of Roundhouse that depicted a future in which everyone was basically the same, so people manufactured a reason to discriminate against each other - and it was about belly-buttons: innies vs outies. I wish I had a good joke about navel-gazing with which to end this comment.
"a maximally compassionate policy would involve both trying to support people who are already transgender, and trying to prevent the switch from being flipped in people who aren’t transgender"
*endless screaming*
This is not a middle way, compromise position. This is an extreme transphobic position. Women who express beliefs far less extreme than this one are constantly threatened with rape or death.
That you could be a TERF without realising it is odd; that you are to TERFs as Pol Pot is to communists, while still considering yourself a reasonable centrist, is bizarre.
Edit:
I should clarify that I'm using TERF and transphobic as descriptors rather than insults; I don't think the first is an insult, and I'm increasingly unsure about the second.
And I'm sure you don't need advice from me, but as a therapist you have to be really, really careful about this stuff. This quote, plus one session with an activist determined to misrepresent you, and you could be accused of attempted trans conversion. Your last experience with the media was unpleasant, but your next one could be much, much worse.
>moreover, he has already been accused of much worse, so any fallout from this will be relatively minor.
The specific claim is that he'd be accused of performing conversion therapy in his capacity as a psychiatrist. It's a bit hard to get someone disaccredited or imprisoned via baseless accusations, though; that sort of thing tends to need evidence.
Also, theoretically Substack could kick Scott off the platform (ACX is his primary source of income). They won't, though, since their whole business model is catering to the deplatformed (seriously, Eharding didn't get banned for advocating that gays and transsexuals be executed).
I think you may be misinterpreting Scott's stance. By "people who are already trans", he means "people who feel there is something wrong, because they were born in the wrong body", whether or not they've transitioned. This may include people who have never thought they were trans, but once someone brought it up, they realise that accurately describses them.
This is a psychiatrist saying that if you see someone who you think might, at some point in the future, become trans, then the responsible thing to do is to try to stop that happening.
Whether or not he's right (I think he probably is, with a loooong list of caveats that I'd imagine he'd agree with), that's a position that is characterised by those on one side of the current debate as transphobic. And that side of the debate holds all of the power. And has no qualms about using their power to destroy people's lives.
It's like seeing someone in first century Rome say "I hear there's a debate about these Christians. Well I'm pretty sure I'll upset both sides by saying this, but I think Jesus Christ was the son of God, and that anyone worshipping another God is wasting their time, and will go to Hell when they die." It's such an odd way of putting it, and suggests they're so out of touch with what's going on that you really hope they don't end up earnestly explaining their point of view to the Emperor Nero, and expecting that he'll give it careful consideration.
"Increasingly, surgeons such as Dr. Bowers are being asked to create adult genitalia from infantile tissues. There also have long been patients who end up with suboptimal depth—often from other surgeons but also patients of Dr. Bowers who lack sufficient pre-operative skin in order to create functional vaginas. The maturation of a large number of children, genitalia growth blocked prior to the onset of puberty, now coming to the age of surgery, is putting an enormous strain on Dr. Bowers and those who care for these adolescents and young adults as they seek functional genitalia. All vaginas require a lining of some sort. Otherwise, surgeons can create the vaginal space but, if unlined with some sort of skin, the area will be simply a raw hole that will usually close itself off."
But sure, emit *endless screaming* about any attempt to say "what are the benefits and what are the costs and should we be just handing over drugs to ten year olds on their say-so that they really really feel like a girl/boy?"
This reminds me of a bizarre conversation I had with my doctor and the student shadowing him last week.
We were discussing the annual testing required after my weight loss surgery ten years ago (I lost 100 pounds) and a recent return of the polycystic ovarian syndrome that went away after my surgery. I asked if it had potentially been triggered by the 20-ish pounds I'd put on over COVID, and my doctor said, "Yes, probably. Losing even just five or ten pounds would probably resolve it."
He went on to add that there was a medication that might help, although it had some potentially nasty gastrointestinal side effects.
I said something like, "I'd rather not do medication if lifestyle change is enough. I'll get back to being more disciplined about my eating. That'll be easy now since my boyfriend dumped me and I'm not frequently going out to yummy restaurants with him anymore."
And then my super-yoked, super-fit doctor, who looks like a Men's Health Magazine cover model for living your best life after 55, said (I'm guessing for the benefit of the student?):
"You know, there's been a movement saying that we should be thinking differently about weight. A lot of doctors offices aren't weighing patients at appointments anymore, or discussing weight at all. Weight loss surgery, especially, is increasingly being frowned upon as an unnecessary intervention. Any thoughts on that?"
And I replied:
"That's really horrible. The extra 100 pounds I was carrying caused a ton of physical issues, including PCOS and a total lack of libido. My life is so much better post-surgery. And I never would have managed the weight loss with diet and exercise alone; I simply didn't have the willpower to consistently stay on a healthy diet, because I could always indulge 'now' and diet 'later.' Only the threat of immediate consequences, like having a bad surgical outcome, or feeling really sick after eating too much, were ever going to motivate me to make the right choices. I'm so much happier today. I feel so much healthier, have so much more energy. Those advocates are idiots."
And my doctor exchanged a look with the (similarly fit, athletic-looking) student and said, "Now isn't that an interesting perspective?"
Hearing Voices, transgenderism, Healthy at Every Weight...these feel like orthodoxy competitions filling the void left by the abandonment of organized religion.
My doctor was saying that the fat acceptance movement has gotten so noisy that many in medicine don't consider obesity to be a disease anymore, much less one requiring interventions like surgery to cure.
The problem is that the medications for weight loss suck. Amphetamines are addictive and cause mania. Dinitrophenol can cook you alive. If there were working diet pills that weren't such Serious Shit, I imagine they'd be first-line.
There's a reasonably-solid argument slowly making its way through the health system (to the point that I've gotten advice to this effect from nurses and doctors) that the "healthy weight" range you will find in Every Authoritative Source Ever is drawn a bit too low, essentially because it's optimising for cardiac mortality rather than all-cause mortality (the weight point above which there's no excess deaths from infection is higher than the weight point below which there's no excess deaths from heart disease).
This is not the same thing as claiming that outright obesity is healthy.
However, there really is a fat acceptance movement pushing against weighing patients at their appointments and against offering and performing weight loss surgery.
Weight loss surgery is an extreme intervention that (ethical) doctors only perform on severely obese patients, people who are either almost universally very visibly unwell, or obviously will be at some point if the obesity isn't addressed.
But the pursuit of fat acceptance extreme orthodoxy is such that offering this often life-saving intervention is bigotry against fat people.
Right, you're probably all going "okay, trick question here" and you're correct.
I'm the 4.2 (good level), she's the 6.4 (bad level). I did withhold some information, in that she suffers from hypothyroidism and that caused her high cholesterol. But as you can see, there is often more going on than simple "all bad things of being obese" for any particular obese person.
"I still remember a patient who asked me if I could cure his anxiety within a week. I told him absolutely not - medications take a few weeks to even kick in, and managing anxiety can be a lifelong process - and why did he need a cure in a week anyway? He said he was an inspirational speaker on the topic “How I Overcame My Anxiety”, and he had a speech scheduled next week, but was too anxious to work on it."
Just a quick personal anecdote on IFS: my current therapist, who considers himself primarily a CBT/Rationality therapist, dabbles in IFS. When he first described it to me, he prefaced it with "I don't really understand why this works or how it works and it seems a bit crazy and unconventional to me, but this does seem to really work for some of my patients. Wanna give it a try?" My initial thought was that it would definitely not work for me, but that since we didn't completely understand why many medications work, why not give it a try and humor him.
The issue was personal and I won't go into details here, but basically, I found myself talking (internally) to a younger, more confident version of myself. It was arrogant and full of BDE (Big Dick Energy!) and I had gradually put this side of myself away as I grew older, got married, had kids, and ran a small business. But that part had never gone away and was actually mad about the second-class status it had developed. It wanted more time on center stage and wanted to help me with the issue I was having. With my therapist's help, I integrated this now mostly dormant part and it basically solved a long-standing issue.
I'm throwing this out there, primarily for Scott, but potentially for others in the therapy space: you and your patient can both be skeptical of how IFS works and it can still work. I've since used it both with my therapist and by myself with lots of success. It can be really helpful to see the different parts of yourself as having needs and roles and once you understand where they came from and what they are doing (a basic tenet is that there are no Bad Parts - just unintegrated ones), I was able to feel like a more whole person.
IFS sounds a bit like what you'd do as part of certain kinds of traditional meditation, just under external guidance, so I wouldn't be shocked it works to some degree. Seems like a decent amount of therapy is simply about giving out cues to make people feel that ruminating on their personal issues for a while is perfectly fine, which gets discouraged in extravert-dominated cultures?
I don't know about the specifics of IFS, but I have thought for some time that given the complexity of the brain and what we know about neuron architecture, it would be surprising if there did not exist what may be termed family members, factions, tendencies, brain areas etc. that disagreed with any given decision made by 'you' and presented the mental equivalent of minority reports.
I think that you are absolutely right about people with "mild" cases being in denial about just how problematic it can be - and also that some of these people are not, in fact, mild cases, and in fact, are hurting other people by pulling them into unhealthy psychosis.
I do agree that there's people who can probably hear voices and be fine. But I also suspect that it is really not so good for you, as you are on the edge of a serious psychiatric condition.
The trans movement feels much the same way in some ways, though to be honest, the thing that concerns me the most about gender dysphoria is the fact that none of the treatments for it have undergone proper clinical trials for the treatment of gender dysphoria.
And I am deeply suspicious of this fact.
Pharma companies are pretty infamous for evergreening patents and "reinventing" medications to make more money. On top of that, if you can have the Only Clinically Proven Drug for the treatment of gender dysphoria, you can potentially corner insurance markets and government support by saying that you are the only medication proven to help these people. There is a lot of money to be made there.
The fact that these companies aren't pushing clinical trials for their drugs so that they can be approved and corner this market makes me suspicious that they don't actually think that hormonal therapy actually works at all.
There's also the whole trans movement that is basically a nasty religious sect that attacks anyone who dares to contradict their core doctrine, but that's not really a problem with trans people but a group of them that are, frankly, pretty gross. The degree to which they've hijacked the gay movement is also not great, because gay people struggle to get equal rights in many parts of the world, and I think this particular sect is detrimental to that goal.
I worry about the same thing with all of these groups. The "pro-autism" groups seem to think that autism is a good thing, when it is pretty obvious that these people have a lot of problems. This group feels like it falls into much the same domain. All of them claim the mantle of human rights but what they want often denies rights to other people, and leads to worse outcomes. for them.
>Pharma companies are pretty infamous for evergreening patents and "reinventing" medications to make more money. On top of that, if you can have the Only Clinically Proven Drug for the treatment of gender dysphoria, you can potentially corner insurance markets and government support by saying that you are the only medication proven to help these people. There is a lot of money to be made there.
>And I am deeply suspicious of this fact.
As I understand it, you think that because pharmaceutical companies aren't investigating a cure for gender dysphoria (ie a medicine that makes a trans person into a cis person), that suggests that the disorder isn't real. Do I have that right?
AIUI, other way around - *transition therapy* was never (AFAIK) properly RCTed to see if it has the effects people claim for it (e.g. lowering suicides).
I think the implication is more that TD doesn't think that there's a medicine with which to actually achieve a transition, rather than that there's no desire to transition. I'm not sure this logic holds. The absence of a tested medical package implies that creating such a thing is expected to be unprofitable not that it is impossible.
Yes. The issue is that the treatments we're giving people right now have never undergone proper clinical trials to prove that they actually are beneficial to patients.
People with gender dysphoria deserve treatment that works and that has clear benefits, and where the risks are clearly established.
Given that there are millions of trans people globally, I don't buy the argument that it isn't profitable.
That's not to say that there aren't other possibilities, but it is a worrisome sign, given the behavior of pharma companies in other treatment spaces.
"The issue is that the treatments we're giving people right now have never undergone proper clinical trials to prove that they actually are beneficial to patients."
The issue is that if trans women say "I want to grow boobs", HRT will do that for them. That's what all parties are agreeing on what they want. The pharma companies don't need to run trials on trans gender people about this, they know it will work that way.
If you want the issue to be "will taking drugs to grow boobs make me happier?" that is a whole other issue. Some trans women will passionately declare yes, and that if they don't get the drugs, they will feel so bad they want to die. Arguing with them that there have never been any clinical trials about "will growing boobs make me happier about my dysphoria?" will get you precisely nowhere.
If you mean puberty blockers, yes I agree that giving these to healthy children is an entire can of worms waiting to explode in our faces. And yes, we won't know the long-term side effects until we've used this generation as guinea pigs. But again, if you claim the drug companies are not picking up easy money, then you can't blame them for selling drugs for easy money even if they end up fucking up the kids. The social pressure is on *not* to do trials about "will these fuck up ordinary kids without precocious puberty, unlike those with precocious puberty who would only be on blockers a couple of years and then go on to undergo normal puberty ", it's on to "just talk to your mom and then you can go see a doctor about getting puberty blockers!"
I mean, that's the core problem. The problem isn't that people with gender dysmorphia don't have boobs, the problem is that people with gender dysphoria commit suicide at a massively higher rate and suffer from various forms of psychological misery.
The argument is that giving them boobs will fix these psychological issues, but there's no clinical trials to prove that these psychological issues are lessened as a result. A lot of people who transition claim to be happier, but they still commit suicide at a much higher rate than the general population and seem to have extremely high rates of psychological issues. It's possible that the treatment is helping a bit... or it could be entirely placebo effect and even though they think "this is helping me" it actually isn't. Which is very common amongst useless drugs and treatments, including acupuncture and chiropractic "medicine" and traditional Chinese "medicine".
We don't do surgery or give treatment to people with, say, dysmorphia or anorexia to try and warp their bodies towards their mental perceptions of it, and it doesn't seem to help anyway; even super thin anorexic people will still perceive themselves as being fat/overweight.
As such, this stuff should have undergone clinical trials before being pushed as a treatment.
Puberty blockers are even worse, because most children with gender identity issues don't end up ultimately being trans.
I am generally in agreement with you about gender dysphoria being part of a constellation of mental problems.
But I am not going to hammer the drug companies (for once) for not doing trials on something they never claimed to be selling. The drug companies never said "Go on HRT and it will fix your mental problems." The drug companies said "These are replacement female hormones for women who don't naturally make their own any more".
The same way nobody has done psychological trials about "does taking aspirin make you feel better?" because yes, taking aspirin does make you feel better since it stops the pain. Now, any psychological effects of "I am a roaring bitch when I have a headache" are not part of the package, all that aspirin is sold to do is "relieve pain".
Same with HRT. "Replacement female hormones" is what it is, and if doctors and psychiatrists are prescribing it to trans patients, then the physical effects are all that the pharma companies are concerned with. They never marketed it as a magic cure-all, that is down to the trans activism lobby which is demanding "no more medical gate-keeping", and "drugs for all if they simply ask for them".
Indeed, there appears to be a knock-off market where people are selling alleged HRT on eBay of all things! That is not Big Pharma in action, that is trans people wanting magic cures which is a whole other kettle of fish.
Yes, there absolutely should be trials done on "does transitioning help?" and "does medical intervention help?" but that is not for the drug companies to do, that is for surgeons, endorcrinologists, and psychiatrists - if the loudly online-screaming extreme activists permit it.
No, gender dysphoria is obviously real. I've known people who had it.
The concern is the other way around - that the treatments that people are selling to these folks don't actually work, and that the reason why the companies aren't spending money on developing a patent for their treatments is that they suspect that they don't actually provide any measurable benefit to people taking them.
In other words, it's a serious disorder that people may well be selling snake oil to cure.
I don't know that it is true, but the fact that no company is trying to profiteer off of this - when these companies are kind of cutthroat in that way - suggests to me that they have low confidence in the efficacy of the treatment, so are content to sell their drugs to people without FDA approval for the treatment of gender dysphoria.
I feel like, once a treatment becomes common enough, we need to have some sort of governmental mechanism where we test it if the companies won't, so as to avoid a treatment becoming prevalent that doesn't help people and might harm them.
Well, hormone therapy is a mixed kettle of fish. HRT was developed for post-menopausal women (do I need to jump through the hoop of putting in "cis women"? Okay, post-menopausal cis women):
Using it for trans gender people is the sort of off-label use that is "okay, we didn't develop this for your specific condition but it'll work in a way":
"Oestrogen and progestogen
The 2 main hormones used in HRT are oestrogen and progestogen.
Types of oestrogen include estradiol, estrone and estriol.
Types of progestogen include dydrogesterone, medroxyprogesterone, norethisterone and levonorgestrel.
Most women take a combination of oestrogen and progestogen. But women who do not have a womb can take oestrogen on its own.
Women who have a womb must take both oestrogen and progestogen. This is to reduce your risk of womb cancer."
"The purpose of the therapy is to cause the development of the secondary sex characteristics of the desired sex, such as breasts and a feminine pattern of hair, fat, and muscle distribution. It cannot undo many of the changes produced by naturally occurring puberty, which may necessitate surgery and other treatments to reverse (see below). The medications used for feminizing hormone therapy include estrogens, antiandrogens, progestogens, and gonadotropin-releasing hormone modulators (GnRH modulators)."
The drug companies are not doing trials on "does this reduce gender dysphoria?" because those are not the purpose of the drugs. Trans gender people want them to grow breasts, have more feminine physical features, and decrease masculine physical characteristics, and that is what they do. Psychological effects are not part of the package, that is different.
The drug companies can make plenty of money as-is simply selling hormones, indeed there is currently a shortage:
Why pump hundreds of millions into the required trials about "does taking female hormones make trans people happier?" when (a) they can just continue to sell the already tested and approved hormones and (b) that's a psychological issue, we're not selling HRT as pscych medications.
We are selling HRT as psych medicine. It is claimed that transitioning will alleviate the symptoms of gender dysphoria. If it does not, then it isn't actually doing what it is supposed to be doing.
The problem with people with gender dysphoria is not that they don't have boobs. It's that they commit suicide and suffer from psychological problems at a vastly higher rate than the general population.
Drug companies are not selling HRT as such, and the gender dysphoria people very much are claiming that their problem is they don't have boobs and once they get boobs, things will be better.
I do think psych tests should be done, but good luck getting away with those in this current atmosphere. Anyone even investigating desistance (detransitioning or not going through with complete transitioning) is getting pelted with stones for being a transphobe:
"One reason many researchers believe it’s unnecessary to delay the social transition of a child is that they don’t think the research on desistance is valid. In other words, they think the number of children who "grow out of" their transgender identity has been vastly overblown."
"Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health, we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities."
""Over the past few years, an endless parade of “concerned” people (trolls) have trotted out the same statistic over and over again: 84 percent of transgender kids stop being transgender on their own. They have used this to justify everything from reparative therapy, to denying medical care to transgender teens, to suggesting that reparative therapy on adults will work."
"The problem is that the desistance narrative is built upon bad statistics, bad science, homophobia and transphobia."
Are you really surprised nobody wants to pick up the live wire and be electrocuted when it comes to investigating "do the things that trans people demand they get, or else it's transphobia and persecuting them into committing suicide if you refuse, really help them?"
>I worry about the same thing with all of these groups. The "pro-autism" groups seem to think that autism is a good thing, when it is pretty obvious that these people have a lot of problems. This group feels like it falls into much the same domain. All of them claim the mantle of human rights but what they want often denies rights to other people, and leads to worse outcomes. for them.
Okay, here's my pro-autism argument.
Low-functioning autism seems to be high-functioning autism + mutational load. Mutational load is bad.
High-functioning autism is primarily marked by an inability/unwillingness to play Molochian social games, and hence tends to be negative for the autistic but positive-sum.
Removing mutational load is generally good. Actively removing HFA seems to me to be directly anti-social.
I've never seen any evidence that this is true, though. As far as I can tell, high functioning autistic people often are just socially dysfunctional and engage in the same sort of "Molochian social games" but are just flat out worse at it. The whole "calling people Neurotypicals" thing and sneering at them while crying about not being accepted is exactly what you'd expect from a dysfunctional group of people. I've seen no indication that they are really somehow more beneficial to society than normally functioning people.
"at least some large subset of transgender people aren’t consciously faking it."
Find me someone who believes that the 15 year old girl who just got her breasts removed is consciously faking it. To a second approximation, nobody believes this.
"Once the switch is flipped, you’re transgender in some pretty real way: you’re not faking it, and you’ll be miserable until you’re allowed to gender transition."
But this doesn't follow: that poor girl would have been fine if she'd just been forced to wait a while, or maybe she would have gone for they/them pronouns and left it at that (a vastly better outcome, imo).
"a maximally compassionate policy would involve both trying to support people who are already transgender, and trying to prevent the switch from being flipped in people who aren’t transgender yet."
I mean, duh? Most elected Republicans hold this position. That is, most don't want to take away Buck Angel's testosterone, or Blair White's estrogen. My guess is that most elected Democrats probably don't want the 15 year old's breasts removed either. So Scott is acting like this is some impossible compromise, but if we can just tamp down a few crazies we're already there.
Are there really any gender correction surgeries performed on 15 years old? As far as I know activist are just pushing for puberty blockers and get a huge backlash from republicans for it.
Not a lot, but it happens. I can dig up a source of you like, but the point would stand even if no doctor was willing to actually perform the surgery: the fact that someone wants to go through that is sufficient to demonstrate they aren't faking anything.
I'm not claiming that no 15 years old transgender person want to undergo a surgery, or that they are faking it, It's just surprising for me to hear that they are actually operated in such an early age. As I said, the way I understand things, currently transgender activists are fighting for puberty blockers - a much less drastic thing.
Puberty blockers are allegedly less drastic, but I’m not sure that’s actually proven, and there are strong tides against speaking about or researching then honestly (see Jesse Singal’s substack for some excellent discussion on the topic)
The other issue is that I strongly suspect that “completing puberty” is actually a pretty key step in determining an adolescent’s “true” gender identity.
I must say that switch flipping theory sounds very improbable. Why would it work only in one way but not the other? Why can you make presumably cis people trans by some groups of people being openly supportive to transness but can't make trans people cis even by full blown conversional therapy?
But even if we accept it as equally possible, wouldn't the obvious and much easier solution be to just let trans identities be normalised as fast as possible? If being trans isn't a forbidden cool thing but just a regular way of being there is no pressure to "flip the switch". No need to develop a sofisticated policies when to encorage transition and when to discorage it, no need for high accuracy tests for real transness. Let's just stop waging a culture war over it and there will be much less casualties.
Citation needed. But even in a counterfactual where it is the case, my why would they be stuck? Why it's easier to convince cis people that they are trans than trans people that they are cis? Why is being trans so much more temptating that presumably cis people would still assume that they are trans, despite all the hardship of transness?
First of all we need some biological explanation why it would be even possible. Why one can change gender identity in such a way, up to the point of becoming dysphoric? Why doesn't it work with other personality traits? I'm struggling even with some hand-wavy evolutionary psychology explanation here.
Secondly, being trans doesn't make you universally celebrated, it puts you in the middle of a huge controversy, where the society in large either hates you, is disgusted by you, or at least have lots of condescending commentaries about your life choices. This doesn't sound as a thing attractive to unhappy teenagers who, if my understanding of conventional wisdom is correct, mostly want to fit in. Granted, some people are into controversy, but it's already a complexity penalty for the theory, until we get good evidence that transgenders disproportionally love controversies and it's controversies that can change people gender identity.
You know what's funny? The methodology you proposed actually makes much more sense when talking about people who are critical about transgenders. That these people choose their position because they want to be in the center of a controversy and thus feel special, rather than because this position is actually true. Indeed, having beliefs (or beliefs in beliefs) based on social status is a well known phenomenon much less improbable then developing actual medical condition. And how Brave and Dedicated to Truth are these people! Even despite all the horrors of Cancel Culture and Thought Policing from the left they keep spreading the word of Reason! I also predict that people actively waging culture war are much more into controversy than median transgender.
Actually, the more I think about, the more it looks as a universal argument to dismiss your opponent's views, regardless of how much they are true. Oh, you hold the position of majority? You are just a conformist! What, you are in opposition to general consensus? You just want the aesthetics of fighting the power! And so on. This is generally a terrible epistemology. I think we shouldn't use it.
There is a huge spectrum between being set in stone and switchable at a whim. Personality traits are hard to change, while opinions are much more changeble. Such traits as sexual orientation proved to be very hard to change. Gender identity and experience of your own body seems even deeper, more personal thing. You do not experience sexual attraction constantly, but you do experience being in your own body all the time. It being more easily switchable is very surprising and requires lots of evidence to be accepted.
>Lol, no.
Yeah, very funny. Do you really believe that some low effort virtue signalling means that corporations and USA goverment are 100% on the side of trans people? Or that there is no controversy? That's trully ludicrous. At this moment I would assume that you are obviously arguing in a bad faith, if I didn't understand how one can be too much caught in the political thinking. Wasn't it Trump elected on the platform of opposing wokeness instead of Hillary on the platform of promoting it? Despite loosing the popular vote? There are also, you know, other countries. President of mine, for instance, is extremely concerned with the disturbing effect of Cancel Culture on the freedom of speech in the West, and the decline of concervative values while killing and imprisoning his political opponents and arresting everyone who dares to say that being gay is okay. But sure, tell me more how social justice went too far.
>Why not, when it happens literally all the time?
Because universal arguments are useless. Because it doesn't allow us to separate truth from fiction. Because it's just another way to smear your opponents, instead of figuring out what reality really is.
They aren't stuck - something in excess of 90% of individuals who think they're trans at some point desist.
Now, put them on cross-sex hormones and give them surgery and, yeah, those rates of desistance drop precipitacely. But even then detransitioners are a thing. Switches switch.
The switch-flipping thing doesn't flip everyone, just the marginal person. Plenty of people will stay cis even under monumental pressure, and some people will stay trans under the same. Then there's a bunch of people in the middle that could go either way.
In my view, normalizing trans-ness would be superior to the status quo, but worse than the state of affairs 10 years ago, because being trans *sucks*. The fewer people who have to live with it the better, and this is best facilitated by strong pressure against. Comparisons to anorexia are apropos, but left as an exercise for the reader.
The question stands. Why the switch of marginal person can be so easily flipped one way, but not back?
I believe the well established conclusion that being trans pre-transition sucks much more then being trans after transition. Previous balance left lots of binary trans people not transitioning and lots of non-binary trans people not aware of their identity, therefore living less happy and less fulfilling lives. Current balance may contribute to transitioning of people who didn't need it if the switch theory is correct. But the full normalisation will be free from both failure modes.
I'm not sure flipping back is impossible, but it does get stuck in some number of people. And even if it eventually gets flipped back, it sucks in the meantime. (People get over their eating disorders, or detransition.)
I'm not sure what you mean by it being easier to flip the switch one way than the other. There are those who are unflippably cis, those that are unflippably trans, and a bunch in the middle that could go either way. Until trans started being cool, most of the flippers stayed cis. Then trans got cool, and a lot of the flippers are now going trans. I'm sure there's tendencies one way or the other among flippers (bell curves all the way down) but flippers they remain.
IIRC, suicide rates among trans people don't change much pre-to-post transition, so that's not great for the thesis that post transition is generally less sucky than pre. But the person I'm primarily worried about is the flippable high school girl who, ten years ago, would have been confused for a couple years in high school, and then gotten over it. Maybe she decides she's a lesbian, or maybe she's just masculine of center, or maybe she's perfectly average and just subject to the mental weirdness that accompanies puberty. At any rate, if that girl is left without medical intervention, she'll go on to live a happy, fulfilled life. This is the path for something in excess of 80% of females who think they're trans at some point.
Or, she goes on puberty blockers, and the desistance rate drops to near 0%. She goes on testosterone, and maybe gets uterine atrophy, necessitating a hysterectomy. Throw in top surgery, and the poor girl is now sterile and has to deal with being trans for the rest of her life due to decisions that got made in her late teens.
I think this second path is bad, relative to the first. Sure, there are females who really are trans, and for whom transition is the best life, but they are RADICALLY outnumbered by those who are just confused for a bit. I think being neutral on this question is bad because, again, being trans sucks (even post transition). The fewer people that have to go through it the better, and that means pushing the switch strongly in the direction of remaining cis. If, despite that pressure, someone remain trans, then more power to them. But that person has a hell of a row to hoe, and I'll bet most wish they didn't have to hoe it.
Yes, massively. Conversion therapy is typically referenced wrt sexual orientation, and even there the effectiveness rate isn't zero. Move over to trans teenagers and even basic conservative care is likely to result in desistance of disphoria.
This style of free wheeling switching between topics is fun and entertaining. Kind of like a discussion between old friends around a campfire where topic come and go based on input from individuals with shared similar experiences.
But, I think that the Hearing Voices and Gender Dysphoria are such important and serious issues that it might have been better to treat them in separate essays.
The Special Snowflake issue seems a lot less important but it is interesting and could have served as the topic of its own fun but less serious post.
But just throwing out one thing, the level of nytimes bashing felt a little jarring, especially in light of the "because I’m balanced and reasonable empathetic to both sides" description. I get there are personal reasons for this, and I agree there are a lot of articles with odd framing and questionable decisions, but I also thing the times is a valuable american institution doing work non else can or will. Maybe it's worth an attempt at empathy even for the nytimes.
Jumping on the trans wagon, I read Scott's post and the other comments carefully, and I feel there is a hidden assumption that exists here that requires naming: What is so socially bad about gender transitioning that we require people to be miserable before we allow them to make that choice?
It seems that people hold the view that staying in one's assigned gender is somehow morally better, and to transition requires special circumstances of misery such as gender dysphoria before it becomes socially legitimate. This is comparable to the pro-LGBT argument that because people were born that way and cannot change their sexual orientation, then we as a society must begrudgingly accept them (rather than simply allow people to be attracted to whoever they desire at the moment, without needing any predefined neurological justification for that desire to be accepted by society). Yes, many gender affirming surgeries are painful and dangerous, but so are cosmetic surgeries, and we don't require people to suffer before we make those socially acceptable. Why do we require misery for breast removal but not for breast enlargement? Shouldn't we allow everyone to change their body, gender, and pronouns as they see fit, similar to how we allow them to change their appearance?
I find this assumption and the subsequent requirement problematic for the cause of trans acceptance. While they do help some people accept gender transition and same-sex sexual orientation, they also prevent the same people from accepting those who don't fit the special criteria: people who are fluid about their sexuality, or people who have a slight, non-painful preference to be of another gender (or not to conform to gender at all, while also changing their body in the process). I want to challenge this view, and believe it will some day disappear like the "born this way" view also all-too-slowly disappears, allowing people to be who they want to be without need for neurological justification.
> usually producing unconvincing results and a lifetime of stress, unhappiness, and unpleasant medical issues
I would imagine gender dysphoria causes the lifetime of stress and unhappiness, rather than the gender affirming treatments. Supporting your claim would require showing that people who transition are less happy than people who experienced similar levels of gender dysphoria and did not transition, which I find unlikely (but big if true, and will change the entire discussion).
Regardless, the argument of cosmetic surgery stands. We allow people to have irreversible cosmetic breast reduction without requiring them to be miserable, while still not living in a sci-fi utopia. This double standard against gender affirming, rather than purely cosmetic, breast reduction surgery hints that something else pushes us against gender affirming actions. Why are we against giving people control over their bodies when it comes to gender?
It seems you have strong feelings regarding gender affirming surgeries, or however you prefer to call them. Why is that?
To make the conversation clearer, when I write about gender affirming surgeries or treatments, I refer to any medical procedure or intervention that changes the body of the individual to exhibit attributes usually associated with the gender of their choosing, similar to the definition on wikipedia (https://en.wikipedia.org/wiki/Sex_reassignment_surgery). This includes breast size reduction, ovary removal, rhinoplasty, and other procedures that also take place in other, more mainstream fields.
>And I note that you veered away from actually defending the ideology to making Dark Insinuations about why anyone would disagree with the ideology.
There was no dark insinuation involved. I noticed you were using heated terms such as "humiliation", "sociopathic" and "embarrassing", so I gave you space to express your feelings on the matter directly. I hear your reasons, and see how believing you cannot talk against a practice that you think hurts innocent people would definitely make one feel strongly against something like that. I think we just disagree on the facts.
You make claims about people who grow out of gender dysphoria or living unhappy lives after gender affirmation, but I am not aware of this being the current research. Are you?
You don't seem to accept that breast reduction, that as you say does not lead to sterilization, is part of the gender affirming toolkit. Since it is (see wikipedia article above), I have trouble seeing why you think gender affirming surgery as a whole ruins lives. When you talk about gender affirming surgery, do you mean specifically genital surgery?
You're assuming gender dysphoria is something inherent, like hair color, rather than something like the desire to drink tea or do fentanyl. I think human history supports the latter interpretation: this is not a problem that needs to exist.
I actually don't think it's inherent, I think it's a combination of culture and biology. My point is that it doesn't matter, and that it is not a problem: People should be able to choose their gender, regardless of gender dysphoria.
> Why do you believe separating women from men in vulnerable situations is needed
Because men are much more violent than women. It's not just random man-hating that makes the default for societies to give men and women separate bathrooms and locker rooms and prisons.
It's funny to watch liberals claim that men aren't any more dangerous than women, though. Big switch from just a few years ago.
Yes, there are more violent incidents coming from men than from women. Does that mean you think people should not choose their own gender because you believe AMAB women will be violent towards other women?
Some meta-commentary: apparently, even if only a small part of a post discusses "trans" issues, the majority of the comments will be on the topic. Or at least a majority of the vitriol in the comments.
I have a draft blog post, stuck in revisions hell: Don't say 'trans', say 'kathoey' or 'freemartin' or 'cross-dresser' or 'teenager who wants to be rebellious' or ...
The theory is that people use the word "trans" to mean so many different things that it simply doesn't mean anything anymore. It is simply a vector for bad-faith and harmful rhetoric.
I remember a documentary about the parents of a "trans" kid, very liberal people who "supported" the "decision" all the way. Yet they still spoke of the process as if their child had been diagnosed with cancer. They had to be "strong," to "be there" for their child, etc.
Some lobby groups have strategies and carry out exercises and train people to dominate social media comment sections. I can only wish I could muster half that organisational commitment to the things I care about most
Organised might be a better way to put this, rather than trained. Collecting together as many people as you can into one communications channel, getting enough people to be scanning social media for every mention of (I'll use a common idiosyncratic New Zealand example) 1080 poison, getting every person on that channel to pile on to that article every time
organisation != conspiracy. The 1080 groups I used as an example aren't at all trying to hide the organisaitonal effort they put in to getting this result. They boast about it occasionally
Regarding people who here voices. I’m still thinking of the rank and file of the Abrahamic big 3 - Judaism, Christianity and Islam - that are fine with prophets receiving messages from God as long as it occurred in some hazy past, but regard direct experience of the divine in their own time as a mark of insanity.
Saul had an experience on the way to Damascus that made him a key player in establishing the largest religion in history. If you accept this at face value why would you be skeptical of a 21st century update?
Or one from the 19th century. More traditional Christians are pretty skeptical of Mormonism, but why? Because the revelations came after the invention of the printing press?
Cardinal on the phone to the Pope: “Jesus has just returned…. In Salt Lake City. Your Holiness, you still there?”
How do you know the guy on the corner delivering his direct revelation of the word of god is just crazy?
Why believe that because it comes down from an ancient oral tradition that was eventually transcribed into a very old language it’s ‘The Truth?’
This is one of the best blog posts I've ever read, and not just on here.
And not just because this line made me literally LOL: "And on one level it’s definitely true that mankind will not be free until the last admissions officer is strangled with the entrails of the last New York Times journalist."
(I've viewed the Gray Lady that way since long before you ran afoul of them; am in fact a recovered NYT subscriber.)
Progressives always say that detrans people are rare. I suspect they're not that rare, and that the studies showing they are are bad science in some way. Remember, scientists and the scientific institutions are utterly and unreservedly devoted to saying that all the things that trans rights activists want to be true are true. The world would look the same as it does now whether detrans people are rare or common.
Something like 41% of trans people attempt suicide. 1 in 3 trans youth have attempted suicide in the last year. (Veale et al 2015) Maybe it's society's fault for not accepting them. But alternatively, we should seriously consider that some trans suicides could be prevented by treating some people with mental health care that doesn't affirm their wish to be the opposite sex.
""Forty-one percent?” the man said with anguish on his face as he addressed the author, clutching my handout. “We’re talking about my granddaughter here.” He was referring to the finding from the National Transgender Discrimination Survey (NTDS) that 41% of 6,450 respondents said they had attempted suicide at some point in their lives. The author had passed out the executive summary of the survey’s findings during a panel discussion at a family conference to illustrate the critical importance of acceptance of transgender people. During the question and answer period, this gentleman rose to talk about his beloved 8-year-old granddaughter who was in the process of transitioning socially from male to female in her elementary school. The statistics that the author was citing were not just numbers to him; and he wanted strategies—effective ones—to keep his granddaughter alive and thriving. The author has observed that the statistic about suicide attempts has, in essence, developed a life of its own. It has had several key audiences—academics and researchers, public policymakers, and members of the community, particularly transgender people and our families. This article explores some of the key takeaways from the survey and the ways in which the 41% statistic has affected conversations about the injustices transgender people face and the importance of family and societal acceptance. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved)".
"- The authors note that the survey was flawed because only one binary, Yes/No question was asked: “Have you ever attempted suicide?” More careful and rigorous studies always follow up with in-person interviews, and when self-harming behaviors (not intended to end life) are controlled for, the actual suicide attempt rate is typically halved—meaning the suicide attempt rate could be as low as 20%.
- The highest suicide attempt rate of all–60+%–was GNC and trans people who self-report a mental disability. No big surprise there; it’s well known that having certain mental conditions is a risk factor for suicidality. But by the authors’ own admission, the survey made no effort to ask for further details about these mental health issues. The status of having a mental condition was self reported, with no corroboration from medical records or a provider. Nor was there any attempt to discover whether the actual rate of mental illness was objectively higher (via diagnosis by a mental health provider) than reported by the subjects.
- People who had either sought or received transition-related services had a higher suicide attempt rate than people who have not. And the survey did not ask whether suicide attempts occurred before or after services were sought or received.
- The data suggest that natal females seem not to be helped at all, in terms of self harm, by being either “stealth” trans or passing as male. (This is the opposite finding from that of natal males.)"
"Finally, it should be emphasized that the NTDS, like all similar surveys, captured information about suicide attempts, not completed suicide. Lacking any information about completed suicide among transgender people (due primarily to decedents not being identified by gender identity or transgender status), it may be tempting to consider suicide attempt data to be the best available proxy measure of suicide death. Data from the U.S. population at large, however, show clear demographic differences between suicide attempters and those who die by suicide. While almost 80 percent of all suicide deaths occur among males, about 75 percent of suicide attempts are made by females. Adolescents, who overall have a relatively low suicide rate of about 7 per 100,000 people, account for a substantial proportion of suicide attempts, making perhaps 100 or more attempts for every suicide death. By contrast, the elderly have a much higher suicide rate of about 15 per 100,000, but make only four attempts for every completed suicide. Although making a suicide attempt generally increases the risk of subsequent suicidal behavior, six separate studies that have followed suicide attempters for periods of five to 37 years found death by suicide to occur in 7 to 13 percent of the samples (Tidemalm et al., 2008). We do not know whether these general population patterns hold true for transgender people but in the absence of supporting data, we should be especially careful not to extrapolate findings about suicide attempts among transgender adults to imply conclusions about completed suicide in this population.
1.For the purposes of this paper, “anti-transgender bias” means bias or prejudice that is directed toward people who are transgender or gender non-conforming."
> whether there’s something to be gained from picking over experiences like these
On what axis is the baseline state of consciousness better than the hippie tripping balls? The obvious metric of "ability to safely operate heavy machinery" etc is unfair as the hippie just took the chemical equivalent of blunt trauma to several key pieces of his brain. This tells us nothing about the validity of the resulting mindset.
I've recently compared thoughts I think on psilocybin and thoughts I think without, and I'm hestitant to consider the sober ones saner or more productive. I don't want to get all postmodern here, jumping out of the window because you don't believe in gravity is still a bad idea. Still, a majority of consensus social reality is complete bullshit, even if (or especially if!) you aim to achieve goals considered valuable in that consensus.
EDIT: Actually the post itself provides an excellent example.
> “I am a guy who works a McJob and is bad at it, and that is all I am”
How dysfunctional a mental/spiritual framework has to be, to reduce a person to a sentence like this? And yet this is how a large part of the population looks at the world, and at each other.
I know. Go your own way. In the words of Bill Murray in the profound classic, ‘Meatballs’, ;) “It just doesn’t matter.” A throwaway line in a comedy that he echoed seriously in ‘The Razors Edge’
It’s all just maya. Read “The Indian Story”, the second ‘posthumous’ story after the death of the protagonist in “The Glass Bead Game.”
I enjoyed the write up and I appreciate the sentiments, but as a "too interesting" person (yes, with a couple of psychotic breaks under my belt) I feel a little self conscious now, lol.
I read "The Spiritual Gift of Madness" years ago and it resonated with me, but I felt at the time like it was only about 75% applicable, and the rest was agenda-driven ranting. A good thing to read, especially if you have a history of mental instability and have chosen not to medicate daily, but the "Mad Pride" movement imo goes a little too far sometimes...
I just don't see how mental health can ever be anything other than case by case. In my case, no meds every really helped me feel better or heal from the atrocious childhood that destabilized me in the first place. I've had to do, yes, woo-woo IFS and other trauma-release modalities to start to get a handle on it.
But I'm not going around telling people never to take meds. What I WILL say is, if you take them, PAY ATTENTION. People may not need meds forever and ever, but only for about 6 months or so, but they just "default" to forever and ever. I'm very thankful for the Zoloft that got me through my father dying for 6 months when I was 20, but once the crisis was past it wasn't doing me any favors so I quit. If I quit and I turned out to need it, I'd have gone back on, but I didn't, so I didn't.
I don't hear voices, but I do have to make sure I can functionally blend my "non default" reality into the rest of the consensus, and I do it very well. Mad Pride helped me understand that this is a valid way to live. I have a personal motto that serves me daily - "It doesn't matter what's real, it matters what's functional." It really doesn't matter what I believe to be true, as long as I'm feeding myself, paying the mortgage, walking the dogs, being friendly to my neighbors etc. It doesn't matter what my neighbors believe to be true, as long as they're able to do the same.
Hearing Voices is also an immensely useful modality for all the folks with dissociative disorders who are routinely missed in diagnosis. Because anti-psychotics do not work for that, while making friends and working with the voices does. And the many of the symptoms of dissociative disorders, as described in Dell's subjective/phenomenological model, look more like psychosis than dissociation to most un- or under-trained eyes.
I am not sure what actual data the social contagion mental model is grounded in. For DID, the iatrogenic/sociocognitive model has substantial evidence against it. And for a lot of groups--trans people, systems, voice hearers, autistic folks, left handers--it seems like there is a lot of pain when the dominant society is furiously trying to make you hide what you are. And there is a real need for medical support that is de-stigmatized, and for individuals to have some autonomy and agency over their own bodies and lives.
I do hope Scott can see how deeply stigmatizing some of his own language and the language in the comments can be. People are trying to draw a hard line between their own rationality and the these conditions, in part because there's a tendency to equate personhood, civil rights, and personal value with having an impeccably rational mind. It's not just my Special Snowflake vs your special snowflake--it's that one group gets civil rights while the others don't always.
Spoken, by the way, as a diagnosed DID system who is nonbinary trans, was misdiagnosed and mis-medicated for years, attends a hearing voices group for this reason, and is a disability rights/neurodiversity scholar.
The Hippie Movement created the greatest art of the 20th century in the form of music. I don't blame Scott for being blind or deaf to this; it's not his field.
The Hippie Movement, which is too broad to break down into a few of names, brought to 20th century America the notions of tolerance and non-judgment. That seems important for the black civil rights movement, and ultimately if not immediately for feminism of the sensible sort and the gay acceptance movement. "Letting Your Freak Flag Fly" was a hippie ethic that seems to have resulted in more good than bad. Accepting weirdos is good. They are often the best among us.
Could be wrong but I think Scott still sees the hippie movement through the lens of his awful On the Road review (Love you Scott, but that one was awful). The hippie movement was anti-rational and gave us a lot of art and symbolism -- post Chirstian symbolism one could say -- in an attempt to make sense out of a post-Christian society. The attempt suffered many failures, but we needed those failures. We need more failures. We need to discover a post-Christian spirituality. The Beats and the Hippies tried to find it. They failed, but in a great American way. I love the Beats and Hippies like Scott likes all those CA gubernatorial candidates. I respect those who try passionately to be American, even if they are pathetic in the final analysis.
Yes, claiming that their total contribution to culture is negative is clearly going overboard. But, there certainly were plenty of negatives, and if Scott was at all accurate about it then On the Road was written from the POV of some pretty disgusting scumbags. Would you disagree?
In high school I read a Rolling Stone retrospective on the origins of the hippie movement and the Summer of Love (Rolling Stone #207, February 1976. Yes, I am that old). They said many of the early hippies were Christians, and I remember a quote: "Let the baby Jesus shut your mouth and open your mind". At the time I was very disappointed, having been raised in the church. Now I find it very touching.
Let's not throw the baby out with the bath water. There is a lot of good in the Hippie philosophy, if I can call it that.
Speaking of hippies being Christians: Recall Joni Mitchell's line, "I came upon a child of God / He was walking along the road" (from her song "Woodstock", released in 1970). Granted, one can be a child of god without being Christian, but that line always struck me as being unusual.
And like Mitchell, you can write the iconic song about Woodstock in your NYC hotel room bc your agent told you not to risk getting stuck in upstate NY and missing your upcoming television appearance
There was this study about communication, where autistic people played telephone games among themselves they scored as well as the none autistic people who also played telephone among themselves.
When the groups were mixed they did poorly.
So autism might be a disorder of communication with neurotypicals, rather than a disorder of communication. Functionally though that might not make a difference. --> prelim findings of study here.
I am pleased to hear that quirkiness is in! Now I suppose I should stop trying to downplay my quirkiness perhaps. (then again my hobbies are not that quirky).
I also think low-levels of hearing things seem much less bad than anti-psychotic side effect medications.
I mean I think its complicated; I think at times there can be a link between mental illness and positive traits, but thats the exeception not the rule.
This may be true for autistics who have gotten the support necessary to give their brains a break from overstimulus and develop those other functions, but young autistics in schoolsdont often doo well together,one person's comfort needs can be anothetr's"makes me have a screaming episode" trigger.
To me this is part of the issue with the autism identity movement. Sure,people are different and with proper accomodation can develop, but its stillobjectively more difficult for those who are young and autistic to do this, and thats a big tradeoff cosnidering we arent sure if eevryone whose autistic can become "high functioning"providede they are allowed to stim and not pressured etc.
Yeah, The autism identity movement has always seemed as wrongheaded as before when power structures seemed to interpret all autism as like childhood defiance, which is what it used to be like for a while.
I wonder what level of functioning autistics were in the study? I mean it wasn't the none verbal ones for sure.
to be clear,its not a study, we can now talk to many austistc who were noverbal who eventualy become fucntional and verbal, and they prettymuch all say yeah,if yuo do it tjis way its fine cause thats based on our own expriene as evidene. This doesnt mean necessarily this is possible for all, and the rationalistleaning ones admit that, but they stillthink this is lkikely the case, even thought is possible theyrre wrong.
Scott knows about this because his ex was one of thesepeople who shared this belief ans he was familiar with ut also criiticalof some of the excess of the community.wich everyone shoukd be cause communites always managed to grw blind spots in the same way they need a "walled garden"to even be a coherent community or subculture
I think the element of “if the voice in my head isn’t agentic then it must be me” is crucial to the distress some people feel about the voices in their head, especially if they don’t like what the voice says.
If you believe the voice is some external force - a demon, angel, fey, whatever - then it doesn’t matter what it says; it’s a different person with a weird opinion. It doesn’t reflect badly on you that they have a weird opinion. In fact, it might reflect credit on you; you’re important enough for some big external force to be contacting you!
But if there’s no magic, if that voice is *you* and is advocating things *you* believe to be wrong … then doesn’t that mean that some deep part of *you* is evil? How is a person supposed to feel about that?
I don’t buy that the answer is “the voice is a demon, don’t worry about it bro”, because that carries a lot of dubious baggage. The way I think about it - and have suggested to others, with all the arrogance Scott predicts - is that we’re not fighter pilots, we’re the captains of a ship. Of course there are a lot of voices in our heads; our stomach, our love, our morbid curiosity, aspects of us even more esoteric; they all have a voice. But those voices aren’t the core you, they’re a part of your body but not your mind. *You* are the aggregator who hears those voices, sometimes with competing views and goals, and steers the ship with all that in mind. Sometimes those voices are flawed! That’s okay! Part of your job in life is to learn how your particular voices are flawed, and fuse them together into a working ship anyway, like some campy Hollywood found family movie. Rarely those voices are too persistent or have no upside, and you have to seek outside help, but even then you’re just being a responsible manager. It reflects credit on you for recognizing the situation and calling for backup, rather than shame for having been made “out of spec”.
I know for a fact that viewpoint has helped 2-3 people, but that is not a lot of people, so take it with however many grains of salt that merits.
I would say its more like the captains hat is passed around between different aspects all the time to stick with the analogy. And every time we feel like "yep thats me" even if angry me is very different from curious me is very different from gregarious me etc. in their view on things.
"But if there’s no magic, if that voice is *you* and is advocating things *you* believe to be wrong … then doesn’t that mean that some deep part of *you* is evil? How is a person supposed to feel about that?"
I'm probably rephrasing a part of what you said a bit later on but I'd see it as the brain exploring counterfactuals on autopilot. It's not about morality or good vs evil: parts of the brain can't correct their own mistakes on auto, without consensus with other modules. That you know that it's wrong is the consensus, one that's meant to see that projection as a mistake, in the same way one might misspell a word, drop an object by accident or add some numbers wrong together occasionally, just within a different kind of module and to treat it otherwise isn't a question of morality but giving too much weight to a glitch.
At some level if you make enough typos you’re bad at spelling. Drop enough objects and you’re a klutz. Have enough glitches and they become the story.
If your consensus judges your own ideas to be wrong, it’s difficult to become convinced that doesn’t have a moral implication. And that logic has a bone-stark quality that reveals and resists platitudes.
That’s the use of the “captain vs pilot” reframing; it shifts the thinking from “I am flawed” to “I contain flaws” or even “I manage flaws”, which is a more productive mindset. It also has at least some physical realism; our reflexes and urges don’t come from the exact same place as our executive functions, for example.
Re-Reading Scotts review of Jaynes (he linked it above) one thing that's really striking is that according to Jaynes not only was hearing voices much more common in the ancient world, but that the disappearance of the voices was considered a great loss for humanity. Even if you disagree with Jaynes on how common these voices used to be, I think that its true they became less common and that this was considered a bad thing.
Now you may say that that was just status-quo bias in a society accustomed to hearing voices, but then the reverse can be said about our culture.
"""And most chronically mentally ill people have been traumatized by the psychiatric system in some way or another. Sometimes this is specific individuals behaving maliciously or callously. Other times it’s just the normal trauma of being shuffled from institution to institution by a system which isn’t optimizing for preventing you from being stuck on a gurney for twelve hours with nothing to do."""
I would become literally murderous. As in I would actively work to tear the throat out of the orderly who strapped me to it, and the doctor who ordered it. Not a metaphor. It would go on my todo, and stay there until it was done. If some court doctor wants to medicalize their understanding of this decision path, they may go on the todo list as well.
"People hate admitting that some cases are mild, and others are severe. Especially the kind of people who work at the New York Times" - I think the reason for this is not the one that Scott cited, but rather due to the fact that if you admit that some cases are mild and other cases are severe then (a) there's no conflict, nothing to boldly declare, nothing to subvert, and consequently (b) the solution to the issue is in the hands of people who are able and willing to discuss the specifics of what makes a case mild enough or severe enough to need certain types of treatments.
If you treat having hallucinations as yet another "identity," yet another abstract-nation that you are either IN or OUT of, then the discussion stays non-specific and emotional. It stays compelling, it remains *broadly appealing,* it stays *fun*.
People are harmed, and harm others, because of things they are wrong about. Although trying to forcefully enforce correct thinking in all situations would do much more harm than good, people should put effort into trying to believe the truth.
Hey I'm one of those people who hear voices, (but from an outside observer, it would look like me saying the things myself, but from my perspective, I'm repeating what you guys would probably call "thoughts")
But who the hell knows where those comes from, so I choose not to take responsibility over them, I tell myself that I'm just saying this stuff out loud so that other people could see what's up with the voices too, (cause hey, isn't this just a teensy bit interesting?) which leads me to believe that there's a third observer-observing this dialectic that I'm coming up with in my head, which makes me immediately start thinking of various creation stories and myths or Me being Marlowe from The Heart of Darkness (but also kurtz and the congo river)
If you would like to see a demonstration of this, I write stuff (for your amusement, for whatever you take amusement in)
The more problematic case is the "Targeted Individuals" community, where paranoid people find each other and confirm each other's theories of persecution. They're much harder to find because duh, they're paranoid and hence secretive, but they definitely do exist in remote corners of the internet.
>at least some large subset of transgender people aren’t consciously faking it.
...
>If I had to steelman their position it would be something like: there’s some switch that can be flipped by social pressure and wanting to look cool. Once the switch is flipped, you’re transgender in some pretty real way
The correct steelman is that "not consciously faking it" doesn't imply "is transgender". It is possible to have mistaken beliefs about oneself. This is especially so since you then add that someone may be pretty miserable without transition, with the implication that transition relieves their misery. How could they possibly know that, at least when they haven't yet transitioned? It's certainly possible to be mistaken about whether something will relieve your misery (and also about what the source of that misery is). Just because someone isn't faking it doesn't mean that they're right.
For that matter, how could they possibly know that they feel like a woman? They don't have any external examples of feeling-like-a-woman that they can compare it to, unless they're psychic.
Basically, you seem to be conflating "is sincere" with "is correct". You can be both sincere and incorrect, especially about things you have no way to really know.
Re: People not always appreciating that severity of mental health issues can exist on a continuum, I think it's worth remembering that people are much more likely to be exposed to people who fall on the mild end of global functioning impact. This can distort their perceptions of what more severe impacts might look like in terms of prevalence and presentation. Unless you are in a relevant field or have a direct personal connection, there's a good chance that severe outcomes are out of sight out of mind.
> This being the real world, many of those patients are right. So they look elsewhere.
As someone who has a number of psychiatric issues, I will just add my voice to the chorus stating that it is *extraordinarily* difficult to trust what is often effectively a complete stranger at first, with information which they could use to have you locked up without an actual trial that involves things like "standards of evidence" and "counsel" and sometimes even "the presence of the person whose fate is being decided".
And yes, **that** factor, more than any other, has been the primary thing which has on multiple occasions significantly delayed my seeking desperately needed care.
Also, section number 8 of this article was completely shocking to me. I had no idea people did things specifically just to get cool points for being weird. I have always just done the weird things I do because I wanted to do them. I even almost can't quite *imagine* doing that. It's just so bizarre.
I think his point was that this WHO document used highly filtered patient reports, so it would be wrong to look at it and infer you were getting something representative of the distribution of patient outcomes. Which, purportedly, the NYT did so infer.
>Do you have *any* underlying unease at the extensive physical force and coercion, even prolonged imprisonment in psych wards, that is commonplace in Western psychiatry?
I'm guessing Scott has given it some thought along the way. One such post (but it has come up other times):
https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/
Good luck! :)
I don't think this is quite right - they describe themselves as the Hearing Voices Movement, not as the Schizophrenic Movement or whatever.
I also think it's fine to say there's a natural cluster of eg autistic people (which is obvious enough that things like "aspie" have entered the lexicon even though psychiatrists would kind of prefer that not happen) and that you can believe this and still be angry with people who think this cluster should be treated with powerful medication.
Hypertension is famously the "silent killer"--without a doctor's appointment and a trip to the syphgmomanometer no one would ever know they were hypertensive before they died of a sudden stroke. Yet the actual phenomenon of blood pressure is as objective, quantifiable sign as a person could ask for: it's the literal pressure of the blood in the vessels. You can quibble about at which exact point it becomes a concern (and no one actually believes that something magical happens when your blood pressure increases by 1/1 and you cross into the hypertensive category, the line is drawn because you have to draw it somewhere) but you can't argue that 121/80 is actually 128/10. It's a poor analogy to mental health conditions, which necessarily create symptoms that the patients are aware of, but which are very difficult to objectively measure, and which can be interpreted through any number of theoretical lenses which radically change the meaning of those experiences.
I agree with the thrust of your ontological concerns about mental health conditions but I actually think the HVM (which I'm not a part of) is coming it from another epistemic place altogether and so avoids many of those concerns. People in the Hearing Voice Movement are gathering around a shared experience that they would be aware of with or without professional intervention. People who are having certain kinds of auditory hallucinations might fret about whether they are truly "hearing voices", but if I understand them right I think the ethos of HVM is very much unconcerned with that kind of line-drawing. I mean, if you exist in modern society and have certain kinds of abnormalities of psyche, psychiatric concepts will have mediated some of your understanding of your experiences, but I don't think that's much of a gotcha for the people who have the abnormalities in the first place.
So what makes people believe they are different, abnormal in this way? The voice-hearing case is pretty straightforward, but I think you might be more interested in other examples. When it comes to autism spectrum, I think the subjective experience that many people who come to identify as AS are gathering around is a lifetime of inexplicable social friction and rejection. I think the gravity that holds those social groups together is less about meeting particular psychological/developmental criteria and more about whether being picked last on the dodgeball team over and over for reasons beyond your comprehension is something that resonates with you--and, you broadly fit the phenotype, so you can bond over the shared similarities. I mean, I happen to think AS is close enough to something of a real thing that it can explain why these people with this broadly similar phenotype are socially rejected over and over, but I don't think that explanatory framework is necessary for those folks to get together on non-hypocritical grounds.
" You can quibble about at which exact point it becomes a concern (and no one actually believes that something magical happens when your blood pressure increases by 1/1 and you cross into the hypertensive category, the line is drawn because you have to draw it somewhere) but you can't argue that 121/80 is actually 128/10."
Except when I was trying to find out about what exactly constituted hypertension, the information online was "we used to think 140/80 was normal but now that has been revised downwards":
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514035/
“The risk of cardiovascular disease begins at 115/75 mm Hg and doubles with each increment of 20/10 mm Hg; individuals who are normotensive at 55 years of age have a 90% lifetime risk for developing hypertension,” the guidelines say."
I hope you all are rigorously maintaining 115/75 BP! And striving to lower it even more!
Okay, and why did they pick "120/80" or "120/70" OR EVEN LOWER as the new "normal blood pressure range"? What studies, what measures, what incidences of cardiac events and strokes at 140/80 versus 120/80?
Scientific American doesn't know, but it knows LOWER IS BETTER:
https://www.scientificamerican.com/article/why-is-normal-blood-press/
"The exact origin of the designation of 120/80 as the threshold for "normal blood pressure" is unknown. It may have come from the large amount of data available early in the 20th century from life insurance exams and what happened to these people as they aged, or it could have arisen from the beliefs of medical practitioners, as so much traditional knowledge has."
I do like the 'traditional knowledge' bit; yes, the ancient and venerable all of thirty years that 120/80 was considered normal BP!
Scientific American may be puzzled by this conundrum of the sphinx, but I know: Brazilian tribe in the rainforest, was the answer. Some study measured their blood pressure levels and found that they had an average of 120/80, so this was set as the new ideal:
"Four remote population samples (Yanomamo and Xingu Indians of Brazil and rural populations in Kenya and Papua New Guinea) had the lowest average blood pressures among all 52 populations studied in INTERSALT, an international cooperative investigation of electrolytes and blood pressure. Average systolic blood pressure was 103 versus 120 mm Hg in the remaining INTERSALT centers; diastolic blood pressure in these four population samples averaged 63 versus 74 mm Hg in the 48 other centers. There was little or no upward slope of blood pressure with age; hypertension was present in only 5% of the rural Kenyan sample and virtually absent in the other three centers"
I went "Dude, I am not a Brazilian tribesperson living in the Amazon, I kinda think personal circumstances and genetics might be a teensy bit different for what you are saying I should be aiming for?" I mean, sure I would *like* "hunt monkeys for two hours, then lie around in a hammock the rest of the day" lifestyle but that's not going to happen in the Western world, you know?
The European Heart Journal is as confused as I am:
https://academic.oup.com/eurheartj/article/39/24/2233/5035212#118044043
"No wonder that many are confused at a higher level: what should we use in our daily practice? When we strive for truly normal blood pressure, we might look back at the days when humans still lived in their natural environment as hunters and gatherers. Of note, there are tribes still living today as our ancestors did thousands of years ago. For instance, blood pressure of Tsimane Indios who live in the Bolivian Amazon forest averages ∼116/73 mmHg throughout life. Interestingly, they also have rather low average cholesterol values of 2.4 mmol/L, much lower than Westeners of today’s world. Furthermore, they exhibit much less coronary calcification than age- and gender-matched US citizens. Obviously, they move a lot and hunt all day long in order to feed themselves and their family, and they eat fish, meat, and fruits; however, the downside of their style of living is an elevated C-reactive protein and eosinophils in their blood due to chronic parasitic infections.
The Yanomami Indios who live across the border in the Brazilian Amazon region, have similar blood pressure values throughout their life span. Finally, the Kuna Indios who live near the coast on small islands outside mainland Panama in the Atlantic also have blood pressure values of ∼100/70 mmHg throughout their life in spite of the fact that they eat a lot of salt, in particular, in addition to cacao plants which are one of their major nutrients. Of note, when they move to mainland Panama or to its capital Panama City, they do show the age-dependent increase in blood pressure typical for Western populations.
If naturally living people have lifelong blood pressures of 100–120/70–80 mmHg, are we all hypertensive? Why do we have so much higher blood pressures and a consistent increase in systolic blood pressure with age? Several factors might contribute: (i) genetic changes; (ii) increasing life expectancy; (iii) the obesity epidemic; (iv) sedentary lifestyle; and (v) the composition of our diet. Gene drifts and selection are a possibility, but hard to prove at this point. The increasing life expectancy may explain the marked rise in systolic blood pressure in the very elderly, but not in the population at large. Indeed, Indios reaching retirement age still maintain low blood pressures.
...What would be the appropriate management in the context of diverging recommendations for optimal blood pressure? Not all hypertensives are made equal; some may be younger and have just recently been diagnosed with elevated blood pressure, but are otherwise healthy. Others may already have end-organ damage such as left ventricular hypertrophy or intima media thickening of the carotid arteries, while others may already have coronary artery disease with or without diabetes. Finally, elderly hypertensives may be frail, have a low gait speed, and a risk for falls. Thus, hypertensives have quite divergent cardiovascular and safety risks. It is obvious that one cannot and should not treat all these hypertensives with the very same approach—we must treat a patient and not a risk factor."
I have never met these people who "insist [polyamory] is good for everyone". I think this is part of the problem: people are really bad at separating "please tolerate me when I do this" from "I think everyone should do this".
(not accusing any specific person, my guess is people on all sides have this problem - both the people making the requests and the people hearing them)
I think assuming someone saying, 'please tolerate me', means 'everyone should do this', is an easy jump to make when the person is saying something to the effect of, 'please tolerate me being more moral than you'. In fact, that is basically just taking them seriously. I think this is why so much vitriol gets spewed at vegans, for example.
I am pretty sure you know poly people who advocate that jealousy is silly (or, in your words, a paper tiger), and the throughline from that to moral superiority is straightforward; you are affected by negative emotion, but we poly people are not.
"when the person is saying something to the effect of, 'please tolerate me being more moral than you'"
Yeah, that's the impression I get from people advocating for poly who are often all "Jealousy? Oh we've solved jealousy!" and while they may not *intend* it, it comes across as "because we are superior to you monos, whose tiny brains cannot handle the work of feeling joy for your partner's happiness, but it's not your fault you are stuck on a lower evolutionary level than we are".
It's like the Bike Thief cartoon: it's a lovely *ideal* to have, but the *expression* of it makes me want him to get run over by his own bike ridden by the druggie who stole it to sell for his next fix.
https://knowyourmeme.com/memes/my-bike-got-stolen-recently
See my response to Jeff above: https://astralcodexten.substack.com/p/in-partial-grudging-defense-of-the/comment/6767996
Actually anti-anti-psychotics would be dopamine agonists like amphetamine, which can generate psychotic symptoms.
Those peak spiritual experiences are not at all promised in psychosis and tend to be rare and brief, not lasting states. It must not be especially energetically stable to be so blissful and all-is-one-y. And when you tumble off that peak you often land differently configured. some-is-nothing? who-is-not? etc. Takes a while to get back to this-is-this and that-is-that. Inducing these states via psychosis seems an especially dangerous route.
My recollection is that virtually everything in DMV (4 and 5) requires "negative impact on patients life" for a diagnosis. It doesn't require that the negative impact be worse than that of the drugs needed to solve the problem(for a diagnosis). Thus there are going to be diagnosed people who may well be better off untreated or at least chemically untreated...
This even-handed analysis is so needed -- and I think it also applies to the movement of people treating psychosis as a "spiritual emergency." Thank you.
I agree. It was an extremely good post.
I'd say that NYT-bashing is a bit excessive, if the goal is to reach reasonable people who aren't already part of this bubble. Like it or not, it's still the newspaper of record, and if your first experience with a rando blogger is their seemingly blind rage towards it, that's probably about as reliable a red flag as they come.
eh, Scott is perfectly allowed to write to his regular readers rather than trying to optimise for outsiders and sanding off everything that made the regulars follow him
Sure, but my impression is that he aspires to more. Like, the general idea seems to be that legacy media is largely discredited and teeters on obsolescense, and brave new solutions are all but ready to replace it, like, say, the Substack-osphere. But for this promise to be realized you actually need to consistently adhere to a higher standard than the legacy media.
Do you actually think that's a difficult? I suspect Scott does so without even really trying.
If legacy _news_ media were able to go back to the way I remember them - when they had more reach and bigger budgets - I'd be a happy subscriber.
Substack isn't better, and it isn't even serving the same customer wants - nor, AFAICT, attempting to do so.
It also doesn't seem to me to be replacing Life Magazine et al., or Readers Digest, or much of anything that ever appeared on television.
Maybe substack is an adequate or better replacement for types of media I never consumed. (Literary magazines? High brow opinion journals?)
More likely, it's another example of adaptations to the way that modern technology too often makes it impossible for people to get nice things. ;-)
I.e. trad media aren't viable on an ad based model, with google et al taking the lion's share of the ad revenue. All we can get are the clickbait-oriented leftovers, controlled by an ever-decreasing set of oligarchs. Substack is little more than a workaround for one of the resulting problems. Plus, of course, an opportunity for some people to make more money than they otherwise would.
No,not reallt, because this blog doesnt make a claim to be "the blog of record" In fact,m one could argue that making such a claim, which was possible when there weremore limited media sources,is part of the problem and the thing should be acknoweldging whatevr perspectives and biases you may have and not try to claim yourself asthe "official"objective source for things.
I thought Scott was being tongue in cheek. Like he obviously doesn't have a great impression of them but I didn't take his lightly ribbing them as anything but him lightly ribbing them.
My impression too.
I agree - pretty clearly comedic hyperbole.
If it's *not* your first experience with this particular blogger, then the rage seems justified (albeit crass, even if it is a literary reference), and his behavior is on average consistently better than theirs.
A joke at the expense of a massive media corporation with a history of dishonesty is hardly a more reliable red flag than anything else that gives a "rando blogger" distinction from any other.
Should he also take out the knocks against religious people? Should he remove any mention of trans people, or should his mentions of trans people be more fawning and less skeptical? Those, too, are "reliable red flags" that could alienate outsiders.
"Should he also take out the knocks against religious people? Should he remove any mention of trans people, or should his mentions of trans people be more fawning and less skeptical? Those, too, are "reliable red flags" that could alienate outsiders."
Probably yes for both of those, since those comments generate far more heat than light. The actual topic of the article is controversial enough, why court even more controversy by bringing up two largely or entirely unrelated topics? It risks having any discussion on the article turn into an argument on religion or an argument on trans people, while the actual point of the article gets ignored!
Though I don't really care about the New York Times put-downs. Anyone who'd clutch their pearls about a blogger insulting a giant media conglomerate is probably unlikely to read this blog in the first place. But religion and LGBT issues are topics that quite a lot of people feel extremely passionate about, and while that doesn't mean he should never talk about those topics, it does mean that it's probably unwise to bring them up as casual examples or analogies or jokes in essays about other topics.
I am glad he talks about these things reasonably, I think the blog would be much worse if he worried about causing offense too often.
I wouldn't call it NYT-bashing. I think what you propose would be NYT sycophanting.
Right. Its definitely "culture war" territory, but theres definitely an issue where people utilize that "well,its an established thing" reputation of the Times and other institutions to see control of that as an important part of gatekeeping- the hysterical reaction to the possibility that Musk might buy Twitter shows that a lot of people are very personally invested in this and believe it on if not a conscious level at least a semi-conscius one, and I suppose as a rationalist whose seen this specific community attacked by dubious means(intentionally) its fair to dismiss that combination of "uses shady suggestive means to attack things that are not partof their gatekeeping while still trying to hold the image of journal of record"
It may not be necessary for x-rationalists to givesome special consideration to a media outlet that has attacked them not for what they actually believe but for insinuations that are based on a desire for controlof a "gatekept,this is the official view of reasonable people" paper, and the argument that people,especially rationalists, should stop treating the Times as anything other then a similar partisan news source as that acknowledgement of its "legitmacy" creates legitimacy.
For example., the times can be cited on wikipedia while ACT probably could not.Thats a problem if you're interested in an ability to understand information without first having to pass a certain political/cultural filter.
I thought there was a slight tongue in cheeksness about it given Scott's personal issueds with the times, and it was assumed readers would interpret it in that context.
Yeah, I agree.
I am a subscriber to both ACX and NYT.
Adorn my head with the bipartisanship crown!
I'm sorry you waste your money on the shitrag NYT.
The NYT is a complete shitrag. Scott would be a coward if he pretended otherwise.
bravery 10/10
I mean, there was the time a NYT reporter tried to destroy Scott's life. Effectively just "for the lulz".
That might potentially be a factor in his hostility towards them in the article.
There is totally successful "church, but for athiests"! I, and most of the practicing Jews I know, are atheists, love going to temple and singing, bar mitzvah our kids, sing praise to the lord, honor our traditions, and think that literally believing in god is infantile.
I'm slightly jealous of my friends who grew up Jewish or Unitarian for this reason - it doesn't seem likely to fill the need for someone who didn't grow up with it though.
I grew up Unitarian, and the main thing I can say is that "growing up Unitarian" is a very silly sentence.
What do you guys get up to?
They believe there is at most one god.
Actually, since the Covenant of Unitarian Universalist Pagans was recognized, it's "We believe in one god, more or less".
The Ku Kluxer Unitarians have been known to go around burning question marks.
I’m told they address their prayers, To whom it may concern
I grew up a different kind of Unitarian.
I believe in a divinity U whose conjugate transpose U* is also His inverse
In terms of actual substance, Unitarian Universalism doesn't reach the level of the "Coexist" bumper sticker.
OMG, it all makes sense now
This is a reasonable point. I think I meant that the thing where atheists try to create something where people go to church and sing hymns about science or liberalism, without even the slightest pretense of association with a previous God-centered religious tradition, doesn't work.
(this *has* worked for rationalists, but we also have some pretty kooky-by-mainstream-standard beliefs, which seems to be an irreplaceable element. For whatever reason, atheism isn't kooky enough, even when it's extreme atheism in an otherwise religious society)
my favorite part of being an atheist is that I get to sleep in Sunday mornings
I asked myself the honest probability of whether something like the God of the Bible existed back when I was in college and admitted the answer was epsilon... and I might not have been willing to do that if not for the fact that I was already sleeping in on Sundays once I'd moved into a dorm.
I love the morning, but going to church isn't one of my top 100 ways of spending it. FWIW, I'm probably one of the most anti-Marxist people around but Freddie, I'm glad you're in the world. You're a stand-up guy and refreshingly honest. I loved "The Cult of Smart". Well, except for the end, which didn't say much about undoing the Cult, just basically "enact everything Bernie says."
Have you ever interviewed Scott or vice versa?
my favorite part of being a Christian is that I get to sleep in Sunday mornings (and then go to evening church) 😉
My favorite part of going to church is dropping my kids - who have been awake since 6am - off at the nursery and children's church.
When I had my first religious experience, at age 14, my main conscious reason for not doing more with it was because I valued my Sunday lie-ins too much.
Then at 18 I had another one that I couldn't ignore so easily (but still went to evening church for preference). I still do prefer evening church and like lie-ins, but kids who get up at 7am anyway have made that a less-relevant factor.
(Of course, the rationalist credo of "I want to believe what is true" very much applies. If God is real, it's more valuable to believe he's real, even at the cost of Sunday lie-ins. I didn't see things that way at age 14, though.)
And you can work on Saturdays, too!
I've participated in some rationalist rituals and ceremonies, but personally, I've found them missing something essential that's common to almost all religious practices. That something is a genuine sense of reverence, the idea that a ritual should be designed to evoke sincere and heartfelt emotion, and then actually taken seriously. A lot of the time the rituals go through the motions of nodding to some kind of deep sentiment, but the participants tend to treat the actual expression as a joke.
Individual atheists may feel deep reverence for some things, but I don't think most of them have a shared sense that they ought to feel and express *shared* reverence in a specific thing, that the experience is made deeper and more significant to the participants if it feels like everyone is in it together and not making a joke out of it.
If you'd like to witness the Next Generation of hippies being inculcated into the faith, https://www.retreatfarm.org/ during food truck night is a good place to go.
Having grown up in a place that had lots of Unitarians, had a serious high school girlfriend whose father was one the most eminent Unitarian theologians of his time, etc....your first paragraph is pretty doggone close to what Unitarianism is.
(Nowadays anyway -- one thing I learned from the professor was that it originally had a stronger God-centering aspect.)
The jokes that we all learned [How does a Unitarian start the Lord's Prayer? 'To Whom It May Concern....'] were funny in part cause they were so close to true.
Secular Judaism of the kind described above and the modern UUs both are continuing orthopraxy (https://en.wikipedia.org/wiki/Orthopraxy) and ritualism rather than orthodoxy, and are the inheritors of a genuine religious tradition that they have cored out the "believing in supernatural stuff" but kept the rest, and the rest is thick enough with content to provide cultural capital for the unbelieving generations to consume.
How long that capital will last is another thing; I give Judaism a way better chance at surviving than the UUs.
"For whatever reason, atheism isn't kooky enough, even when it's extreme atheism in an otherwise religious society"
Except we're not living in an otherwise religious society. We're living in a secular society that has a non-religious basis for its social, cultural, moral, political, and legal norms. So in that regard, being an atheist is not very "kooky," because being a secular atheist doesn't result in any noticably different behaviors or lifestyles or values or non-theological beliefs than being a functionally secular theist. In that regard, being devoutly religious in a highly visible way is far more "kooky," even if being a nominal theist is technically the norm.
Being an "extreme atheist" might be seen as weird in an exclusively negative way, if "extreme atheism" implies an active and vitriolic hostility to religion. But that's less because of the belief itself and more because hostility towards other people's beliefs is seen as rude, belligerent, and antisocial.
I agree. I think atheists might have a better shot at having a religion-like thing in a setting where actual religious feeling predominates. Maybe it doesn't even have to predominate, they just have to plausibly believe that is the case (the reddit atheists of earlier in this century come to mind). Nowadays, it's very hard to pretend we live in very Christian communities, so they died out accordingly.
I think just being an "atheist" isn't enough to sustain any kind of movement because its just a "not" movement. It doesn't head towards anything it only heads away. After you've all finished congratulating yourselves for not believing in God, then what?
What, rationalists sing hymns? Is there a book of them?
"Le semeur" https://fr.wikipedia.org/wiki/Le_Semeur_(chant) -- sung at Brussels University since 1890: https://www.youtube.com/watch?v=_e8dWqMa4Rg
One issue is that Judaism isn’t a proselytizing religion and seems fairly ambivalent about welcoming converts (refuse three times, etc.). So to the extent that something like the Bright (lol) movement was intended to provide community while defanging the harms caused by most revealed religion, Judaism doesn’t really fit the bill. At times I’ve been lowkey jealous of secular Jews because of the dynamic you describe, but being insular appears to be a key part of making it work. Something like Mormonism for atheists would be great (family home evening!) but just hasn’t gotten any traction.
Other successful secular churches are various intense music subcultures. Straight edge is a particularly clear example.
I was also thinking of music and dance communities. I grew up in an pretty intensely committed multi-generational folk music community with a charismatic leader that 100% served this niche. Even decades later I have only positive reflections on how the structure and values of the group influenced my life. Contra dancing scenes can have this dynamic as well. Toward more quirky, inclusive, and high functioning affinity groups!
But can a music subculture persist over multiple generations? I was in an intense music subculture in my twenties, but it kinda went away eventually as people got older.
Yes they can. I've seen it with contra and folk dancing in New England. The New England Folk Festival started in 1944 and is still going strong.
I'm seeing a bit of this direction in Catholicism among people my age (late 20s early 30s). People who keep a lot of the traditions and rituals but don't really believe genuinely anymore.
That's interesting, because I've had the opposite experience. I was raised Catholic, and I think a lot of Catholics in my parents' generation did keep the traditions without really believing. I know my dad waffled in his beliefs while I was growing up, and the mother of one of my childhood friends didn't believe in the resurrection, but she still raised my friend Catholic and attended church with the family. But among people I know around my age who were raised Catholic, most have left the church, and the ones who stayed are actual believers who abide by the more difficult rules.
I think this just implies your peer group is at a later stage than GlacierCow's in the multigenerational process of dissolving strong religious bonds. Scott actually wrote about this on SSC in a post called The Ideology Is Not The Movement (Section IV-4):
https://slatestarcodex.com/2016/04/04/the-ideology-is-not-the-movement/
I am slowly realising that the church my parents and grandparents would have went to was almost entirely like this.
Then my idiot generation had to go and ruin it by saying the "well ackshually god doesn't exist so I'm not going to church" part out loud.
I believe a critical mass needs to actually believe everything, though. In the Catholic setting, a certain subset of women come to mind.
Edit: arguably in most settings, since, as far as I know, women report more religious feelings in most of the world. But women were certainly very important for the early successes of the Catholic church.
Yeah I see a very similar thing with my friends at home with (rural, European) Catholicism. It is just part of the village traditions/customs, believing anything is not required, just proper protocol.
[And from a Catholic angle you are saved anyway by eating the bread at communion, so there is no need to really believe in anything ;) ]
"And from a Catholic angle you are saved anyway by eating the bread at communion, so there is no need to really believe in anything"
Did you get your Eucharistic theology from a Jack Chick tract?
(1) "Eating the bread" - I would recommend you read up on transubstantiation; this was a big deal during the Reformation
https://en.wikipedia.org/wiki/Transubstantiation
(2) "Get saved" - this is a very American Protestant Evangelical term. First, and again this is a big deal for some of those denominations, Catholicism does not have 'eternal assurance/eternal security', it is entirely possible to lose your salvation:
https://en.wikipedia.org/wiki/Eternal_security
Second, just receiving Communion will not 'save' you and indeed can damn you:
1 Corinthians 11: 27-30
"27 Whoever, therefore, eats the bread or drinks the cup of the Lord in an unworthy manner will be guilty concerning the body and blood of the Lord. 28 Let a person examine himself, then, and so eat of the bread and drink of the cup. 29 For anyone who eats and drinks without discerning the body eats and drinks judgment on himself. 30 That is why many of you are weak and ill, and some have died."
(3) "No need to really believe in anything" - this is also incorrect. I'd have to end up quoting the entire Catechism to you to refute this one, so have a snippet from this publication:
https://www.dummies.com/article/body-mind-spirit/religion-spirituality/christianity/catholicism/basic-requirements-for-catholics-193154/
I swear, I have no idea how I turned into an evangelist, but whatever nit-picking module of my brain gets engaged when I read incorrect statements of doctrine kicks into high gear. I don't expect anyone to *believe* all this, but I would like if they could state the things they don't believe in correctly.
I remember having transubstantiation explained to me before my First Communion. “It really happens. It becomes the body of Christ. Don’t chew it. Swallow it quickly.” We were to fast from the previous day until we received the sacrament. My fourth grade teacher gave me a religious medallion to mark the occasion. Miss Kaye, nice woman, smart as a sack of hammers. I never could convince her that magnetism could pass through glass or that Mexican jumping beans have a larva inside.
That was in 1962. My autobiographical memory is weirdly reliable.
Oh it has changed *so much* since our day! Did you get the little lecture too about "what do you do if the priest drops the Host before you receive it in your mouth? No, you don't touch it! You *let* it fall to the ground, because lay people cannot hold the Host, their hands are not consecrated!"
And then communion in the hand came in decades later 😁
Fasting from midnight until you received at Mass - this was why people used to faint in church (I saw a couple of instances when I was a small child). Now it's only an hour's fast, and I wonder if even that is observed.
Yeah, the changes are pretty dramatic. As I understand it people don’t go to confession much anymore. There used to be a big line every Saturday evening to prep for communion on Sunday morning.
Dropping the host was an inconceivable event so we I never got that lecture. Even if it were to somehow happen an altar boy held a small gold plate under it so it could never reach the floor.
Hey, my remark was about 50% a throwaway joke, but thank you for responding still. Let me write out a non-joke reply.
(1), (2). English is not my native language (I even had to google what a chick tract is) and I have to admit I was too lazy to look up the translation for "Hostie" (which is "host"), so I just wrote bread. The point about me translating "getting saved" is super interesting though, I wasn't aware that this was such an Evangelical term, but I must have picked it up unconsciously from Evangelicals in the US.
I was thinking of "Sündenvergebung", meaning "forgiveness of sins", during mass as in "mein Blut was für euch und für alle vergossen wird, zur Vergebung der Sünden, tut dies zu meinem Gedächtnis".
(3) I'm not trying to refute my catechesis(?) here, I am giving an accurate (in my worldview) statement how Catholicism is lived in my home town, and closely connected to tradition and protocol.
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Catholicism, or really any religion, is lived more differently than people think, even when they think there are regional variations.
For one thing, the German bishop conference does have a different focus and interpretation of the catechism. There are also over-regional practices that are common all over German-speaking areas, such as large easter fires (which are lit from a single bonfire in the church yard during easter night), that are, as far as I know, not common in other areas. These are definitely seen as "a Catholic thing" where I am from and there is no separation of "village tradition" and "religion".
I am not arguing that these are schism-level differences, people do agree on broad strokes, but I would argue the way they conceptualize the same words is different. I am also not saying this as a total outsider, I did spend a lot of time in church - as altar server during my teenage years. You have all these people coming to church, murmuring "Herr ich bin nicht würdig, dass du eingehst unter meinem Dach, aber sprich nur ein Word, so wird meine Seele gesund", because that is the proper thing you do, and the actual words don't need to have meaning. You are part of the community by coming and saying them and (in mine/their eyes, not necessarily the catechism), makes you a decent Catholic.
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Another tangent: I didn't remember the church laws to be that strict. I looked up a German version, and quickly found one here: https://www.katholisch.de/artikel/13650-das-sind-die-fuenf-gebote-der-kirche (This is from the news portal of the German Catholic church)
The google translation is not great, but I think good enough to examine various differences. For example, the German version explicitly mention that work is forbidden on Sundays and holy days. The suggestion to go to church every day, on the other hand, is omitted here, only requirements to go on Easter and in danger of death are mentioned. The bullet point regarding marriage is ommited completely. Assisting the church does not mention financial aid. Below the commandments is an interview with a guy who is explaining and further relativising them, saying that context matters and things shouldn't be taken too literally. Maybe you'd find this comparison interesting.
Hello again, and thanks for the reply. Let me take this in no particular order:
(1) I have a high view of the Eucharist, so I do get twitchy at terms like "bread" because they were part of Reformation polemic and because online atheists like to toss about terms like "crackers" when referring to the Host (and in part because of a stunt like this one back in 2008: https://en.wikipedia.org/wiki/PZ_Myers#Eucharist_incident)
(2) We're translating between English and German here, so linguistic and cultural differences ahoy!
(3) I would not be one bit surprised by anything you say about the understanding the ordinary Catholic globally has of the faith; the state of catechesis has been abysmal over the past few decades. I could do the usual "blame Vatican II" bit, but it has always been so, my father was an altarboy himself during the days of the Latin Mass, and he had been trained to just parrot off the responses but never told what they meant, so he had no idea what he was saying. Pope-Emeritus Benedict XVI back when he was still Cardinal Ratzinger also mentioned the likes about not having false nostalgia for the 'good old days', that even back then there were the bulk of Catholics in Germany who just went to church because that is what you were supposed to do but they had very shallow understanding and no real faith.
(4) You are not obliged to attend Mass every day, but you must atttend on Sundays and holy days of obligation.
(5) Yes, the words of institution which you quote in German are the same for the Mass in English; recent translation of Eucharistic Prayer I: "TAKE THIS, ALL OF YOU, AND DRINK FROM IT: FOR THIS IS THE CHALICE OF MY BLOOD, THE BLOOD OF THE NEW AND ETERNAL COVENANT, WHICH WILL BE POURED OUT FOR YOU AND FOR MANY FOR THE FORGIVENESS OF SINS. DO THIS IN MEMORY OF ME."
This is the acknowledgement of the saving sacrifice on the Cross which redeemed fallen humanity, but this is already turning into a theological tract so I'll keep it short. It's not "go up and receive communion and all your sins are forgiven even if you haven't been to confession and you will never lose your salvation" theology.
I have probably been arguing/discussing with American Protestants on the Internet too much, since they tend to have a much different view of salvation and the Lord's Supper, so I was interpreting your words in their sense. Sorry for that.
(6) Lighting bonfires outside the church door on Easter? Yes, that's the new fire - you extinguish all other lights and fires, kindle the new fire, light the Easter Candle from it, and in turn light all other candles from it so you have the new light. It was not alone a tradition but part of the rubrics until very recently; churches over here seem to have given up on it a bit but I am glad that your parish is keeping it up 😀
It's the incident mentioned in the Life of St. Patrick:
https://www.libraryireland.com/Wonders/St-Patrick-5.php
The pope still does it:
https://www.youtube.com/watch?v=1kBdYFlitwE
It is a very big ceremony in the Eastern Orthodox Churches:
https://www.youtube.com/watch?v=kb6fcZSU2qM
> my father was an altar boy himself during the days of the Latin Mass
I read it phonetically off a cheat sheet. Didn’t stick with it long enough to memorize it.
Hi, thanks for the additional info.
Regarding the new fire. Yeah, the core idea is Catholic, I am trying to say that the way people act and interpret it can be very different. I really mean a bonfire, here is an example: https://www.youtube.com/watch?v=aIIrnrmdFJg&t=249s
(You see them coming up to the bonfire at about 4 minutes with candles coming from Easter mass.)
That's not "church, but for atheists." That's "atheists participating in other people's religious activities, usually largely for social reasons."
Nah. It's just putting the "ethno" in "ethnoreligion".
Unitarianism seems sort of like a social workers convention to me.
Unitarianism seems sort of like a social workers convention to me.
I know some people like this as well. But for myself, I can’t bring myself to see the point of restricting how I eat or how I spend my time, given that I don’t actually believe in the underlying belief system.
I suggest not following the rules that seem pointless, but asking people around you if they go to a church, synagogue, mosque, or other temple that they absolutely love (especially if there is good music), and checking it out. Most people who think of themselves as following the rules are super inconsistent and intellectually lazy about it anyway -- you're doing what they do, but just being more honest about it.
Careful though, this is how I started attending Mass and now I'm a legit Catholic.
It’s because being Jewish is also an ethnic identity that, historically, had lots of issues assimilating. Not a church for atheists.
I hear you, but lots of Jews aren't even very ethnically Jewish. My kids are less than 1/4 Jewish by ancestry. Everyone just adopts the identity they want, you can too. You can just show up, sing along with the singing, disagree somewhat with the sermon, go home, read a Dilbert and go to bed.
Isn’t becoming a Jew comparatively hard?
There's no Jewish card. You just start going to stuff. I guess some Jews are annoying about ancestry or whatever, and the official policies of the state of Israel are designed to exclude people, but just find a temple with gay couples and I promise it'll be cool and not annoying about if you're Jewish enough. As with most of the world history of the last 200 years, places that treat gay people well are safest and best
You don't feel ridiculous singing "praise to the lord" when you think belief in that lord is "infantile?"
It's ironic how atheists get more obsessed with religion than the religious. It's also interesting to me how many atheists seem to latch on to Abrahamic stereotypes, especially Christianist stereotypes, when they argue against the existence of god and religious practices in general.
Not all religions require a belief in a particular god or gods. Buddhists, for instance, can get along quite well without a belief in a god or gods (Buddhists can believe or not believe as they wish deity-wise, and it makes no difference for their practices or how they're regarded by their fellow Buddhists). Likewise, Marxism displays many of the beliefs of millenarian religion without a godhead—but they substitute historical inevitability for god's will—and True Communism for the rapture. And in extreme sects of Marxism, a god-like cult is built up around a leader and large-scale worship rituals are promoted and enforced.
Meanwhile, (many) US atheists who think the worship of god is infantile stand for the Pledge of Allegiance (though they might remain silent or mumble "under god" part). And even without the "under god" component, Jehovah's Witnesses long ago sussed out that American flag worship is a bizarre cult where the US flag has become an idol. Their refusal stand for for the pledge is because they see flag worship as violating the 1st and 2nd Commandments, and the enforcement of flag worship rituals in US society as a violating their 1st Amendment rights (BTW: we owe the Witnesses a lot for bringing and *winning* many free-speech 1st Amendment cases before SCOTUS).
But most atheists seem to be as ignorant of religion as Christian Fundamentalists are of science.
My understanding is that you can combine pretty vague deism with Catholicism, happy to have someone tell me that I'm wrong though.
It is wrong, not sure where you got this idea from.
1. Nice analysis.
2. It's pretty much bell curves all the way down.
3. Many people who claim God is talking to them are, at best, misinterpreting their experience.
4. It would be nice to have some basis, experience, or expertise for claiming there is no God. As someone I respect once said, "That God you don't believe in? I don't believe that God, either!"
Well, it depends what you mean by "God".
At last I am understood!
I often specifically say that it's the God of Abraham that doesn't exist.
"Born again Christians are constantly having what would normally get classified as psychotic experiences - I have asked a bunch of evangelicals who say “God told me to X” whether they actually heard God in a, you know, hearing God type way, and they usually say yes"
Regarding that, the Catholic Church is very "hmmmm" about people claiming to be hearing the voice of God directly communicating with them. (Yes, all the Reformation Protestants will now chime in about putting intermediaries between God and man).
There is a distinction between the voice of conscience, the promptings of Providence, and God Almighty speaking directly to you, and some of that distinction may have been lost in the more enthusiastic denominations in the USA. So you might say "I know Bill is perfectly genuine and sincere, but I don't believe God spoke to him" and I would agree, but not on the grounds that "of course not, God doesn't exist, Bill is just hearing voices".
https://www.newadvent.org/cathen/04268a.htm
" -The natural conscience is no distinct faculty, but the one intellect of a man inasmuch as it considers right and wrong in conduct, aided meanwhile by a good will, by the use of the emotions, by the practical experience of living, and by all external helps that are to the purpose.
- The natural conscience of the Christian is known by him to act not alone, but under the enlightenment and the impulse derived from revelation and grace in a strictly supernatural order.
- As to the order of nature, which does not exist but which might have existed, St. Thomas (I-II:109:3) teaches that both for the knowledge of God and for the knowledge of moral duty, men such as we are would require some assistance from God to make their knowledge sufficiently extensive, clear, constant, effective, and relatively adequate; and especially to put it within reach of those who are much engrossed with the cares of material life. It would be absurd to suppose that in the order of nature God could be debarred from any revelation of Himself, and would leave Himself to be searched for quite irresponsively.
- Being a practical thing, conscience depends in large measure for its correctness upon the good use of it and on proper care taken to heed its deliverances, cultivate its powers, and frustrate its enemies.
- Even where due diligence is employed conscience will err sometimes, but its inculpable mistakes will be admitted by God to be not blameworthy. These are so many principles needed to steady us as we tread some of the ways of ethical history, where pitfalls are many."
https://en.wikipedia.org/wiki/Private_revelation
"It is a misconception that the church is quick to accept mental illness or drug abuse, such as schizophrenia or hallucinogens, for private revelation and demonic activity. The church is skeptical, and only accepts private revelation after discernment, because it is "the pillar and bulwark of the truth" and because it has a long history of dealing with fraudulent visionaries."
"all the Reformation Protestants will now chime in about putting intermediaries between God and man"
Now you are putting an intermediary between me and my "Yes, but!" comments. Typical Papist!
Anyway, a large number of canonizations happen exactly because people claim to have seen an intermediary like Mary or a saint in the sky or whatever. And not metaphorially seen, but seen the same way a cloud or sun is seen in the sky.
The Catholic church, while ostensibly ruled by the Pope, is in a constant tension between very serious Jesuits and wacky superstitious Mexican abuelas. The superstitious abuelas are always getting visions, the very serious Jesuits are always saying that this kind of thing doesn't happen, and occasionally they agree to compromise.
Sounds very similar to Eastern Orthodoxy. Lots of woo-woo from babushkas about visions, reincarnation, basically anything mystical, that often contradicts basic biblical tenets. Hopefully it's not just from the Russian state media's ability to obliterate critical thinking from its populace.
I was actually thinking of 19th century French and Spanish revelations but yeah that's how it shakes out these days
Catholicism is weird along a lot more vectors than that. I was raised Catholic, but I didn’t realize how weird it could be until I went to Europe. Sure, 600-year-old relics of saints’ body parts are easily written off as “back then”, but at Fatima there is still a huge oven for burning wax effigies of body parts and human figures as offerings. You can buy a wax breast and throw it in as an offering with prayers for someone with breast cancer. My Catholic mother would have screamed “Witchcraft!” at things still done by Catholics in other times and places.
Hey, whatever works to gain money and power
The abuelas are better company, better people, and better cooks.
It makes sense once you realize that tulpas are a real phenomenon in people high on the dissociative scale.
If you spend several hours a day for ten years visualizing your meditation deity, it's very likely to appear to you (it did for me, and it scared the shit out of me). Rather than seeing it as dissociative, a better rational explanation for phenomena like tulpas would self-hypnosis through ritual focus (although I think that explanation is also facile). But it suggests to me that the mind is much more flexible in what it can perceive than standard rationalist dogmas allow for.
I didn't want to say the actual reason I posted the above but now that I'm seeing your comment, might as well: I have a comparably long personal practice of meditation and have seen a similar thing happen with a different sort of a visualization. AFAIK, it can be done via hypnosis and faster as well. It didn't quite change my beliefs on the mind though: it seems that if you imagine a sufficiently elaborate entity while in a certain state for long enough, you can make the idea loop and become self-sustaining... Dreams where one talks to imaginary convincing people are a common phenomenon, this must go in a similar vein, or at least so I keep telling myself to stay sane. :)
Dissociation, however, might be related to how one might do such a thing unconsciously.
This occurrence didn't become self-sustaining for me, and I'm happy it didn't. After it left, I realized that I had forgotten an important instruction from my first meditation instructor — "don't undertake meditation practices without the supervision of your teacher". Later in an informal seminar on Buddhism, given by Robert F. Thurman, he echoed that dictum with the codicil, "because you might find yourself in a mental space you'll find very frightening or one that's difficult to escape from without assistance."
Silly me for not taking these warnings seriously.
And this is why I'm against teaching meditation in schools. Are people still pushing that stupidity?
It was more or less an attempt to remember a deceased relative over multiple longer sessions. I don't even know whether that's something one is supposed to do at all, but, well, when that unexpectedly happened, it felt like talking to what I best remembered of them and then the image went away after a while, it was self-sustaining in the sense that I stopped feeling like I was focusing at some point. Never did it again, but at least I gave them remembrance one last time, figment or not and found out just how terrifyingly realistic tulpas of the familiar may seem.
While you definitely can do damage with deep meditation, standard mindfulness stuff might be alright? I'd also assume the Zen approach is built around safety, though that's not what I did and I'm not really familiar with it, so it's just a guess. I stuck with the practice for far longer than most should just as at first it helped me learn to tolerate chronic pain better than prescription meds in terms of not slowing me down, then I kept doing it out of habit as I saw it more as focus training than a rite. Schoolkids are unlikely to practice since it's really easy to get distracted with any other hobby over it unless you have a very good reason, but I've never seen that idea brought up somehow. Wonder if they already do it in any country?
But if you suddenly start realizing what some of the normally silly sounding terms in something like Tantric Buddhism might mean to your own surprise, yeah, I'd really stop joking around and find an expert to talk to, as at that point you might be 'painting' with mixed psychiatric failure states to some degree. I didn't even figure what exactly I was doing at first and still can't be 100% sure either. I think the specific intention 'saved' me from longer term consequences there.
Nothing here I intrinsically disagree with. Not familiar with "the order of nature". I would quibble pretty seriously with "derived from revelation and grace...." I think that may be true, but it's not clear to me that the person operating with "natural conscience" is aware that they are operating under revelation and grace.
Yes, I asked an evangelical I knew well if she actually heard God's voice, and she was quite clear that yes she actually heard it. It was an actual auditory experience, just like hearing me talk -- but she knew it was God's voice. She was not the least bit crazy. I just do not know what to make of it. I wouldn't exactly call myself the sanest of the sane, but I have never once heard a a piece of actual audible speech from someone who was not there -- except when in bed, on the verge of sleep, & I'm pretty sure auditory hypnogogic hallucinations are common and normal. I keep thinking that she must have just *thought about what God would say,* and rounded that up to actually hearing a voice, because direct communication with God was regarded as normal in her community, and in fact was highly valued. And yet she was an extremely honest person, in fact one of the most honest I have ever met. About most other things she would tell me the actual, literal truth, even if the truth was embarrassing, socially undesirable and made her look foolish. So why think she was lying about hearing God's voice?
I believe she wasn’t lying about her experience. I’d have to
Know her a lot better to know whether I thought she was actually having an experience of, hmmm, enlightenment.
Re "bell curves all the way down", how would tinnitus fit into this? Very high prevalence (on the order of 10% of the population). A high pitched hum doesn't suggest an alternate reality... Does this count as a hallucination or as a sense organ problem? There seem to be something like nine different theories of the cause
( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686891/ )
( Doesn't anyone succeed in ruling _out_ a hypothesis anymore? )
A good question!
I think it's a common phenomenon with multiple causes which can both be independent and coexisting. I have tinnitus, it varies, it seems related to physiology more than psychology.
Many Thanks! Certainly there could be multiple causes (e.g. analogous to type I and type II diabetes). It would be nice if the possibilities could be disentangled as definitively as e.g. checking insulin levels distinguishes those.
FWIW, for me it correlated very strongly with experienced stress. Once I realized that, i took steps to reduce stress externally (people and situations in my environment) and internally (meditation, counseling). I got an immediate drop of 30%, and now I'd say on most days about 70% less than at the peak. I'm also taking a diuretic, which seems to help, too.
Many Thanks! ( I'm lucky - I have some tinnitus, but at the level of a minor nuisance, so I haven't attempted to chase down what might reduce it. )
Sure. Oh, I sometimes get relieve by creating alternating suction and pressure with my thumb over my ear canal.
I have something that might be tinnitus, but it's subjectively extremely quiet; I can only hear the tones in extremely quiet settings or if I plug my ears with something.
"It would be nice to have some basis, experience, or expertise for claiming there is no God."
A default to not believing things there isn't good evidence for?
It's perhaps too complex to go into here, including the nature of evidence. IMHO, there's plenty of evidence. There are many credible reports of experiences of the divine-some more or less replicable. To assume that the mundane, untrained experience of quotidian reality is accurate is as ungrounded as assuming that a person lacking the appropriate training can understand AI or string theory. And to be clear, there are many false claims for the existence of God-I'm not arguing against that assertion. Perhaps a rough analogy: at some point, there was no evidence for virii or bacteria. That didn't establish their non-existence. At the least, agnosticism seems a more reasonable stance.
I'm agnostic, with respect to both God and the photon. Both seem like useful ideas, even if hard to nail down. Truth may not be as important as utility.
Fair
I agree. That's why I don't believe there is a god, but I don't n believe there is not a God. God is unfalsifiable, as is Atheism.
The Saturday Morning Breakfast Cereal a few days had "running the arguments for god in reverse". It puts some rigor in arguing for that default, and end up making it look more than a little ridiculous.
What is this Saturday Morning Breakfast Cereal you speak of? And why should I consider that a bowl of soggy corn flakes has any insight to the existence or non-existence of god? The image of eating Froot Loops from the Holy Grail came immediately to mind, though. ;-)
Google is a thing. Give it a try, you might learn something. Or at least be more funny.
OTOH, I can't stop chuckling over the idea of breakfast cereal arguing over the existence or non-existence of god. Do they have religious wars—Kellogian's vs the Postians? In my younger more slovenly days, some bowls of breakfast cereals became science experiments, but none of the evolved consciousness let along became a philosopher of religion.
God is so powerful, that she doesn't need to exist, in order to save the world.
Well, it depends on what you mean by "exist", I guess.
Yeah, I guess, belief is enough.
Miles might be my favorite sci-fi male lead ever.
Me, too. I'm listening to an audiobook of "The Vor Game" as I'm typing.
More fulsomely, if one has an experience of God, belief is irrelevant. It's like asking if you believe in iron, or electricity.
It is straightforward to prove that there is no God that likes people and is able to verifiably communicate: observe that all communication that appears to be from God is via unreliable channels, and there are things He should have been saying but didn't, such as various practical medical things some thousands of years ago.
The other options are a God that dislikes people or is unable to communicate. Nobody seems to believe in those much, for emotional reasons. Loki is on the Disney channel because hardly anyone believes in him, but Loki seems like a more plausible deity to me than the others I come across.
1. That's not a proof; it's an observation.
2. I agree with your observation, generally.
3. You, obviously, aren't capturing all claimed communication from God.
4. "Should have been saying" has too many assumptions buried into it to address in this forum. That said, for instance, it seems to anthropomorphize God.
5. Again, it's less that God is unable to communicate than that humans are unable to hear, so to speak. For instance, to understand, oh, say, bio-neurology n a deep way takes, I'll arbitrarily say, a Ph.D. and a post doc--call it 6 years? I'm positing that it takes at least that much time, in the equivalent of a good Ph.D. program and post doc, to communicate with God. At least for most folks.
6. There are factors in the human being which interfere with the ability to "hear God"-fear, shame, anger, impatience, ego (in a negative sense), etc. These have to be cleared out of the way for communication to occur. Otherwise it's like trying to talk with a friend at 120db+ rock concert.
7. Etm.
>You, obviously, aren't capturing all claimed communication from God.
Okay, you are saying that you know of claimed communication from God that came through reliable channels. What would that be? If it actually is reliable, we should have a talk with Him (or Her, or Them). Which God do you have in mind?
The best lead I currently have is a bald assertion from some stranger on Astral Codex Ten. I would be happy to accept a videoconference projected in the empty air, or letters written on the sky, or a chat with some guy who demonstrates He can walk on water so long I can verify that the water doesn't have transparent objects inside and He doesn't have ridiculous buoyant shoes. There are many other reliable communication channels that could be used so should we assume that part of the problem is uninteresting? A God Who made the universe doesn't have to be subtle, and He is claimed not to be subtle in many holy books.
>"Should have been saying" has too many assumptions buried into it to address in this forum. That said, for instance, it seems to anthropomorphize God.
Seems like you are withdrawing from the conversation abruptly. Okay, fine, but that's not consistent with "It would be nice to have some basis, experience, or expertise for claiming there is no God." If you think it's nice to have a such a thing, you ought to be open to a conversation about whether you already have it or not.
We're calling this thing a God, and as a consequence I am assuming that this God has recognizably goal-directed behavior. I posit that that is part of what we mean by "God". As a non-example, a God that behaves exactly like the laws of physics is the laws of physics, not a God.
>Again, it's less that God is unable to communicate than that humans are unable to hear, so to speak.
>There are factors in the human being which interfere with the ability to "hear God"-fear, shame, anger, impatience, ego (in a negative sense), etc. These have to be cleared out of the way for communication to occur.
I could read letters written on the sky describing a cure for aging. More generally, humans can communicate with each other, a God can do more than humans, therefore a God can communicate with humans if He chooses to and He actually deserves to be described using the word "God". Subtlety is not required or useful.
Not withdrawing more than from anything else given the heavy demands on my time at work and at home, and in groups I'm involved with.
Let's try this: What do you think are the characteristics of this God? God can do everything that humans, can do, and more? I disagree with that. The customary line is that God is omniscient, omnipresent, and omnipotent. Where I disagree with that is with respect to omnipotence. My understanding is that all potency is God's but it is not all exercised by God.
Again, what do you think the characteristics of this God are? Like a human being, only God can do anything? God wants what human's want? I mean, no insult intended, the concept you seem to be arguing against is sort of the same general Christianist all powerful hairy thunderer Father in the skies. That's not what i'm talking about. What are you talking about?
The argument gets to the conclusion that God doesn't exist if we assume God likes people, is able to communicate reliably, and knows anything useful to people that He obviously chose not to communicate to them. "God likes people" is also implicitly assuming that God is purposeful enough to be said to like people.
If He is omnipotent and chooses not to exercise that for the benefit of the people He allegedly likes, that implies either not liking people or not being omnipotent (and therefore not being God). I don't care which.
He only has to be omnipotent enough to be able to communicate reliably, so the amount of omnipotence required depends on the communication channel. I will leave out the tradeoffs there because I hope they are obvious.
This conversation seems repetitive. Now I doubt that you really want to "have some basis, experience, or expertise for claiming there is no God". If you did, you would have defined your terms by now instead of making me repeat my best guess about what you mean.
My definition of omnipotent is different from yours. In my understanding, "omnipotent" means that all potency belongs to God, and some of it is delegated to human beings. It doesn't mean that God can do anything.
And, again in my understanding, God isn't "conscious" in the way you seem to be thinking. It's more like God is dreaming, and it's the role of the completed or completing human being to be part of God's awakening.
It seems reasonable to me that if someone is claiming there is no God, that they define what it is that they are saying does not exist. I'm not trying to have you guess what I mean; I'm trying to you to tell me what you mean. You don't seem to be doing so, instead saying things like "God likes people, is able to communicate reliably, and knows anything useful to people". So those sound like aspects of God, or characteristics.
Lastly, I would say that "communicate reliably" is trying to do too much work here. I'd argue that God is trying to communicate all the time, but just because a person breathes, eats, eliminated, and can read a blog doesn't mean that they have done the preparation to communicate reliably with God. You seem to think that if God is omnipotent (and I think I disagree with your definition, as I understand it), that God can communicate to anybody, any time. The record shows that's not true. The record also shows that some people have made credible claims to communicate with God- one could start with Ibn Arabi, or Rumi, or Jesus, or Shefa Gold.
OK sure, but I'm thinking about a different kind of god. God on a meta level, so there is no 'real' god. But the idea that there is a god, which mostly just means you should behave nicely, 'Do unto others as you would have others do unto you'. Is actually a pretty good first guess on how to behave in the world. At least that's my experience. I'm not sure I believe in god, but I like the idea of a god. And so, on some meta level, I guess I do believe in god... I believe that the idea of a god is a good thing, and I want to hold onto the idea, that I don't have to believe in any specific god... Christian, Buddhist, or otherwise.
I don't understand how you got the premise that "there is a god" means "you should behave nicely". (I agree that behaving nicely is a good thing, if we could figure out a definition for it, and I even believe that describing it is feasible so I'm not accusing you of being uselessly vague here. The connection with god is the part I'm missing.)
I can imagine god perhaps wanting all sorts of things. Many holy books describe gods who want things other than behaving nicely, so apparently the people who wrote those books could too. Maybe you are unaware of this (unlikely) or you are doing wishful thinking (much more likely), but my dominant hypothesis is that you're having thoughts about this that I can't anticipate.
"if you’re desperate enough to join the KKK or your university’s Black Student Alliance"
This is too tasteless for a throwaway "murder arson and jaywalking" joke, too short and off-topic for a serious "what are the implications of some races having much better options than others" digression.
Yeah, this was, in Scott's words, pretty cringe. I immediately wondered whether Scott thinks that you have to be desperate to join a campus Hillel group.
Joining a group based on shared religious activities and beliefs does seem to be a step up from joining a group based on shared melanin levels. Even joining a group based on shared ethnic background makes more sense to me than joining one based on race alone. But then I married a foreigner so maybe race matters less to me than normal people? Still, I would at least aim for "shared hobby" group membership before race.
People join racial affinity groups because race correlates with shared culture, shared experiences (of discrimination _and_ of other things), etc. I think the Hillel comparison is very apt. It's not just melanin.
I don't know about that. I am not sure a black student from Brooklyn would have more in common with a black student from Botswana than with a white student from Brooklyn. I agree there is probably some common "black culture" in the USA that is somewhat distinct and maybe shared across regions to an extent, but seems a very weak thread compared to religion or hobbies and other interests.
Like I said, maybe I don't identify super strongly with my own racial group compared to other group markers, and that makes me strangely unable to see the appeal, but shared race seems like the lowest common denominator to use to meet friends.
That's because "race" doesn't exist outside of the shared social context in which it is defined/enforced. Two "black" people from Brooklyn have "race" in common with each other but not with the Botswanan. Botswana certainly has its own "racial" or ethnic identities but they will be wildly different. If the Botswanan moves to America and spends significant time within the sociocultural context, they may well "become" a different "race" than when they arrived, despite the fact that "race" is nominally something you are born having.
Isn't the reason that there is a Black culture in America that a lot of ex-slaves had been disconnected from their national cultures, so they made one to fill the gap? So there is a genuine culture there that is primarily linked to melanin levels because that determined who needed it, whereas everyone else had their national culture still and didn't need a skin colour based replacement?
Yes, that's what race is: shared melanin levels.
Also, the assumption that members of Hillel have shared religious beliefs is wrong. I'm Jewish. I'm also an atheist. In my experience of secular, American Judaism, this is more common than not.
Black people in America are obviously not a monolith, but they do have shared ethnic background(s) in much the way that American Jews do.
I don't like woke-ism, but I do have a hard time associating myself with anti-wokeism when it comes with opinions as dumb as yours.
I agree with you on this issue, but I wish you wouldn't be rude. It worsens a comment thread just as much as "stupid" opinions do.
I thought about pulling my punches, and then I thought otherwise. Usually I agree with what you're saying. In this case, I don't. I think it's completely relevant to point out that Doctor Hammer's comment is not only wrong but also that it's insanely, idiotically glib and ignorant. It is an incredibly dumb opinion.
It's also dressed up with the kind of pseudo-high minded condescension that characterizes a lot of this kind of dopey commentary. Oh, look, "race matters less" to this person. He obviously isn't infected with the kind of base tribal impulses that cause his lessers to want to associate with their co-melanists.
Sometimes it's worth puncturing this kind of arrogance and pointing out that the person with the terrible opinion really isn't very clever.
I agree with this, but I’m usually too exhausted to respond.
I have a different opinion on this, maybe you can help me understand it. Race strikes me as a categorically different quality than one's skin pigment. A Hadza hunter, a Caribbean farmer, and a Portland professor might all have functionally identical levels of melanin, but I can hardly a imagine a situation in which it is appropriate to say that they are all the same race. Is that your position?
"Black people in America are obviously not a monolith, but they do have shared ethnic background(s) in much the way that American Jews do."
Really? Genetically and linguistically the ancestors of afroamericans are probably much more diverse than those of jewish americans. So the shared ethnic background refers to slavery and some generations of afroamerican cultures? Is the ethnic background of american jews considerably less shared?
"Even joining a group based on shared ethnic background makes more sense to me than joining one based on race alone."
At least in some parts of the world, this is a distinction without a difference.
Fine, I'll take that out.
Thanks, I also found it wildly offensive, bordering on evil. One is a group dedicated to perpetrating oppression and the other is built around the shared experience of being on the receiving end of that oppression (among other things). Maybe it was a joke (?), but if so, it landed very very poorly.
Ah yes, I do remember when black university clubs took over all three branches of government in 2020. Never again.
Crime is also up in red states.
The KKK and its affiliates and offshoots has obviously murdered more people than has Black Lives Matter and its affiliates and offshoots. The effect of the KKK on American policy and culture has also obviously resulted in more death, destruction, and misery than has the effect of Black Lives Matter and its affiliates.
Crime is still lower than in the 1980s and 1990s.
Amen to this. It turns out that anarchy and mob justice don't magically solve all societal problems just because it's "oppressed" people doing the anarchy and mob justice instead of "privileged" people. Who knew?
I think a one-dimensional concept of "oppression" that justifies everything is both superficial and causes a lot of damage, but I don't super want to get in a fight right now.
Interesting that you would read oppression justifying everything into my comment. I only stated the obvious, that the two are very different. Something does need to be desperate or wrong with you to join the KKK. Nothing needs to be wrong or desperate in you to join a black student union. I'd be very disappointed if you thought otherwise.
He means that you focused on the evil<->good axis. They're pretty different in that aspect.
They're similar in some other aspects (like focus on race).
> Nothing needs to be wrong or desperate in you to join a black student union
It seems nakedly identitarian. "White student union" would be cringe; this less so due to history, but still...
Regardless of whether you think that you would be interested in joining the Black Student Union if you were black, lots and lots of nice, normal, well-adjusted Black students join Black Student Unions. I've had several black students who were involved with our college's Black Student Alliance, and none of them were Black Supremacists, antiwhite racists, or anything of the sort.
I haven't met a lot of KKK members, so I can't speak from experience, but my strong suspicion is that most of them are racists, and most of them are losers.
I think basic respect for other people should mean that if an organization like a campus BSA draws a bunch of nice, normal, well-adjusted people, onlookers should consider that it might have some value for such people. You might even want to talk to some people who have been part of such an organization before deciding it's the equivalent of the KKK.
And if you've never been friends with someone who was a member of a Black Student's Association, or an Asian Student's Association, or something similar, maybe your own social life is more identarian than you imagine.
But which is which?
eww
Ditto
Very perverse comment.
You might find it bordering on evil, but I think the double standard in who may or may not join race-based groups is itself bordering on evil. Either we say that race should be de-emphasized and other, less immutable shared characteristics should take precedence as the basis of group identity, or we say that people can and should feel pride in their race. Saying that everyone except white people can and should be proud of their race is rapidly becoming exposed as a cynical double standard used by some (not necessarily minorities) to silence and dominate others.
The problem is that, as was pointed out above, indigenous black Americans (American descendants of slaves) are an *ethnicity*, not a race. They possess a genuine shared culture and history.
A Black Student Association is therefore much more like Hillel (which accepts non-religious ethnic Jews) than it is like a hypothetical White Students' Association.
Funny, I take pride in being Irish-American and no-one has tried to silence OR dominate me about it. Am I doing it wrong?
I'd leave it in. Those two are merely opposite sides of the same coin.
EVEN IF you believe that BLM and the KKK are morally equivalent (which, living in an area where there's still KKK successor groups and having known an ex-Klansman before the ex part AND having known people involved in BLM activism, I'll inform you the former are more dangerous), the BLM and black student orgs certainly aren't equivalent. I don't see many Black Campus Republicans marching around chanting Black Lives Matter.
Just registering my vote for "don't take it out."
It's fine if people are offended. Just let them be.
Please dont. And ignore everyone who ever asks you to again.
Thanks for this comment; I was going to post something like "really, Scott????" but you said it better. I almost stopped reading at that point (but I'm glad I didn't because this is a really interesting piece otherwise).
I've stopped being surprised at this point. The race takes on this blog are really bad, as a rule. I'm just disappointed that they've started showing up in otherwise-unrelated posts.
He's doing what he said in the body of the article: trying to get people to read his article by aggressively signaling he's anti-woke so that anti-woke types will listen to him. I just wish he didn't feel the need to do it every time he writes about politics.
No, there are a handful of wokes in the comments who are mad that their sensibilities are not being especially catered to every post, but pretty much everyone else is fine with it.
I was honestly surprised to see anything like this reaction in the comments. There is a threshold of time past which historical groups which committed heinous acts cease to be regarded with reflexive horror. I think of (as a previous commenter said) the Huns, or the Inquisition. I suppose I underestimated the extent to which other commenters associate the KKK (largely a relic, current membership 3000-6000) with broader recent white supremacist violence in the US. In retrospect, this was probably a pretty stupid assumption by me.
I think the saliency of the KKK disproportionate to current membership is primarily the result of recency; burning crosses and child murders are in living memory still. Surely "exit living memory" is a necessary condition for the threshold of time passed.
As Sourdough points out, "the crimes and victims thereof exiting living memory" is a necessary element of the hatchet-burying. I doubt many people are eager to cast the Holodomor or the Holocaust or the Cambodian Genocide or the Rwandan genocide into the "forgive and forget" categories alongside their enactors quite yet.
Many people are completely willing to deny that the Holodomor, the Cambodian Genocide, or the Great Leap forward were all that bad IF they happened at all, and really even to mention them is an act of gaslighting in defense of White Cishetereopatriarchy and its corporate arm, the GOP.
You contribute less than nothing to this conversation. Those people are rightly considered to be politically-braindead ghouls. Even pretty hardcore leftists think tankies are mouth-breathing imbeciles.
This is being debated as if it were not a joke. Obviously it is a joke, so the debate should actually be "can you joke about this?" You can be super woke, and also be OK with irreverent humor. Can't you?
I'm not super-woke. I thought it was unfunny joke in extremely bad taste. And if you look at some of the other responses in this thread, you can see the type of mouth breathers this type of "humor" brings out of the woodwork.
Here's a pro tip: if you want to make the case against wokeness (which I think is a worthwhile thing to do), you're not going to win a lot of converts to your side by drawing equivalences between the KKK and Black campus groups.
Why are you bigoted against people with severe sinus congestion?
Is there any woke idea you disagree with?
Fwiw, I thought it was funny. The butt of the joke is the people who make that kind of comparison.
This is obviously well covered by now, as I come to read it, but I'll add for the record that I thought Scott's line here was neither true, necessary, nor kind.
When it comes to the trans point, one stab toward a compromise:
Part of the question is "how broad is the funnel for prompting intervention" and I *do* think it's too broad. The good-faith reason to talk about introspecting on your gender, framing it as common to be fluid/trans is that you think it *is* common, that introspecting doesn't become a dysphoria-cycle, and that it's better to catch GNC kids early, so they don't encounter stigma/big dysphoria.
Whereas I'd rather offer help to kids who have an issue that is sustained, and they feel meaningfully and negatively impacts their lives. I want to avoid inviting people into the funnel if they're tomboyish or butch lesbians (I'll use Alison Bechdel as my example, since she is a butch woman who thinks she might have identified as trans if she were little now, but likes her life as a butch woman!).
An advocate will be frustrated that I am saying people should suffer a bit to rise to the level of an intervention, but that is the tradeoff I favor (just like I favor not offering routine mammograms to low risk women before 50).
The funnel is ever broadening. A 7th grade Health textbook was submitted to my kids school district for review (not chosen, but in use in other districts/states so some kids learn in school and then others through social media) that specifically stated that gender is a spectrum, and then used stereotypical examples such as a boy who likes to cry, and that such a boy would not be just all boy on the gender spectrum.
Sorry, but no, females have lower pain tolerance than males even a few hours after birth. And even if the reason women cry more is because of socialization, how do you explain the fact that human societies across the world, from primitive hunter gatherers to ancient Romans to Information Age city dwellers, socialize their people in the same way, unless you invoke a biological reason for the socialization patterns?
Which cultures normalize crying for men to the same extent as for women? If a man saw his child get slaughtered in front of him, of course nobody would call him weak for crying, but the range of situations in which it is acceptable to cry is much smaller for men than for women. Is there any culture where the opposite is true?
Yes, baby boys and girls are similar in how much they cry, which does weaken my point about pain tolerance. But baby boys and girls also look similar and have similarly sized breasts. Does that mean the physical differences between post-pubescent boys and girls are due to socialization? Crying behavior begins to diverge around puberty, just like all the other differences between the sexes: "From the age of 11, however, differences in crying proneness and frequency begin to emerge (van Tilburg et al., 2002)."
The same paper shows (in Table 2) that women cry 3 times as much as men, and that a similarly enormous difference occurs in all 5 of the countries they studied. Thailand, with its more traditional gender roles, actually has a less lopsided ratio than the Netherlands and the UK.
I agree with you that keeping emotions under wraps is often psychologically harmful, but I think there's a reason why "suck it up, be a man" is a universal attitude across cultures. If a man cries often, he is likely to be perceived as weak. His enemies will bully and attack him at every opportunity. His comrades are less likely to trust him to perform well in battle. Women are less likely to be attracted to him. He will be lower status, less successful, and less likely to find good sexual partners. So "suck it up, be a man" might be disastrous to perpetuate, but the alternative of "cry as much as women" is probably far worse.
Men emoting is absolutely frightening if they turn violent, and disturbing if other people are looking to them for reassurance.
There are ways to be in touch with your emotions as a man, but they're difficult to figure out if you have no role models to learn from. Most settle for either stoic dissociation or, less commonly, letting their impulses throw them around.
You say "emotionally stunted," I say "capable of self-control."
Keats & Co would like a word
I'm just waiting for someone to say I'm not a woman because I like math, so I can rhetorically punch'um inna mouf. On the other hand, if math caused menopause, I'd make time for it every day.
The problem with a "you must suffer this much" sort of approach to transness is two-fold. First, the gatekeepers are often misinformed (for example, your assumption that every GNC person is seen as a transition candidate by doctors/activists) and that sort of environment also makes it easy for unscrupulous conversion therapists (like Dr. Kenneth Zucker) to string people along for ages and put them through all sorts of crap. Second, it's a pretty common experience for trans people to look back after they've transitioned and realize that they were way more dysphoric pre-transition than they thought. When you grow up with it (and since it tends to increase gradually over time, barring more abrupt changes like puberty), it's hard to notice the effect it hasuntil it's taken away or dramatically lessened. So you have people who don't feel like they're suffering, might even deny that they're suffering, but who nonetheless end up benefiting greatly from transitioning because they were suffering, and putting up a "you must be this dysphoric to be a real trans" sign will mean many of those people will just silently suffer (evidenced by the number of people who transition quite a bit later than they initially wanted to because of being told exactly that, but are nonetheless helped greatly by transition).
"Second, it's a pretty common experience for trans people to look back after they've transitioned and realize that they were way more dysphoric pre-transition than they thought."
I would not discount the potential for hindsight bias here.
Oh hindsight bias is part of it. But some things really just smack you in the face when you think back over them in a way that hindsight bias isn't sufficient to explain.
My initial reaction to this would probably get a warning from Scott. Suffice it to say that no, there is pretty good evidence that trans people are genuinely happier and in better mental health post-transition. The reduction in suicidality alone is pretty indicative.
It seems plausible to me, since "transgender" has only recently spread to the mainstream and therefore I would expect a lot of people had the experience of "I felt something weird and wrong about my body, but I didn't know that "dysphoria" was the word to describe that feeling." Kind of like how people with chronic pain sometimes say they didn't know that feeling pain throughout their daily life wasn't normal.
Exactly this. Until pretty recently only a very specific type of sympathetic trans narrative was ever really publicized, the "I've known since I was three and I was always extremely gender-nonconforming and homosexual with respect to my birth sex, and have very severe physical dysphoria about my genitals" narrative (and doctors tended to kick you to the curb if you didn't fit that narrative or pretend to). If your experience didn't fit that you not only might not realize you were trans in the first place, if you went to a gender specialist there was a good chance that they would say you weren't really trans after asking a bunch of questions about your childhood and masturbation habits and perhaps criticizing you for not presenting sufficiently stereotypically feminine or masculine. Also rather like the experience of many people with chronic pain, now that I think about it, particularly women.
The statements like "I might have identified as trans if I were little now" are extremely prone to typical mind fallacy. We read reflection of transgenders on their journey and our mind automatically tries to find similarities between their experiences and ours in order to understand them. And then we can think something like that:
"Wait a second, I too felt not fitting in, not satisfied with the gender roles society tried to impose on me! But I found a way to deal with it without hormones and surgery. Maybe these people didn't need all these things too!"
We imagine that what binary transgenders mean by not fitting in is the same things we mean by not fitting in, because we have no other way to grasp the concept. But this is very much not the case! Just the imperfections of our language and our way of understanding things.
If we look at the dynamics of detransitionings the rate is pretty low. And more importantly, the major reason isn't the sudden reveal that the person wasn't actually trans, but pressure from the family. I think it means that the funnel isn't too broad. Of course it's extremely important that physical transition wasn't the only available option for GNC people. We do need communities of tomboys, butch lesbians and all kind of queer people so that everybody knew that there are other options and could choose the best suiting them.
This isn't especially relevant to your post, but I despise the term "queer" and believe it encourages narratives of being "improperly LGBT", as well as the usual massive dose of academic pretension which shouldn't be allowed to get anywhere near real issues.
Sorry to hear that, I've never seen it in a gatekeeping context. I like this term because it was successful reclaimed from being a slur, it allows to describe a broad category of people by a one short word and I personally identify with it.
Does this term mean anything in particular, other than denoting membership in a subculture? Serious question.
If you consider LGBT+ a subculture then it's mostly membership in it, yes. But there is also a notion of not wanting to label yourself in a specific narrow way. Like you see that existent categories are not actually a good fit for your experience and inventing new words isn't helpful. For me, personally, it echoes with Kafka's quote:
"I never wish to be easily defined. I’d rather float over other people’s minds as something strictly fluid and non-perceivable; more like a transparent, paradoxically iridescent creature rather than an actual person."
Right, but what I mean is, I don't see myself conforming to rigid gender norms imposed by traditional culture, but neither do I like LGBT+ worldview and aesthetic. Does this qualify me as queer?
Exactly. I have found it very difficult to successfully explain to cis people the internal experience of being trans and having gender dysphoria without reference to stereotypes/tendencies or in ways that they can round off as you describe if they are so inclined. It's like trying to explain sight to a someone who's been totally blind since birth or why you absolutely hate chocolate to someone who loves it. Gender dysphoria is not something that cis people ever really experience except if they are forced to or decide to pass as the opposite gender for quite some time. There's an interview with Amanda Bynes about her experience playing the protagonist in "She's the Man" and she describes, without giving name to the feeling, a perfectly typical experience of gender dysphoria as she recounts some of her mental health struggles during the filming of that movie. She might actually understand some of what us trans people experience but for the vast majority of cis people the inferential gap is huge and very challenging to bridge.
+1 on tomboys (and their genderflipped equivalent) being at risk here.
My generation had a lot of "non gender conforming" people who felt no need to transition, socially or medically. They did what they want, gave no fucks, occasionally encountered social resistance but mostly grew up well adjusted (and still not quite gender conforming). I think every single one of them would at least be tempted into declaring themselves trans if they grew up in 2022, with massively worse outcomes.
Is what you've described different from what happens in practice now? I know that (at least about a year ago when I looked into it) not very many of the patients who sought help for gender dysphoria ended up getting surgical or even pharmacological interventions. The guidelines recommended letting those patients explore gender through social transition and similar, giving time, and reviewing. Those who, after exploring other options still had significant impact on their lives from dysphoria were recommended the pharmacological interventions. Assuming those guidelines are followed in practice, it sounds a lot like what you propose above, to me.
The whole "Hearing Voices Movement" seems like a different take on the same phenomenon that people with "Dissociative Identity Disorder" ("plural systems") are describing. Is it?
I don't think so.
When you hear voices, you are still clearly yourself, in control of your brain, but you hear voices. These voices probably aren't other full agents, but even if they are, they never get control, they just talk to you.
In DID, people claim that other agents sometimes take control of their brain and affect their actions directly.
I think people conflate the two because of Hollywood depictions of "multiple personality disorder," which combine the most extreme form of DID (an alternate personality taking control of their thoughts and actions while the core personality is unconscious) with elements of psychosis (during times when the core personality is still in control, they'll hallucinate the alternate personality as a separate being interacting with them). I don't think there's a single recorded case of this hybrid disorder ever occuring in real life, but that hasn't stopped movies/shows like Fight Club, Secret Window, and more recently Moon Knight from portraying "multiple personalities" in this way.
This portrayal makes sense from a storytelling perspective, since it lets the writer pull off a twist wherein a character who was believed to be a separate person is revealed to actually be the protagonist's alternate personality, and also allows for dramatic confrontations between the core personality and their alternate self. Unfortunately, some people have started taking it as an accurate depiction of DID, which is pretty far from the truth.
And, if the story is made into a play or screenplay, it lets the actor or actress portraying that role exhibit several different personas in a single performance (the opposite of typecasting?).
What do you think of the online "tulpamancy" movement? It seems to be in an interesting space between different ways of thinking about consciousness, and yet it seems to be a very real phenomena (in the sense that there's clearly *something* going on)
I once created a tulpa by accident. During an LSD trip I suddenly had the realization that if I wanted to pay close attention to the environment, all I had to do was imagine someone else was sharing my eyes and senses and wasn't from this universe and for whom I was the tour guide. And to be a good host I just had to pay close attention and talk to them non-stop about it.
And it worked. It was fantastic. I could just sit on a long bus ride, rapt in the act of paying attention. And they started feeling real. Not like I didn't know they were just in my head, but like there was someone following me, watching stuff over my shoulder. Holding my hand while I walked. Thinking problems through with me.
Truth be told my main view on the experience is that the Unitary Self doesn't actually exist beyond a way to think and model ourselves, so I think of a tulpas or plural systems as just having a different story we tell ourselves, whether consciously (or accidentally) cultivated, or through some variant in experiences. Probably being in a culture or community where different stories about self are common makes them more accessible.
I heard of that movement for the first time today and am a little curious about it. My impression so far has been that brains sometimes fail in providing the experience of single individual agency, like in third man syndrome, hallucinogen trips, spiritual practice.
The notion of being in control of your brain is an interesting one. What does it actually mean? It feels like there's a spectrum here: I don't ever feel like I'm 100% in control of my brain.
Have you lost control of you brain if:
1) You can't empty your head of thoughts to get to sleep at night
2) You can't stop distractedly thinking about something you read in the news
3) You're asleep and dreaming, but acting as a semi-rational actor in your hallucinated world
4) You're asleep and dreaming, but acting in ways that you would never do in reality
5) You're participating in a pain-tolerance study, but can't bring yourself to administer another electric shock to yourself, even though rationally, there is a large positive net reward payoff
What are the capabilities required of the "agent" part of your brain that determine whether it is in control or not?
This is my big question.
The idea that any person actually has agency is, at best, speculation; right?
I'm a lucid dreamer, so I'm used to have mixed control of other entities in my mind. I've been two entities at once.
I have dream characters who have depth that is superficially similar to their real life counterparts(friends,family,etc.). These characters sure aren't my friends or family, but they aren't me either. I'm not interested in whether or not they have agency, I'm interested in what actually makes "me" different, if anything.
This reminds me of the Steven Wright joke about how his girlfriend got poison ivy on her brain and the only way she could scratch it was by thinking about sandpaper
I don't think we have much more control over our brain than we do over our liver.
No. Hearing voices is schizophrenia. DID is something else that probably doesn't exist.
I think DID probably does exist in some form. What doesn't exist is the Hollywood-style combination of DID itself and DID-related hallucinations.
I would be more likely to believe in DID if its proponents were less dubious.,
"I'm sorry I can't take credit for that good deed, it was my alternate personality that did it" -- no sufferer of DID ever
The traditional response to this question is "No, schizo-spectrum neurotypes are different to multiple personalities, the idea that they have anything in common is a Hollywood meme". In practice, everyone I've met who can split their psyche up like that is either clearly schizospec or clearly borderline, and "clearly schizospec" and "clearly borderline" are not non-overlapping categories. If you're one or both, it can be easy enough to trigger the experience that you do it mostly by accident! I've described tulpamancy as "if you roleplay while schizotypal it'll start talking back to you" before.
(On the object case of the post in general, I'm vaguely sympathetic to HVM and this post made me more sympathetic to it.)
In the first picture, why is X's twitter username redacted/blurred but his Twitter handle/@ isn't?
Mistake, which I've hopefully now fixed.
Gotcha! I'll edit my comment
"Alcoholics Anonymous makes an interesting comparison: they’re solving this problem in their own way, by being more conservative and unforgiving than the psychiatric establishment would like.'
A number of recovering addicts wrote to me to tell me that this was the most important part of the recovery culture: that unlike with Hearing Voices, the perspective on twelve step programs is very explicitly that your default/instincts are NOT okay, not healthy, not to be humored or sugar coated. The disability rhetoric that has spread from autism to the broader world of mental health insists that you're fine the way you are. AA and similar say, no, you have to change.
As somebody who is "on the spectrum", with a couple family members formally diagnosed, the important insight for me was that while "how I am" may be "perfectly OK" in some sense, the fact that it's not, like, _morally bad_ that my brain doesn't process social cues the same way as the brain of the majority of humans isn't actually relevant. If I _want specific results_ that come from accumulating social capital, I'm going to have to put in the damn work to learn to mimic social behaviors in a way that the majority of humans (or at least the ones I have to deal with) respond to positively. And so I did, and I ended up as a "high functioning" aspie type -- I'm economically secure, with a job as a senior engineer at a highly respected company; I have an appointed position in my town government where I derive meaning from trying to improve the world for people in general by way of making land use rules less dumb; I have friends and a spouse; etc.
So I guess my question about the Hearing Voices folks would be: Are they helping people _get what they actually want_? And to the extent that they're causing people to _change_ the definition of "what I want", is it in a way that reduces suffering and is generally pro-social, or actually encourages people to be anti-social while feeling good about it?
I do think the worst thing was folding in Asperger's Syndrome to autism and instead making it all a 'spectrum'. Really bad autism is nowhere near "I have trouble with social cues", it's cases (again, from social housing) where a family with two teenage autistic sons were looking for a grant to build on an extension so when the kids needed individual alone time, they would have a special room to go to.
It needed to be a padded room, because of the 18 year old who had to wear a motorcycle helmet 24/7 due to his constant attempts to literally beat his brains out against the walls.
People forget that if it's a spectrum, that means you start on the lighter shades and move to the darker shades, and some shades are very dark indeed. I'm now working in an early years intervention service (and here I take the opportunity to wave the flag for early intervention for physical and mental needs for children, the earlier the better - it's fantastic, it's necessary and it makes one hell of a difference) and we include children on the autism spectrum. The aim is to support the families, help the kids, and get them into mainstream education when they turn 5. Most of our kids do go on that path, but some don't, they will instead go on to special schools. They'll have lives and a place in society, but they are never, ever going to be the quirky autist software engineer of pop culture mythology.
Light is a spectrum, from red to violet - but so is the whole electromagnetic spectrum, from radio to gamma rays.
Public outreach is full of cloudy tactical decisions and trade-offs and I don't pretend to grasp them, so maybe it is good to focus first on getting people to understand that autism comes in degrees (from a-bit-quirky to chews-own-fingers-off). But, I found this slightly more sophisticated model to be quite illuminating: https://neuroclastic.com/its-a-spectrum-doesnt-mean-what-you-think/
Thanks, I haven't seen this perspective before. However, while spectrum isn't gradient, for practical purposes there does exist a gradient of how debilitating the condition is, and that's what people mostly care about when discussing questions like how to deal with it.
I was thinking about this recently, and I sense that high functioning people on the spectrum are just doing a more explicit and specific version of the kinds of social learning I did as a kid. Which, given what I know about autism, makes perfect sense! I had my own issues in elementary school, but I remember very clearly having the epiphany “My behavior is going to cost me things that I really want. I have to stop being a pain in the ass before it’s too late.” And I changed, and it worked.
Exactly. I felt this way when I got diagnosed with ADHD as an adult (I am also likely mildly on the autism spectrum). I'd interpreted my issues as a moral problem, to be fixed by "caring more" and "getting organized" and the way my parents treated it reinforced that. Both of them have sub-clinical attention issues which they've been able to handle without medication, so they sort of rounded my experience off to that since I wasn't bouncing off the walls as a kid like the stereotype. There wasn't really a sense that I could be inherently categorically worse at all this stuff (especially given how intelligent and capable I was in other areas) and have it not be somehow my fault. Figuring out what was up let me forgive myself. I still put in the extra effort I have to do to remember important things, be on time, and so on, because that benefits me and other people even if it's a lot of work, but I stopped beating myself up emotionally if the occasional thing falls through the cracks. And medication obviously helped me actually manage to keep on top of things, and gain the skills I hadn't really been able to learn previously.
Unrelated to anything else, if your alias is a reference to the Jacqueline Carey books, big <3. The path of Elua is deeply appealing to me.
It is a Jacqueline Carey reference, yes. When Scott made the initial post mentioning Elua way back when I decided to go read the books and really enjoyed them, despite them being very much not what I expected.
We live in a world where Slack is chronically low. I'm not surprised people turn inward instead in order to release some of the constraints they operate under, but I'm disappointed that the rewards for negotiating in good faith with society-at-large are so small it seems worthwhile to drop various pro-social acts.
I see this happening with anorexia and associated eating disorders too. There's a lot of "reduce the stigma" rhetoric that tells sufferers that they're doing great, and that everyone's body is different, and that we're all on different schedules.
But the way I got better was to quit giving into my tendency to self-starve. I improved my life was by changing, not by learning that I was fine all along. If I'd been listening to the "you're taking your own path" stuff, I would never have actually recovered.
I fear that there's a background conversation going on that more or less takes for granted that we've removed all objective truths about the human condition, therefore "better" or "worse" have no meaning.
I happen to believe that there are objectively better and worse ways to live, and that even just consequentialist approaches easily find them (and obviously religious ones even more so).
If you do remove objective "better" then the only thing left is subjective, at which point anything that people feel better about ("I am happy about the voices" "My lived experience is the most important") becomes the ultimate. Unfortunately, this thought process is doomed to failure, and can only exist in societies with huge surplus levels of wealth. If we had a true downturn, or in places where people don't have excess wealth, then the consequentialist results hit hard and make people more miserable than if they had tried to fix their problems and contribute to society. I can't imagine that "I hear voices" or "I'm not going to medicate my obviously debilitating condition" stand up too well in 3rd world countries, no matter how hard someone might try.
You might think it'd only happen in societies with huge wealth surplus, but a lot of subsistence societies have traditions of spiritually exalting some of those who might be afflicted by states modern medicine can more-or-less control.
The odds that an afflicted person dies an ignominious early death could be higher than the odds of achieving spiritually-exalted status, but it does mean people from these cultures can be resistant to medicating their loved ones in the typical Western way when that medication finally becomes available.
For example, among Hmong immigrants to the US:
https://www.epilepsy.com/stories/when-epilepsy-goes-another-name
and in Western Africa:
https://www.google.com/books/edition/Human_Development_Theories/zXaynPJ-hJcC?hl=en&gbpv=1&dq=people+in+developing+world+refuse+medical+treatment+in+favor+of+spiritual&pg=PA104&printsec=frontcover
The Marian apparitions at Fatima, Portugal, beginning in 1916, were reported by children working as shepherds, hardly indicating excess wealth. From what I understand, the children's families weren't supportive, but evidently somebody was.
I, too, would expect the reaction of financially-struggling families to a family member believing himself "too special" to be medicated would be, "Shaddup already and take yer goddamn pills" for as long as they could afford medication. But that's not always what happens.
I think that there could be multiple reasons that a person doesn't take medication or seek help, but I'm focusing on one that I think is both new and novel. That is, a postmodern expectation against universal morality or norms. I don't think that this new reason can exist absent a surrounding society that chooses to support it, even if it's an incomplete society (like the social community Scott's talking about here).
It's also relevant that in AA, this rigidity and absolutism is tempered with, "take what you want and leave the rest," as a frequently cited motto.
This is interesting. I had heard about the rigidity of AA's approach, as Scott mentions above, but not this balancing principle. Do you have an example of how an AA participant has established a good way of life by keeping in mind both the official rules and this balancing principle?
AA is very religious but many individuals and occasionally even groups have formed unofficial atheist chapters.
Despite the insistence on, "working the steps," many people do not. They experience varying degrees of success (as too those who do "work the steps").
For younger people, sometimes it is just a place for support while they learn to live a way they never have before (since childhood anyway)...
This is how one of my close relatives, an alcoholic who last year had his first serious relapse in a long time, participates in AA on and off. He is a thoroughly secular person but speaks highly of AA a useful tool for his situation.
The problem for “highly functioning” autists is that practically no one will tell them what they need to change. Simply saying that one should not be a dork and understand social cues are not helpful. They need very specific instructions and deeper analysis of situations which most people are not even aware of because they learned them instinctively. Whereas for autists you need to be very explicit.
I got that from a truly excellent therapist, who I worked with on and off for the better part of a decade, starting when I was around 12 or 13 and severely depressed, right on through most of college. Lots of long conversations trying to analogize systems I _did_ understand to social dynamics. (I was really, _really_ into the idea of psychohistory at the time. Boiling messy social issues down to math would've made life _so much easier_. Math, I can do!)
I am glad that you were able to receive such guidance and explanations. We need more such therapists that understand highly functional autism. That's the way to go!
Yeahhhhh.... the thing is, when I was a child and into my teens, I had delusions. It wasn't hearing voices, but it was something in the same general area and I'm not going into more detail.
"But I thought it would be helpful for him to have people he could talk to about his situation who wouldn’t think he was crazy, or try to get him locked up."
While I too do not want to be locked up, sorry but I *am* crazy. Having [delusions of that type] *is* nuts, bonkers, insane, loopy, lunatic, whatever other term would make the Hearing Voices people need a fainting couch. That's why even when I was having them, I *knew* they weren't real and I told nobody at all about them, because yeah you bet that would have got me labelled as crazy. I sort of trained myself out of having them, but it would be easy to slip back in.
And a movement like Hearing Voices would be the worst possible thing for me: a sympathetic group egging me on to continue and indeed expand having my delusions? That I was special and wonderful for having them? That everyone from doctors to the dogs in the street who said I was a nutcase was wrong and evil?
I would have gone so far over the edge that I would have indeed ended up involuntarily committed in our local loonybin. For some people, who have it together and aren't extremely unbalanced by what they are experiencing, then maybe a movement like this is helpful; whew, I'm not the only one out there with this going on.
But for other people, it would be like handing an alcoholic a litre of vodka and slapping him on the back encouraging him to chase it down with this naggin of whiskey.
Sometimes when everyone says "this is nuts", it *is* nuts.
EDIT: I suppose the snarky part of me is going "Interesting how when the NYT is interviewing people about hearing voices, it's this nice middle-class group of presentable, articulate people and not the homeless person smelling of urine ranting on the street, huh?"
There are 2-year-olds that don't hear voices?
I have never heard voices, fwiw, and it feels a little alienating that this is so often described as central to psychosis
Psychosis seems to be a many-splendoured thing, and people who are not psychotic do hear voices. I imagine lists of symptoms are "the most common things everyone reports" so that while some people don't hear voices, more people do so they whack that down as "Symptom of psychosis".
Our paranoid schizophrenic client when I was working in social housing didn't hear voices, but other staff had anecdotes of dealing with clients who, for instance, used to report that they could hear people talking about them in circumstances where 'no, that is definitely your mental problems' was the reality.
I think people talk about voice-hearing a lot because it's one symptom that's easily relatable to the non-psychotic. When you hear voices, it's exactly what it says on the tin: you hear sounds in your head that don't come from the external world. But to my mind, delusional thinking is very hard to capture and convey to someone who hasn't experienced it. "Having strongly held false belief that's immune to evidence" is just not an adequate picture of what's going on. Many interesting descriptions have been attempted but they don't make very good memes, and negative symptoms just aren't very exciting at all. Hallucinations are just easier to wrap your mind around than delusions, are probably more interesting to the non-psychotic, and voice-hearing is far and away the most common form.
I've actually wondered if you might attempt the kind of description of psychotic thought processes that would get across some felt aspects of the phenomenon to the uninitiated.
My own pet loneliness is that no one talks about the experience of catatonia, and that catatonic people are often talked about like they aren't "in there," which just isn't the case.
Is it really hard to explain? Like a lot of people, I have enough delusional tendency that I think I've learned to explain it to myself.
Delusions are getting stuck on a bad narrative. Everyone else is doing one narrative, and this person is stuck doing a different one.
I think it only gets recognized in one of three ways. First, retroactively. Second, by recognizing the looping property, following your tracks so many times you realize you are circling. Third, by having a rude contact with reality (or, if you're lucky and not paranoid, by having contact with someone you really trust).
Absolutely everyone has lived through this. Severe delusions are a major difference of degree, but not a difference of kind. The difference is not "I have X experience that you could never understand", it's "I have X experience, just like you, but it was very strong and had ruinous consequences".
> That's why even when I was having them, I knew they weren't real and I told nobody at all about them, because yeah you bet that would have got me labelled as crazy.
On the one hand, this is where some sort of an acceptance movement for people with delusions would be useful: so that the next generation's Deiseach doesn't have to suffer in silence, and can instead go to the psychiatrist in the same way she'd go to an ophtalmologist or a cardiologist or something. On the other hand, the current iteration of the Hearing Voices movement appears to be moving in some orthogonal direction, at best...
> EDIT: I suppose the snarky part of me is going "Interesting how when the NYT is interviewing people about hearing voices, it's this nice middle-class group of presentable, articulate people and not the homeless person smelling of urine ranting on the street, huh?"
The modal person who hears voices is in fact middle class and presentable, because benign voice hearing is more common than the psychotic illnesses that also cause voice hearing, and even then, most people with those illnesses are not "smelling of urine ranting on the street". But since that's the image that's conjured up when someone thinks of a voice-hearer (which again, not the same as psychotic illness) I rather think the Times doesn't need to bang that gong any louder.
That's basically how psychiatrists treating me have described it. Having some strange audio pareidolia where running water or wind or other noise sounds like a huge choir singing words I can't make out? Not normal, but not psychosis.
The fixed idea (I won't call it a delusion because I could always reason myself out of it) that everyone can secretly read my mind? Surprisingly common psychosis.
I think these things might be on a spectrum. I have some patients who, at the very beginning of a psychotic episode, will interpret wind as music more (but have few other symptoms) and then further on in the episode they'll hear genuine voices.
For what it's worth, mild sleep deprivation (i.e. several nights little sleep, one/two nights no sleep) will cause me to interpret white noise like sounds as music.
Latest I've had is the shower making me convinced I'm getting a telephone call.
(Of course this is just my tired brain going into over pattern matching mode, similar to when using certain drugs or a sensory-deprivation tank. So maybe in itself this is just mild schizophrenia that occurs only when exhausted?)
Daaaaamn – I've experienced both auditory and visual hallucinations like this when I'm sleep deprived. But I wouldn't think even just a single night of no sleep is _mild_ sleep deprivation; maybe only sleeping for a few hours instead.
But I also notice my brain/mind 'falling into' "over pattern matching mode" a LOT anyways. I'm not sure that everyone doesn't experience that pretty regularly, ex. "Oh, I thought I saw X.".
Annoyingly, I also experience mood-lifting from 'acute' sleep deprivation sometimes, so I don't reflexively respond or adjust to it, e.g. by taking a sick day from work.
Wait, the audio pareidolia is not normal? I had enough conversations about similar perceptual distortions, with different people, that I'd at least expect it to be widely distributed...
My mom heard voices. She was encouraged further by the local Catholic parish, who recognized them as apparitions, and... well, that didn't go so well in the long run. I *don't much like* this Hearing Voices thing.
This is exactly why the authorities are supposed to take a sceptical view of such matters and have them investigated. Lay people are more inclined to be a lot more enthusiatic and credulous - see the moving statues in Ireland, bleeding statues, visionaries of all sorts, turning up to see images in glass, etc.
I hope your mother is doing better, if she is still alive?
If it's not too sensitive a topic, would you be willing to elaborate on the internal experience of having delusions that you know aren't true? It never occurred to me that that was possible, it naively seems contradictory.
I suppose it rather runs along the lines of 'madness need not mean losing your reason'. It's the split between the reasonable mind, which is telling you "you know this is not real, right?" and the - hmm, I need a term here, let's invent 'the experiencing mind' which goes right ahead with what it's doing.
Something along the lines of 'when you're having an anxiety attack at three in the morning, your reason can be telling you that no, you are *not* really dying but that cuts no ice with the emotional experience of how flippin' awful it is'.
I had a lot of little rituals which I brute-forced myself to break since I knew if I continued in them, they would only get worse (and I could see them getting worse anyhow) to the point that they would grievously impact on my ability to function.
An example of what I mean by delusions - and it is really hard for me to type this out as I feel like such an idiot - believing that pictures/photos could see. If there was, for instance, a photo or a picture of a person on the cover of a book or a magazine or wherever, that they could see what I was seeing. As if a real person was in the room with me.
So, for instance, if I was getting dressed and there was such an image in the room, I would cover it so it couldn't see me. Absurd and delusional, but my reason telling me "this is nuts" didn't help. I believed my reason, of course, and I knew it was correct, but I still did it. From around late pre-teens to early teens, then I finally (as I said) brute-forced my way out of it because I knew it was crazy and the fear of insanity is a good motivator to 'stop doing crazy things' (if you can get there early enough and it's not too severe). I used to look up the physical copy of the Encyclopaedia Britannica in school and wonder "Do I have hebephrenic schizophrenia?" https://en.wikipedia.org/wiki/Disorganized_schizophrenia
I've never been able to get that kind of willpower going to break other bad habits, so I suppose I really need the lash of terror about being declared insane to motivate me!
> It's the split between the reasonable mind, which is telling you "you know this is not real, right?" and the - hmm, I need a term here, let's invent 'the experiencing mind' which goes right ahead with what it's doing.
Something along the lines of 'when you're having an anxiety attack at three in the morning, your reason can be telling you that no, you are *not* really dying but that cuts no ice with the emotional experience of how flippin' awful it is'.
Yes! There's a lot more going on in like capital-P-psychosis but that's the essence of the split--see my comment to James above.
> An example of what I mean by delusions - and it is really hard for me to type this out as I feel like such an idiot - believing that pictures/photos could see.
That's a great example to illustrate the point, way better than my rose thing. It's the difference between thinking "this photo can see me" and experiencing the actual feeling that you get when a person is looking at you when you look at the photo. Hence the insight continuum(s?)--how much you are aware that the feeling is just a feeling, and how much the feeling is commanding reality. That kind of experience is common on the lower end of the psychosis spectrum, I bet a lot of people who've overindulged on Adderall, weed brownies, or all-nighters could relate.
I'm glad you decided to share this piece of your history, it's honestly fascinating to me, and I really really hope you will take it as a compliment if I say that your writing (an 8000 horsepower engine bedecked with lit sparklers) paved the way for this development.
Thank you for the compliment about my writing, from this end it feels more like a creaky, rusty tricycle powered by vitriol! 😁
I'm glad it was helpful for you. I wonder if a lot more people have these kind of experiences than we ever hear of, because they keep them quiet (due to "I don't want to be marked as crazy") and these experiences are not severe enough to render them in need of treatment, or they go away on their own/with effort to suppress them.
Considering all the Nazars in use and these studies with the eye pictures, there seems to be a hardwired tendency in a lot of people to consider oneself watched whenever anything resembling a human eye is around.
Also, the eyes in the picture follow you as you move around.
That makes sense, thanks for the description!
I chalk it up to the modularity of the brain. Think System 1/System 2 but I'm not committed to that theory, I'm just gesturing at it for intuition. There is a kind of two-track awareness though, which parallels those observations loosely.
Picture a red rose. When you encounter an object like a rose, several things are immediately apparent. Not in the sense that they occur to you quickly; in the sense that you perceive them directly. They are practically the constituents of reality itself--the redness of the rose, the curls of the petals, the contours of the stem--immediate roseness of it all.
Imagine that, when you encounter a red rose, with the same immediacy and pre-conceptuality as the redness and and the stem, the idea the person you love in is mortal peril seizes you. That meaning inhabits your perception of the object as much as its physical properties, is processed as quickly, and is equally unassailable. Someone might convince you that the seeming red rose you're looking at is actually blue, because you're under powerful hypnosis or it's been painted or some such, but they could never make you see it as blue, and neither could you yourself. I think most people feel on a gut level that they would be resistant to psychotic delusions, that they're too smart or reasonable or normal, that they wouldn't succumb. But no one sees the rose as red, no matter how cleverly or carefully they've deduced its blueness. Psychotic delusions don't live in the realm of the mind that's amenable to that kind of reasoning--they live in how you the world smacks you right away, and what it compels you to do.
You can retain propositional awareness of facts like "I am experiencing psychosis" and make predictions about the world based on that, like "no one else is thinking that my love is in mortal peril so I should not act like it is the case right now and run out of the building". Instead of "deep down, you know that's not true," it's more like "way up high, you know that's not true". Deep down it's like, truer than true. At least some psychotic people spend a lot of time pretending not to be psychotic, because they have enough of their higher cognitive functions in tact to figure out how to do so and to care enough about goofy mortal concerns like not get arrested, killed, or expelled to do so.
The actual blood-and-sinew experience of it is so hard to describe/remember--if you've ever tripped on hallucinations, you know all that ineffable, profound feelingness that frustratingly wilts in the light of day, and the differences between psychosis and ordinary cognition have that property as well.
Right, that distinction between apparently direct experience and deliberative reasoning is helpful. I think I could implicitly see how that distinction could be applied to hallucinations, which are sensory in nature, but I hadn't thought about how thoughts can also have that quality of immediacy of perception.
Section 8 explains so many of the pathologies of our culture…I’ve had thoughts along those lines before, but this really crystallized things. I’d be interested if anyone has any pushback.
I agree. I might build on it by saying it seems to be related to the internet and social media generating a competition to be interesting and get attention. If you only have access to a couple hundred people in real life, it is easy for many to be different in interesting little ways; when you have access to thousands of people suddenly you have to be really unusual to stand out. For people who want attention and approval, or need to join a group based on who they are as opposed to what they like, that really ups the ante on how strange your profile has to be to stand out from being "just another ____."
Very good point: the beauty of the internet is that it allows weird people to find one another and create communities (of a sort), the ugly is that people in weird communities need to become extra weird in order to "stand out".
the way I would paraphrase this section is "People who do/have done more novel things are more interesting and enjoyable to be around than people who do/have done fewer novel things." I understand Scott's point that there seems to be more shaming of people with minimal quirkiness, but I also understand Scott's mom's concern that he would be socially stunted if he spent all of his time doing one minimally quirky activity.
I want to talk to the woman who went to China to learn arcane tofu recipes more than the woman who did all of the same things as the first woman, except for that.
Even if they can be a great place for mild cases (edit: and I'm not convinced they are, see Deiseach), their misguided policies will lead them to take in some severe cases who need medical care, not a support group. Violence will result which could have been prevented.
I don't think that their treatment model is applicable to everyone; I think they think it is; this is likely to have dire consequences. HVM is not ready for what will happen when one of their members tries to kill another, is not even engaging with that as a possibility.
I think they've had a lot of members now without this happening. Even if it does happen tomorrow, it will mean they have some very low but nonzero murder rate, just like most other things (would public schools be too tasteless an example today?) I think shutting the whole thing down over one murder per few years would be a disservice to people who are well-served by them.
I agree they should have policies in place to escalate people they can't deal with to a higher level of care, and I agree that potentially their ethos will make this hard for them. Hopefully if something ever goes wrong they'll bite the bullet and get those policies. I don't want to accuse them now, partly because I don't know what their policies are, and partly because AFAIK nothing has gone wrong.
I think I agree. Shutting them down over it will probably be an overreaction. But it's the predictable overreaction that will happen to them. When the family of the murder victim sues them for wrongful death, they'll have a case. "our son was in your care. you let his killer in? you let them stay after hearing them express murderous intent? you failed to refer them to care or authorities?"
And that family will have a point. HVM needs to have a policy of referring people to care and authorities. Per the article, HVM is precisely dead set against having such a policy, meaning they're not engaging with reality in a way that might destroy them.
The analogy to public schools is also very apt here. Nobody blames the school system for the shooting... until and unless it comes out that they ignored the warning signs, kept the clearly dangerous kid in school, and swept the potential for catastrophe under the rug. That's exactly what there's potential for here.
Public schools are so profoundly dysfunctional as institutions that promote human thriving that I think you could use virtually everything they do as negative examples.
Which... they did. Many times. It's harder to find times they did not.
Yeah, you make a good point, I just...kind of hate optimizing for lawsuit avoidance. I've seen the results of this taken to an extreme, and it's not pretty. If you go through the mainstream psychiatric system with any kind of violence/psychosis history, then to a first approximation you get treated as a lawsuit risk with arms and legs, rather than a human being. I think part of the advantage of Hearing Voices Movement over the regular psych system is that they avoid doing that, and so (eg) you don't have to be strip-searched before attending meetings, and if someone wants to say "Oh, that sounds hard" when you give your tale of woe, they don't have to imagine a lawyer saying "The defendant ADMITTED the patient had a hard life, but refused to escalate them to a higher level of care!" Places where they optimize entirely for maximal lawsuit avoidance REALLY aren't good places.
I think you could tell a story where the entire advantage of Hearing Voices over a mainstream psych ward is that Hearing Voices is too poor and scrappy to be worth suing, plus judges would be sympathetic to them, so they don't have to err as far in this direction.
As a former lawyer, I also hate optimizing for lawsuit avoidance. Everyone treats it as being prudent, but I think there need to be people who are willing to put themselves out there, especially in situations where they don't have much to lose, and say "I'm going to do what I think is right to make the world a better place, and I'm going to trust that other people will act in good faith and not attempt to sue me into oblivion if something bad happens."
I think there's a dynamic where people optimize for lawsuit avoidance because they don't trust people, but the act of optimizing for lawsuit avoidance decreases trust, both by making the optimizer more worried than they should be and by making everyone who interacts with the optimizer feel like they're being treated like a potential attacker. I think one of the easiest ways to increase trust is for people to make themselves "vulnerable" in obvious ways and sometimes the only way to do that is unilaterally by doing something like *not* optimizing for lawsuit avoidance.
Institutions are paranoid about avoiding lawsuits because the least-cost avoider actually at fault is often "judgment proof", so our legal system goes after the nearest deep pocket.
https://www.overcomingbias.com/2015/10/requirelegalliabilityinsurance.html
I'm not in favor of Hanson's proposal. One of the options under it is:
"To convince them you are a low risk, you could show them many things about yourself, and even let them continually monitor you in many ways."
By privatizing law in this way, we would lose the constraint now on the government:
"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized."
Yeah, taking lawsuit avoidance as your highest value sucks, and god knows plenty of places are doing that, which might make this seem refreshing. But you need at least some pragmatism... and you need to value protecting those in your care. At some point, you've got to face reality.
Uh, consensus reality. Pragmatic reality. Fuck, you know what I mean.
Realistically that's true, I just don't know how you avoid optimizing for lawsuit-avoidance in this climate without having a strong culture of being against that, and strong cultures aren't the best at stopping at pragmatic stopping points.
The NYT magazine article also highlights another organization - Israeli-originating "Soteria Houses" - which, if the article's summary is accurate, seem to strike a far better compromise. Doctors can impose medication and escalate care, though it is not too frequently necessary; and they occasionally reject people as security risks. And apparently, insurance in Israel is now covering stays in them and programs like them.
A better balance seems possible! And what's more, it's necessary if people are going to succeed at building an institution that can last.
I strongly oppose the Hearing Voices movement, but I don't see why they'd let in someone expressing murderous intent. Did they say anywhere that they would? If they just let in people who hear voices but don't express murderous intent, it's hard to argue that they're responsible for anyone's death, given that everyone joined the group with the understanding that everyone else in the group hears voices.
Yes, it's very clear from the article. "Afiya house", which is the shelter "run by the alliance", took in the protagonist of the article when she was hearing voices telling her "they're going to kill us" and "we have to kill them." The article quotes its director as saying "Here, we have people express that they want to harm someone. These are all normal thoughts. But people train themselves to believe that they’re not. Giving space to express these things, to have these conversations, that’s the healing thing, that’s the magic here. When we don’t allow that space, things get bigger."
Again, there may be people for whom space and opening up is the best approach even if they are hearing voices urging violence. But there will also be people with severe cases who act on their delusions if not medicated, and Hearing Voices and Afiya are not being realistic about that or prepared for it. It certainly looks like they're failing to protect the people in their care from one another.
I think it's much more common to hear voices telling you to kill people than to be anywhere close to killing people. I find I sometimes (mostly unconsciously) mutter "die die die die die" when I'm really angry, but I'm not going to commit murder or suicide.
For what it's worth an emailer tells me that the article leads the reader to believe that the Afiya is a bigger deal than it is. It's a small program that treats a tiny percentage of Israel's psychotic population.
Yeah, like tutoring, it probably doesn't scale. The model relies on someone (an intern playing the role of "melavim", companion) being there to listen to each person at any given time.
(btw I assume you're referring to Soteria - that's the Israeli one, Afiya is the "peer-run respite house" in Western MA run by Hearing Voices.)
Oh. Well, I guess that's what I get for not reading the article before commenting.
To be cynical, there's probably a natural filter in place. The type of person who ends up at a Hearing Voices group that gets written up in the NYT is your functional computer programmer with a successful career and the same social background as the other members, not the part-time worker as a supermarket cashier who is always losing her job because the voices interfere with her ability to function.
When and if we get groups for the people in threadbare cardigans and worn-out shoes, we're getting down to the level of 'severe cases who need medical care' and that is where the possibility of violence will arise, but those groups may in fact be better placed to recognise and deal with that possibility, because that is the reality of life for its members.
Relevant comedy sketch:
https://www.youtube.com/watch?v=e3rNn3qSB5s
TIL I need to be institutionalized right now because my clothes are worn out
We can go in together. :)
Interesting to hear your perspective on peer specialists. I’m about to start a practicum placement on a psychotic disorders unit with a few peer specialists, so I’m curious to see how the dynamic among the treatment team plays out.
Re the pressure to be quirky: I think it exists in parallel with the pressure not to be quirky, maybe in disjoint filter bubbles. Just the other week there was a dating advice thread on DSL where some posters were advising people to be bland and normal and not have any weird hobbies. I spent my teens trying to pass as normal, and am now comfortably weird in a bubble of other weird people, but I still feel intense social pressure to hide it whenever I step outside that bubble.
I think there might be what logicians call an omega-inconsistency here. It may be that there is pressure towards "there should be a quirk that you have" and *also* pressure towards "that particular quirk is one that you shouldn't have", for every single quirk.
But I also think that as you say, the different aspects of this have different strengths in different social bubbles. And it could be that the social bubbles that pressure people not to be quirky are the "dark matter" bubbles that make up the majority of society, but that don't interact with people like Scott or me at all (as described in section III here: https://slatestarcodex.com/2014/09/30/i-can-tolerate-anything-except-the-outgroup/)
Is beauty omega-inconsistent, or am I understanding the term wrong?
People whose faces are flawless in every respect look boring. People whose faces have lots of flaws look ugly. Having one or two facial features outside the normal range of variation might be a kind of sweet spot.
The strict definition of omega-inconsistency is for a theory of arithmetic.
A theory that proves "there exists a natural number x such that P(x) is true" but also proves "P(0) is false" and "P(1) is false" and "P(2) is false" and so on for each particular number is said to be omega-inconsistent. This theory is not actually inconsistent, because it can't even state the claim "every natural number is either 0 or 1 or 2 or ...", and since it is not inconsistent, there is some formal set-theoretic model that satisfies the theory. However, any such model must include some objects other than 0 or 1 or 2 or ... among the "natural numbers". Since "omega" is the name set theorists use for the actual set of natural numbers {0, 1, 2, ...}, the theory is said to be "omega-inconsistent", because it is consistent, but inconsistent with the model actually being omega.
I was applying the concept a bit metaphorically to the idea that society says "you should have a quirk" but "you shouldn't have quirk 0" and "you shouldn't have quirk 1" and "you shouldn't have quirk 2" and so on for every single possible quirk.
But I think once we try to apply it more concretely as you suggest, something about the analogy breaks. It's not that "you shouldn't have that flaw" it's something like "most people shouldn't have that flaw, but if it's the only flaw, then you absolutely should".
So, basically the "be yourself! No not like that!" meme?
That's exactly what I was thinking!
The signalling theory of quirkiness would be this: all quirks are status-negative. A high-status person adopts quirks in order to countersignal that they're so damn high-status that they can afford to take these status hits. A person with no quirks is signalling that they're sufficiently insecure in their status that they can't afford to step outside the lines at all. Then you have low-status people who don't understand the game, adopt quirks, and lower their status even further.
But the "countersignalling boosts status" thing is sufficiently well understood by humans (at least subconsciously) that you can't appear to be adopting quirks _just_ for the purposes of boosting your status, you need to actually appear to naturally enjoy them.
This is probably true for the mainstream culture, but for certain subcultures certain quirks increase in-subculture status, or are even required.
You can define quirks as status-negative, but I think that's not reflective of common use. Someone whose hobby is learning new languages is quirky, but that is status-positive. Other examples are easy to imagine.
I was getting ready to say something about Scott's take on transgenderism, but your comment is so on point that I think I'll just leave mine as a reply to yours.
There is definitely cross-pressure from the general culture and from the various subcultures all of us inhabit, and I think this is relevant to issues of trans identity. Scott's "switch" theory is interesting but I don't know how it could be confirmed or disconfirmed in our current social environment. There's enormous pressure from Society Writ Large not to express a nonconforming gender identity, but there's also pressure from specific social environments (especially for young women, I think) to embrace such an identity on what might not be the strongest grounds.
So if more people nowadays identify as trans, where does that leave us? Is it a case of "we must protect people from the subcultural pressures, otherwise their switch will flip and they'll be forever miserable because of counterpressure from Society Writ Large?" Or a case of "thank goodness subcultures are helping to cancel the pressure of Society Writ Large, because now more people are embracing an innate condition they otherwise might never even have interpreted correctly"?
Scott's main argument against flipping the switch is that it should be avoided because Society Writ Large still makes trans people miserable. That strikes me as less plausible than the standard trans-skeptical position, which is basically "there is no switch; some people are just temporarily confused and we shouldn't let them make irreversible body modifications, at least not until they're a little more mature".
Rightly or wrongly, the underlying assumption there is that people who transition too early may end up being unhappy *with themselves*. If there is a trans switch, however, then people whose switches are flipped won't have any internal problem with being trans; it's Society Writ Large that may have a problem with them. That's an argument for changing society, not for worrying about the switch.
"Scott's main argument against flipping the switch is that it should be avoided because Society Writ Large still makes trans people miserable. "
This is part of it, but I think an important amendment here is that I think even with zero social pressure, it's harder to be trans than cis. Cis people pass effortlessly and never stress about it; from my experience of trans people, they pass intermittently and stress a lot. Hormones, surgeries, etc are expensive and unpleasant. Some people never manage to pass even when they try very hard, and then feel bad about it. It's hard (though not impossible) to have children as a trans person. None of these problems are so big that they make it a bad idea to transition if you've already got the switch-flip, but I think in general it's much easier to be cis than trans for reasons not related to discrimination. I think most trans people implicitly agree with this - they wish they had been born a cis person of their preferred gender, and not just for discrimination-related reasons.
Fair enough. I was dubious because of the parallel with the ridiculous, obviously circular argument that anti-gay people used to make ("we should stigmatize homosexuality because if we stop doing that, more people will turn gay and then they'll be stigmatized"). But identifying as gay or lesbian doesn't require surgery or affect your capacity to have children, so... yeah.
But is there any evidence for the switch hypothesis?
My impression is that sexuality is different in men vs women. Homosexuality in males seems to be robust against quite a lot of pressure. But the largest shift in sexuality in recent decades has been among women, who were never really the primary targets of things like laws against homosexuality, and they tend more to be bisexual than obligate homosexuals.
I think that has been shown true in so far that bihacking and conversion therapy on men is quite hopeless. Once determined, male preference is set in stone (or very hard wood at least). But we'd have trouble knowing if a specific cultural environment itself can make more men gay when they grow up. There's more openly gay people than ever before. Assuming that 100 years ago, we'd have the same relative number of closeted gay men may be true, but it's unfalsifiable and should not be unduly priviliged as a hypothesis. Identical twin studies point towards some degree of malleability.
It's unheard of among some populations, who find it hard to believe that such a thing exists.
https://www.theatlantic.com/health/archive/2012/12/where-masturbation-and-homosexuality-do-not-exist/265849/
“very hard wood” 🤣
Evidence for the switch hypothesis for gay people: Identical twins separated at birth can turn out with different orientation suggesting a switch.
Also we haven't found evidence for a purely genetic explanation either, to my knowledge (no gay gene or polygenic gay score so far).
In practice, gay people have far fewer children and that cannot be blamed entirely on persecution. Also growing up with an avoidably smaller dating pool could be considered a potential harm to your child. Gay men also have a far higher STD risk, I believe. (and STDs are externalities, too)
I would say that arguing for persecution in service of hoping to prevent switch-flipping would therefore only be partly circular, the degree depending on a variety of unknown factors.
Fundamentally I am against having opinions on things I cannot directly affect. Please don't fight me, because I am not disagreeing with you, just pointing out perceived flaws in your epistemic position as a matter of... entertainment. (I should get back to work now, sigh)
Greg Cochran has an explanation for why male homosexuality does not appear to be genetic or culturally induced.
Josh Barro would argue straight men have a more difficult time dating than gay ones, especially if they are short.
I'm not sure that it does not appear to be culturally induced. What would a world look like, where culture/upbringing/education had nothing to do with it. You think it would look exactly like ours? I think there actually is some progress on genetic explanations.
And aren't there ethnic differences, too? (though disentangling those from culture is hard)
Doesn't mean that Cochran's gay-germ theory must be entirely wrong either. Iirc, 10% of ADHD cases come from a specific prenatal neural infection. (though it may be that those should have their own taxon, if we could reliably know that cause being present)
So my current model is that "being gay" is some kind of program/attractor state/mode/taxon that the brain assumes, that multiple causes can push one into.
Hmm, my understanding is that transwomen usually have unending difficulties passing, unless they were lucky enough to never go through male puberty - but transmen generally pass easily, with hormones and "top surgery", in any situation where they can keep their pants on.
Yup. Zinnia Jones, who blogs at GenderAnalysis.net and (in addition to being trans) knows a shitload about endocrinology and other stuff, has written up research on this topic. Basically: the human brain is conservative and demands lots of cues before identifying another person as female, but requires just a few cues to label someone as male.
I have absolutely no expertise in this field but the policy implications seem pretty straightforward. Puberty blockers for trans-identifying minors are good and they're especially crucial for natal boys who identify as female, because otherwise natural puberty may leave them permanently androgynous (which is what some trans people want, but not all). Surgery and positive hormone therapy are more questionable interventions for patients under 18--and especially for natal girls who identify as male, since the social factors in gender dysmorphia may be stronger in those cases.
IME, transmen pass extremely well facially, though the hips and voices clock as formerly women. The hairlines aren't quite malespec either.
In my place of employment transmen vastly outnumber transwomen, which I read is not the case on the west coast.
How much of this anxiety about passing is a result of (fear of) discrimination, though? If all cis people accepted trans women as women, I think a lot of trans people would cease to be so desperate to pass.
I don't mean that desire to pass is a result of fear of being violently discriminated against, e.g. beaten up for being trans. What I mean is…
Like, it upsets a trans women to be thought of as men. Anxiety about passing is based on a fear that people will think of them as men despite their best efforts. Being recognized as a trans woman, instead of "passing" for a cis one, is a failure mode because of the risk that ordinary people will mentally think of a "trans woman" as a kind of man, rather than a kind of woman. To be clocked is to be misgendered, more often than not.
But in a society that was widely supportive of trans people, it should matter a lot less to the same trans woman if people notice that she's trans. The bystanders would just think "cool, a woman, specifically a trans one". No one's getting implicitly-misgendered, and the trans woman can save herself a lot of worry about her jaw size or whatever.
(Reasonable minds may, of course, differ on how much this sort of internalised, society-wide acceptance is achievable, in the foreseeable future or at all. I'm just making the point that if *for the sake of argument* we remove all transphobic sentiments from the world, then I do think a lot more of the anxiety associated with trans people's day-to-day lives evaporates than you suggest.)
I don't know. There are some medications that give men breasts. If I took them and developed big breasts, I would be sad. I wouldn't expect anyone to mistake me for a woman, I just would...clearly be failing at having an ideal male body (without succeeding at having an ideal female one).
You can always go further and say "well everyone should agree to stop having beauty standards", but that's a stronger ask.
I don't dispute this! But wanting to look feminine (or masculine) feels different from wanting to *pass* in the sense of wanting to be genuinely hard to tell apart from a cis person. I thought the anxiety you were talking about was the worry some trans people retain about things that hormones and surgery *can't* alter very much (e.g. facial bone structure) even after successful undergoing transition in other respects.
Dysphoria is commonly described as feeling that you're in the wrong body. Isn't having the "wrong" bone structure for your gender a part of this?
> If all cis people accepted trans women as women
Well, the problem is that with current level of surgery they are typically clearly not women, often in ways blatantly obvious.
To be more specific, if you defined "women" in way other than "labelled themselves as woman", based on biology at all then they will fail it.
I don't think you understood my post. The whole point was to draw a distinction between the scenario "ordinary people are unable to tell a trans woman apart from a regular ('cis') one", and the scenario "ordinary people, when clocking someone as a trans woman, readily think of her as nevertheless a woman". The latter depends on changes in social attitudes/descriptive linguistics, not on surgery getting improbably good.
What I meant (as I thought was clear), in other words, was a hypothetical where everybody genuinely thought of "trans women" as "a type of woman" rather than "a type of man" or a weird in-between — not just mouthed words to this effect out of sympathy or duty, as I think many "trans-supportive" people do, but genuinely updated their mental definitions to this effect. A lot of people in very progressive, or simply very LGBTQ, spaces are there already, so it's not an absurd thing to wish for, even if I think we won't see such a shift in intuitions in the wider population in our lifetimes.
(It's worth noting that ordinary people, when we abstract away LGBTQ stuff per se, are perfectly capable of acknowledging the idea that a person might be a "woman" because she thinks like a woman, looks feminine even if she doesn't look like a biological woman, and has a female name.
Namely: outside of sci-fi that explicitly tries to make it into a trans allegory, no one looks at robot girls in fiction, who don't have chromosomes or uteruses or any such thing, and say, "no, this is a sexless entity that *defines* themself as a woman but they're not biologically female, so we shouldn't call them a 'she' however much she asks". If we can accept a sentient piece of software might be female if she says so, despite lacking *all* human biology, I don't think trans women not having a complete female biology is the insurmountable semantic hurdle you make it out to be.)
> [readily thinking of transwomen as women] depends on changes in social attitudes/descriptive linguistics, not on surgery getting improbably good
I think you're understating how hard it is to "genuinely think of 'trans women' as 'a type of woman' rather than 'a type of man' or 'a weird in-between'." Treating a non-passing transwoman the same way you'd treat a cis woman is a difficult thing to do (even if it's a worthwhile one).
Sure, linguistic changes, like respecting people's pronouns, are easy to do, and a matter of basic respect. On the other hand, "social attitudes" are hard to hack, even in yourself. People behave differently towards men and women. For example, when a (cis or passing) girl walks into a room that has previously been all guys, the dynamic changes. Why is complicated, there are probably many evolutionary biology stories you could tell - but whatever the reason, people behave differently towards and around men and women, and it happens mostly unconsciously.
What happens when a non-passing transwoman enters a previously all-straight-male conversation? The dynamic also changes... but in the same way as when a cis woman (or passing transwoman) walks in? I don't think so. At least, not without sincere, difficult, intentional effort by the other participants in the conversation. It's a rare person who is aware and sensitive enough to mock up their attitudes that well. As a matter of "social attitudes", I think it's downright impossible for transwomen and women to be treated the same when there are very noticeable physical differences.
So fossil's point has some validity... even well-intentioned people who respect pronouns and philosophically agree non-passing transwomen are women will fail to *actually treat them the same way*. Which implies that at current levels of surgery, being a transwoman is a dysphoric, stressful, depressing, emotionally taxing experience, even in the total absence of discrimination or ill will.
The female robot analogy is interesting, especially since a lot of straight guys would be up for trying sex with a “pleasure-bot” but would balk at trying sex with a trans-woman.
Why is an "in-between" a problem as a category (in the absence of persecution)? If e.g. a transman has XX chromosomes and testosterone levels typical of a man, what's wrong with just noting "This is a trans person, a bit unlike either the central example of a cis-man, or the central example of a cis-woman". (And, except in situations where the transman is a plausible sex partner, or in medical situations where their steroid levels or reproductive organs are relevant, what difference does it make? )
I'm a retired programmer. I've seen _lots_ of situations where we tried to describe alternatives with a single bit, then found that we needed a richer description with more bits and more alternatives.
(edit:fixed typo)
How many of the "trans women are women" crowd really think it, without playing semantic games? That's just... not how the instinctual process of categorization works.
They can aim to fall in an "androgynous person of unclear gender" category, demanding anything more is a pointless exercise in doublethink.
Oh, as I said, I absolutely do agree a significant number of people who quote the slogan don't actually believe it, in that deep sense of "believe" I mean. I'm saying that trans people *wish* more of them believed it. Further, I was arguing that if more people did, this would be sufficient to alleviate most trans people's passing-based anxiety (as opposed to the view that only successfully passing for cis would do the trick). But in practice, sure, it's not realistically going to be something the general population grok, any time soon.
Still can work on the individual level, though, as an aim for people who *want* to be more welcoming to trans people to try to shape themselves towards, and as something for trans people to try and get from their immediate circle of friends/relatives instead of attempts to be treated precisely like a cis person — since the latter are, especially in the case of people who knew you pre-transition, usually unattainable.
I also agree the aim being "falling in an 'androgynous person of unclear gender' category" is a good realistic target to begin with. It's serviceable even if the cis observers can't or won't think about it deeper than that, in the sense that what's upsetting to a trans woman is "being thought of as a man", much more than "not being thought of as a woman, exactly". Also, it's a good first-approximation of the more sophisticated mental-category-shuffling I described elsewhere in the thread, which we might summarize as "form a bespoke 'trans woman' category and get into the habit of thinking of it as a category of 'female', distinct from 'cis woman' but closer to it than it is to the 'weirdly-dressed man' category".
"trans women are women" isn't a claim that trans women are the same as cis women. It's a claim for inclusion in the broader social category of women
I've heard it expressed at different levels of literalness, some of which sound very much like "literally exactly the same as cis" and others closer to your definition.
What does it mean to be "includ[ed] in the broader social category of women"? What would that entail, and how would it be achieved?
If having the switch flipped makes them unable to live happily without invasive surgery and disruptive hormone treatments that they otherwise wouldn't need, then I think it's fair to say that's a worse outcome. Regarding your follow-up comment, I don't think there's much evidence either way; note that Scott called this a "steelman" which probably means he thinks it's the strongest form an argument he doesn't agree with.
Ah, okay. I don't think I understand "steelman" (or "motte and bailey") despite having read the definition a couple of times. Why does having opinions have to be so hard?
It's the opposite of strawman. If I was to construct a strawman of some group (an exaggerated caricature that obviously sucks), that group would be:
People who hate X, selfish, uneducated, inexperienced, etc.
If I were to steelman them, they'd be:
People who disagree with X, have different priorities, were unable to access resources most people take for granted, etc.
If I got to the point of learning the terminology I think I'd feel obligated to write fewer substack comments
I nearly lost my mother last winter due to post-surgical infection following a double-mastectomy for medical reasons (cancer). About a year ago I lost my step-father due to post-surgical infection following heart surgery. Surgery is dangerous. It is expensive and painful and people can die. Take away all of the social stigma, and trans surgeries are still expensive, painful, and dangerous.
There's "acceptably quirky" and "unacceptably quirky" and those differ for different groups. As per Scott's example, for some people 'going off to China to learn to cook rare varieties of tofu' is acceptably quirky, while for others that will be "Mother of God, it must be nice to have more money than sense" territory (I couldn't imagine being *jealous* of that person, because my 'they must have little to be worrying them' reaction over-rides any 'ooh, if I had a hobby like that, I would be so cool and not have to cultivate being interestingly odd to fit in with our boho social circle!' reactions).
For the "tofu is acceptably quirky" crowd, 'I went to the megachurch in that blue-collar neighbourhood for a year and participated in all the events and services' is unacceptably quirky, unless you can portray it as an anthropological quest or finding ammunition to subtly mock those types. Doing it sincerely? What are you, some hick from the sticks?
Interesting, I was also thinking of the DSL dating advice thread!
For a moment I thought there was a DSM-IV dating advice thread somewhere.
I say go with cable
Better use both in redundant seemless failover mode. A bit difficult to set up and more expensive, but best don't put all your internet in one basket.
"In order to be appealing to the opposite sex one must display at least three of the following behaviors:
-Approachability
-Aloofness
-Cooperation
-Self Reliance
-Confidence
-Vulnerability
-etc..."
I think you are right. Much of these sorts of issues seem to be an attempt for people to form smaller tribes and communities to center on. Such groups are always going to focus on "like what I like, but don't like what I don't like!" thinking to create the community's boundaries. Perhaps this is the emergence of dispersed subcultures replacing the geographic/regional subcultures that dominated 50 years ago?
The boundary enforcement is more aggressive because there isn't a default area to base it on. So you can't say "we Lancastrians do X, and those Lititz people do Y" is wrong so far as it is based on what the people living in the areas do, but if you are basing who is in the sub-culture on who does certain things, then what people do becomes a question of wrong or right. More like religion than regional subculture.
Sorry, thinking in type, but it is an interesting question of how those bubbles interact!
> Just the other week there was a dating advice thread on DSL where some posters were advising people to be bland and normal and not have any weird hobbies.
Different things impress different kinds of people. Do you want to date nerds or normies? Nerds are more interesting, but normies are more numerous.
Maybe the advice is more about the direction than about the desired end state. If you are a normie, you should probably get a hobby. If you are a DSL reader, you should probably tone down your weirdness.
Disagree -- as a normie (well, an aspiring normie), I find nerds pretty boring. Unless you happen to share their particular obsession, they don't have anything else to say.
Whereas normies, they can engage in conversation on a wide variety of general-interest topics. Did you just come back from Uruguay? Great, tell me about that!
As an autistic nerd, this doesn't map on to most nerds I know. Maybe I just know a lot of highly-sociable nerds by pure happenstance, but even the most stereotypical one I know (obese, mildly agoraphobic, loves comic books and video games) can talk about a wide variety of topics with some confidence.
I think part of you is creating a very flat stereotype to beat up to countersignal here.
Anyone want to clear up what DSL is? For us squares? I only know of two meanings for that acronym, neither of which make sense in context
It's a derivative community from ACT, which Scott links to near the top of the blog under the name Bulletin Board. IMO, it's freakishly insular and intolerant of liberal language. The community is mostly a coalition of libertarians and religious conservatives. But the most uniting force in that community which does bring some moderate Democrats to the table is a passion for fantasy, D&D, sci fi and comic book heroes, All political division are forgiven if you love Lord of the Rings or Star Wars or Heinlein or the X-Men. That's what really holds that group together, even though it mostly pretends to be about conservative politics
Is there a reason you're avoiding the name?
DSL is the name. Oh, well, I suppose that is short for Data Secret Lox, which is an anagram of Astral Codex Ten.
Actually, it's an anagram of Slate Star Codex (no N, and it's "secrets" so there's the extra S). Figured I'd ask, though, since I remember someone on here (like, almost a year ago?) who claimed linking to DSL was bad due to the nature of the userbase.
This is very true. I often feel as though I'm neither weird enough nor normal enough, if that makes sense. Or maybe I'm weird in the wrong ways (the ways that don't make for interesting New York Times articles or instagram posts).
I think "quirky" is the wrong term. In fact, it's the opposite of quirky that people are looking for. They want you to assist in creating your character for them, by providing them with convenient handholds (to stick with the rock-climbing idea) to understand your personality. They need you to tag yourself with the various topics and stereotypes that apply to you.
HotelConcierge's tumblr has a great article on this idea: https://hotelconcierge.tumblr.com/post/140529495929/how-to-be-attractive
Here's my take, which is similar. Assume that you have no internal drives - that you are doing everything to appear maximally attractive to others. Your strategy should be to ensure that you have many labels, and that you inhabit them in a way that a bad novel would have a character inhabit them.
For example: If you are a straight white man, you have the most options.
The first is to become a "straight white man." This means that you need to watch a mid-afternoon sitcom and become the husband. Exactly. In every way. Watch sports, drink Budweiser, wear the wardrobe you see in the sitcom, and treat women like they're ineffable.
"But people hate those guys." No, some people hate those guys, and some think they're great. The "straight white man" is a concept that it's easy to form an opinion on, which is what we're trying to do here.
You could also choose a straight white man subtype: Get really into politics, closely aligning yourself with one of the two parties. Make sure that if you're conservative you have wraparound shades and a pickup truck. If you're liberal, a hybrid car and a twitter account. You could be a workout guy: Get into working out, and make sure there's protein powder involved.
You could choose a mild mental disorder. This works better for women, but you can make it work if it's the way you'd see a mentally disordered man act on TV.
There's lots of other ways to do it, but the point is - adopt the character that you choose completely. Do not, do not, do not, have contradictions in your character. With advanced techniques you probably should have some surprising labels: e.g. "Yeah, I'm a conservative but I support gun control." That's the kind of thing that makes characters more interesting. But those should be very well-defined exceptions to a very culturally recognizable rule.
Everyone these days is on a script, and when you make them go off script it's a very bad experience for them. Don't do it.
This doesn't quite work for me. I think people would be unimpressed with someone who played video games and did nothing else, and more impressed with rare tofu guy. I think we have a mental bin for "person who plays video games and nothing else" and less of a bin for the tofu thing, so I don't think this is just mental binning.
That's fair. I'm tempted to say two things in defense of the mental binning hypothesis:
First, that people in my social circle might be unimpressed with someone who plays lots of video games, but they'd definitely be *more* impressed by someone who plays lots of video games and does nothing else (and adapts video-game-player attributes) than they would be by someone who plays video games, watches lots of sitcoms, and doesn't adopt any clear "character."
Second, in my mind, rare tofu guy is a pretty recognizable character. Not because we have a bin for "rare tofu guy", but because when you say "spent several years learning to cook rare varieties of tofu in China" I can imagine a whole character in a specific kind of prestige TV or novel. I can imagine the audience for that novel, and suspect the audience for that novel would find him attractive and interesting. Because we're discussing a genre, the tofu and China has nothing to do with it. It could just as easily be a dog breeder in France, or New York Socialite learning candle-making in Appalachia. The bin is <person> goes to <unfamiliar culture> where he learns <highly specific, unusual skill>. The key point is that you know the genre, and therefore all the characters. You picture locals as being less "sophisticated" but wiser, you can play the role of visiting person from hometown, etc. There's still a script.
With that said, this theory is coming dangerously close to being unfalsifiable. I suspect I just spent too many formative years reading Edward Teach stuff :P.
people always say ‘spend your weirdness points wisely,’ like it’s a budgeting exercise, but maybe it’s more similar to investing—a good investment (or short) gives one license to amplify their natural mix of weird/normal, and ‘successful’ investors are hedged enough across different contexts they can take more risks in ‘being themselves’ or whatever in new/bigger contexts.
...maybe the halo effect is something like ‘trading on insider info,’ etc....
That matches my experience, yes. Or perhaps it's just progressively getting less inhibited while also filtering your social bubble?
What's "DSL" in this context?
Data Secrets Lox is a bboard that was created during the Dark Time when Scott had removed himself; it is still active.
Would you be more or less likely to express your quirkiness if criticizing your expression was considered 'ableist' and grounds for ostracizing the person being critical?
I think that's something the article overlooks; certain quirks are heavily protected (at least in large parts of society), and if you can cast your quirk as one of those, you can take advantage of those protections.
I think that would only work in the social circles that already tolerate or encourage quirkiness. In those that don't, that argument would be met with either confused incomprehension or hostile derision.
I took up EMS as a hobby for several reasons. It gives me another topic people want me not to talk about!
Earthen manure stockage as a hobby? Ranchers might be interested in talking about it.
Good, balanced observations. I liked Freddie de Boer's article, but you make some good points for looking at it another way.
Nice out-of-the-blue Aleister Crowley quote, too!
I imagine this post will get a lot of excited responses.
It doesn't feel as balanced to me as it does to you. Of course that may mean that it is balanced, and people on all sides of the relevant issues will be equally certain it's imbalanced, aka doesn't privilege their particular positions. Or then again, it may not.
My experience biases me towards the camp that sees various DSM conditions as often better handled without pathologizing them. I'm personally somewhere on the autistic spectrum, and connected with religious communities prone to ceremonial possession, aka channeling. (They don't just hear voices; they provide a mouthpiece for the speakers, variously conceptualized as mostly benign non-embodied entities.)
I'm also in the weird place of supporting the agitation against Autism Speaks, while at the same time knowing a person who works for them.
For those who don't know, there are two issues with Autism Speaks. First of all, they are a group of do-gooders lacking any autistic representation, which claims in their name to speak for autistics. (They understand us better than we do ourselves, at least in their own opinions.)
Second, they appear to claim that we *all* need to be "cured" and favour a wonderful (sic) treatment called ABA (Applied Behavioural Analysis(?)) which according to autistic activists basically involves "curing" the autistic person by punishing problematic behaviours until they stop. Done sanely, that might be a last resort, used only for dangerous behaviours - such as physical violence. Done by someone desperate to make autistics normal, it's likely to involve punishing a lot more, up to and including everything the autistic wants to do, enjoys, or has available as methods of self-soothing etc..
With humans involved, and the tendency of neurotypicals to project their needs and desires onto everyone else, not to mention the tendency of parent to want their children to be just like them, I'd be sure the bad version happens regularly, even without having encountered people who claim that it happened *to them*.
It's a mess, and I don't know how to solve it. Some people are messed up enough to benefit from help that has really noxious side effects. Or they are sufficiently dangerous to others that there's good reason to restrict their liberty, e.g. by treating them against their will. Others just need people to stop using their kind of person as a bad example, or demanding that they pretend to be a cookie-cutter example of normality. Most need strategies and tools for improved living, whether or not they are considered to have a psychological disorder - but the tools that will work for them won't be exactly the same as those which work for others, and while knowing what they see as problems may help select good tools to offer, a diagnosis is likely to be helpful in selecting tools, as well as in proactively suggesting tools to address problems they might not have mentioned.
If people were rational, those people could get useful-to-them help whether or not we called them "psychotic", "autistic", etc. - i.e. however we defined condition boundaries. But human beings generally aren't rational in that way; we over-simplify any category we define as Other, and thus tend to try the same things for a violent non-verbal child and a somewhat socially awkward child nerdy child that's fascinated with dinosaurs. And when we reclassify the nerd as non-autistic, we then try to treat them the same way as their sports mad, social butterfly classmate.
I agree that the seizure disorders need to be cured, though I suspect the 30% number isn't based on the whole group the American Psychiatric Association chose to consider autistic in 2013, with the World Health Organization registering their agreement in 2021 (Technically, autistic people all "have autistic spectrum disorder"; AFAIK, "autistic" is otherwise meaningless).
I'm not clear that autistic spectrum disorder, per se, needs to be cured in all cases. The analogy that comes to mind - suppose there was some morbidity that affected 30% of males. (I can't think of anything that approaches 30%, or even 3%, mind you. But OTOH a greater proportion of males than females generally die at all ages.) Should we cure their maleness? Should we selectively abort male fetuses, keeping just enough to sire a new generation, so as to increase overall life expectancy? (Females live longer, on average.)
Clearly, my analogy is a reductio ad absurdum. But my autistic symptoms give me very few problems, except to the extent non-autistics make trouble for me because of them. My prospognosia - another thing more common among folks on the autistic spectrum than in the general population - has been a lifelong nuisance, and when I was younger it would have been great to get rid of my general clumsiness. But other than those two things, I'm glad no one came along and "cured" me when I was too young to give informed consent, and wouldn't take a cure if it were offered today.
Medicine without diagnosis sounds like a terrible idea to me. Pragmatically unmanageable, at the very least.
But is it medicine e.g. to tell an autistic child that many people get upset if you don't appear to be looking at their face when speaking to them, but you can avoid the (common among autistics) stress of meeting their eyes by looking at their mouth, or their eyeglasses, and they'll never notice you aren't meeting their eyes.
There's a lot that's interesting in your comment, both as a specific mental health treatment issue, and as one example of the perpetual struggle to figure out how useful social categories actually are. I hope Scott and others engage with it in a way that's beyond me, at least at the moment.
Right now I have a specific question.
>[The Autism Speaks activists] appear to claim that we *all* need to be "cured" and favour a wonderful (sic) treatment called ABA (Applied Behavioural Analysis(?)) which according to autistic activists basically involves "curing" the autistic person by punishing problematic behaviours until they stop.
So far I have read little about Autism Speaks, or any rival autism activists, although I think I grasp the outlines of the debate. Can you link to an Autism Speaks publication which specifically addresses high-functioning autistic people, as well as undiagnosed people who see themselves as similar? What I would like to see is confirmation that Autism Speaks activists are actually including such people when they talk about how to treat autism. The alternative is that Autism Speaks may view such people more as a distracting phenomenon of misdiagnosis, e.g. along the lines of Freddie deBoer's recent post (https://freddiedeboer.substack.com/p/the-gentrification-of-disability).
That's a really good question. My impression has been that Autism Speaks doesn't address autistics much, if at all - it primarily addresses parents of autistic children, generally in ways that seem to presume the parents are nowhere near the autistic spectrum themselves.
But I haven't read much of their literature myself, and none at all recently. (Frankly, I got sick of reading rants about them every time I went near any online Asperger's Syndrome support group.) I don't know how or whether their literature changed when the terms "Asperger's Syndrome" fell out of favor.
So I popped over to their website, and looked at their page linked as "what is autism" at https://www.autismspeaks.org/signs-autism. It pretty clearly refers to mild as well as severe autism - given the symptoms listed, and their prevalence among those previously referred to as having Asperger's syndrome.
They've also improved somewhat - not all of the page is addressed to "parents or caregivers" of children who might be autistic; there's a small section at the bottom addressed to adults and teens who suspect that "their feelings and behaviors involve autism".
Their page about "Interventions for Autism" at https://www.autismspeaks.org/interventions-autism lists Applied Behavior Analysis (ABA) first, but since the list is in alphabetical order that probably doesn't mean it's their first resort.
Their page on ABA at https://www.autismspeaks.org/applied-behavior-analysis makes it clear that the goal is to change the subject's behaviour, not to teach them coping skills or make them happier. The page stresses _positive_ reinforcement. But being cynical, and given the past controversy, when I see "Positive reinforcement is one of the main strategies used in ABA." I wonder what the other strategies are, and whether they could equally well say "Negative reinforcement is one of the main strategies used in ABA."
Overall, there's nothing flagrantly wrong with what I'm reading on the site, other than the badly chosen organization name. There are some inconsistencies and gaps, such that I feel as if a not-so-competent job was done of adding material relevant to (a) higher functioning autism and (b) people old enough to read the site themselves and investigate whether they are themselves autistic. I don't have a copy of their site as of when I first encountered them, but I suspect that material simply wasn't present at that time.
There are some unfortunate leftovers. E.g "Autism’s severity scale reflects how much support a person needs for daily function." from https://www.autismspeaks.org/what-are-symptoms-autism The implication, at least as read by a literal-minded person (many autistics) is that *all* people on the spectrum require some support for daily functioning, unlike healthy/normal individuals.
But overall, if they had called themselves "resources for parents of autistic children", and included things I'm seeing now, but don't remember from before, they probably wouldn't have become such a negative symbol among high functioning autistic teenagers and adults.
Thanks for sharing these links and thoughts.
You're right that a literal reading of that reference to the severity scale implies that all people with autism need support for daily function. But if very few or none of these activists have autism themselves, and then there's less reason to take them literally. ;-)
My impression from the website is that Autism Speaks activists are not discussing the phenomenon of mental health directly. They are discussing the burden on themselves and other parents/caregivers, with reference to its cause. If a parent of a high-functioning autistic person said to them, 'Sure, my child is puzzling, but not in need of special support', I expect Autism Speaks would have little further to recommend.
This is in some ways how I feel about my bipolar disorder. I am well aware that for some people even the THOUGHT of mania is terrifying, that it's a life-destroying monster that comes in and wrecks their finances, relationships, career, everything.
I'm not unmedicated, but I'm lightly medicated. I had problems finding psychiatrists who wouldn't consider anything on the high end, no matter how marginal or seemingly stable, a serious problem. They'd say "If normal people go from four to six, every time you come in here you're at a 6.5 or 7." and want to start monkeying with my medication. It felt like to their mind living /under/ the norm was better than living /over/ the norm.
And this really bothered me. I didn't want to go WITHOUT treatment, because I wanted the ability to know when something was a bad idea to actually work. And to have a bit more stability and not be at risk of falling into a mixed state. And to not have to act increasingly squirrelly because I felt like people just walking down the sidewalk were talking about me, then awkwardly apologize with "Sorry, I'm having delusions of reference." But I wasn't willing to live in constant brain fog and dysthymia either.
It's one reason why I'm so keen on the idea that psychiatrists should be expert consultants on making people comfortable, happy, and effective in their own minds. And why I think a transhuman viewpoint is kind of the best way to think of it. (I like many details of how I think and feel. I don't like all of them. My ideal self isn't 'normal', but it's not my unmedicated self either.)
But I KNOW people who've had their lives destroyed by the same condition I have. Even if I decided I didn't want medication, there's no way I would jump on the 'Medication is bad!' bandwagon. This is just another one of those ways where I happen to benefit by dumb luck and I have no business chastising others who have a harder time of it. I don't even think I could give them techniques to try, beyond "If you have good insurance, time, and your life is sufficiently together, shop around for doctors and don't be afraid to fire treatment providers who aren't helping you or you feel don't listen to you or share your priorities."
You make an interesting point about the relative severities of different peoples' hallucinations. I can admit to having had a couple of them in my life. They were so ridiculous that I knew immediately they were hallucinations. It's absurd for one's dog to walk up and say "Hello."
Knowing I'd had an hallucination was, well, troubling, but it's not as though they have come with any frequency or regularity. They were many years ago, many years apart, and my dog hasn't said a word since. Perhaps it's still upset that I didn't engage it in conversation.
I wonder whether hallucinations may not actually be more common than is generally assumed. Are we just wired to ignore things that don't conform to our expectations? I've seen that film clip of a person in a gorilla suit walking through a basketball game. Nobody ever seems to notice him until he's pointed out.
They are! Oliver Sacks wrote a book about that.
Now I don't know whether to feel happy or sad that my dog may never talk to me again. It could have been chatting with me all this time, and I just wasn't paying attention!
The White Christmas Task shows it's pretty easy to induce a musical hallucination in people by asking them if they hear the tune "White Christmas" on what's just a recording of white noise. From what I understand of predictive processing, it's reasonable for people's minds to resolve white noise into a familiar tune if someone suggests they'll hear it.
Among musicians, hearing music that's not physically present must be completely normal, "not even a hallucination" (because hallucinations would be weird and bad?) normal. It's normal for musicians to be briefly fooled into thinking the music is "coming from outside the house" if they're in a situation where they hallucinate music in a setting where they really might be overhearing someone else's music, but you usually realize pretty quickly it's just your own imagination, and it's not weird.
I once asked a psychological expert whether hearing voices singing counted as "hearing voices". He said, no, it didn't — that you don't describe hearing imaginary voices as hearing imaginary voices unless those voices are harassing you or telling you to do bad things. Or at least, you don't describe it that way to mental-health professionals.
If you don't notice a hallucination, did it really exist?
"They were so ridiculous that I knew immediately they were hallucinations."
That's interesting, since IIRC normally with schizophrenia at least hallucinations/delusions seem to override whatever mental filters the brain usually has to separate reality from delusion, no matter how much you know you're schizophrenic.
Cecilia McGough, founder of Students With Psychosis, experiences visual hallucinations. One of her most common hallucinations is of spiders. If it's a giant spider, she's relieved because she knows those don't really exist and it must be a hallucination. It's smaller spiders that really bother her, because they might be real.
https://youtu.be/7csXfSRXmZ0?t=462
The short answer is that insight is a spectrum, and it tends to fluctuate along with the intensity of other symptoms. It varies from person to person but especially over time if someone's condition is active and they are experiencing psychosis. If they're well, deteriorating insight might be a warning sign. It's interesting that reality-ness isn't an either-or proposition. (This is sort of a nomenclature thing but someone with schizophrenia could have intact insight while they are well. It's psychosis, the active symptomatic event that is shared with other conditions, that is better thought of as blocking insight, and I think is what you intended anyway.)
interesting!
Questions: is psychosis identical with diminished insight? Alternately, are diminished insight and psychosis causally related but not identical - i.e. does diminished insight cause psychosis? Or vice versa? Or is the relationship between insight and psychosis merely correlative, i.e. does psychosis have, among its many possible symptoms, diminished insight? I'll go out on a limb and predict that the answer is "nobody knows", but I though I'd ask anyhow.
> Or is the relationship between insight and psychosis merely correlative, i.e. does psychosis have, among its many possible symptoms, diminished insight?
That's closest to my experience. Insight and psychotic experience are neither identical nor uncorrelated; I would think of them as loosely tethered.
Hope it wasn't first hand experience!
There's a difference between hallucinations (non-real sensations) and delusions (irrational, unshakeable beliefs).
Delusions are essentially defined as beliefs that aren't logically derived or amenable to reason, so it's tautologically true to say that they override one's ability to determine what is real.
Hallucinations do override one's ability to determine reality in the very weak sense that knowing they're not real doesn't stop you from seeing them/hearing them/etc., but they're frequently recognised on the higher, conscious level as being non-real.
It is, of course, possible to delusionally believe that a hallucination is real, but even in schizophrenia there isn't perfect co-occurrence.
Delusional belief also is carefully distinguished from beliefs that would be understandable to have for a person in their cultural context. You can have a belief that is not rationally warranted and it not be considered a delusion. Catholics aren't experiencing a potential psychotic symptom for believing in transubstantiation. This allows us to not start declaring each other's cultural views, and especially religious ones, as meeting a diagnostic criteria for a psychotic disorder.
Sometimes this gets fuzzy. Religious delusions are common in psychosis, for example, and you as a clinician get placed in a role of deciding from the broader context if this "counts" as something a person can fairly think or is delusional. You sometimes have to end up making calls like, "It's Ok for people to unreasonably think God is speaking to them, but not like *that.*"
Wellll...but...
I think that hearing voices is perfectly normal. What's wrong is when you think it's someone other than yourself talking to you.
ISTM that wherever I read or write I hear voices saying what's coming in or going out. And I frequently hold discussions with myself about why this or that song is running through my head. If this didn't work, then Mantras wouldn't work at all. (They don't work that well, but they do affect my thought patterns.)
Just sitting here considering what to write, I find myself wordless until a voice in my head starts suggesting the words I should write (and revising itself).
So. Most mental things are gradient in nature. I would propose (without reading any of their literature) that these "Hearing Voices" people are a rather extreme form of the same experience that I have. The problem comes when they stop owning the voices as a part of themselves. Religious history tells us that that can lead to severe problems. So I strongly agree that your suggestion of the Family approach is worth following up. Actually, anything that will get a dialog going should help, but ideally they need to accept the ownership of the voices. This, of course, requires accepting that they aren't just their conscious mind...but I don't know of an author that believes that. (Consider the problem of writer's block.)
I wonder what, in this context, would you think of the tulpamancy movement? They don't have any relevant psychiatric diseases to start with, but they self-therapy into hearing very well-defined and agenty voices and consider that to be totally normal and accpetable. They certainly don't want to be "treated".
An obvious fact but one worth repeating is that psychosis isn't just "cleanly" hearing voices, which as described in this post seems like it would often be fairly manageable if that were the only symptom. There are lots of other aspects -- seeing patterns where there are none, trouble reasoning and using language, paranoia, etc.
And the diseases that can cause psychosis also have lots of other bad symptoms.
I often talk to myself. It's the only way to guarantee a stimulating, intelligent conversation.
I have insomnia and sleep apnoea. These occasionally combine to make me very sleep-deprived.
In that state, I hear voices (I last did a couple of years ago, before that was the time my CPAP broke down in 2015). Usually my mother's voice as she sounded when I was about ten years old (not as she sounds now). Usually just asking if I'm OK, or telling me to go to sleep, or scolding me for not going to sleep - in many cases, resulting in it being harder for me to sleep.
This is not a problem for me; I know that the voices aren't real; I know they are caused by lack of sleep; I am usually lying in bed trying to sleep at the time I hear them; they are not telling me to do anything other than sleep. Sometimes I wake up later on, unsure if I heard voices before I went to sleep, or if I had a dream after I did. Other times, I am more clearly awake and hearing voices.
But, as Scott mentioned, I have very carefully avoided mentioning this to anyone involved in my work or family or medical practice, because I am scared that the result will be antipsychotics from the medical people and family, and losing my job from the work people.
This sense that there are versions of all sorts of psychiatric conditions that are basically just a personal quirk and there are versions that are utterly debilitating - and all points in between - is one I think really matters; I would feel a lot safer talking about hearing voices if I could rely on other people treating them as a minor quirk rather than as a serious medical condition.
Yeah, hallucinations from insomnia are a thing totally separate from actual psychosis (had a couple of instances myself).
A less charged way to describe it would be "dreaming while awake".
Maybe it's because I'm old, but I personally find "quirkiness" irritating. I could spend hours listening to a person passionately expounding on the history of Australian Aboriginal flute-making techniques, or something to that extent -- because I like learning new things, and I admire passion when it is coupled with competence. But if that same person says, "I've read all about Australian flutes ! Tee-hee !", my only response to that is "STFU". I don't care about things that make you feel special; I care about things that make you actually special.
I think this is part of the problem, though; it's too much trouble to distinguish real specialness from fake specialness, so a demand for specialness increases both. I actually don't care if you know lots about Australian flutes! I don't like Australian flutes! I'm not against you learning, and I hope you have a good time, but I am not going to increase my estimation of you as a person just because you know stuff about them.
I realize this is kind of an unstable signaling equilibrium and it does show *some* positive things about a person if they're willing to have a nonstandard hobby, but I think I err on the side of not caring.
I that, for me, the difference between "you're an interesting person" and "STFU" amounts to competence. I don't really care about Australian flutes either, but I can respect someone who put his heart and soul into studying them in great detail; has published articles about the flutes; is currently involved in a bitter academic rivalry with his nemesis who believes that long flutes are superior to short ones and not vice versa; etc. Even though the flutes themselves do not interest me, the mindset of such a person would. On the flip side, I cannot respect someone who puts an authentic Australian flute up on the wall for an extra 50 quirky points. That person hardly has anything that qualifies as a "mind", IMO.
> That person hardly has anything that qualifies as a "mind", IMO.
This is too much. You're jumping from 'this signal is empty and tedious' to 'this signal allows me to diagnose the sender as a barely-human moron'. I know you might not mean it entirely literally, but I think that being so willing to write off other people for making inept moves in the signalling game is a real mistake. Just about all of us have some combination of empty pretensions and genuine depths.
edit: maybe you don't see those signals as 'inept' so much as unjustifiably successful? If you see society at large actually assigning the quirkiness points in exchange for the empty signal, I get the frustration. But, if anything, that probably makes it harder to write the flute-hanger off as mindless; they're just seizing an opportunity to score cheap points in a harmless way.
> Just about all of us have some combination of empty pretensions and genuine depths.
That was so well said. Kudos.
It's not an inept move in the signaling game, it's a valid, information-carrying signal that the person is a moron.
Leaving aside the truth or falsity of your assertion, that seems a fairly bleak and isolating worldview. In the ocean of social signals that surrounds us, some non-trivial percentage are undoubtedly empty. Do you feel like you’re surrounded by morons?
There's a series from around forty years ago called "Hands", made by our national radio and television service about craft traditions of Ireland.
This particular episode is from 1983 and the workhorses of Dublin. The narration is irritating because it's done in the style and accent of one of the "Professional Rale Ould Dubs", but the historical interest is engaging. This is the 80s in Ireland, in our capital indeed, and this is how we were living. The 80s were a time of very bad recession in Ireland, whatever about the rest of the world, and high emigration levels. This is the period and the reality in which I grew up.
https://www.youtube.com/watch?v=Z-FWhUec0kM
And now it is all gone.
I have friends whose parents immigrated from countries like China and India, and they've mentioned that the difference in material standards between their childhoods and their parents' is hard to fathom. I also had a childhood friend whose mom immigrated from a part of Ireland that has historically been poorer than Dublin, so I imagine she experienced something similar. But I think children growing up in the same country as their parents and experiencing such a gap in living standards in one generation is probably a pretty rare experience. The only other examples I can think of are modern China, South Korea, and Singapore, but maybe there are other cases I'm unaware of.
I find the narrator's voice absurdly soothing. I find the fact that Ireland still used coal to heat individual apartments in their capital absurdly terrifying.
Poland is in process of banning such practice. Capital of Poland, Warsaw, legislated such ban a week ago.
It starts in 2023 (unless it is legislated away or stopped by courts).
Kraków, Poland banned coal and wood burning in 2019, with exception for municipal heating plant. This was done after someone managed to block earlier attempt due to some legal trickery. It remains legal outside city limits, resulting in massive smog during winter.
Also, it is common to burn lower quality fuel than coal.
Wait, did they ban all wood burning, period ? That's going too far, IMO. I have no problem with people having outdoor barbecues or campfires in the woods or whatever. I was just extremely surprised that Irish citizens had to rely on coal as their main heating solution as far as the 80s.
I admit that I am unsure about legal status of grills. But looking at https://inzynieria.com/energetyka/smog/wiadomosci/54968,smog-w-krakowie-zakaz-palenia-obejmie-takze-grille it banned "installations" and barbecues do not qualify.
So grilling remains legal.
> campfires in the woods
this ban is within city limits, with limited urban forests
but this ban also does not influence campfires
I think responding to someone enjoying the fact they enjoy something with active hostility is one of the only things that make me want to tell people to shut the fuck up (along with unnecessary destructive criticism).
A nice data point for Scott’s vendetta against the NYT:
https://www.instagram.com/p/Cd3bpv1LdO5/
"The worst failure mode is people who handled ... their condition without medication, ..."
This line touched a nerve I have been poking for a while, so asking for advice on the internet. ¯\_(ツ)_/¯
In the last ten years, I have been in psychotherapy thrice, a few months each time, all of them CBT to my knowledge. The first time was very effective, the second was in hindsight ineffective, and the most recent one (TEAM-CBT) seems effective for now. During the last one, I learnt some tools and techniques, but I am starting to have doubts as to what extent and how effectively I can apply them on my own in the future after I will have already forgotten most of the experience.
I have explicitly avoided having to take any medication aka going to a psychiatrist. Mainly because I personally know zero people who had successfully done that -- I personally knew zero people who were in therapy as well but it felt less risky (even at the cost of being ineffective) -- and I worry about some sort of dependency/addiction/side-effects. I agree it is irrational, as I don't think that way about doctors/medication treating physical ailments.
Since Scott has been writing a lot on this subject: has he already written something to address questions like this? Like a primer about psychologist vs psychiatrist, and ways to find one? Thank you.
What condition are you dealing with, and where are you located?
Social anxiety, in New York.
I'm surprised you manage to know zero people who have successfully seen a psychiatrist for social anxiety. How many people do you know who have unsuccessfully done so?
If you saw a psychiatrist for this and asked for medication, you would probably get put on SSRIs, which are not addictive in the classic sense but can produce dependency after a while. They would have a 30-50% chance of making you feel less anxious in general (higher if you count placebo) including with social anxiety. I've written up my thoughts on SSRIs at more length at https://lorienpsych.com/2020/10/25/ssris/
If you wanted to do this, you could ask your primary care doctor if they were willing to do it (about half are). Otherwise you could ask them for a referral to a psychiatrist, or ask your insurance for a referral (they collect information on which psychiatrists in their network have openings). If neither of these sources was helpful, you could look around on psychologytoday.com, which has a psychiatrists classified section.
Let me know if you have other questions.
I knew a handful of people in India who saw a psychologist/psychiatrist. Not idea about the actual diagnoses, as people are very private about such matters. Other than extreme cases (which needed some in-patient care), the couple of instances where someone was prescribed medication, they had discontinued the course on their own as they felt it made them dizzy/lethargic.
Based on news and the internet (your blog included) it appears to be comparatively vastly more common to seek help in NY/US. But I have never run into conversations where someone I know openly talked about their experience. I am not very social, so I mean this to say, "I don't know whether X has so-and-so and is getting help," and not, "I know X doesn't have so-and-so condition".
Thank you for the links, and for your writing in general.
I need to determine if I have ADHD, get medication if true, but also talk to someone about life issues involving long term depression and anxiety, while likely not taking anything prescribed for those. Psychiatrist sounds ideal for first but psychologist for second. No GP due to no more insurance because of these issues (guess I'll pay $). Who do you recommend?
You'll occasionally find psychiatrists who do therapy, but this is very expensive (psychiatrists bill more per hour, and usually you avoid getting hosed by only seeing them for the short amount of time it takes to discuss meds).
More likely, you'll have to do both at the same time. I think the easiest way to do this would be to start with the therapist, ask them about the ADHD, and if they also think this is important/needs treatment, see if they can recommend a good psychiatrist (most of them will have people they work with and know well). But you could also do it the other way around, start with the psychiatrist, and see if they can recommend a therapist.
There are a few large clinics that have both psychiatrists and therapists at them and handle the coordination for you. My old employer https://www.pcpasf.com/ is an example.
You know, I want to ask you a straight question. I've had dealings with a psychiatrist and he was a bit of a hypocrite when I was quoting his own hospital site that about the rates of SSRI success and claimed that he knows nothing about it, never heard of it and he knows SSRI are effective blah blah blah.
I mean if your pacients ask do you give them the straight answer that this stuff helps - sometimes. Or you give them fake hope?
It's all about regulating your nervous system. Work with a professional who understands this approach and healing will probably work better for you, like it did for me and does for so many others. The medication will regulate your nervous system for you or you can learn to regulate it yourself. It sounds like you're in no level of distress that would require medication to stabilize while working on a long term plan.
Just my very personal take on a little part of this:
In school they taught we'd be peer pressured into fun things like drugs, drinking, sex. The only form of peer pressure I've ever consistently received was pressure to identify in ways that made me easier to label.
For years I was encouraged to seek psychiatric help, specifically to get a diagnosis. This was... ultimately good, and I think some people spoke from a place of genuine concern. But I remain convinced that a lot of that pressure was that people had no idea what to do with a person who didn't have a good label.
Likewise, I continue to be encouraged to take on some LGBT+ moniker. To be clear, I am unquestionably a dude with a boring, conventional sexuality. I'm not stereotypically masculine but I've never felt that I'd be happier identifying as some other gender or "refusing" a gender label by labeling myself non-binary. Frankly I just don't consider my gender an important part of who I am. The same is true of my sexuality. I think people just need that crutch to know how to relate to folks, even when I just objectively do not belong in that community.
But this pressure has significant downsides! When I was first diagnosed with ADHD I was added to all kinds of support groups on social media, got all kinds of positive reinforcement from my friends, and my symptoms became objectively worse. I did not "consciously" decide to play up my ADHD symptoms to get positive attention. I just spent a lot of time talking about ADHD and thinking about the positive attention my ADHD symptoms got me, and somehow, "unaccountably" I found myself acting more ADHD. I brought this up with my friends, and they celebrated it, saying that I'd been masking before, and could finally act in accordance with my nature.
It would be so easy to take that road, without even consciously choosing it. Deferring responsibility, inhabiting a stereotype, and helping the people around me feel better about choosing their most superficial traits, or even their weaknesses as their entire personality.
Eventually I'd get accommodations from a job that feared lawsuits, and they'd quietly note to themselves that I probably shouldn't get promoted or get the good assignments. My wife and daughter would learn to accept less from me. I'd quietly replace all my object-level goals with superficial identity politics. I could enjoy all the benefits of being raised an upper-middle-class white man, while still claiming discrimination and oppression. Ultimately I could replace everything real in my life with words, and spend the back half of my life bitter that those words can't shape reality.
I should have been more careful in my initial comment and I'm going to try to be more careful here: There are, of course, lots of people who *actually do* have mental disorders/are actually LGBT/etc. I definitely would not advise a policy of "never tell anyone or seek treatment" for mental disorders or a policy of "never form a community to advocate for your interests and seek mutual support" for minority groups.
But label culture brings out the worst part of the dichotomy between self-acceptance and self-improvement. It doesn't want "uniqueness", it wants "quirkiness": a well defined set of behaviors allowed for people who have the same labels as you.
There is a difference between being "a person with ADHD" and "The ADHD guy." A person with ADHD struggles with attention, emotional regulation, executive function, but in an uneven way, while working towards other goals (probably too many other goals :P). "The ADHD guy" is a hypothetical guy whose every behavior is defined by their ADHD. Nobody is really "The ADHD guy" all the time, and I probably exaggerated a bit in my first post.
But in the weirdly asocial culture of the present, people think in abstractions more than they do in terms of complex human beings. They understand "The ADHD guy" who cannot succeed because they *are* their ADHD. That person is worthy of sympathy and compassion because the abstract concept of ADHD is worthy of sympathy and compassion.
People have a harder time with a person with ADHD who tries, sometimes succeeds, and sometimes fails. It's the social equivalent of losing disability because you tried to go back to work.
This is interesting and well-written but I'm not really sure any of the things in the last paragraph would really happen.
Probably everything in the last paragraph would not really happen to one person in the same life time. But definitely it happens a little to everyone.
It's human nature to want to believe you have power over every circumstance in your life, and it's also human nature to want to avoid responsibility for failures. We all know people who fall off that dichotomy into either crippling self-pity/learned helplessness, or delusional over-exertion. That's a hard problem, both as a reality modeling thing (almost certainly we don't have as much control over our success/failures as we'd like to think) and as a self-actualization thing (probably it's better if we think we do).
I'm not really talking about that personal struggle though, I'm talking about what happens to your efforts to deal with that struggle when everyone in a peer group is more concerned with their own Quest To Have The Right Opinions than with interacting with each other. Then suddenly the less agency you have, and the more you appear to be the archetypal "struggling person" the greater their opportunity to demonstrate their compassion and understanding. You don't need conscious effort for either of those things to happen. Just a bad reinforcement loop.
That loop can exist independent of this weird "prove your quirkiness" labeling culture. In college we had a very troubled friend who attempted suicide, and who was so moved by the outpouring of love and support he received, he did it a few more times. I don't think he consciously thought "I should attempt suicide to get attention." He just somewhere deep down inside knew that he felt bad and also knew the steps to feel good again.
But a culture where nobody is willing to make judgments for fear of being a "stigmatizer", and where people are just a collection of labels instead of a person with agency is a good petri dish for that dynamic to grow in.
> When I was first diagnosed with ADHD I was added to all kinds of support groups on social media, got all kinds of positive reinforcement from my friends, and my symptoms became objectively worse. I did not "consciously" decide to play up my ADHD symptoms to get positive attention. I just spent a lot of time talking about ADHD and thinking about the positive attention my ADHD symptoms got me, and somehow, "unaccountably" I found myself acting more ADHD. I brought this up with my friends, and they celebrated it, saying that I'd been masking before, and could finally act in accordance with my nature.
I'm really curious about how common this is for ADHD. And for autism. How often is "unmasking" actually clearly good for someone? To what extent is it natural vs a result of social pressure?
I can't speak intelligently about autism. To the best of my understanding, attempting to "act normal" is both possible, and literally physically painful for some autistic folks. If the idea is to make the people around them more comfortable (which is unfortunately sometimes the aim of autism treatment) you could easily teach an autistic child that it is right and proper that they live their entire life in agony for the comfort of others. That's...probably not good psychology.
For me, I can say for sure that it's extra stressful to meet deadlines, take an interest in the conversations of others, plan out a responsible day, stick to a schedule, sit still in meetings, etc. etc. That's tiring, and I'm grateful to have friends and family who are willing to give me time to, y'know, not do that.
But also, I want to meet deadlines. Doing good work is important to me. It makes me feel good. I like my friends to feel supported in their interests and concerns. I'm willing to make extra effort to listen to them. I know if I stick to a schedule I'll feel happier and healthier (I don't *do* it, and being kind to myself about failing to do it is probably better than not, but still).
I'm not willing to allow the people in my life to lower their expectations of me because I have my own stuff going on. It's my thing, I'll figure it out. Probably you can put up with me fidgeting in meetings though. Meetings are dumb.
>If the idea is to make the people around them more comfortable
Yes, this is the general idea of being able to coexist with other people. If autists aren't so lucky as to afford to live in comfortable isolation from society their whole life they probably need to learn social interaction for their own interest, and then presumably to calculate the tradeoffs with how much agony they are willing to tolerate for engaging in it. It sucks, sure, but what is the realistic alternative?
I think that's where the anti-stigma and "neurodiversity" movements are useful, to be honest. We could, as a society, become comfortable with a greater variety of non-harmful behaviors without incurring much cost. Sure, if someone is literally dangerous to themselves or others, does not do the things they promise to do, is consistently rude or hurtful in their speech, that's always going to be socially maladaptive.
But do we really need to stigmatize stemming/twitchiness, for example? If we know someone for whom holding still and staying silent for long periods is physically agonizing, wouldn't the compassionate thing to do be to just ignore/accept the fact that they're going to move and make an occasional noise?
The question of which behaviors someone with a mental disorder should control themselves, and which should be accommodated is obviously non-trivial. But for sure, unless you're willing to declare all deviation from the norm to be disordered, there's some element of meeting people half way. And IMO the point of therapy is to help people find a way to exist that works for them, not to make them shut up so the rest of us don't have to deal with them. It's a little adaptation/coexistence, and a little self-acceptance, and a little support from friends/family/society. Nobody ever said it was easy.
Indeed, somewhat changing the society no longer seems to be that unrealistic, at least for some subsets of it, as the ongoing apparent success of the trans movement indicates. It would be interesting to see where the halfway ends up.
It's mostly a risk in echo chamber environments. IMO in an ADHD case it's more just giving yourself permission to be a little bit ADHD. The adaptive version is designing your life/ living space around the fact that you are like that (examples - i have lots of containers, many of them disposable, because realistically I won't be able to wash them every single time and also I tend to lose them. I have lots of socks and underwear, probably 4x the average person, because I will forget to do laundry and giving me more allowable time between loads of washing helps. Vacuuming doesn't necessarily always happen as often as it should. That's okay).
The maladaptive version is changing nothing and complaining that life is hard. This is where I often have my annoyances with a lot of ADHD based communities, but understandably a lot of people are burnt out from trying to do things "the hard way" and not being allowed to use more adaptive routines. And yeah, I've occasionally been the latter, when I'm just too damn tired to life hack my way out anymore. But I feel no one is permanently the latter, because generally speaking it's not really... Tolerated long term except in very specific circumstances.
This comment shows that whether somebody is or is not "consciously faking it" is not a particularly illuminating question to ask. As Randall Collins says, sincerity and sincere belief are social products. It is unnecessary to posit a biological trigger for gender dysphoria, just as it is unnecessary to posit a biological trigger for Red Guard / Cultural Revolution type behavior.
> Frankly I just don't consider my gender an important part of who I am. The same is true of my sexuality.
I've heard this described as "cis by default," which seems as good a label as any to me. Like, apparently some people *do* have strong intuitions that they're a man and would be unhappy if that changed, but it doesn't seem to be a universal experience.
I don't know what you mean by "encouraged to take on an LGBT+ label." Like, have people seriously gone up to you and said you'd be happier if you identified as gay or trans? That seems pretty weird and rude, even by Bay Area standards.
AH! That's where the "+" in LGBT+ comes in. There's tons of ways to identify as "queer" while having an entirely conventional sexuality.
For instance, there's a nasty trope in not-that-old sitcoms of trans women "tricking" straight men. This pretty clearly grows out of discomfort with how arbitrary attraction is. If a person has feminine features and signifies feminity with dress and mannerisms, it's entirely normal for a straight person to find them attractive. In an extreme case you can imagine a person in public who has a penis (which obviously you can't see) but otherwise displays all the characteristics of a woman. Or you can imagine a non-binary person, born assigned female, who presents as very masculine. Or an intersex person with attractive features. The list of incredibly specific, incredibly rare exceptions to our understanding of "straightness" is long.
The mainstream progressive party line to all this is "uh, yeah duh. The only reason you thought this was a challenge to straightness to begin with is that our culture is rampantly homophobic. Also trans women are women." And that line is entirely correct. End of discussion.
But if you're seeking ways to both have a conventional sexuality and also take on a Label Of Oppression you could always identify as a demi-romantic gynosexual, which means that you're attracted to female-presenting people, and that you only develop strong romantic feelings to people you have a close personal connection with.
While I've never had a relationship with anyone other than cis women, and, to be honest, I'm rarely attracted to trans women, the fact that I think in principle that it would be possible for me to find someone other than a cis woman attractive given a circumstance where I didn't know she wasn't a cis woman is enough for people to urge that kind of labeling. It all strikes me as mostly harmless, but very very very silly.
> Some of these people are your typical homeless schizophrenic, but many aren’t. One of my patients was a successful computer programmer
Sometimes people are both! For some definitions of 'successful programmer', at least. I'm referring to Terry Davis.
This is exactly why I'm an atheist, and why, despite Scott declaring atheism to be no longer cool, I still think religion is harmful to society. There is such a thing as reality, and such a thing as truth. Magic talking unicorns don't become real just because you, a schizophrenic, hear them threatening to kill you. Gays should not be killed simply because your Bible or Quran says so.
Men do not become women simply by declaring themselves as such and coercing everyone to go along with the absurd falsehood. The world is the way it is, and although I'm certainly not the ultimate arbiter on truth, I don't appreciate being forced to agree to absurdities, because as Voltaire said, "those who can make you believe absurdities can make you commit atrocities".
Well I'd ask you 1) how much have you engaged with trans people and 2) what's it mean to be a woman
Not sure if you've already seen this, but I wrote about my position on this here - https://slatestarcodex.com/2014/11/21/the-categories-were-made-for-man-not-man-for-the-categories/
That hair dryer again. You didn't end up using it as your logo when you opened your private practice!
Thanks for pointing me to that post! Despite our disagreement, I wanted to say that I'm a fan of your work and I appreciate that you took the time to reply to my comment.
In terms of your position, I disagree that "the Zambezi River is full of angry hippos" is a brute fact while "this person is a man" is negotiable. In fact, I'd argue the latter is more of a brute fact than the former. The former is only a brute fact if everyone agrees on the meanings of the words "Zambezi River", "full", "angry", and "hippo". The latter is a brute fact if everyone agrees on "this person" and "man". Every human who has ever lived can easily tell a man from a woman on sight, and they don't need to look at the sex chromosomes, because those chromosomes are nearly perfectly correlated with obvious physical characteristics and behaviors. Meanwhile, most people throughout history had no idea where the Zambezi River is or what hippos are. I'd go as far as to say that "this person is a man" is among the most brutish of brute facts that can ever exist, because how many other statements can get near-universal agreement across all cultures, religions, and ethnicities, and across all of history and prehistory?
Even if I grant that "this person is a man" is negotiable in the same way as the border between Turkey and Syria is, a negotiation is not an ultimatum, and the counterparty has the right to say no. Yes, the border between countries does not arise from some fundamental law of the universe. But what would happen if Syria declared 1 km^2 of Turkish territory to be Syrian and started treating the territory as if it were really Syrian, including sending military and police to occupy it and bureaucrats to administer it? What if it then declared that it was going to shame, fire, ostracize, and jail anyone who dared to continue calling the territory Turkish, including the residents of that territory? In such cases, almost everyone would agree that Turkey is justified in resorting to extreme measures to defend the pre-existing categorizations of "Turkish territory" and "Syrian territory", including the killing of Turkish soldiers and deportation of the Turkish bureaucrats and their families. No Syrian cries of "borders are just negotiated categories, not brute facts!" or "but 1% of my ultra-nationalist population would be really really sad if this territory isn't Syrian!" would get them any sympathy. Turkey would be well advised to respond forcefully despite the small amount of territory taken, because if Syria sees it can take an inch without pushback, why would it not take a mile? Why would it not make itself master of Anatolia?
And that's where I stand. The woke want to coerce me to use the language they invented five minutes ago and are still in the process of inventing, instead of the language of my childhood and my cultural heritage. They demand that I abandon the gender categories recognized by most human society since time immemorial, categories that reflect a fundamental facet of our humanity. I say no. I flatly refuse. I do not agree to the deal, and I will strongly resist all attempts to unilaterally enforce it. The transgender can call themselves whatever they want, and just like with all mentally ill people, I wish them the best and treat them respectfully. But the moment they try to force me to call a spade a hippo, under penalty of losing my job and even my freedom (e.g. https://www.cbc.ca/cbcdocspov/features/canadas-gender-identity-rights-bill-c-16-explained) if I don't, is the moment I lose all sympathy.
Is this person a man?
https://media.glamour.com/photos/61687dd84d1d3e62aedee6c0/4:3/w_2663,h_1997,c_limit/lede_social_river%20(3).jpg
Give me a video and we can talk. It's often possible to make a trans person pass in a still picture, for the same reason that a Madame Tussaud's wax figure can pass as a realistic human (male or female). When a person is moving, and especially when they're talking, is when it's much harder to pass.
Kim Petra's is a beloved German pop star, so there fortunately absolutely tons of video of her.
https://youtu.be/y9t09g79lSs
And yes, she is trans.
Or consider Nikkie De Jager, of Nikkie tutorials fame. She runs a makeup YouTube channel with _14 million_ subscribers, and had been running it for nearly a decade when just a few years ago, to the entire worlds surprise, she revealed that she was also trans.
Contrary to whatever you've been lead to believe, trans people don't want to destroy the meanings of words. In fact we mostly agree that "a woman" is a real specific thing.
But if your definition of "a woman" doesn't include Kim Petras or Nikkie De Jager, you're the delusional one.
I can confirm the rock climbing thing, one major reason I did it was because I wanted a funky activity to put on my dating app bios. Incidentally it's a pretty fun hobby that's deceptively easy to get into and with a surprisingly good gender ratio.
I worry that when both men and women are performatively picking up hobbies they don't actually care about just to appear interesting to each other, Moloch is winning.
Oh it's very fun I don't plan on stopping
I did this for my martial arts training, apparently, but unconsciously. I stopped those classes once I had a girlfriend and never went back. I couldn't put words to why, but the timing was so perfect that it seems hard to avoid the conclusion that I was doing it to appear interesting to women.
Aaaaaaaah!
I've been rock climbing for years now, but I just wanted to do it. (It's very fun!)
But I'm also trying to psyche myself to join some dating apps and this makes me want to avoid doing that at all because what the fuck could I share with anyone that wouldn't be perceived as some kind of 'quirkiness signal'?
If it makes you feel better all human activity is fundamentally mate-signaling behavior so no matter what you're doing, why you think you're doing it, or how you express it you can't win
Aww – thanks!
I know that – or believe a weaker version anyways, and have for a long time.
I did feel called out specifically by the rock climbing mention in the post tho!
I imagine I will have trouble using dating sites/apps regardless of whether I remember any of this specifically.
I'm somewhat sympathetic to the view that "drugs suck and psychiatry is bad". I wouldn't express my view that way, but I do think that psychiatric drugs are more harmful than is generally believed (and no, I'm not a Scientologist). My views are based partly on the unfortunate experiences of people who are close to me. But I've also been influenced by the work of Robert Whitaker, and especially his book, "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America". Whitaker admits that anti-psychotic drugs have a place in treating schizophrenia, but he advocates using low doses over relatively short periods of time. Whitaker's thesis is that psychiatric drugs may possibly work in the short term, but they can have paradoxically negative effects if used over longer periods of time (i.e., they worsen your condition instead of improving it). Here's a link to the Amazon page about the book. Whitaker is a journalist, not a clinician or a researcher, but I find his critiques to be convincing. https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing-ebook/dp/B0036S4EGE
I have to go further: I don't think that taking long term courses of drugs that affect the most complex organ in the body just based on them reducing the symptoms is a good idea in general. Antipsychotics seem to just make the brain into a stable soup for a bit, hopefully halting or breaking apart whatever malignant process was in motion. In the longer term you just habituate to the soup state. But then psychiatry can't explain what the full cognitive consequences even of taking SSRIs might be - till we have a comprehensive understanding of the brain, and yet routinely hands those out like candy while having no clue what they may make someone miss out on in their internal experience in exchange for the calm. Chemical treatment for personality issues should be the last resort scenario IMHO.
why do you apply a different standard to psychiatric drugs and other medical treatments
Say, 'anxiety' can be seen as a medicalization of something natural, and I'm saying this as someone who has had severe problems with people at one point. 'Give a man a fish vs teach them to fish' etc It's hard to distinguish what's the product of a real disorder and what's nonstandard personality or a quirk.
But then, most drugs have relatively clear impacts by comparison. For psychiatry not even the metrics of success seem to be sufficiently clear.
I can guess at why lithium is used in epilepsy, I have my hunches about how serotonin is used by the body for regulating attention modes and why antipsychotics might freeze an erroneous connection in the process of being formed, except all of those might happen due to dissimilar underlying factors, each can happen due to a myriad of different reasons - metabolic, or let's say computational, so it appears like the treatments are akin to hitting the car with a set of broad purpose wrenches, all of which may or may not have wider reaching consequences. But I can't tell what consequences are for making the actual HT whatever A signal even out uniformly and how that impacts your perception when it's unclear how much information the spikes carry. You're not going to get to see the exact impact of most of these in a petri dish, and just try understanding say what exactly the fractional anisotropy changes subjectively stand for on the scans.
Knowing that dopamine correlates with OCD doesn't let you understand how messing with it long-term will do for a specific personality type but it still may force the rest of the machinery to adjust in subtle ways along with it.
I'd rather not add entropy to the one organ that generally carries around the reasons we live for if that's avoidable. Funnily, I don't even have that trouble with nootropics(since you can take many of those only once in a while) or most illicit substances(despite the e.g. permanent openness increase factor for some) since it's generally not expected they be taken in courses - you'll forget how you normally feel sober by the time an SSRI kicks in, antipsychotics are _meant_ to strip awareness away from you, et cetera, so: it's just a fundamentally different matter when the drugs you take also affect your ability to judge their effects critically, day after day, to the point where Ship of Theseus applies. Risperidone is all too common and yet it turns off what, 16 receptor types indiscriminately while also affecting hormone regulation? It's carpet bombing where you can't even be sure whether the problem went away or just stopped being noticed on some level. Cancer drugs will tend to be more accurately targeted than that, I reckon.
At the moment, certain branches of machine learning probably have a better general idea of what the organ does than the people who service it medically and I'd rather not accidentally sacrifice self-awareness for comfort when there exist incentives to overprescribe.
But, eh, figure out futuristic brain implants that can record all the activity changes and let you compare and contrast the states directly somehow and you'd probably have my inner transhumanist approval. Plus, some number of psychiatric disorders seem to be resolved by just talk.
This piece is so great for so many reasons.
9. I’m adding my two cents to the discussion about transness. The teen years/puberty were dismal for me. Gender has a trajectory; as far as I could tell, “female” meant “will eventually have the process of Olivia Newton-John’s character in Grease,” ie, a socially-mediated larva-cocoon-butterfly experience ending in oneself capable of performing as butterfly.
I could tell that wasn’t happening for me but couldn’t tell why. It was long before the verbiage of gender was common. I stumbled on “Stone Butch Blues,” read it in my 20s, thought “that’s kind of like me” and proceeded to do nothing whatsoever about it. I still did not do “butterfly” very well so did self-destruction instead and wrote tortured poetry, some about gender and expectations.
Would medical transition have helped in my late teens? I think social transition, or better understanding of being non-binary, could have saved years of damage. Medical? Not sure. Pregnancy was terrible but I’m glad I had kids. And as a parent of two boys, one of whom is very, very cis-het, bless his heart, I realize there is a whole fabric of experiences of bodily maleness that I don’t & wont share. The whole crossing the legs versus the testicles thing? Just the beginning.
I think non-binary people with a uterus who date men can track a quasi-straight-female role for a while and have it work fine. I think there’s a lot of value in the lived experience of being outside important categories. I’ve had my nose rubbed in being different so many times I have no belief that that can be erased; I think “trans men are men” erases a whole stage and genre of experiences that are valuable. To society and to self. Am I ever transitioning medically? Doubtful. Should I transition more socially? Maybe. I got called “sir” last winter in a grocery store and then pitched my voice high and the poor kid freaked out. He apologized at least four times and I thought it was adorable. Long way from the days when seeming trans meant getting beaten up, which fortunately I never experienced myself, only saw. But I can’t get on board with the erasure of the outside ness and the transitionality. I don’t expect an Olivia Newton-John moment in any gender at this point. Medicating the kids will medicate away the gray area, which we need. Those of us in the gray need to describe and communicate about it more. I think a broader social recognition of a gender range is really important. Using medicine to group everyone at either end is a mistake. Plus yeah all the weird lifelong side effects. Also what “masculinity” I have is not due to high natural T; it’s right in the middle for a biological female.
Awakening to one’s transness should not devolve automatically into injections. Letting the first switch flip shouldn’t automatically trip the other ten. Gender is being mediated in sociocultural ways that we ignore at our peril if we make every little kid medically transition.
One of the most male-passing people I ever met maintained her very feminine name, never took T, dated men & had multiple kids. These are all real and valid choices.
I identify with a lot of what you're saying in this comment. Back in the 90s I adopted the term "tomboy" because that was the only way to vaguely describe my 'gender role' to people (and I was always eager to accurately describe myself to people, so they would not end up with unpleasant surprises where they expected me to have particular, say, interests). The whole trans conversation hasn't changed me, but it's given me much better vocabulary to describe myself, which I really appreciate.
It follows that I *personally*(!!! i.e. I am not saying others need to have this attitude) don't care very much how other people describe me - my interest is in communicating honestly about myself, what others do with that information is 99% up to them. Lots of people close to me still refer to me with she/her every day and that's a-okay; indeed, I'm actually glad I'm evidently not adding to their cognitive burden. But I am even more glad that I have the vocabulary to explain more of my subjective experience to people.
I don't have dysphoria and I don't want a body other than the one I have now for any other reason (well, maybe one with a better-functioning gut, I suppose, but otherwise I'm happy for it to be identical). But I'm into dinosaurs, computers, science-fiction, astronomy, I hang out on IRC and have happily coded in Assembly, and you'd have to pay me a lot of money to get me to put on a dress, any make-up whatsoever, or ride a horse, and an *obscene* amount of money to make and raise a child. (Yes, these are stereotypes (fortunately ones that are getting increasingly outdated), but that's more or less what gender roles consist of. It's possible to talk about them in other terms, but this way is easy, and I didn't want to waffle on forever. :) )
> but it's given me much better vocabulary to describe myself
And that vocabulary would be?
You have completely misunderstood the transgender divide.
The actual truscum argument goes as follows: there are two groups, one group of real trans people and a second group of social-contagion sufferers. There is no similarity or overlap between these groups, no "switch" that toggles individuals between the two. The second group is delusional, and it would be nice if they could be prevented from pursuing medical transition in their teenage years...after that, whatever...you be you.
Is the distinction mild vs. severe, or is it hallucinations+disordered thoughts/delusions+catatonia vs. just hallucinations? Hearing voices is the marquee symptom of psychosis, but also seems like the most manageable.
Thanks for writing this, this is the kind of article where if I'm late to work because I read it then it is worth it! Some killer quotes. One omission from the discussion of the group thing is Nationalism, but people don't do that like they used to, in the well off West at least who would identify them selves by country of origin in their three word bio on this site? But Nationalism is pre Diamond Age (Stephenson reference), the Phyles he talks about in that book always fascinated me. Partly because there is unlikely to be a country that I'm really in sync with values wise, but there could be a Phyle.
Stephenson was right on about clothing patterns coming back in fashion after HD TV would prevent them looking crap.
On transgenderism, I think you've misunderstood the divide. There is a group that seems genuinely (I say "seems" because outside perspective can't ever be sure, but I do not doubt it's true) repulsed by their own body and sex, and really wants to change. This has been in existence for quite a while, quietly in the background of society. Estimates put the frequency at 1/X,XXX or less of the population. Recently, riding the coattails of the LGBT movement, far more people are identifying as trans than ever before. This isn't universal, but there are subgroups where the prevalence is around 1/20 (female teens in the UK) or more. That's two orders of magnitude, or higher, more common than any reputable estimation of transgenderism.
To me, it looks very much like the current generation's Goth or Emo. Which meets the criteria that teens are often looking for - not approved by their parents, cool to peers, different from normal. Lots of teens look for that stuff. There are some other elements making it even more enticing, in that you can get adults at school and other locations to call you by whatever name you choose, and often treat you better than they might otherwise. In terms of teens following fads, it's not overly concerning, and most people move on from it as they develop their own identities and become more comfortable with the person they are. The only issue I see with this is that many parts of society want to encourage real trans individuals, and not allow any discouragement (lest they feel even more miserable than they often do already). This impedes the normal process whereby these individuals move on to other styles, but that's more minor. What is a really big deal is that some individuals who are not really trans are convinced that they need permanent surgery and life-altering medications. Then, they have no option to ever really go back. This would be a problem if the incidence was 1/X,XXX, but it's a massive problem if the incidence is 1/XX.
I feel like we need to put gatekeepers back on the process, which used to be standard, and weed out those individuals who are merely confused and quite likely to change their minds later. I doubt that psychiatrists did a great job of this before, but surely better than 1/XX of teenage girls being pressured to get permanent surgery and told that they really are boys and should accept themselves as boys, even if we know that can't possibly be true (at that level of frequency).
All of the evidence I have seen says 1/X,XXX or fewer, until very recently and then it's a mess to figure out.
Are you suggesting that dysphoria can be caused by outside factors? I'm not opposed to that idea, though I would think the pro-trans side would have a lot to say against that. Because women have been treated very poorly in pretty much all societies in all human history, and did not become trans, that seems to imply something new, possibly related to egalitarian ideals, that would cause this? I'm not sure what else you could be saying. I would consider it laughably false to say that women are treated worse now than in previous times in history.
> see e.g. societies that have traditionally had a "third" gender with which some people identified
The problem is that there is pretty much no research on said "third genders" to discover where they lie at the intersection of biology and culture.
This implies that we could reduce dysphoria by returning social and cultural norms to a previous era's understanding of gender.
Genuine question (not a "gotcha" or anything)—have you ever sat down with a transgender individual (either irl or online) and talked about what being transgender means to them? I'm asking because your description does not sound like what I've heard described in conversations with my trans friends, who when pressed, often describe something like an experience of phantom limbs—they sometimes literally feel a physical (or psychological) sensation in locations outside their bodies where sexually dimorphic body parts would be. Those I've talked with who have gotten surgery have also described it as being incredibly helpful, almost completely removing their prior sense of dysphoria, which in some friends used to be so bad as to make them suicidal. While having "the option to go back" would be *nice*, I don't think that that downside is so bad that those who want surgery shouldn't be able to get it, considering this.
EDIT: It sounds like there are some people who actually do fall into the "I'm doing this to be cool" category. I don't live in an area where being transgender is considered cool at all, so I cannot really speak to that. My intuition is that those people still make up a very small minority compared to "sincere" trans people, if Scott's friend group is anything close to a representative sample—one friend knows one person who does it to be trendy (out of ~10% of Scott's total number of friends), and this is in the Bay area!
Yes, I've had both in person and online discussions with trans people. That's why I started with agreeing that they seem genuine.
My problem is two-fold. First, the frequency of individuals identifying as trans is clearly significantly higher than ever known, to the point that there's no plausible scenario where this has been the historical norm. From my viewpoint, the frequency can be explained in only two ways, 1) You can convince someone into becoming trans, that would not otherwise be trans (obviously bad for the individual and for society), or 2) You can convince people into claiming they are trans (potentially bad for the individual or society, but maybe not, depending on what they do with it). Secondly, there is a non-trivial percentage of individuals (I have heard high and low estimates, but really don't trust the numbers on either side of the question at the moment) who formally desist. They claimed to be trans, went through all the normal stages and said all the right things, and then later changed their mind. I know people personally who have done this, including at least one who went through irreversible stages of transition prior to desisting, and several who were at least taking hormones before changing direction (girl -> boy -> non-binary or similar) or fully desisting. I've read a number of first hand accounts of people who got pressured into getting surgery, then changed their minds, filled with regret. I get why trans individuals are encouraged to get puberty blockers and surgery as soon as possible, but the timing is very poor for other reasons - namely that teenagers frequently have no idea who they are or what they want out of life, and that often changes by the time they get into their 20s. I fear we're going to have a generation of people, especially young women, who regret some big decisions that they can't ever reverse. We may not know this for another 10-15 years, after many thousands or hundreds of thousands of people have made those decisions. The dysphoria they would feel at that point could be much worse than they felt if they had just waited, and could potentially be larger (or at least more numerous) than if we denied the choice to real trans individuals totally. I'm not in favor of that last option, but hopefully you can see the point that if 10s of thousands of individuals desist after surgery, and 10s of thousands are happy after surgery, we haven't resulted in any net improvement in happiness at all!
Ah, thanks for the clarification! I appended an edit to my prior comment, and also commented above (https://astralcodexten.substack.com/p/in-partial-grudging-defense-of-the/comment/6769746?s=r) with a brief argument for why socialization likely isn't the primary cause (though it may very well be the cause for some smaller percentage of people).
I think we can definitely agree that if the majority of people desist after surgery, that would be pretty horrible! May I ask at what desistance percentage you would say that medical transition is almost certainly an overall good? It might be possible for us to come to a testable crux here, which I like doing when possible.
That's hard for me to say with certainty, but I'll give you some of my thoughts about it. Obviously different levels of transition have different levels of cost (both for the individual psychologically, and also the actual cost in money, time, resources, etc.) If someone is happy with just hormones, or even better, happy by wearing different gendered clothing, that's going to be much less problematic than full surgery and lifelong hormone treatment.
To try to keep it apples to apples, I'll try to only look at full transition verses full desist. Because there are costs to surgery (as above), and also surgery is not 100% able to perfectly change a person's sex, the number is certainly less than 50% desist rate to be considered medically good. How much below 50% is too hard for me to say, because I cant estimate how much dystopia a person might feel even after surgery, due to it being imperfect. If surgery could perfectly transform a person into their desired sex, including functional reproductive systems, the number would still be less than 50%, depending on how much cost we consider relevant - a notoriously hard thing to value, happiness verses the cost of medical intervention, especially one that can be considered elective (which I also get that some people consider it life-saving, and would not therefore consider it elective).
Okay, fair enough. Calculating this sort of thing is very hard, and it isn't unreasonable at all to simply say "I'm not sure".
It should be pointed out that *every* medical procedure has some amount of desistance—I can think of plenty of people who deeply regret taking chemotherapy for example, even when they know it saved their life! So desistance existing in a very low percent of cases isn't too worrying to me, the problem only comes if that percentage is sufficiently high. Personally, I'd say if it's above 10-20% I would strongly consider putting more restrictions on access, though from the (admittedly imperfect) studies I've read, it seems to be closer to ~1%.
If I had to put a number on it, I would have said 10-20% might be where I would draw a line as well. It's nearly impossible for an outsider to even guess at how strong a feeling of dysphoria someone else might be feeling, but if dysphoria were stronger or weaker, I might want to move that higher or lower.
As I said before, trying to get an actual answer to the question of desisting is nearly impossible. I've heard ranges from your ~1% to a clear majority. It appears that the topic is so central to the culture war that nobody studies it for disinterested reasons, and therefore every number is suspect.
Desistance alone doesn't deal with the possibility that someone could be mistaken about whether transition was a positive. We can't run the counterfactual of if they had never adopted the identity to begin with. If I had transitioned in my youth and grown to accept that outcome I couldn't have known that I would have grown up to be a well adjusted many otherwise.
It's good not to ignore possibilities, but I don't think this one has the evidential weight you suggest. The feeling that "the grass is greener on the other side" is pretty common, but that counsels against making it easy for people to transition in various forms, given the costs of transitioning. No?
The critique is to the experiment. Just because someone doesn't desist doesn't mean that transitioning wasn't a net negative for them. Because they may have naturally improved without transition. I think this is most important for kids put on blockers, because going all the way through puberty could have actually been the thing that would have cured their dysphoria.
This concern and others like various cognitive biases downstream of the sunk cost fallacy is why I don't think we can naively use desistance rate as a measure for how good our diagnostics tools are and thus measure the net good.
For a trivial hypothetical imagine that every single person who is diagnosed for blockers as kids would have grown out of their dysphoria but after going on blockers and adopting the identity as "trans" with the associated bucket of "transphobia" to place all their problems they go on to transition and struggle for the rest of their life with the various issues trans people have but within their memeplex aren't able to consider de-transitioning or even think of it as a betrayal to their identity and ingroup. So none of them desist. That world would imply that transitioning is always a net negative but yet we'd see very few detransitioners making the above proposed experiment yield a false positive.
Minor (admittedly improbable) comment on: "First, the frequency of individuals identifying as trans is clearly significantly higher than ever known". For all I know, there might be a _biological_ cause for this (perhaps analogous to the odd increase in obesity - presumably _something_ is changing set points). Maybe a weird effect of a contaminant, maybe (unlikely!!) a weird effect of pervasive fluorescent lighting, maybe even a weird side effect of ameliorating some subclinical deficiency. Lots of possibly-biologically-relevant factors change over decades.
I would not be surprised if we learn this is the case in the future. I know that there are easy-to-perform experiments in which one can effect the “gender presentation” of animals like mice and frogs, though I have no idea how transmissible to humans those effects are.
Good point! Many Thanks!
Good point! I confess to a (frankly, terrifying) suspicion that persistent year over year reductions in testosterone levels and sperm counts likely correlate with incredible amounts of polymer contamination in every conceivable part of the biosphere, particularly given that we've known that certain classes of polymer are powerful endocrine disruptors since the 1920s....This is also my pocket explanation for the obesity increase given that AIUI it's been observable in non-human animals and not just humans since the 1970s.
Relatedly: can we please take plastic contamination more seriously as a society? Surely if it's actually having tangible effects on increasing gender dysphoria that's a BFD (not that obesity and testosterone decline weren't enough already).
" From my viewpoint, the frequency can be explained in only two ways"
The third explanation, the one trans activists use, is that as societal pressure against being trans weakens more people realise they're trans, and that eventually the number of people identifying as trans per year will become a straight line, as happened with left-handedness.
While that's certainly a possibility, it seems beyond reasonable to think that the increase could possibly be so dramatic as what we've already seen. At least, if those who now identify as trans feel as strongly about dysphoria as the historical cases. If a significant percentage of those now identifying as trans could have been fairly to significantly happy without identifying as trans, and would historically neither identified as trans nor had significant negative effects from not so identifying, that has different implications for the discussion.
AFAB non-binary-ness and classic male-to-female transness are really different phenomena with totally different causes and shouldn't be limpoed together as the same thing. I hate the total lack of nuance forced on this discussion.
Also as someone in the trans and LGBT community, and the medical industry, I've never encountered many desisters. Nor have the surgeons who perform these surgeries.
Trust me, surgeons at the University of North Carolina Hospital absolutely would not perform surgeries that has a substantial likelihood of resulting in desistance. (And they aren't especially gate-keepy)
I managed to get myself to feel a phantom tail after enough time imagining one, so it seems reasonable to me that an individual who desperately wants and imagines any body part long enough could feel such phantom body parts.
I also recovered from intense gender dysphoria caused by self-hatred, so I know experientially that there can be similar (or even identical?) dysphoria caused by non-trans experiences. In my case I hated myself so much that the idea of becoming a new person thru gender transition was a very appealing answer. It was easy to convince myself that my self-hatred arose from being trans, rather than vice versa. I felt disgust at my body and intense physical sensations of wrongness.
I believe there are sincere trans experiences, 100%. But I also had the personal experience of having dysphoria switched on by social contagion and depression, and later switched off by treating the depression and self-hatred. I haven't felt gender dysphoria in 7 or 8 years.
I've talked to a pre-teen 'girl' that – AFAICT – is convinced that they're non-binary because "I like doing boy things.". That seems potentially very terrifying (and an ironically vicious defeat of 'feminism' too).
Why is that necessarily bad? It’s certainly a very different way to think about gender than you may be used to, but I highly doubt they’re going to get permanent surgery as a result (almost no non-binary people do, as far as I’m aware), and if it gives them a sense of community and self-definition, I don’t see what’s the harm.
The 'I must be non-binary because I like to do some stereotypically boy/male things' is sad enough on its own. Where did they get the idea that anything in particular is a 'male thing' versus a 'female thing' or that being a girl and enjoying a 'male thing' has anything to do with transgenderism?
It sure _seems_ like kids are learning really grotesque stereotypes of sexes/genders that, until very recently, would have been considered 'harmful' themselves. (I still think those stereotypes are, for individuals anyways, very 'stupid'.) I'm pretty sure they're picking these ideas up from school. I'm also pretty sure no one is intentionally pushing kids to be non-binary or transgender, but I also think kids are picking up on the obvious subtext that non-cisgender is 'better', if only because of the obvious, visible, and significant effort by the relevant people to 'be inclusive'.
If they were – 'naturally' – non-binary, or transgender, or anything else, even cisgendered and heterosexual; that'd be fine. Dysphoria seems generally bad tho, so I wouldn't choose that for them myself. But I still find modern ideas about gender confusing, so I'm skeptical that kids this young, or the adults teaching them whatever it is they're hearing or seeing, have a better, coherent, or consistent understanding of it either.
But, yes, I admit the chance that it will lead to permanent surgery or even, e.g. hormone therapy, is probably pretty small. But I also don't think any resistance to that idea at all is socially acceptable and just the fact of a child that young jumping to that conclusion (that they're non-binary) on such weak evidence is mildly frightening.
It's astounding how retrograde a lot of modern liberal discourse is. It used to be that if a girl liked to play with trucks, she was still a girl and should be proud of it, don't let anyone tell you who are!
I agree this is a good statement of the trans-skeptical position.
I haven't met anyone who clearly falls into the "just the equivalent of Goth" bin. But some of my trans friends say they have, and I trust them, since their incentive is to say the opposite. And I don't know a lot of actual teenagers. I'm sure there are nonzero examples of these people, since there are nonzero examples of everything. But I could believe they're 10x more common than real trans people, 10x less common, whatever. I think these would imply pretty different levels of gatekeeping.
I'm in a weird situation, which is that I'm in the Bay (maybe trans capital of the world?) and the rationalist community (autistic people are trans at 10x normal rate, draw your own conclusion). Even though I don't select for trans friends and am known to be Problematic, about 10% of my friends are trans. As far as I can tell, all of these people are in the "really real trans" bin, which makes me wonder how vast a supply of fake trans people there can be out there compensating for this.
I am sometimes asked to gatekeep trans people. I want to admit here, down in the comments section, that I am terrible at this. Psychiatrists don't have special creepy mind powers to figure out when people are lying (except sometimes forensic psychiatrists), and a person who's pretty smart, Googles "what do you say if you're trans?", and is able to cry convincingly would probably fool me. The only real filter you can use to block these people is to make transition a kind of miserable and drawn-out process which nobody would do unless they absolutely had to, which was the standard ten years ago. But unsurprisingly, this did make a lot of trans people miserable.
Hopefully we'll have more data on this in a few years when all the teenagers grow up and have a chance to decide whether or not they regretted their actions. I predict most of them won't, but I'm up for being proven wrong.
I feel like in the context of talking of transness as a trend we should also talk about the rising phenomenon of self-identified trans people refusing medical transition. "I hate my body with a burning passion and literally feel like there's something else between my legs than there is" is not the dominant narrative anymore, at least not on tumblr, afaict. Strong dysphoria is not considered a prerequisite to transness in those circles. So if falsely identifying as trans is indeed a thing (I think it might, but I will not make a guess as to which degree) then what seems to follow *isn't* "teens transition and then regret it" but "teens experiment with pronouns and fashion" which isn't really any different from any time before.
I don't think it should matter, but I am five years into hormones (testosterone), yet have no surgeries planned, because I do not feel a strong drive to do so. I sometimes wonder whether I should stop T, because I don't desperately *need* it, I just kinda wanna, and have most of the time for most of my life.
And as an aside, most people who detransition seem to do so for ideological reasons, not because their feelings changed.
seconding your latter comment—there's a great study I read a while back (can't find it offhand) which interviewed ~100 trans people over ten years, and those who de-transitioned universally described having a friend group that didn't support their descision.
I agree that gatekeeping would be very hard to get right.
I do know a fair number of teenagers, including some who strongly appear to be the Goth equivalent for trans - going back and forth, changing their name multiple times. I know one who's gone by at least four names and 3+ different genders since January. Exploring who they are can be okay, but if they decide (or get pressured) into non-reversible surgery, that could end up as a major problem. Even hormones can be a big deal - weight gain, body changes, etc. that very likely will stick with them for a long time, if not permanently.
What you're talking about is gender-fluidity, which is a mindset/philosophy that I don't think is at all likely to lead to permanent medical surgery. The idea is more of viewing gender as a presentation or even public performance, and that some days you might want to present yourself to the world through differently-gendered lenses. They are often explicitly and consciously doing it for the "aesthetics," (though this is not the case for everyone, naturally) and I don't think there's any real potential harm or danger in that, as long as they act responsibly. Everyone knows that surgery is not really reversible, and no sane person is going to commit to that if they know they're likely to continue experimenting with their identity—it's something you do only once you're quite certain it's what you want for the rest of your life (though even still some people may be mistaken, of course).
I agree that performance is generally pretty harmless. It also reminds me a lot of Goth/Emo performance, which is why I started this conversation with that observation.
I think it's important for society to push back enough, and curb some of the more radical tendencies of the pro-trans movement, to make surgery and permanent/semi-permanent changes less accessible. We wouldn't want to get into a situation where a performance carried out for a few months or a few years gets conflated with someone living with significant dysphoria and both end up with surgery or irreversible choices.
Are you absolutely certain they're really as accessible as you think?
As a "really-real" trans person or whatever, having been this way for about a decade, in a liberal medical bastion in the US, even though I'm smart, fairly well off, and better than average at navigating beauracracies, I _still_ _constantly_ run into hurdles even just getting hormones, not to mention surgery. It's a year long process at absolute best with like 4 different doctors I need to see.
So from living it it's just so hard for me to imagine this being too much access? And scares me that people want to make it even harder.
What happened to people owning their bodies and informed consent? Why shouldn't an adult have access to surgery if they want to, for literally any reason?
I don't have an issue with adults getting surgery or otherwise making these decisions. My concerns are entirely about children, who often lack the context or psychological capacity to understand the gravity of a lifelong decision.
I'm not totally convinced that HRT is totally irreversible. I mean, we have HRT treatments that go both ways. It stands to reason that you'd just dose the reverse if you changed your mind.
It's also, at the moment, a moot point - in most places the most dramatic thing a trans minor can get is a puberty blocker. At the moment, gender affirming surgery is definitely inaccessible enough, and some would say far too inaccessible.
Hormonal treatment can lead to permanent effects, including infertility. This is especially true if taken early in life. Puberty blockers definitely have permanent effects, even if only to change body type (that's the point...).
Thank you for this blog. As always, well reasoned and informative.
I found the NYT piece highly upsetting. Encouraging psychotic people to abandon their medication is immoral and irresponsible.
A “caring” therapist convinced my very ill sister to give up her medication early last year. She’s spent the last 12 months in and out of private and state institutions- her admissions have been both voluntary and involuntary. It has been a traumatic and costly journey. Made so much worse by the fact that no one would have been put through this trauma had her therapist not been so irresponsible.
The journalist who wrote the NYT piece and the editor who approved it should have spent time with the families of the people they hold out as examples of people living without their medication - I’m sure their families have a very different story to tell.
I don’t think the Times piece was encouraging psychotic people to abandon their medication.
Heard a joke once. Man goes to the doctor. Says he has anxiety. Says he can't even work. Asks doctor about a cure in a week. Doctor says: "Medication does not work in one week, however Great Inspirational Speaker Pagliacci is in town giving a speech about how he overcame anxiety. Go and see him. That might work." Man bursts into tears. Says: "But doctor.. I am Pagliacci."
Good joke. Everybody laugh.
It is a remake of an old one, inspired by our host's text.
I know, I was quoting the next lines from when it’s told in Watchmen: https://www.goodreads.com/quotes/1525835-i-heard-joke-once-man-goes-to-doctor-says-he-s. :)
Great article but there really is no reason to be so even handed. Psychosis is not equivalent to other differences people may have. Psychosis is equivalent to, for example, having a broken arm -- something in the brain is not working correctly.
1. Almost invariably there is neurodegeneration with untreated psychosis -- MOCA scores fall, SPECT neuroimaging shows a brain getting worse and worse, even structural MRI which is less sensitive will pick up a brain that is in decline
2. The above #1 does not apply to people who may have this or that belief, ie, to the differences between people -- it applies to psychosis.
3. Patients sometimes say things that could be diagnosed as hallucinations but they really aren't (e.g., "my mind keeps saying to check this again two time or else" eg in OCD)
4. Psychosis seems to occur only in humans -- not in other mammals. (Similarly full causal reasoning seems to occur only in humans, not in other mammals.) It is most probably a design flaw, i.e., occurred because of a tradeoff, rather than a typical disease, hence seems to involve not one but thousands of genes.
Just about all psychiatric disorders, including OCD, observed in humans also seem to be observable in mammals, except for psychotic disorders.
"Psychosis seems to occur only in humans -- not in other mammals."
Well, if it did, how would we know?
If animals heard voices, would they even care?
Dogs might, if the voices told them to sit.
hahaha
what about rabies?
Jones, C.A.;Watson, D.J.G.; Fone, K.C.F. Animal models of schizophrenia. Br. J. Pharmacol. 2011, 164, 1162–1194. [
As a European, this extreme hunt for quirkiness that you describe seems alien to my experience. Is it an American thing? A Californian thing? Or is it happening in Europe too and I was simply lucky or inattentive enough to not notice?
It's certainly a Cali thing. I sometimes suspect that it's a form of conspicuous consumption within a culture which has tried to stigmatize explicit conspicuous consumption as 'classist.'
I don't think of hunting and butchering your own kills as being a California thing. It is however, absolutely an example of quirkiness for status.
I sure don't think of Los Angeles as a place that has tried to stigmatize conspicuous consumption.
You could call it a subculture, maybe. There's a definite air of 'check your privilege' and retaliatory envy among some people.
Yeah, I suppose it's possible that the conspicuous consumption in CA has gone so crazy that something even crazier was required to break ties among really rich teenagers with materialistic, competitive parents.
(That's a hypothesis, not an assertion.)
Primarily an American thing, in my experience in both places, but there are some edges of it in Europe as well.
It's primarily a suburban and West Coast Upper-Class thing. Most other people in the US have some kind of regional culture they can plug into to have a sense of identity, but the WCUC never managed to cement a coherent identity (although I'd argue things like rationalism are an attempt) and suburbs are inherently designed to strip humans of their identity and replace it with a cardboard corporate McSelf.
I mean, you can find pockets of it anywhere if you turn the sensitivity high enough- turn it up to max and you can describe every aspect of human behavior not essential to survival as an attempt to be quirky. I consider quirkiness-as-personality to require that pathological component where there seems to be little genuine interest in the hobby beyond a surface attempt to augment the personality- not out of hesitancy, but out of some bizarre reflexive detachment or vapidity.
I wondered about this as well, coming from New Zealand, but then I haven't ever done the Dating Scene(TM) thing, so I wouldn't put too much weight on that.
"Cheat Sheet For Reading Popular Media Articles About Psychiatry"
There is one to be written about "neoliberalism" but I'm too lazy to do it. :)
Can you tell us the sorts of things that the programmer's voices were saying?
"The DSM says that you can’t diagnose a psychotic disorder if someone’s in a cultural context when they’re expected and encouraged to hear voices - which sure does sound like the experts think cultural context can affect whether you hear voices or not."
This sounds a lot more like the DSM being culturally relativistic and not wanting to tell cultures their sacred traditions are actually the result of mental illness, plus the usual "well if it's not upsetting the patient, we can't call it mental illness". I don't think it says anything about whether or not anything is actually mentally different.
> I don't think it says anything about whether or not anything is actually mentally different.
I'm not sure about that. The purpose of this piece of the diagnostic criteria is to say ok, given that someone is hearing voices, how much does this increase the likelihood that they are psychotic? It's not the only diagnostic criteria so it's one consideration among others.
We can translate this to a familiar cultural context, though. If someone is proclaiming they've heard the voice of God, and you are trying to predict whether they are psychotic, it matters whether they are a devout evangelical christian who believes in speaking in tongues and the whole nine, or if they were an atheist just yesterday. It matters because it seems to be the case that when an evangelical hears the voice of God, they're a lot less likely to be having a corresponding complete mental decompensation.
As to the very specific neurological thing that is happening when someone has an auditory hallucination, it probably looks similar whether it's the evangelic case or the atheist (who is in the throes of psychosis) case, for that narrow phenomenon alone. But the phenomena it exists in concert with would look very different. It might have a different proximate cause and immediate effects. The global picture would be different, and that's what the criteria attempt to assess.
More specifically, the purpose of the DSM is to provide consistent guidance as to whether one is or is not hampered by a particular disorder. Every diagnosis requires "yes" to X of the following Y questions (eg yes to 4 of 7) plus "is this causing them problems in their life." We wouldn't want make it easier for members of certain cultures to receive positive diagnosis. Additionally, I would guess that if you are experiencing audio hallucinations due to schizophrenia, you are probably getting more variation than just God providing guidance/moral support.
So you write a whole bunch on how the DSM is very focused on whether or not something is actually causing problems for someone, but completely ignore how different cultures are going to change whether or not something is causing problems for someone.
I do not think the DSM would label someone psychotic but not mentally ill. Furthermore, I strongly doubt that this is merely just them trying to find the precise cause, and I definitely don't think it provides any proof for social contagion.
If you command Barack Obama to come to your birthday party, and he doesn't, that doesn't prove he doesn't exist. He's a very powerful person, and he's in charge of what parties he goes to, not you.
However, if you don't believe he exists, and he shows up at your birthday party, you'd have to be deliberately ignorant to keep on not believing in him.
So I'm one of those Christians who has heard God. Hi! Just popping in to say that there are a lot of us and we are the way we are because of being unwilling to deny things that have actually happened to us.
1. Internal. 2. Probably? Same as being unable to "hear myself think" because of distraction. 3. No, no, yes. 4. & 5. See #1. 6. I suppose I could be confused as to whether it's God or my own thoughts, but in practice, I don't think I ever have been. How to tell the difference is a matter of deep theology and spiritual practice.
7. The mark of something living is that, as it grows and unfolds itself along various dimensions over time, structural complexity is revealed that was not evident at first, but, after the fact, shows itself to have been necessary all along. As the DNA in a seed unfolds along many dimensions to reveal the structural complexity of the adult plant, which ends up having been the necessary unfolding of that specific DNA all along. Or how the ending of a great novel or film makes all the seemingly-unrelated information from the beginning "snap" into place, so that, although you couldn't have guessed the ending, after getting there, you see that it was the only ending possible.
God hasn't spoken much to me, in my life. What he's said has been grammatically simple, but had much, much more of this living quality than I'm able to produce, myself. I don't think that quite counts as linguistic; but he certainly has communicative capacities that I don't.
Oh, yeah, definitely different things. I haven't read the Jaynes book Scott mentions (although I have a copy somewhere!), but as far a I can tell from my own life, the experience Christians have of hearing God usually has little in common with a psychotic experience.
Do you think that if someone performed a study comparing the proportion of the Christian, Muslim, Tenrikyo, Mormon, etc, population who claim to have personally heard God, Christians would come out ahead? Why or why not?
I think evangelical christianity (baptists and the like) would beat most other sects of Christianity, Buddhism, and Judaeism, because they have a tradition of hearing from god. They would probably come out behind any religion that used drugs (spirit walking type stuff), and more radical religions like radical Islam.
Also, are mormons not considered Christians?
EDIT: I also think an important thing to consider is what threshold people put “hearing from God” at. Among agnostics (which I am), assumedly 0% have “heard from God,” because if they had, they would stop being agnostic. But I have had a dream where, if I wasn’t already agnostic, it would’ve probably been coded as “hearing from God.” And honestly I don’t think I’d have even needed to be in a religion with a strong tradition of such things to cross that threshold.
Generally only mormons consider themselves Christians. It's usually delineated by sacred book additions everywhere else. Judaism = Torah. Christianity += New Testament. Islam += Quran. Mormons += Book of Mormon.
> Also, are mormons not considered Christians?
I would consider them Christians, as they also believe that Jesus Christ is the son of God, died and was resurrected, etc, etc, but if they're right all the other Christians are wrong in a way that is not equivalent to how if the Catholics are right, the Protestants are wrong.
If Mormons are Christians then aren't Muslims too? They just have one more "son of God" after Jesus in their canon.
neither jesus nor mohammed are sons of god in islam, they're both prophets (like abraham, moses etc.) who are still regular humans.
The Quran has an account of Jesus being born of a virgin, but notes that creating things is easy for god, and that this doesn’t make Jesus a deity in his own right. It has an ambiguous account of the crucifixion, implying that something supernatural happened but the Christian account of Jesus’ resurrection isn’t accurate. Also, the doctrine of the trinity has never been accepted by Muslims, who believe that there is 1 and only 1 god, and 3 does not equal 1.
> They would probably come out behind any religion that used drugs (spirit walking type stuff), and more radical religions like radical Islam.
In the books I've read about Islam, hearing Allah's voice does not happen, and any Muslim's claim to the contrary would be heresy. I think one book explicitly said this, but I can't recall which. I'm referring to mainstream (i.e. non-Sufi, non-liberal) versions of Shia and Sunni Islam, whether 'radical' or not. (The category of 'radical Islam', although not meaningless, seems to be more political and sociological than theological.)
Yes, even Mohammed himself said he received the Quran from the archangel Gabriel, not directly from Allah.
Don't forget members of new religious movements. I'd naively expect they'd be ahead of most other religious groups.
This is a question that's pretty easy to map to the "powerful person" framework. You could ask, "Do you think that if someone performed a study comparing the proportion of the Democrat, Republican, Libertarian, Socialist, etc, population who claim to have personally talked to Barack Obama, Democrats would come out ahead? Why or why not?"
Democrats would probably come out ahead, but maybe not. Because Obama is a powerful person, he could talk to lots of Libertarians or Socialists, if he wanted to. And if a Democrat got mad because Obama was talking to a Libertarian, Obama could very properly say what God says in the book of Job: "Who are you to tell me what to do?" [chapters 38-41, Matt's paraphrase]
Also, you would expect all the different political groups to have really different ideas about Obama's character, because they each have a different (and complicated) relationship to his power. His power makes the relationship complicated and subjective. And the different ideas of the Republicans, Democrats, Libertarians or Socialists who had actually met and talked with Obama would be founded--legitimately, in their own minds--on first-hand evidence, talking with the man himself. And yet, despite inspiring different descriptions, Obama really does have a specific character, and some of the descriptions are more accurate than others.
(Edit: And, of course, some people lie about Obama, or deceive themselves about his character. Because he's powerful, and they have a subjective relationship to that power. If God is like a powerful person, you would expect to encounter a lot of widespread lies and self-deception about him, too.)
I can imagine how you would convince a skeptic that Barack Obama showed up at their birthday party, but not how you would convince a skeptic that you are hearing God's voice. At the worst, you can bodily push the skeptic into Obama, but you can't let them into your head to listen. If the skeptic keeps insisting that they haven't bumped into anything, you know that's false. You might try to take the same line with God's voice - say that they are hearing the voice but are stubbornly refusing to listen - but you can't provide any evidence that the skeptic is hearing the voice, because you can't let a third party into the skeptic's head any more than you can let the skeptic into yours.
Yup! That's why the thought experiment is about evaluating evidence that you've received yourself, not convincing a skeptic you have evidence even though you can't show it to them.
It's not intended to convince anybody that God exists. Mostly it's just a window into what things are like from our end. But I think it could also serve to debunk a certain flavor of proof that God doesn't exist.
"if someone had been willing to do this to the original hippies we might have saved ourselves several decades of weird art and dumb politics."
I'm sensing this is lighthearted, but still. Why denigrate the hippie movement like this? There is a major war going on right now and the hippies were the ones whose politics were trying to prevent the US from the Vietnam and Iraq wars. I guess I've got too much love for people who thought they were on a breakthrough of the human condition, only to grow up unable to prevent the sad realities, on their deathbed seeing Trump trying to overthrow US democracy. Basically proto effective altruists.
I genuinely think the hippie movement has been really damaging. I'm grudgingly okay with Hearing Voices, but I think there are versions of the same tendency (eg Thomas Szasz, Gregory Bateman) which are entirely about denying mental illness, and that those groups have done a lot of damage. I think there's a clear line between that and "Defund The Police" style social initiatives that say if we just stopped trying to treat problems and make them better, they would go away of their own accord - this definitely isn't true and has made many things worse. I think the anti-nuclear movement set technology back 30 years, and various anti-science forms of hippieism (including but not limited to blank slatism) set the social sciences and some harder sciences back 30 years.
I agree they were right on war, and directionally right on some non-nuclear parts of environmentalism. I guess this goes back to a question of whether, in the absence of ideological movements whose ideologies do bad things, everyone would just be rational and do good things, or if you need them to counterbalance other even worse ideological movements. I'm not sure. I still wish someone had tried to knock some sense in the original hippies and tone them down 50%.
Does the "defund the police" movement actually say that "we should stop trying to treat [police-related] problems and make them better"? I think their steelmanned point is much closer to "police are a cost-ineffective partial solution to the problem (or may even contribute to the issue), and we should be spending those same resources on something more effective". That isn't *necessarily* denial of effectiveness, though in practice it can often bleed into it.
"Steelmanned" is an attempt to deal with the argument on its own grounds. It is not (necessarily) what they are actually saying, which is "defund the police".
We should at least do them the courtesy of believing them.
I feel obligated to say that I'm yet to find a 'defund the police' person who doesn't immediately tell me three other things the money could be spent on, usually including housing and poverty aid and trained mental health professionals deployed on front lines.
Fair. Not my experience, but that isn't universal.
Also, I don't know that the MHP really want to respond to the calls the cops have to take.
I'm in ideological agreement with you, except in that you ascribe these negative things to Hippies far more than their stronger link to more positive things. Polyamory and drug experimentation are directly descended from the bravery of the hippie generation to be the first to significantly contest the conservative traditional way of life for a thousand years.
I'm not aware of any link to anti-nuclear, other than that the Bay Area is the cultural descendant of hippies and is at the forefront of pushing forward nuclear in the US today.
I guess I'll just reiterate that, in spirit, EA / rationality has the same countercultural forward progress view (it's not coincidence they're based in the same area hippies were 60 years ago), and that EA / rationality will get some things wrong, and hopefully not roasted over the coals because of it like you're doing with the hippies.
Bias: my aunt and uncle are actual "summer of love" Bay Area hippies in contrast to the rest of my family.
I'm sorry but that's just absurd. People have been sleeping around or engaging in complicated non-marital affairs for centuries (read eg, the memoirs of Casanova for plenty of examples of people living what we would now call polyamorous lifestyles), and people have been taking drugs for millennia. The prohibitionist drug war started by Nixon is new and weird, not traditional culture for 1000 years. Plenty of cultures had stuff to say about alcohol at various points in history, but plenty freely allowed it too.
Name me a modern polyamorous culture. Niche groups throughout history that didn't become prevalent are a historical dead-end. That hasn't happened with hippies. Same thing with drugs. People have indeed been taking drugs for millenia. War on drugs isn't just Nixon, it's in every conservative culture from India, China, Japan, Russia, etc. I'm not talking about alcohol here, that's clearly a global traditional drug. Our modern use of Cannabis, Psilocybin, LSD, MDMA, PIHKALs and TIHKALs are directly because of hippies. I'm actually amazed this is an unorthodox view here when the rationalist core, and the reason for this very blog, live 50 ft. down the road from UC Berkeley and Sasha Shulgin. Computers, drugs, polyamory, civil rights, human progress, charity, eccentrism; it's not a coincidence, it's a direct lineage.
This analysis surprises me; I was a young adult around 1980, and if the remnants of the hippies were anywhere, it was in the anti-nuclear (both weaponry and power plants) movement.
This is interesting. I always thought about rationalists as partially descending from hippies - I mean, you are in the same place, and some similarities are apparent (e.g. polyamory, drug experimentation, moral universalism)
It's a little concerning that for all the rationalist hoo-rah about getting to the bottom of things, they must be so concerned with the future, that they haven't even realized why they're centered in Berkeley in the first place.
Unfortunately, "Those who do not learn history are doomed to repeat it."
I wonder if it's that "uncanny valley" / tribal proximity issue, where peoples who are very similar, but not quite, end up very focused on the ways they're different, and go to war with their neighbors over it, unaware or uncaring how they're actually most related to each other and far more different than the rest of the world.
I thought the Merry Pranksters buried Hippy in 1967. Isn't 'hippieism' just blaming the postwar generation? What's 'hippieism'?
On your take on transgender individuals: I'd like to offer some counter-evidence to the idea that being transgender is necessarily a cultural phenomena. For one thing, many (if not most?) transgender individuals describe voicing confusion about their gender when extremely young, for some around the time that they start speaking in coherent sentences. If you want specific examples I'd be happy to provide. This does not seem to be the case with anorexia (and other plausibly culturally-induced disorders), which tend to appear later in life, often during teenage years, when most susceptible to cultural influence. Yes, many transgender people "come out" as trans when teenage, but a number of my trans friends tell me that they tried to tell adults beforehand, but were dismissed/laughed at until they found the right words to describe their experience to others. I know of multiple(!) trans folk who didn't realize that other people *didn't* desperately wish to be the opposite gender, and discovering that was shocking. I think the closest analogue here is left-handedness, which appeared on paper to become vastly more "popular" in the 20th century, but which was mainly due to the stigma against it being removed. For a long while, people were "coming out" as being left-handed later in life, but this was not an internal development on their part! They simply weren't able to share that fact about themselves until they were older and in an environment where it was safe to do so.
(This is tangential, but on a personal note, I grew up without once hearing the word "gay" until I was fourteen or so, having grown up in a fairly insular religious community. This did not stop me from being bisexual, but it did stop me from having *words* for my experience until I was much older.)
For another thing, the majority of trans people I interact with online grew up in *transphobic* households, and in fact most are still not "out" to their family members. This is may be due to small sample size (around 10), but it does suggest that being transgender is not strongly correlated with being in a transgender-friendly environment—while publicly *expressing oneself* as being transgender is.
I have some other thoughts, but this comment is getting long, and I need to go to an event, so if you're interested in hearing more when I have the time to continue, please let me know!
Thanks for this. I wrote on the subreddit that I'm about evenly divided between "people feel more comfortable coming out", "social contagion" and "endocrine disruptors or something" as the explanation. But let me try to get into more depth on what I think "social contagion" and "switch-flipping" might mean.
There are a lot of psychosomatic conditions that start with some minor weirdness, then some kind of focus on the weirdness, and then the focus becomes all consuming and takes over your life.
For example, consider the statement "you are now consciously aware of swallowing, and your swallowing is weird and awkward". I think most people, asked to meditate on the statement, will find that it's true. A few people will go further - I remember when I was a teenager, I suddenly noticed my swallowing was weird and freaked out for a few hours thinking I might have some kind of throat disease. There's a condition called "globus hystericus" where exactly this fear takes over people's lives, although it's pretty uncommon nowadays.
If for some reason one of your throat nerves fires wrong, or you have some minor irritation in your mouth, this causes a focus on swallowing. If you're naturally prone to this kind of thing, then that focus itself then makes you feel worse, and sustains itself until it burns itself out somehow (or sometimes until you get psychiatric help).
This is also a common cause of panic attacks. A typical pattern is that they start when someone is on a drug, and something is very wrong with their bodies. They panic over this, which causes something to be even more wrong with their bodies (panicking puts you in fight or flight mode), and then they have a panic attack. Then they might get sensitized to the idea "the slightest feeling of wrongness = panic attack" which causes them to freak out when they get slight feelings of wrongness, which means they will get panic attacks all the time from then on.
Or consider chronic pain. A typical problem is something like "their arm hurts for a little while, much the same as everyone's arm hurts sometimes for mysterious reasons". They focus on this so intensely that it causes their pain-gating system to get wonky and now their threshold for noticing pain in their arm is so low that it *always* qualifies as having pain.
I think the steelmanned social contagion theory of transgender is something like: some small number of people (let's say 1%) will have massive irresolveable differences between their gender identity and natal gender that will bother them forever no matter what. Some much larger amount of the population, let's say 50%, has some minor mismatch which might be easy to ignore. If you're in a society that thinks that makes no sense, and that obviously sex == gender, then they'll ignore that feeling and it legitimately won't bother them in any way (or will nag at them every once in a while). If you're in a society that focuses strong attention on it, then you'll get sensitized to/obsessed with it, think about it all the time, and feel very unhappy until it's corrected.
In this model, you're completely right that you "didn't have words for your experience", but in some sense this actively made your experience less real and less anxiety-provoking. There's a decent amount of evidence suggesting that in some cases, telling people mental illnesses are real and biological makes them worse; I think telling people transgender is real and biological might have the same effect.
Ah, okay, that seems like a plausible theory, thanks for clarifying! One possible way to test this would be to see if we can find a way to measure reported well-being before and after someone is exposed to the "trans meme" (such "unexposed" people still exist, as I can personally attest). My personal prediction (based again on anecdotal experience) would be that we'll find people who are "out" as transgender* (*and are in a relatively supportive environment) will report greater happiness, but I'd be willing to concede to the social contagion theory if this is not the case.
EDIT: Thinking about it more, social contagion might still be the correct theory even if my prediction is correct, though in such a case it would be weird to call it a "contagian" if getting infected makes people feel better about themselves. I think we can still round this out as a fairly good test if it's possible to operationalize it?
[By the way, for me personally, not having the words for it made my situation *way, way worse*. In retrospect, I would have given just about anything to know that other people like me existed, and weren't deviant evil people. That being said, I also found that being diagnosed with POTS (postural orthostatic tachycardia syndrome) later in life was one of the most helpful things to happen to me, even without having a good treatment plan until a few years after that. For me, knowledge that I'm not alone, and access to a supportive group environment where I can learn from others dealing with similar issues is positive enough to outweigh any potential harms, like increased awareness of pain. I get that the calculation may be very different for others though.]
Sociologists have been writing about "social contagion" for a long time. It's called that because of how it spreads, not because every contagion is harmful like a disease. Similarly, on the internet something can "go viral", but that does not imply it is killing healthy cells.
Fair enough! I don't know how to cross out a sentence on Substack, but I publicly take back that line. Thanks for pointing that out :)
Can you think of any words that mirror the meaning of 'social contagion' without the negative connotation?
It's my experience that connotations can have a profound impact on the direction of a discussion; even in a community that is willing to stringently clarify meanings and intentions.
How about “memeplex”? Nice and neutral connotations there I think
I think that memeplex is better than 'social contagion' for sure.
I feel like 'meme' is overused however. I find it hard to separate meme/memetic from the concept of internet memes, and I imagine that would be the case for many internet inclined people.
If we're reaching in the bag for new words/combinations, we might as well grab something fresher. A foreign word perhaps.
I'm thinking something like 'thought implant', but 'implant' feels like it adds an implication of intentionality to the idea.
Maybe something like "thought pollen" would be better. I think I like the pollen metaphor, firstly because any plant can be beautiful or ugly; beneficial or invasive. Secondly because pollen spreads in proximity and without intention, which is pretty similar to the sort of memetics were are talking about.
I'm kinda thinking out loud here.
My guess for the social contagion part is that it has two dimensions: society's knowledge/tolerance of transgender people, and society's tolerance of gender non-conforming behaviour. Under this theory, societies or groups where being transgender is unknown or stigmatised but gender conformance/enforcement is low would see the fewest transitions, but you'd expect the most in a society that both awards extra good-kind-of-unusual points for being trans and bad-kind-of-weird points for being gender non-conforming but not trans.
Another post mentioned a school textbook with "stereotypical examples such as a boy who likes to cry, and that such a boy would not be just all boy on the gender spectrum". I find this a terrible example in many ways but it shows both dimensions at work: we're perfectly accepting of you crying sometimes, as long as you don't claim to be "all boy".
There is a blog post called "Toward an End to Appropriation of Indigenous “Two Spirit” People in Trans Politics: the Relationship Between Third Gender Roles and Patriarchy" which as you might guess from the title is from a radfem author, but the post makes a factual and falsifiable claim that deserves to be treated by looking at the argument rather than the author. (I won't link it, but searching for the title should bring it up.) If the facts are true, and I have no way of verifying myself, then it's interesting as it's as close as one gets in the wild to a randomised controlled trial.
The author claims that in pre-Columbus northern America, Apache children had a "very non-gendered upbringing" because there was constantly some kind of war on so everyone needed all the same "home front" skills they could get. The Iroquois meanwhile had a comparatively peaceful society which was largely gender egalitarian. Neither of these peoples had any "two spirit" people of their own, even though they knew about the concept (presumably through trade with other peoples). In contrast, the Sioux and Dene had a very gendered and, in the author's words, a very patriarchical upbringing of children - and had two-spirit people.
Someone with more knowledge of the facts than me is welcome to check them, and if they're false then the whole claim is of course dismissed. But if the facts are true, then they support the hypothesis that the prevalence of transgender people is influenced by intolerance for gender non-conformance as well as tolerance for gender diversity.
"Someone with more knowledge of the facts than me is welcome to check them, and if they're false then the whole claim is of course dismissed. But if the facts are true, then they support the hypothesis that the prevalence of transgender people is influenced by intolerance for gender non-conformance as well as tolerance for gender diversity."
This mostly matches what I've seen. I expect the trans population per capita will top out and decrease as society grows more androgynous.
This theory sort of ignores anatomical reasons for transitioning however. Part of the reason I transitioned is due to my dislike of experiences that are mostly caused by testosterone(greasy skin,acne,anger,libido,especially spontaneous erections). That is to say, I partially transitioned because being a man is inconvenient in and of itself, regardless of society's stances on gender expression.
From what I heard, the term "two spirit" dates to the 1970s.
1990s actually, but that's because we needed a non-offensive English word. The Apache, Sioux etc all had their own words, there is definitely evidence of the "phenomenon" before 1990.
Pre-90s, I believe the English word people used was berdache, but that had gained connotations and so a new term was needed, just like the originally value-neutral "retard" became a slur and had to be replaced.
"My personal prediction (based again on anecdotal experience) would be that we'll find people who are "out" as transgender* (*and are in a relatively supportive environment) will report greater happiness, but I'd be willing to concede to the social contagion theory if this is not the case."
Huh, the experiment that most immediately came to my mind was: are people from conservative backgrounds with a slight tendency towards transgender but completely repressing it, happier or less happy than people from liberal backgrounds with a slight tendency towards transgender who haven't yet transitioned but are thinking about it?
I guess these are both true, mine for the epistemic question and yours for the utilitarian one.
A counter to the idea that exposure to the idea of trans people being normal and right necessarily makes people more likely to transition: I grew up in a fairly conservative culture, then met various queer people in high school, and later some trans people in my 20s. This prompted a lot of discussion and rumination on gender. The conclusion I drew was that I had a minor mismatch between my AGAB and my internal identity, but I didn't really weigh gender in my self-image highly enough to go through the effort of transitioning. I experimented by asking one of my friends to refer to me as "they" and on net I'm not sure I noticed the difference.
Conversely, if I wasn't able to calmly examine and dissect this part of my identity, the wrongness could have grown more uncomfortable over time, eventually driving me to take action, who knows. I would say I greatly benefited from my acquaintance with trans and non-binary people, despite not transitioning at all!
"Or consider chronic pain. A typical problem is something like 'their arm hurts for a little while, much the same as everyone's arm hurts sometimes for mysterious reasons'. They focus on this so intensely that it causes their pain-gating system to get wonky and now their threshold for noticing pain in their arm is so low that it *always* qualifies as having pain."
I think it's worth pointing out that "focus[ing] on this so intensely" often isn't under conscious control where chronic pain is concerned, but something our brain does "for us" at lower computational levels whether "we" want it to or not:
"if the brain believes there’s a threat, you’re going to hurt, no matter how pointless it is or how intensely you focus on trying to have more reasonable and rational sensations. It’s mostly just not up to you. But that doesn’t mean that we’re completely powerless. Mind has some influence over brain" though it's indirect and can be counterintuitive.
https://www.painscience.com/articles/pain-is-weird.php
For example, the "no pain, no gain" school of physical therapy for chronic pain is still quite popular. Sometimes it works, other times it might make things much worse.
"Pain is a warning system, and central sensitization is therefore a disease of over-reaction to threats to the organism — a hyperactive warning system. When physical therapists, massage therapists, and chiropractors treat chronic pain patients too intensely, they may trigger that alarm system, potentially making the situation worse.
"Central sensitization is bad news, but worse still is how few health care professionals are aware of the neurology and make things worse with careless or even deliberately rough, no-pain-no-gain treatment... With tragic irony, the most likely victims are also the most vulnerable and desperate patients, patients going through the therapy grinder, their hopes leading them right into the hands of the most intense therapists."
https://www.painscience.com/articles/sensitization.php
Stoic minimization and attending away from pain isn't enough, by itself, to convince the brain there's no threat present, especially if there is some underlying physical problem present (even if the brain is blowing it out of proportion — which might become pretty easy for the brain to do when someone has an underlying physical problem dismissed as "merely" moral or psychological) or therapy is repeatedly painful.
If conscious focus is so ineffective at directly controlling pain perception, I wonder how effective it is at ignoring marginal feelings of gender mismatch in an environment bringing them to the fore, or other social expectations, for that matter. On the other hand, since having legitimate concerns shut down is pretty threatening, and threat tends to make discomfort worse even when you're as consciously chill about the discomfort as possible, maybe rigid policing of gender norms sometimes turns tolerable discomfort with natal presentation into intolerable discomfort.
"If you're in a society that thinks that makes no sense, and that obviously sex == gender, then they'll ignore that feeling and it legitimately won't bother them in any way (or will nag at them every once in a while)."
This, as well as some of the comments above, confuses me. (Or did you mean '=/=' Scott?) I'm (sorta) "trans-skeptical", but that's because I think there's a strong distinction between sex and gender. Sure, gender is fluid, there can be many different types of gender expressions, people of one sex might identify more with the (main) gender associated with the other sex. Gender non-conformity is fine, I kinda dig it. But being a man or a woman has to do with sex, not gender: a man is a male adult human, a woman is a female adult human, just the way a stag is a male adult deer and a doe is a female adult deer. (I mean this just as a linguistic claim: we have terms for referring to things by their sex (rooster/hen, bull/cow, etc. etc.), it would be astounding if we lacked such terms for humans, and if we have such terms 'man' and 'woman' are obviously them.) Part of why I'm (sorta) "trans-skeptical" is that it seems like* the pro-trans movement elides the distinction between sex and gender: if you "identify with" the masculine gender, you must actually be male (a man), etc. I'm happy to be polite and let girls play with the boys etc. in most contexts, but it's reached a point where if you think there are any contexts (jails, shelters for abused women, etc.) where we should be separated by biological sex you are deemed a bigot. Which just seems ridiculous. (Maybe worth adding: I don't deny thing there are some people who genuinely feel like they were born with the wrong sex, I just think that there are many more that identify with the "opposite" gender and become convinced that they are trans, which I don't think is good for various reasons.)
*But maybe I'm wrong about this? I honestly have trouble understanding what the "standard" position is.
Sorry, I don't follow. The claim is that 'man' refers to male (a sex) adult humans, as opposed to masculine (a gender) adult humans, just like 'bull', 'rooster', 'stag', etc. refer to the adult male members of their respective species. Obviously, the part about being human is important!
> many (if not most?) transgender individuals describe voicing confusion about their gender when extremely young, for some around the time that they start speaking in coherent sentences
I'd love to see some studies on this. IMO, "most trans people were confused about their gender from a young age" sounds like the sort of belief that's pretty susceptible to confirmation bias. (I expect the trans people who experienced confusion/dysphoria from a young age are much more likely to speak up on this topic, and the trans people who *didn't* are much *less* likely to speak up.)
I know a lot of trans people, and I don't personally feel convinced of this.
It also seems plausible to me that this could've been true in, say, 1990, but false in 2022. (Since being trans is less socially costly than it used to be, so people with relatively less dysphoria may find it more worthwhile now.)
My two cents.
It can be hard to tell if someone naturally would have expressed dysphoria in childhood. As a young boy, I expressed femininity in a number of ways that were pretty much immediately shut down. I ended up dropping any behavior that wasn't deemed acceptable. You're just taught not to act like that.
Ultimately, I didn't express much femininity during my later adolescence. However, I was known for not being very manly, and people made note of it. I wonder if this would have manifested differently in an environment that was less hostile to male femininity. Even for me, it's hard to parse through, given the fact that none of these things happen in a vacuum.
One of the failed book reviews was of a book on memetics and social contagion in psychiatry, which could be relevant,.
https://apsychiatryblogger.substack.com/p/from-paralysis-to-fatigue-a-history?r=1jkibi&s=w&utm_campaign=post&utm_medium=web
"Whatever your criteria for a mild case are, there will be someone who fits those criteria, but says the condition ruined their life and you are dismissing their pain. Whatever your criteria for a severe case are, there will be someone who fits those criteria but is thriving and living their best life and accuses you of wanting to imprison them in a hospital 24-7. "
Couldn’t the absence of suffering, absence of endangerment of yourself and others and the ability to manage your life autonomously be criteria for mild cases?
"Absence of suffering" is a strong claim. Being rich causes nonzero suffering (doing your taxes gets much more complicated), but it's still overall a good thing. "No excess suffering on net" would work better, but at that point it's almost tautological.
As psychotherapists once told me, or as I understood their explanations, Leidensdruck is a criterion for whether some behavioral trait should be given therapy. As far as I understand it, the word can be translated as level or degree of suffering, psychological stress or strain. Of course we do not have a sufferometer, but I guess a therapist should be able to give orientation, such that the patient is able to judge whether s/he suffers so much that s/he wants treatment.
In this whole context and similar examples, it seems to me that the more complicated question is whether the affected people have a moral entitlement that society behaves in a way that they do not suffer and if so, to what extent. The easy part is tolerance. But at some point qnd in some context, people started saying that tolerance is not enough, instead we need acceptance. But what does this include? In the extreme, it implies second-guessing everybody else's personal preferences including on ways to talk or not talk about something.
So the degree of suffering depends on the society you are in, and possibly that is also true for the other criteria. That is what makes them debatable, not their inherent fuzziness.
"People hate admitting that some cases are mild, and others are severe."
They don't hate it: they are incapable of comprehending it. It's an instance of being able to keep multiple incompatible thoughts in mind. It's anti-memetic: they literally forget there is a scale involved right after they admit there is a scale involved.
ClearerThinking.org has numerous quizzes/tools/mini-courses which are intended to help users think more clearly, as would be expected from the name. (https://www.clearerthinking.org/tools-and-mini-courses)
And when we encounter some new concept in mathematics, we tend not to master it just by reading the explanation several times. We master it through practice problems.
Maybe people would benefit from some form of practice at applying the idea 'a scale is used differently from how a category is used'. The goal would be transforming this comprehensible, yet totally abstract, idea into something we might actually succeed in applying next time we encounter a scale.
This very good article also highlights something that should be obvious without even reading the article to anyone not writing this at 2am, like I am, but yet often overlooked: the metaphor about how transgenderism is something taken up by people, is not a deep part of "themselves" in some kind of metaphysical sense, and yet is very much an extremely important part of who they are, and definitely not something they could walk out of if they wanted to, etc., makes me think that a reason why sociology, even when done by people who acknowledge that they are biased, still makes a lot of people feel uncomfortable, is that people actually believe their own culture, the same way people who took up trans culture really are trans, and certainly feel like they are. Yes, it really is very obvious, but I’ve seen quite a few sociology professors who are at a complete loss when it comes to understanding why laypeople won’t listen to them, and I myself had mostly stopped at "it’s because you make me sound like a crazy conspiracy theorist, you fool!" without understanding it as clearly as this article puts it.
Sorry for the clumsy phrasing and uninteresting content, as I said, I’m writing this half-asleep.
Also, are there people who actually do not bother to want a personality apart from being honest, kind, and the like? I’m sort of almost autistic, and I often feel like that on a superficial level, could people with actual ASD actually be that way, or think they are? And would they be fooling themselves in thinking so?
Re: 1st paragraph: You have definitely scrambled the 'culture war' script by comparing transgender people to socially conservative commonfolk, and gender-critical commentators to academic sociologists.
Re: 3rd paragraph:
> Also, are there people who actually do not bother to want a personality apart from being honest, kind, and the like?
Sometimes we have conflicting values and need to maximize one. For example, kindness and honesty can point to different actions. Aren't the decision criteria (conscious or unconscious) which we use in these situations themselves the core of our personality? If so, then not wanting a personality would mean not wanting a way of deciding, in a particular context, between honesty and kindness.
I have low confidence in this understanding of what the core of personality is, and will gladly read any counterarguments.
But I will say that the aspiration you indicate, even if I can't work it out in theory, sounds virtuous.
> The DSM says that you can’t diagnose a psychotic disorder if someone’s in a cultural context when they’re expected and encouraged to hear voices - which sure does sound like the experts think cultural context can affect whether you hear voices or not. Born again Christians are constantly having what would normally get classified as psychotic experiences - I have asked a bunch of evangelicals who say “God told me to X” whether they actually heard God in a, you know, hearing God type way, and they usually say yes.
Related book recommendation: TM Luhrmann, "When God Talks Back: Understanding the American Evangelical Relationship with God." Her book is explicitly about how religious people cultivate the experience of hearing (or otherwise perceiving) God respond to their prayers. I thought it was quite good.
Love the post. One thing I will push back on, I think the demand for quirkiness or special snowflakeness depends on your environment. My impression of San Fran is that it is the city of quirkiness. When I lived in DC, quirkiness wasn't important, instead it was connections. Now that I'm in Florida, no one care about quirkiness. Obviously Florida has plenty of quirky people, but more people are happy to just confirm and live a relaxing life. These kind of groups seem to be created in San Fran, then slowly move across the country, with Florida being one of their last stops.
I think you are just defining quirkiness based on what you see in California. Is not boat or motorcycle owning and hunting and gun collecting(edit or golfing) the same type of behaviors(quirks)? I don't know what you mean by connections but if you feel the need to share the existence of these connections with people you meet, then that feels pretty quirky to me...
I think that quickly evolves into describing every aspect of a human personality besides working a job as "quirky", and I think once you've condemned the entire human soul to the garbage as pretension (or, more generously, that everyone should just do their hobbies while hiding under a blanket and a dark room and feel shame about it) you shouldn't be listened to.
So, hobbies of Californians are pretentious but hobbies of other state's residents are legitimate? Or were you just replying to me out of context?
I'm not sure how you read "We shouldn't write off people's hobbies as vapid status-seeking just because they exist" and got "Fuck Californians".
Some people do, of course, engage in vapid attention-seeking, but I think most people have hobbies because they like the hobby and not because of Teachian Dynamics.
Exactly the point of my previous comment (to which you replied) where I was saying that our use of quirkiness as possessing interesting attributes applied equally well to DC and Florida.
In other words, my rock climbing and coffee roasting and wrenching on cars (all of which started in California) are no more or less quirky than someone hunting, BBQing, golfing and boating in some other part of the country. That "Aristides," if he was defining quirkiness as only applying to Californians, was doing so because he found Californian hobbies "unusual."
(And this was what I meant by you taking my reply to "Aristides" out of context)
There is an awful lot to unpack here. I hadn’t read the Times article initially so I had to give that once over. I watched Freddie’s response too.
I’m going to have to re-read Scott’s article before I give any opinions. Probably going to need to read Saul/Paul’s account of the events on the way to Damascus too.
This disagreement comes about because we have a weird system where some people who get mental illness diagnoses truly suffer from their "illnesses" and find them unrelievedly bad, while some people who get mental illness diagnoses truly do not suffer from them at all. And many people probably see both pros and cons in those characteristics and experiences that get labeled mental illness.
It might make more sense to save the label "mental illness" for only characteristics/experiences that are distressing or disabling, but that's not the world we live in. We don't really have a way to talk about people who are very weird without labeling those characteristics as an "illness." And yes, it is possible to get a mental illness diagnosis without being distressed or disabled by those characteristics. I don't think Freddie gets this. Some of us had diagnosis thrust upon us, and those people are naturally the ones largely driving Hearing Voices, neurodiversity, autism pride, and critical psychiatry in general. But it isn't that those people don't recognize that disabling and distressing mental illnesses exist—but the culture already pays enough attention to them. For everyone who glorifies mental illness and trash talks psychiatric drugs, there are 100 people who think that anyone with a mental illness diagnosis is dangerous and unstable unless they are on drugs and in therapy at all times.
>But the opposite of this are the people who think psychosocial interventions and acceptance are the only possible solution for anything and trash talk the meds every chance they get.
Who are these people who think no one should ever use psychiatric drugs? Cause I've read a LOT of critical psychiatry stuff, and I have literally never heard anyone say that no one should ever use psych drugs. This seems like a straw man. People do point out that these drugs have often very large downsides that don't get discussed or acknowledged very often in most doctors' offices or in the culture at large. (When I asked a doctor about the side effects of an SSRI, her sole response was "eh, you might get drowsy.") But the vast majority of critical psychiatry/Hearing Voices people acknowledge that people can legitimately and reasonably choose to use psych drugs after being informed of their risks and benefits.
Peter Breggin is a very prominent anti-psychiatry voice who does explicitly believe that psychiatric medications are bad. He's been an expert witness in hundreds of trials. The website Mad in America is also a thriving home for people who express this sentiment. They exist.
> It might make more sense to save the label "mental illness" for only characteristics/experiences that are distressing or disabling, but that's not the world we live in. We don't really have a way to talk about people who are very weird without labeling those characteristics as an "illness."
Based on your comment and a number of others, I've been attempting a scale. Affected people might move in and out of these 4 (for now) semi-arbitrary levels over weeks/months/years. After each level is a sentence or two on what sort of community I would expect.
'a pattern of thinking and behavior which differs from the norm, sometimes to the point of mild social distress'. This level is sufficient for appreciating Buzzfeed listicles and other in-jokes. Few affected people consciously seek out similar people.
'a pattern of thinking and behavior which differs from the norm to the point of moderate social distress'. This level is sufficient for bonding among affected people involving a mix of recrimination against social norms, and relief at finding an oasis from those norms. Medication and/or therapy are sometimes suggested.
'a pattern of thinking and behavior which differs from the norm to the point of clinical significance in THIS society, but probably not in a plausible alternative society'. Medication and/or therapy are often advised, but not if the affected person successfully orchestrates a lifestyle as if they were part of a plausible alternative society. This includes e.g. the Hearing Voices Movement, or working in a workplace which is sufficiently autism-friendly to feel more like 'Right Planet' than 'Wrong Planet'.
'a pattern of thinking which differs from the norm to the point of clinical significance in ANY plausible society'. Medication and/or therapy are highly advised. A community of affected people would most likely either reinforce medication and/or therapy, or else harm its members.
>Some of us had diagnosis thrust upon us, and those people are naturally the ones largely driving Hearing Voices, neurodiversity, autism pride, and critical psychiatry in general.
To overgeneralise a little, autistics usually do appreciate the diagnosis. This is because a layperson will easily notice that an autistic is different but extremely-often "misdiagnose" the problem as malingering, as sociopathy, or as being a serial/spree killer - all much, much worse things to be labelled.
I appreciated this discussion. I think as a culture we have become too tolerant of deviant behavior in public places while at the same time demanding excessive conformity in opinion in offices and educational establishments. The dividing line on medical coercion has to be based on behavior and whether it is harmful to the person himself or to others around him. It's not an easy line to draw but denying that many harmless people hear voices or see visions which don't need to be medicalized is almost as harmful as failing to provide restraint to those who are dangerous.
Daniel Patrick Moynihan called it "Defining Deviancy Down" in 1993, as America was nearing the end of an earlier crime wave.
I'm old enough to remember. I was impressed.
Excellent piece, but as I read it, mentally copy-edited this sentence: "Study after study has shown you will be happier if you go to church." Shouldn't it read like this? "Study after study has shown people who go to church are happier."
Actually, neither is correct. I'd bet large amounts of money that while the *average* churchgoer may well be happier than the *average* non-churchgoer, there exists at least one churchgoer who is more unhappy than at least one non-churchgoer.
More likely, there also exists at least one churchgoer who is more unhappy than the _average_ non-churchgoer, and at least one non-churchgoer who is more happy than the average churchgoer.
Good point, thanks.
One should note that even the weak version is only true in the US.
Or put differently, it's actually "people going to church are only happier in poor countries, but are not happier in rich countries. The US are an outlier."
https://greatergood.berkeley.edu/article/item/how_does_religion_affect_happiness_around_the_world
I have also heard the version that it depends on how important religion is in the country. What I seem to recall is that in countries where religion is still very important (the US, Poland) church-goers are happier. In non-religious countries they are less happy. But I didn't fact-check this version.
Yes, a lot of the effect is probably 'people with more community ties tend to be happy'. For poorer countries, it means having an extra support network, and there might be some impact on values related to work ethics.
I have Aphantasia, meaning I have no mind's eye. When I read a book, for example, images do not ever pop into my brain and indeed until I learned about Aphantasia it never occurred to me that reading text could possibly cause a human to picture anything other than the text. Hearing voices that are not there seems remarkably like seeing things that are not there. Why is the former considered a sign of mental illness while the latter is not? I guess the obvious but unsatisfactory answer is that "the majority is always sane".
the question comes down to "is it harming people?" I think
Has anyone studied if seeing images in your mind's eye harms you? I can imagine that it distracts you when driving, increases rage (as you picture the thing you are mad at), makes you more confident in false believes (as you picture what you think is the truth) and increases post-traumatic stress disorder as you vividly remember the bad happening. Before I learned about Aphantasia I could never understand why adults worried so much about kids seeing violent or sexual images as it never occurred to me that the kids could continually revisit the images in their mind's eye.
Although it's impossible to compare in any rigorous sense, I would say I have someone with a very vivid 'mind's eye'. I would say yes! I've mostly derived pleasure and aesthetic benefit from it, but am certainly haunted by chilling images intrusively recurring at times, and do indeed (exactly as you say) have more rage when I start imagining a frustrating/bad thing happening and then can't help myself from 'watching the rest of the movie', so to speak. That's a very interesting observation!
If you had involuntary visual hallucinations that seemed like you were physically seeing them, that would also be a strong sign of mental illness.
Don't most people have involuntary visual hallucinations all the time, or can those without Aphantasia always turn off their mind's eye?
There is an unmistakable distinction between imagined visuals in my mind’s eye, and actually seeing something. Likewise for imagined voices and actually hearing something.
I don’t think I am skilled enough to describe the difference to someone without the experiences, but it’s like they live in two completely different places. My understanding is that most people who hear voices or hallucinate also draw some distinction between hallucinations and their normal use of imagination.
I think one way of giving an inaccurate-but-possibly-still-informative impression of this might be to say: Look at a shining lamp for a few seconds. Now look at the wall. You can see the retinal burn of the lamp, but you know it's retinal burn and not a feature of the wall.
The mind's eye isn't like this (most strikingly, it doesn't obscure actual features from your sensory input), but it *is* comparably separate in a way that is subjectively obvious.
Yes, speaking for myself, I can turn them on/off at will. More importantly, I always know what is a real thing that I'm looking at, and what is a visual fantasy. Strictly speaking, sometimes unwanted visuals do pop up, but I can choose to dismiss them/turn my attention away from them.
A combination of "the majority is always sane" with the fact that hearing voices often (though not always, as in the case of the programmer I talked about) correlates with other kinds of crazy behavior. If you weren't hearing voices yesterday, and then you started hearing them today, decent chance you're about to have a bad time.
Also, I think you're overestimating what other people mean by "not being aphantasic". Having a mind's eye feels very different from visual hallucinations. It feels like the images are in some kind of nonspatial location separate from the ordinary sensorium. At least it feels that way to me. I can go "Oh, that image is in my mind, not in the physical world". Also, I only see the images when I choose to / when I think about them - there's some complicated subtle sense where this isn't true, but to a first approximation it's true.
"nonspatial location separate from the ordinary sensorium"
That's the best description I ever heard. It totally correlates to how I can "see" various virtual images in my head
Do you have an internal monologue? If so, I imagine you'd feel pretty weird if other people described it as an auditory hallucination.
I’m in (almost?) full control of my internal monologue. I assume hallucinations don’t work this way.
Similar. I have an internal monologue, but I'm in control and it feels like it is generated the way my talking is generated.
Wait, actually? Now I want to see wider polling on this. I have about as much control over my internal monologue as I do over my mental radio (like a poster above, I have music playing in my head most of the time, but it takes some effort to 'turn the knob', so to speak). It's not intrusive or anything, but also definitely not under conscious control most of the time.
Do you get negative/unwanted self-talk?
I have a "conscience" which speaks up and makes me feel bad about stuff I probably should feel bad about. It is somewhat of an internal monologue and tells me upsetting things that I need to hear. If I ignore it long enough, then I guess it turns into what you could call negative self-talk. But again, it's because I am acting poorly in a pretty specific way, like lying, causing harm, or ignoring something important. When I stop acting poorly, the negative talk stops.
I wonder if this is an appropriate way to think about negative self talk. Some people don't listen to their conscience and as a result have a lot of unresolved and intrusive monologues. Others have a poorly tuned or impossible to please conscience, and no matter what they do, it will never stop.
I also have unwanted/negative anxieties that kick in, but they are purely "felt", with no monologue.
I like the idea of excessive negative self talk as poorly tuned conscience; that does a reasonably good job explaining it for me. Food for thought!
“Right now, our society demands you be a Special Snowflake. Women who aren’t quirky enough are “basic bitches”, men who aren’t quirky enough are “yet another straight white dude”. Just today, I read some dating advice saying that single men need to develop unusual hobbies or interests, because (it asked, in all seriousness) why would a woman want to date someone who doesn’t “stand out”?”
There’s empirical backing for this. In “Don’t trust your gut”, Seth Stephens-Davidowitz writes:
“The mathematician and author Christian Rudder studied tens of millions of preferences on OkCupid to learn the qualities of the site’s most successful daters. He found—and this was not at all surprising—that the most prized daters are those blessed with conventional beauty: the Brad Pitts and Natalie Portmans of the world. But he found, in the mounds of data, other daters who did surprisingly well: those with extreme looks.
Think, for example, of people with blue hair, body art, wild glasses, or shaved heads. Why? The key to these unconventional daters’ success is that, while many people aren’t especially attracted to them, or find them plainly unattractive, some people are really attracted to them. And in dating that is what is most important.
In dating, unless you are drop-dead gorgeous, the best strategy is, in Rudder’s words, to get “lots of Yes, lots of No, but very little Meh.” Such a strategy, Rudder discovered, can lead to about 70 percent more messages. Be an extreme version of yourself, the data says, and some people will find you extremely attractive.“
Is being "a very successful okcupid dater" what you want? It presumably means you're able to get dates, but not actually able to turn them into long-term relationships. (Or else you're poly, which is another kettle of fish and no doubt strongly associated with blue hair and body art).
The really successful okcupid users are the ones who show up for a couple of weeks, find someone they really like, and then never log in again.
I agree that this set of incentives for attention-getting is problematic, especially at the societal level. We need a fairly large amount of fairly standard “boring” relationships to multiply and replenish the Earth after all.
Everyone has a fetish and you're probably someone's fetish as long as you make them aware of it.
I had an interesting experience with a mushroom overdose (described in several of my blog posts below) and it gave me interesting auditory and visual hallucinations for a while (which I have now fully recovered from), so I think that I have an interesting perspective to add to this discussion.
https://questioner.substack.com/p/accelerated-evolution
https://questioner.substack.com/p/the-psychedelic-outlier
https://questioner.substack.com/p/crazy-like-a-fox-part-1
https://questioner.substack.com/p/crazy-like-a-fox-part-2
In hindsight, I realize that those were just another aspect of my personality that "split* from my ego, and needed to be reintegrated through discussion and understanding. Now that I'm fully recovered, I don't need to talk to myself out loud, because I've reintegrated that aspect of my personality into my core persona. Nevertheless, it would have been EXTREMELY damaging to my mental and emotional health if anybody had overheard me and attempted to put me on any sort of psychiatric medication against my will. In fact, I would go so far as to say that if anybody HAD tried that on me, I would want to kill those people - not only at the time that they were doing it, but also now that I am fully recovered. (Granted, while I was going through that traumatic experience I would probably have wanted to torture them to death slowly, and now that I am fully "myself" again I think a quick death by firing squad would be more appropriate, but GENERALLY speaking my feelings about this have remained the same.)
I don't think that there's ever any need to medicate somebody for being "weird." As long as they're able to obey the law and their condition is not a danger to themselves or others, society should have no business interfering with them. "Making sure other people feel comfortable" is never a good reason to exercise state control over somebody else's personhood, and people who feel otherwise are simply evil human beings. Nobody has an inherent right to feel comfortable, certainly not at somebody else's expense.
Has Freddie ever interviewed Scott or vice versa? That would be fascinating.
+100 would pay money to read!
I don't find interviews to be an interesting format. Either I have specific pressing questions for Freddie or not. If I did, I'd ask him. If not, it feels kind of fake to pretend I do.
Generally, I agree with you. I don’t listen to interviews of or by any of my favorite substack authors. But ... I’d make an exception to listen to you and Freddie talk with each other about psychiatry. You each have very distinctive takes from very different perspectives. But I understand your preference.
Or about public education in the United States! You both have very strong feelings and interesting thoughts about it.
Maybe think of it as a public conversation (or a non-antagonistic debate) rather than an interview?
And so was invented "the podcast".
Interesting. Wouldn't suggest you do start doing interviews, but consider this as a way of changing perspective: did you have all the blog topics you've written in you innately and/or in response to circumstances, or did the act of writing cause you to dig deeper and generate more topics of interest? I would guess the latter.
I think a good interviewer learns the habit of searching for interesting questions, often to good effect.
I have no pressing questions for Nelson Mandela, but I'd like to think that if you gave me a dinner with him, I could find a few good ones. For starters, "aren't you supposed to be dead?"
"People need personal mythologies. “I am a guy who works a McJob and is bad at it, and that is all I am” isn’t going to cut it psychologically. “I am a guy who works a McJob by day, but my hallucinations give me a higher level of insight into the problems of the world than all these people who are superficially more successful than I am” is just healthier, as long as it doesn’t get taken to a grandiose extreme."
This phenomenon is nothing new. Henrik Ibsen's famous play, from 1884, The Wild Duck, examines exactly this topic. There is even a supporting character, who is said to be "daemonic". We never really learn what this means, but it's dark and mysterious and he is apparently proud of it. I imagine him as the 19th century equivalent of a Hearing Voices member. At the end, we learn that one of the main characters, who is a doctor trying to help people in any way, encouraged his pride in being a mysterious daemonic figure:
"What the devil do you mean by daemonic! It's only a piece of gibberish I've invented to keep up a spark of life in him. But for that, the poor harmless creature would have succumbed to self−contempt and despair many a long year ago. "
Huh, interesting!
They actually have a word for this in Japanese. 'Chuunibyou'. Basically, it's this type of delusion, and it's usually associated with middle schoolers, thus the name(Eight Grader Syndrome)
It's a very common trope in anime and manga to have a 'chuuni' character.
https://en.wikipedia.org/wiki/Ch%C5%ABniby%C5%8D
Oh this is too convenient
I've been thinking recently about DID systems, and how the people who experience a non-singular life may be better suited for thinking through concepts that are difficult for a persistent individual ego.
To that end, I was wondering if it would be beneficial to group many such DID systems/tulpamancers into a society, where they could live in a way that was compatible with their internal experience. In human society, it's basically mandatory that you structure your life around a single ego, even if you have to fake it(SSN,Bank account, Passport,Lease, Etc). What observations would these people be able to make if they could live life in a way structured around multiple egos, where they wouldn't have to act as chameleons half of the time? I bet they could come up with some interesting stuff.
What I have in mind is something reminiscent of Castalia from 'The Glass Bead Game'. A class of thinkers sponsored by the state to maintain, advance, and disseminate a tradition of knowledge. A similar example from fiction would be the Keepers from dath ilan. Honestly, I think the benefit of such a society would far outweigh the costs, even if it only ended up providing insight into these mental states.
The cases on the edge are interesting. We no longer consider synasthesia a form of hallucination and instead view it as a sensory quirk. I hear music in my head all the time which is intense enough that I sometimes have telling whether there's music playing in the next room or it's coming from inside my head, and differentiate by checking if I can control the music at all, which I can moderately if it's coming from inside my head but not at all if it's external. In practice it's much more common that music which I assumed was all in my head was actually playing than that I thought something was there which actually wasn't. I don't identify this as hallucination. I think of it as simply intense imagination. But something which was either more intense or happening to a person who wasn't completely clear that the music was imagined might unambiguously qualify as hallucination.
Many Thanks!
Nicely done.
If you've ever used DMT, it seems to become obvious that the human brain can easily 'rephrase' any sensation or idea to fit through entirely inappropriate bits of its architecture - including 'entities' that seem to be formed from plugging random abstract categories into whatever machinery you normally use to model the behavior of other people or animals. Some portion of the contents of our dreams may be similar to that phenomenon. Which makes me believe that at least some of the 'voices' cases stem from disrupted connectivity between other regions whose traffic simply ends up accidentally rerouted through 'hardware' responsible for speech recognition. Mild cases are probably a lot more humane to leave alone rather than treat with antipsychotics, smashing that channel as well. Makes me wonder whether if this were better understood it could be that trying to restore the original connectivity via something like repeat directed TDCS along the intended pathway would be seen as the proper thing to do rather than damping every single connection in the brain to get at a single glitch.
All hallucinogens do is demonstrate the effects of sudden connectivity changes - typically long-distance potentiation - across some type(s) of receptors, which tends to be considered to be more conducive to general introspection than not, just rather confusing, yet many of those states seem to have semi-synesthetic qualities. So, formally: no, it's not definitive proof, but raises the prior on at least some types of hallucinations being long-distance miswirings for different reasons.
Very minor tangent. I have never other than here seen the word “woo” used to refer to (I take it) new age nonsense or the like. Is that usage, which is different from the ordinary meaning of attempting to obtain reciprocal romantic interest, (a) a common meaning that I have just missed, (b) a regional meaning from the west coast, or Michigan, or wherever, (c) a meaning that is distinctive to the “rationalist” community or some other group, or (d) an idiosyncratic usage by Scott?
I think a? I seem to vaguely remember having seem people in the "skeptic" movement unconnected to Scott or rationalism use it, and I don't *think* they were all from a particular US area. I think (not certain) British skeptics use it?
RationalWiki (not always a reliable source but probably fine on this) claims it originated in the 1990s. I associate it with the likes of James Randi but I'm not sure who actually invented it. https://rationalwiki.org/wiki/Woo
It comes from the "woo-woo" sound made by a stereotypical spooky ghost.
Alas, I can attest that the term is older than that.
It seems to be in common use in the part of California where both Scott and I live. Possibly short for "woowoo"
Pretty common among east coast atheist groups I frequented in the early 2010s
Thanks NYT, for without you I never would have found this blog!
It is so amazing these days to meet a truth-seeker, who in good faith tries to investigate two sides of a contentious and polarized subject, and tries to reconcile them (not for one, but for two contentious subjects!). Thanks, Scott.
I was seeing a psychiatrist a few years ago. After 10 sessions or so, to my surprise, I was the one who brought up meds, not him. We had a discussion about several options, I choose one and have been taking them ever since, and they make my life better. I don't like to put some chemical into my body daily, but hey, what can you do? Life is a game of trade-offs...
There are some great pieces I'd normally want to dig into, but overall this article is simply to uncohesive, uninformed and tasteless around a sensitive topic.... My tipping point was when Scott called IFS "woo-y" whilst speaking in a myraid of other assumptions and rather absolute statements.
This is your blog and your perspectives are yours Scott, and mine include using IFS and acupuncture to recover from severe physical and mental developmental trauma without medicine, and then become a mental health professional to help other patients find their path to healing. I'd be curious to talk about mental health when your perspective has been informed by a broader set of perspectives... or can at least hold back on the callousness that was in this article.
Scott, like most rationalists in my estimation, blends together an incredible amount of sympathy with basically zero empathy, and I'm afraid it's something you're going to have to get used to.
Well put on sympathy vs empathy and the rationalist perspective. I'm not sure what you mean that "it's something you're going to have to get used to". I hear something I disagree with and comment my dissenting opinion authentically. I am used to disagreeing with people and continuin to listen to them and engage with them. Most of the time I find Scott's manner of communication to be quite effective, but in this particular post I found it to be brash and underinformed. That is fine, it's not my blog and it would be less interesting if it was!
I mean that you can say what you want, but don't expect him to change or even to take your feedback, that's all.
I don't expect anyone to change for me, but I also recognize that people can't change without experiences that expand their perspective. Scott could screenshot my comment and send it to a friend and say "Look at this chump!" and I don't care. It's all about living authentically and making peace with what happens around you. I spoke up as I wanted to and that's good enough for me :)
In my experience, people just become more and more entrenched in more twisted and extreme versions of their mindset no matter what you do, and it happens faster if you try to push back. This is why I've basically given up on meaningful discourse and am bordering on giving up on communication (at least online) entirely. IMO humans are entirely irrational and any "reasoned thinking" we do is just post-hoc fluff to justify what we were going to do anyways.
But then again I can be very bitter at times.
I mean, I'd suggest reading the rest of that paragraph and the next one - he agrees that it works for some people.
I read it all.
Okay, but then where's the contradiction?
I am not sure what you mean, I haven't used the word contradiction.
Do you think that all perspectives deserve equal attention and consideration? If not, which criteria could one use to prioritise some before others?
Makes me think of college application essays. In order to be admitted here, write an essay on all you're grateful for in your life.
No wait, it's always the opposite. Whoever can best list their grievances gets in.
I'm not sure this focus is the best thing for developing life strategies.
re-reading my message, I hope I was clear I don't think Scott's post is like a college application essay. Just his point that rewarding quirkiness begets more quirkiness makes me think of how college applications are similar (and a lot of life), and not always in a good way.
Kay Redfield Jamison approaches this question in 'An Unquiet Mind' (1994), and 'Touched With Fire' (1996). She recommends a combination of chemicals and therapy for symptoms. I believe she's a therapist. So, no magic bullets there, but she does cover the idea that quashing a little madness may also arrest any savant-ish 'genius' that often comes with it.
Civil service agencies frequently acknowledge 'personal' days, in addition to sick days, only obliquely suggesting they might be important. With all the disinformation, war, and disaster in play, we really need to recognize that mental health is physical.
>My starting point for any discussion of this, which I feel like it’s really hard for a well-informed and well-intentioned person to disagree with, is that at least some large subset of transgender people aren’t consciously faking it. That is, they genuinely have the experience of feeling like they are the other gender, they’ll be absolutely utterly miserable if forced to live life as their birth gender, and telling them “no, just snap out of it” will not work, at all. I think it’s hard to know transgender people closely without coming to this conclusion, unless you have some kind of really galaxy-brained take beyond my ability to even imagin
>So what’s left for the people who believe transgender is a “social contagion” or about “special snowflakeness”? If I had to steelman their position it would be something like: there’s some switch that can be flipped by social pressure and wanting to look cool. Once the switch is flipped, you’re transgender in some pretty real way: you’re not faking it, and you’ll be miserable until you’re allowed to gender transition. Still, being transgender makes people worse off on net, so society should try to avoid flipping that switch.
This is not a good steelman I don't think. It's difficult to distill the issue I have with the trans movement into one argument because the trans movement is really four or five different and mutually incompatible movements in a trench coat. When I try to steelman the trans movement I end up with something reasonably close to what I believe was called transmedicalism, the idea that there is something akin to body integrity disorder that some people unfortunately have where they experience extreme dysphoria at certain body parts and desperately want to modify those to reduce their pain. I find that steelman pretty strong and difficult to go after but it's a motte to a "Gender bailey".
In the "Gender bailey" we go from the fairly difficult to mis-selfdiagnose symptoms like a terrible urge cut off parts of your body that feel wrong to some fairly squishy claims of some essential soul like feature that people have access to which informs them of their proper social role, and these social roles seem suspiciously like sexist caricatures. My issue with trans social contagion/snowflakeness is that when I put myself in the shoes of a kid today, or just my own shoes from a couple decades back, and I try to seriously answer the question "am I transgendered?" I can't see how an answer either way can be falsified. Even taking the assumption that there is a thing to "feel like a man" or "feel like a woman" we are each only endowed with one of those states and have nothing to compare our state to in order to categorize it. So kids are going to fall to second order things to answer this question. Many kids who are going through those awkward puberty times who would have gotten through and been better off for it might take the totally ordinary confusion and angst as evidence that their problems are caused by their gender.
Kids make stupid things their identities all the time. When I was very young my family went to a restuarant that normally served chicken tenders that I loved but for whatever reason they were not able to produce them. So my parents tried to get me to have a burger instead. In the petulant way of children I, being quite cross at not getting my favorite meal, declared that I hated burgers(which I had never had before). And for many years after not liking burgers was somewhat of an identity marker that I, to my embarrasment today, took seriously. Kids will latch on to anything as an identity, if you give them one that comes with a community and a tool like being able to call anything against you 'transphobia' I don't see how kids aren't going to fall hard into that identity group. I'm almost certain I would have as I had my own feelings of not fitting in with the other boys. And that's really where my objection to the trans kids phenomenon lies, I'm absolutely terrified that if I was a kid today I would have fallen down that rabbit hole and I worry for all of the kids like me today who are going to end up permenantly altering the course of their lives.
My father has been involuntarily and continuously in a psych institution since I was 8 and he was 36 in 1993. Schizophrenia with Christian-themed hallucinations that he thinks are real. He thinks he can channel the spirits of Jesus, Joan of Arc, Leonardo da Vinci, etc. He complains of his freedom of religion being violated by the institutionalization. Every time I see him he asks me to contact celebrities or congressmen to pull the right strings to get him out of there. Often he's too medicated to even get out of bed to see visitors, but when he does get out of bed he's doing elaborate rituals to combat demons and hatching plans to get out. Once in a while he gets better enough to go to a sort of on-site halfway house, and then relapses and goes back to the psych ward. He still beats all the staff at chess.
He had an acrimonious divorce from my mother in 1990 and then made a good living flipping houses for a few years. He went to some sort of convention for "clairvoyants" in 1991, which sounds like a predecessor to the Hearing Voices movement. He met his second wife there. The details of how he got committed in 1993 are still unknown to me, but it involves being convicted of arson. He complains of his second wife being possessed by demons shortly before the episode, which probably means they got in an argument or something. No idea if the arson was intended to hurt anyone or was just an anti-demon ritual or an insurance fraud. The cultural context that told him his hallucinations were real and important spirits probably made him a lot worse through making him not want to take his medication properly and more likely to act on the hallucinations. (He probably also got some chemical induced brain damage from repainting / remodeling many houses.) Being his biological son gives me a ~10% base rate of getting schizophrenia but since I'm 37 years old with no sign of it yet that updates down to below 1%.
The half-dozen times I've smoked weed over the years I've experienced what I believe is much like schizophrenia: what starts as my interior monologue quickly shifts into a slightly different voice which I realize I'm not in control of, and it scares the fuck out of me to discover that my interior monologue "isn't me". The moment I realize I can't control that voice a new interior monologue begins overlapping the previous one which is now another voice, and then that interior monologue turns into another voice I can't control, and another starts, and so on and so on for hours. It terrifies the shit out of me. The voices don't tell me to do bad things, but they terrify me because it feels like someone else is doing the thinking in my head, not me.
Luckily, the cure for me is to not smoke marijuana. But I feel massive sympathy for those who can't control voices in their heads.
This spurred a thought which is a small sidetrack - Effective Altruists have a self perception that not only are their ideas are weird, but that they themselves are personally weird. In my experience, EAs are not really that weird? My picture of the median EA is someone who dresses in casualwear, needs a haircut, works a 9-to-5, gives their money to charity, tweets about current events, goes to little houseparties where talking takes precedence over music, and gives a bit of side eye to those rationalists they get lumped with (who are some real weirdos, let me tell ya). When everyone else is jockeying to stand out by being weird, EAs seem to be the weird ones out for trying to move in the opposite direction! Or, maybe it's easier for everyone in a social circle to all pretend we're all unusually weird together so nobody has to admit that none of us are actually that weird, in which case we'd have nothing to bond over. In that case sorry to fellow EAs for blowing our cover.
I would agree! Most effective altruists are pretty aggressively normal, people except for the extremely unusual beliefs that 1) The suffering of people far away is actually real, and 2) Some of that suffering is at least partially solvable in some surprisingly cost-effective ways.
Good post.
> Still, being transgender makes people worse off on net, so society should try to avoid flipping that switch.
Says who? Besides you could use this same logic about LGBT people to justify abhorrent laws like Don’t Say Gay in Florida. And in fact, that is exactly what’s happening. I’d argue that trying to prevent the switch from being flipped is far worse on net, leading to a host of concrete terrible outcomes for transgender and LGBT people. If a few guys who wouldn’t have become a girl, become a girl… that’s the price of freedom. That’s what I’m told after every school shooting so gun nuts can keep their weird hobby. At least transgenders don’t massacre crowds of people on a regular basis.
Scott's responded to this elsewhere in the comments - transition therapy currently has a pile of downsides like the expense and danger of surgery, plus the usual sterilisation. It is clearly worse to be a transitioned transsexual than a cissexual; the argument for transition is when the alternative is *not* "cissexual" but rather "untreated transsexual".
"We can admit that you don’t need a “personality” beyond being responsible and compassionate."
A passionate secular "Amen!" to this!
Re. the man who wanted to overcome his anxiety in a week, I think that if he was coping with his anxiety enough to be functional, he should have given a talk on how he coped with his anxiety without overcoming it.
Re. Scott's transgender dichotomy, there is another dichotomy in play. Last year, I was picked up at a party by a trans woman who didn't tell me she was trans until shortly before we reached her bed. We had a long conversation then, and she said, with sadness and bitterness, that she avoided the trans community as much as possible. She had been born intersex, and lived as a man for a while, but decided (partly because she could never match the masculinity of her macho older brothers) to become a woman.
She actually wanted to be a woman, and /worked/ at becoming a woman. Then in comes the contemporary trans activist community, saying (for the most part) not that men can become women by taking on the female gender role, but that gender roles aren't "real", and so a man can identify as a woman without bothering to act out female gender. A lot of what she saw in the new trans community was former men who had felt like failures as men, and didn't really want to be women; they just didn't want to be men anymore. But they thought that not being men meant they were women. They didn't know that being a woman is more than having a woman's name and wearing pink.
In other words, they felt that being a man was hard work, but being a woman was not. And she felt like this was shitting on all the work she had done to learn femininity after adolescence, and insulting all women, cis and trans, as being nothing but inferior un-men. She cried while telling me this.
So where Scott describes a dichotomy between trans people who are happy changing genders and people who probably shouldn't change genders, she saw a dichotomy between people who actually change genders, versus people who identify as a gender without adapting that gender role, and really want to destroy the concept of gender. They want to stigmatize the gender performance and personality she had worked so hard to internalize and embody.
And I wonder how highly correlated these two dichotomies are.
Wow! I wonder what she thinks of people who don't have a strong gender identity in the first place, and would prefer not to be required to perform any gender role.
I would guess that she think they should say they have no gender identity, rather than identifying as women. Saying "I don't want to have a gender identity, so I'll just be a woman" sounds to me like an insult to women.
Loved this one! Thank you
This is relevant to a few comment chains above, but it's also relevant to the main post and it would be a bit obnoxious of me to post it 5 times, so I'll put it in a top-level comment.
I'm ex-trans, and in the full sense of "had gender dysphoria, full phantom-limb, and it has gradually but almost completely abated".
So I'd go further than Scott's steelman and say "it is possible to be gender-dysphoric and honestly want to transition, and yet for transition to be a bad idea that won't help".
EDIT: If there's one thing that would really clear up the mess, it's a full RCT of transition therapy. That is, you take 5,000 people who say they want to transition, transition 2,500 of them, tell the other 2,500 they're just confused and should get over themselves, then follow up in 20 years and check life outcomes and happiness. Good luck doing that these days, but RCTs are the only way to avoid Aslan's old dictum that "no-one is ever told what would have happened". You'd probably want a bunch of pre-registered subgroups so that you could verify, after the study, that X criterion is actually relevant to whether transition is warranted.
This post is bad.
People should not be put on risperidone for having spiritual experiences and wanting to tell people about them. At all. I don't know why you thought that was a reasonable thing to say. Please do not put people on risperidone for having positive experiences that are meaningful to them.
If any other crazy people are reading this, please know that Scott, although better than average at respecting the humanity and self-determination of people who seem crazy to him, still will throw you under the bus like this.
Also, antipsychotics are known to cause significant decreases in brain volume and cognitive function, even after the meds are discontinued. Citation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758211/
> please know that Scott, although better than average at respecting the humanity and self-determination of people who seem crazy to him, still will throw you under the bus like this
what is your source for this claim?
I presume it's from assuming that the first two-and-a-half paragraphs of section 5 (reproduced below) are how Scott makes forced-treatment decisions as a psychiatrist. I think this might be a bit harsh a reading, given the "but" immediately following this passage, but I can see how you'd get to that conclusion.
>Imagine that you go to the top of a Himalayan peak, take some obscure Ecuadorian psychedelic, sink deep into meditation, and have the most profound experience of your life. You see God approaching in the form of an arrow of pure light, which splits open your head and then blossoms like a flower, and this makes you realize that your whole childhood was [and so on in this vein].
>You try to explain this to someone, and before you even get three words out, they tell you that you’re crazy and God doesn’t exist and you need to take risperidone 2 mg daily until they tell you to stop.
>This is probably the right response, and if someone had been willing to do this to the original hippies we might have saved ourselves several decades of weird art and dumb politics.
Your comment is bad.
Believing in spiritual experiences is bad. Telling people about your spiritual experiences is bad, especially when there's a potential of spiritual memes:
https://www.chicagotribune.com/news/ct-xpm-1989-09-24-8901150766-story.html
https://www.deseret.com/1991/8/24/18937672/study-finds-higher-death-rate-among-christian-scientists-than-seventh-day-adventists
https://www.theguardian.com/world/2019/aug/06/christian-science-church-medicine-death-horror-of-my-fathers-last-days
(I could have written the last article, except about my grandmother who died slowly and horribly from a skin cancer that has a 99%+ survival rate when treated on a reasonable time table.)
Using Christian Science to condemn all spiritual belief is like using Stalinism to condemn all materialist belief.
I would add more, but there really isn't anything else to say.
While I think indulging in spiritual belief is always a bad idea, I was also being performatively strident and overly simplistic, in response to the OP's tone.
If the alternative to indulging in spiritual belief in death, I do not think it's a bad idea. If I had not "indulged in spiritual belief", I would not be here today. I found genuine faith at my lowest point, and it gave me a path back to life where medication couldn't.
Is this a bad thing, to you?
That's some pretty good straw-manning there.
But I'll nevertheless ask:
How do you know faith was the *only* possible intervention saving you from death?
Plenty of people are bumped out of low points by things that aren't adopting (explicitly spiritual / fantastical) faith. Psychedelic drugs, being badly frightened by a near fatal event, meeting someone who helps/inspires them to get better, getting arrested, etc.
And faith in what? Because some faiths have a lot more potential to do toxic harm than others. If your faith motivates you to survive so you can practice jihad or get abortion banned or deny your children medical care...well...you adopting a faith is really not a good outcome for other people.
I had an actual answer for these, but I realized I actually don't think your opinion is rational or even discussable and that nothing good for either of us will come out of this conversation. I can say "Yes, some people are saved by other things, but others are saved by religion and I think it is grotesquely unfair to say those people shouldn't have been saved", but you will not listen. I can say "you literally just said that you think faith is always bad, so me saying that you think faith is always bad is not strawmanning" and you will not listen. So I will not speak any further.
I don't understand how Essex is straw-manning: if indulging in spiritual belief saved him from death, that's decent evidence that it's not always bad, which is what you claimed. I'm also not sure how the fact that other things *could have* saved Essex from death is supposed to be relevant. (I'm honestly trying to understand.) Compare: A: "Group X isn't all bad, one of them saved me when I was drowning." B: "But someone in another group could have saved you." A: "??"
untreated psychotic disorders also cause decreases in brain volume and cognitive function
The NYT article which started this off reminds me of one I read in 2011: https://www.nytimes.com/2011/11/26/health/man-uses-his-schizophrenia-to-gather-clues-for-daily-living.html
I hadn't noticed it was part of a series back then: 'Lives Restored: This is the fourth article in a series of profiles about people who are functioning normally despite severe mental illness and have chosen to speak out about their struggles.'
I kinda assumed that as it becomes more mainstream more people will "catch" being trans but that doesn't seem so bad. Yes, gender dysphoria seems bad, but I figure that as it becomes more common and appealing it will start to simply blend into a general kind of non-conformist sexual and gender expression. I mean, when I first started running into people who were trans they were almost all fully medically transitioned. Now, I seem to run into far more people for whom being trans seems to mostly be about hiding their breasts or otherwise refusing to conform to gender stereotypes in a way that's frankly pretty mild but for the name.
And I'm hoping that this will moderate out the whole thing. I can't prove it, but my hope is that not only does this create greater acceptance for those that would feel deeply out of place in their birth gender regardless, but, also, by making it less of a big deal with basically make being trans kinda like being goth/punk/whatever (while also reducing the focus on medically transitioning).
--
I'm much more worried about the rhetoric about how it's innate and the implications that they have the other gender brain. Not because I even disagree (I'm skeptical it's that simple but don't know), but, rather because it creates an excuse that's the one special reason we have to be compassionate to people who are different in this one way but don't have to do so for all the other weird people.
If by “trans” you mean “quirky teens that use various non-binary or genderqueer terms to describe themselves but are otherwise just standard quirky teens that are vaguely gender non-conforming”, then fine I guess.
But if by trans you mean “start taking medications and getting surgeries with permanent and life altering impacts, including at basically a minimum high likelihood of reproductive issues”, then no, that’s a very bad thing for people to seek out as an answer to general teen awkwardness.
I think almost every teen is a little dysphoric - puberty is weird, adolescent socialization tends to suck sometimes.
It would be very bad if physical gender transition became anything like a first line treatment for that. At least until we’re at the point where seamless and infinitely reversible gender transitioning is technologically feasible.
This Hearing Voices movement sounds like the start of a bad positive feedback loop.
Contrast with AA's firm negative feedback loop.
I understand the idea behind maximum compassion and all that, but I am looking at this picure and I can't shake a feeling it makes no sense:
1. If you feel that your neighbor have been replaced with a hostile alien robot, you get medicated and maybe compulsory hospitalized
2. If you feel your left hand has been replaced with alien computer that serves as a beacon for alien invasion, you get medicated and doctors try to do their best to dissuade you from cutting your hand off and throwing it into a volcano (how else would you destroy an alien computer?!)
3. If you hear voices that instruct you to do things, you are medicated (or at least told to get medicated). Unless you either hide it or proclaim you are a member of an official religion and the voices are voices of God, in which case you are lauded and considered blessed.
4. If you feel your body is of a wrong shape and you need to stop eating until it is shaped correctly, you're anorexic and need to get medical help to start eating again.
5. If you feel your genitalia are of a wrong shape and need to be cut off or reshaped, you are stunning and brave and any doctor that is not rushing to help you to cut them off or heavily medicate you to "affirm" your feelings - even if you're a pre-pubescent kid whose opinion has zero value in any other case but this one - is a nazi bigot who should lose their medical license as soon as their bigotry became known. Also, anything less than enthusiastically embracing the fact you already *are* of the gender you feel like means the non-believer is a violent nazi who should be shunned, shamed, fired, and probably physically beaten or shot if one can get away with it.
Did I get any of it wrong? If not, should it make sense to me?
I mean, in none of these cases people are "faking" it - they may be genuinely believing it, even if the environment, as Scott pointed out, may have triggred the specific form of expression. But in some cases we think it's a medical issue which has to be dealt by professionals - with maximum care and attention to the patient, of course, and all that Scott mentioned - but as medical issue. And in other cases it's a public civil rights issue where holding a wrong opinion about it gets you physically attacked and societally destroyed. How does this work?
As a point of fact: I would call "physically beaten or shot if one can get away with it" (i.e. vigilante action) a fringe position among SJers (though not unheard-of), and as I understand it TERFs get a *little* mercy.
The rest is mainstream, though, and "imprisoned" and "disenfranchised" are entering the Overton Window. "Hound them, impoverish them, exploit them, imprison them, just *do not kill them* and you are God's noblest of men."
"Get away with it" part plays a role here. For 1000 people thinking "it'd be nice if somebody beaten him up really bad" there may be would be one who is inflamed enough and insane enough to actually do that, in normal situation. Of course, if you're in antifa-occupied territory like Portland, the calculus may change.
As for murder, it is true the Western left (Chomsky excluded) aren't ready to embrace the killing fields for their enemies just yet. Violence is already ok, but outright premeditated murder is still rare. But I don't see them mellowing out anytime soon.
My impression's been that mainstream SJ doesn't actually approve of antifa - it just doesn't particularly want to talk about them because admitting there are thugs on one's side loses face (cf. I Can Tolerate Anything Except The Outgroup, paragraph on beheadings).
On the other hand, something like this ( https://greens.org.au/sites/default/files/2022-04/Greens-2022-Policy-Platform--Anti-Racist--Genuinely-Multicultural-Australia.pdf ), while mad, can be definitively termed inside the Overton Window and semi-mainstream since 12% of Australia just voted for that party. That's where I fished out "imprisoned" and "disenfranchised" from.
(I was glossing over a bit by saying "disenfranchised". What the Greens want to do is institute a requirement that all elected legislators uphold SJ positions and condemn the far-right - in other words, ban the far-right parties from contesting elections. I figure that the literal ability to vote is of little use if a group's preferred candidates are not allowed on the ballot.)
> My impression's been that mainstream SJ doesn't actually approve of antifa
Do they disapprove of them, or do they say ritual formulaic things about disapproving them when they have no other choice, but secretly wish there would be more of them and may be even fantasize how they could be one of them if they weren't afraid of consequences?
Because I see great reluctance in prosecuting violent Antifa or denouncing even the worst excesses - even when there's no particular loss of face in admitting there could be one or two criminals among the comrades. In fact, I hear a lot of politicians approve or justify their actions, as maybe exaggerated, but just reaction to the wrongs of the world. I do not see a cultural rejection there.
> What the Greens want to do is institute a requirement that all elected legislators uphold SJ positions and condemn the far-right
This is essentially how major parts of academia has been operating for years. And now, through mandatory DIE trainings, which pretty much always are prepared by those coming from that academia, the capture of major business proceeds apace. So, we have a pincer maneuver here - from one side, the wrongthinkers are getting cut off from the "polite society" and its economic and status opportunities, from the other side, in the inpolite society, they are allowed to be physically attacked and their property destroyed with impunity. Of course, if they try to defend themselves, the whole giant force of federal, state and other law enforcement would be thrown at them immediately.
Next they're going to tell us that furries should get to use the same water fountains as the fur-less.
This has to be a reference to something. Am I the only one not picking it up?
We used to have separate water fountains for white and colored students in schools. And furries, like trans people or psychotics, are a group of people with different mental states that might equate lack of acceptance with overt discrimination.
I was trying to express that I feel like the battles for acceptance and against discrimination move along the axis from serious to less serious and eventually to trivial as the low-hanging fruit is picked. But the seriousness of the issue of the day is always portrayed as the same as slavery or Jim Crow.
I'm reminded of an episode of Roundhouse that depicted a future in which everyone was basically the same, so people manufactured a reason to discriminate against each other - and it was about belly-buttons: innies vs outies. I wish I had a good joke about navel-gazing with which to end this comment.
"a maximally compassionate policy would involve both trying to support people who are already transgender, and trying to prevent the switch from being flipped in people who aren’t transgender"
*endless screaming*
This is not a middle way, compromise position. This is an extreme transphobic position. Women who express beliefs far less extreme than this one are constantly threatened with rape or death.
That you could be a TERF without realising it is odd; that you are to TERFs as Pol Pot is to communists, while still considering yourself a reasonable centrist, is bizarre.
Edit:
I should clarify that I'm using TERF and transphobic as descriptors rather than insults; I don't think the first is an insult, and I'm increasingly unsure about the second.
And I'm sure you don't need advice from me, but as a therapist you have to be really, really careful about this stuff. This quote, plus one session with an activist determined to misrepresent you, and you could be accused of attempted trans conversion. Your last experience with the media was unpleasant, but your next one could be much, much worse.
>moreover, he has already been accused of much worse, so any fallout from this will be relatively minor.
The specific claim is that he'd be accused of performing conversion therapy in his capacity as a psychiatrist. It's a bit hard to get someone disaccredited or imprisoned via baseless accusations, though; that sort of thing tends to need evidence.
Also, theoretically Substack could kick Scott off the platform (ACX is his primary source of income). They won't, though, since their whole business model is catering to the deplatformed (seriously, Eharding didn't get banned for advocating that gays and transsexuals be executed).
I think you may be misinterpreting Scott's stance. By "people who are already trans", he means "people who feel there is something wrong, because they were born in the wrong body", whether or not they've transitioned. This may include people who have never thought they were trans, but once someone brought it up, they realise that accurately describses them.
For people who are not in that camp, I guess Scott would discourage them from thinking about whether or not they're a trans person because of the phenomena described in this post: https://astralcodexten.substack.com/p/book-review-crazy-like-us?s=w
Scott's stated policy does imply that the latter camp is not negligible. But it doesn't impy that it is huge either.
I don't really understand what's so transphobic about it; could you explain?
I'd assume anything other than enthusiastic 100% endorsement of whatever a particular transactivist is advocating is "transphobic".
This is a psychiatrist saying that if you see someone who you think might, at some point in the future, become trans, then the responsible thing to do is to try to stop that happening.
Whether or not he's right (I think he probably is, with a loooong list of caveats that I'd imagine he'd agree with), that's a position that is characterised by those on one side of the current debate as transphobic. And that side of the debate holds all of the power. And has no qualms about using their power to destroy people's lives.
It's like seeing someone in first century Rome say "I hear there's a debate about these Christians. Well I'm pretty sure I'll upset both sides by saying this, but I think Jesus Christ was the son of God, and that anyone worshipping another God is wasting their time, and will go to Hell when they die." It's such an odd way of putting it, and suggests they're so out of touch with what's going on that you really hope they don't end up earnestly explaining their point of view to the Emperor Nero, and expecting that he'll give it careful consideration.
>Women who express beliefs far less extreme than this one are constantly threatened with rape or death.
To be sure I understand correctly - are you saying that people threaten to rape women for being transphobic?
Yes.
Huh. Seems a bit off-brand for SJ, but I guess there'd be a few who buck any trend.
I like that you consider "hey, let's try and figure out who really is transgender so we can help them better" is "extreme transphobic position".
Meanwhile, the surgeons doing the post-puberty blockers/gender affirmation surgery are running into problems:
https://marcibowers.com/transfem/tilapia/
"Increasingly, surgeons such as Dr. Bowers are being asked to create adult genitalia from infantile tissues. There also have long been patients who end up with suboptimal depth—often from other surgeons but also patients of Dr. Bowers who lack sufficient pre-operative skin in order to create functional vaginas. The maturation of a large number of children, genitalia growth blocked prior to the onset of puberty, now coming to the age of surgery, is putting an enormous strain on Dr. Bowers and those who care for these adolescents and young adults as they seek functional genitalia. All vaginas require a lining of some sort. Otherwise, surgeons can create the vaginal space but, if unlined with some sort of skin, the area will be simply a raw hole that will usually close itself off."
But sure, emit *endless screaming* about any attempt to say "what are the benefits and what are the costs and should we be just handing over drugs to ten year olds on their say-so that they really really feel like a girl/boy?"
This reminds me of a bizarre conversation I had with my doctor and the student shadowing him last week.
We were discussing the annual testing required after my weight loss surgery ten years ago (I lost 100 pounds) and a recent return of the polycystic ovarian syndrome that went away after my surgery. I asked if it had potentially been triggered by the 20-ish pounds I'd put on over COVID, and my doctor said, "Yes, probably. Losing even just five or ten pounds would probably resolve it."
He went on to add that there was a medication that might help, although it had some potentially nasty gastrointestinal side effects.
I said something like, "I'd rather not do medication if lifestyle change is enough. I'll get back to being more disciplined about my eating. That'll be easy now since my boyfriend dumped me and I'm not frequently going out to yummy restaurants with him anymore."
And then my super-yoked, super-fit doctor, who looks like a Men's Health Magazine cover model for living your best life after 55, said (I'm guessing for the benefit of the student?):
"You know, there's been a movement saying that we should be thinking differently about weight. A lot of doctors offices aren't weighing patients at appointments anymore, or discussing weight at all. Weight loss surgery, especially, is increasingly being frowned upon as an unnecessary intervention. Any thoughts on that?"
And I replied:
"That's really horrible. The extra 100 pounds I was carrying caused a ton of physical issues, including PCOS and a total lack of libido. My life is so much better post-surgery. And I never would have managed the weight loss with diet and exercise alone; I simply didn't have the willpower to consistently stay on a healthy diet, because I could always indulge 'now' and diet 'later.' Only the threat of immediate consequences, like having a bad surgical outcome, or feeling really sick after eating too much, were ever going to motivate me to make the right choices. I'm so much happier today. I feel so much healthier, have so much more energy. Those advocates are idiots."
And my doctor exchanged a look with the (similarly fit, athletic-looking) student and said, "Now isn't that an interesting perspective?"
Hearing Voices, transgenderism, Healthy at Every Weight...these feel like orthodoxy competitions filling the void left by the abandonment of organized religion.
Oh, forgive me, I didn't make it clear:
My doctor was saying that the fat acceptance movement has gotten so noisy that many in medicine don't consider obesity to be a disease anymore, much less one requiring interventions like surgery to cure.
The problem is that the medications for weight loss suck. Amphetamines are addictive and cause mania. Dinitrophenol can cook you alive. If there were working diet pills that weren't such Serious Shit, I imagine they'd be first-line.
There's a reasonably-solid argument slowly making its way through the health system (to the point that I've gotten advice to this effect from nurses and doctors) that the "healthy weight" range you will find in Every Authoritative Source Ever is drawn a bit too low, essentially because it's optimising for cardiac mortality rather than all-cause mortality (the weight point above which there's no excess deaths from infection is higher than the weight point below which there's no excess deaths from heart disease).
This is not the same thing as claiming that outright obesity is healthy.
Agreed that BMI is nonsense and so on.
However, there really is a fat acceptance movement pushing against weighing patients at their appointments and against offering and performing weight loss surgery.
Weight loss surgery is an extreme intervention that (ethical) doctors only perform on severely obese patients, people who are either almost universally very visibly unwell, or obviously will be at some point if the obesity isn't addressed.
But the pursuit of fat acceptance extreme orthodoxy is such that offering this often life-saving intervention is bigotry against fat people.
Yeah, I've seen some examples and I getcha. Just noting that there's a separate, not-insane point in that vague direction.
While I agree (both about willpower is the problem and there is definitely not Healthy At Every Weight), there are other elements.
Me: Very overweight (all my life), sedentary (and indeed lazy), Type II diabetes, high blood pressure
My sister: Normal weight (all her life), active
Last blood tests: (One of us) Total cholesterol 4.2, (Other of us) Total cholesterol 6.4
https://onlinedoctor.superdrug.com/cholesterol-levels.html
"As a rough guide, the total levels should be:
5 mmol/L or less for healthy adults
4 mmol/L or less for those at high risk
High cholesterol levels are considered:
too high: between 5 and 6.4mmol/l
very high: between 6.5 and 7.8mmol/l
extremely high: above 7.8mmol/l"
Okay, now assign which level to which sibling!
Right, you're probably all going "okay, trick question here" and you're correct.
I'm the 4.2 (good level), she's the 6.4 (bad level). I did withhold some information, in that she suffers from hypothyroidism and that caused her high cholesterol. But as you can see, there is often more going on than simple "all bad things of being obese" for any particular obese person.
"I still remember a patient who asked me if I could cure his anxiety within a week. I told him absolutely not - medications take a few weeks to even kick in, and managing anxiety can be a lifelong process - and why did he need a cure in a week anyway? He said he was an inspirational speaker on the topic “How I Overcame My Anxiety”, and he had a speech scheduled next week, but was too anxious to work on it."
https://youtu.be/z_PR7GUeFh0
Just a quick personal anecdote on IFS: my current therapist, who considers himself primarily a CBT/Rationality therapist, dabbles in IFS. When he first described it to me, he prefaced it with "I don't really understand why this works or how it works and it seems a bit crazy and unconventional to me, but this does seem to really work for some of my patients. Wanna give it a try?" My initial thought was that it would definitely not work for me, but that since we didn't completely understand why many medications work, why not give it a try and humor him.
The issue was personal and I won't go into details here, but basically, I found myself talking (internally) to a younger, more confident version of myself. It was arrogant and full of BDE (Big Dick Energy!) and I had gradually put this side of myself away as I grew older, got married, had kids, and ran a small business. But that part had never gone away and was actually mad about the second-class status it had developed. It wanted more time on center stage and wanted to help me with the issue I was having. With my therapist's help, I integrated this now mostly dormant part and it basically solved a long-standing issue.
I'm throwing this out there, primarily for Scott, but potentially for others in the therapy space: you and your patient can both be skeptical of how IFS works and it can still work. I've since used it both with my therapist and by myself with lots of success. It can be really helpful to see the different parts of yourself as having needs and roles and once you understand where they came from and what they are doing (a basic tenet is that there are no Bad Parts - just unintegrated ones), I was able to feel like a more whole person.
IFS sounds a bit like what you'd do as part of certain kinds of traditional meditation, just under external guidance, so I wouldn't be shocked it works to some degree. Seems like a decent amount of therapy is simply about giving out cues to make people feel that ruminating on their personal issues for a while is perfectly fine, which gets discouraged in extravert-dominated cultures?
I don't know about the specifics of IFS, but I have thought for some time that given the complexity of the brain and what we know about neuron architecture, it would be surprising if there did not exist what may be termed family members, factions, tendencies, brain areas etc. that disagreed with any given decision made by 'you' and presented the mental equivalent of minority reports.
I think that you are absolutely right about people with "mild" cases being in denial about just how problematic it can be - and also that some of these people are not, in fact, mild cases, and in fact, are hurting other people by pulling them into unhealthy psychosis.
I do agree that there's people who can probably hear voices and be fine. But I also suspect that it is really not so good for you, as you are on the edge of a serious psychiatric condition.
The trans movement feels much the same way in some ways, though to be honest, the thing that concerns me the most about gender dysphoria is the fact that none of the treatments for it have undergone proper clinical trials for the treatment of gender dysphoria.
And I am deeply suspicious of this fact.
Pharma companies are pretty infamous for evergreening patents and "reinventing" medications to make more money. On top of that, if you can have the Only Clinically Proven Drug for the treatment of gender dysphoria, you can potentially corner insurance markets and government support by saying that you are the only medication proven to help these people. There is a lot of money to be made there.
The fact that these companies aren't pushing clinical trials for their drugs so that they can be approved and corner this market makes me suspicious that they don't actually think that hormonal therapy actually works at all.
There's also the whole trans movement that is basically a nasty religious sect that attacks anyone who dares to contradict their core doctrine, but that's not really a problem with trans people but a group of them that are, frankly, pretty gross. The degree to which they've hijacked the gay movement is also not great, because gay people struggle to get equal rights in many parts of the world, and I think this particular sect is detrimental to that goal.
I worry about the same thing with all of these groups. The "pro-autism" groups seem to think that autism is a good thing, when it is pretty obvious that these people have a lot of problems. This group feels like it falls into much the same domain. All of them claim the mantle of human rights but what they want often denies rights to other people, and leads to worse outcomes. for them.
>Pharma companies are pretty infamous for evergreening patents and "reinventing" medications to make more money. On top of that, if you can have the Only Clinically Proven Drug for the treatment of gender dysphoria, you can potentially corner insurance markets and government support by saying that you are the only medication proven to help these people. There is a lot of money to be made there.
>And I am deeply suspicious of this fact.
As I understand it, you think that because pharmaceutical companies aren't investigating a cure for gender dysphoria (ie a medicine that makes a trans person into a cis person), that suggests that the disorder isn't real. Do I have that right?
AIUI, other way around - *transition therapy* was never (AFAIK) properly RCTed to see if it has the effects people claim for it (e.g. lowering suicides).
Correct. That's my concern.
I think the implication is more that TD doesn't think that there's a medicine with which to actually achieve a transition, rather than that there's no desire to transition. I'm not sure this logic holds. The absence of a tested medical package implies that creating such a thing is expected to be unprofitable not that it is impossible.
Yes. The issue is that the treatments we're giving people right now have never undergone proper clinical trials to prove that they actually are beneficial to patients.
People with gender dysphoria deserve treatment that works and that has clear benefits, and where the risks are clearly established.
Given that there are millions of trans people globally, I don't buy the argument that it isn't profitable.
That's not to say that there aren't other possibilities, but it is a worrisome sign, given the behavior of pharma companies in other treatment spaces.
"The issue is that the treatments we're giving people right now have never undergone proper clinical trials to prove that they actually are beneficial to patients."
The issue is that if trans women say "I want to grow boobs", HRT will do that for them. That's what all parties are agreeing on what they want. The pharma companies don't need to run trials on trans gender people about this, they know it will work that way.
If you want the issue to be "will taking drugs to grow boobs make me happier?" that is a whole other issue. Some trans women will passionately declare yes, and that if they don't get the drugs, they will feel so bad they want to die. Arguing with them that there have never been any clinical trials about "will growing boobs make me happier about my dysphoria?" will get you precisely nowhere.
If you mean puberty blockers, yes I agree that giving these to healthy children is an entire can of worms waiting to explode in our faces. And yes, we won't know the long-term side effects until we've used this generation as guinea pigs. But again, if you claim the drug companies are not picking up easy money, then you can't blame them for selling drugs for easy money even if they end up fucking up the kids. The social pressure is on *not* to do trials about "will these fuck up ordinary kids without precocious puberty, unlike those with precocious puberty who would only be on blockers a couple of years and then go on to undergo normal puberty ", it's on to "just talk to your mom and then you can go see a doctor about getting puberty blockers!"
https://www.youtube.com/watch?v=f7VyJKVBt7g
I mean, that's the core problem. The problem isn't that people with gender dysmorphia don't have boobs, the problem is that people with gender dysphoria commit suicide at a massively higher rate and suffer from various forms of psychological misery.
The argument is that giving them boobs will fix these psychological issues, but there's no clinical trials to prove that these psychological issues are lessened as a result. A lot of people who transition claim to be happier, but they still commit suicide at a much higher rate than the general population and seem to have extremely high rates of psychological issues. It's possible that the treatment is helping a bit... or it could be entirely placebo effect and even though they think "this is helping me" it actually isn't. Which is very common amongst useless drugs and treatments, including acupuncture and chiropractic "medicine" and traditional Chinese "medicine".
We don't do surgery or give treatment to people with, say, dysmorphia or anorexia to try and warp their bodies towards their mental perceptions of it, and it doesn't seem to help anyway; even super thin anorexic people will still perceive themselves as being fat/overweight.
As such, this stuff should have undergone clinical trials before being pushed as a treatment.
Puberty blockers are even worse, because most children with gender identity issues don't end up ultimately being trans.
I am generally in agreement with you about gender dysphoria being part of a constellation of mental problems.
But I am not going to hammer the drug companies (for once) for not doing trials on something they never claimed to be selling. The drug companies never said "Go on HRT and it will fix your mental problems." The drug companies said "These are replacement female hormones for women who don't naturally make their own any more".
The same way nobody has done psychological trials about "does taking aspirin make you feel better?" because yes, taking aspirin does make you feel better since it stops the pain. Now, any psychological effects of "I am a roaring bitch when I have a headache" are not part of the package, all that aspirin is sold to do is "relieve pain".
Same with HRT. "Replacement female hormones" is what it is, and if doctors and psychiatrists are prescribing it to trans patients, then the physical effects are all that the pharma companies are concerned with. They never marketed it as a magic cure-all, that is down to the trans activism lobby which is demanding "no more medical gate-keeping", and "drugs for all if they simply ask for them".
Indeed, there appears to be a knock-off market where people are selling alleged HRT on eBay of all things! That is not Big Pharma in action, that is trans people wanting magic cures which is a whole other kettle of fish.
Yes, there absolutely should be trials done on "does transitioning help?" and "does medical intervention help?" but that is not for the drug companies to do, that is for surgeons, endorcrinologists, and psychiatrists - if the loudly online-screaming extreme activists permit it.
No, gender dysphoria is obviously real. I've known people who had it.
The concern is the other way around - that the treatments that people are selling to these folks don't actually work, and that the reason why the companies aren't spending money on developing a patent for their treatments is that they suspect that they don't actually provide any measurable benefit to people taking them.
In other words, it's a serious disorder that people may well be selling snake oil to cure.
I don't know that it is true, but the fact that no company is trying to profiteer off of this - when these companies are kind of cutthroat in that way - suggests to me that they have low confidence in the efficacy of the treatment, so are content to sell their drugs to people without FDA approval for the treatment of gender dysphoria.
I feel like, once a treatment becomes common enough, we need to have some sort of governmental mechanism where we test it if the companies won't, so as to avoid a treatment becoming prevalent that doesn't help people and might harm them.
When you say treatments, you mean hormone therapy? Surgery?
Well, hormone therapy is a mixed kettle of fish. HRT was developed for post-menopausal women (do I need to jump through the hoop of putting in "cis women"? Okay, post-menopausal cis women):
https://www2.hse.ie/conditions/hrt/
Using it for trans gender people is the sort of off-label use that is "okay, we didn't develop this for your specific condition but it'll work in a way":
"Oestrogen and progestogen
The 2 main hormones used in HRT are oestrogen and progestogen.
Types of oestrogen include estradiol, estrone and estriol.
Types of progestogen include dydrogesterone, medroxyprogesterone, norethisterone and levonorgestrel.
Most women take a combination of oestrogen and progestogen. But women who do not have a womb can take oestrogen on its own.
Women who have a womb must take both oestrogen and progestogen. This is to reduce your risk of womb cancer."
That is, trans gender male-to-female undergo https://en.wikipedia.org/wiki/Feminizing_hormone_therapy
"The purpose of the therapy is to cause the development of the secondary sex characteristics of the desired sex, such as breasts and a feminine pattern of hair, fat, and muscle distribution. It cannot undo many of the changes produced by naturally occurring puberty, which may necessitate surgery and other treatments to reverse (see below). The medications used for feminizing hormone therapy include estrogens, antiandrogens, progestogens, and gonadotropin-releasing hormone modulators (GnRH modulators)."
The drug companies are not doing trials on "does this reduce gender dysphoria?" because those are not the purpose of the drugs. Trans gender people want them to grow breasts, have more feminine physical features, and decrease masculine physical characteristics, and that is what they do. Psychological effects are not part of the package, that is different.
The drug companies can make plenty of money as-is simply selling hormones, indeed there is currently a shortage:
https://pharmaceutical-journal.com/article/feature/hormone-replacement-therapy-shortages-will-the-governments-new-approach-work
Why pump hundreds of millions into the required trials about "does taking female hormones make trans people happier?" when (a) they can just continue to sell the already tested and approved hormones and (b) that's a psychological issue, we're not selling HRT as pscych medications.
We are selling HRT as psych medicine. It is claimed that transitioning will alleviate the symptoms of gender dysphoria. If it does not, then it isn't actually doing what it is supposed to be doing.
The problem with people with gender dysphoria is not that they don't have boobs. It's that they commit suicide and suffer from psychological problems at a vastly higher rate than the general population.
Drug companies are not selling HRT as such, and the gender dysphoria people very much are claiming that their problem is they don't have boobs and once they get boobs, things will be better.
I do think psych tests should be done, but good luck getting away with those in this current atmosphere. Anyone even investigating desistance (detransitioning or not going through with complete transitioning) is getting pelted with stones for being a transphobe:
https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth
"One reason many researchers believe it’s unnecessary to delay the social transition of a child is that they don’t think the research on desistance is valid. In other words, they think the number of children who "grow out of" their transgender identity has been vastly overblown."
https://www.tandfonline.com/doi/abs/10.1080/15532739.2018.1456390
"Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health, we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities."
https://www.gdaworkinggroup.com/desistance-articles-and-critique
""Over the past few years, an endless parade of “concerned” people (trolls) have trotted out the same statistic over and over again: 84 percent of transgender kids stop being transgender on their own. They have used this to justify everything from reparative therapy, to denying medical care to transgender teens, to suggesting that reparative therapy on adults will work."
"The problem is that the desistance narrative is built upon bad statistics, bad science, homophobia and transphobia."
Are you really surprised nobody wants to pick up the live wire and be electrocuted when it comes to investigating "do the things that trans people demand they get, or else it's transphobia and persecuting them into committing suicide if you refuse, really help them?"
>I worry about the same thing with all of these groups. The "pro-autism" groups seem to think that autism is a good thing, when it is pretty obvious that these people have a lot of problems. This group feels like it falls into much the same domain. All of them claim the mantle of human rights but what they want often denies rights to other people, and leads to worse outcomes. for them.
Okay, here's my pro-autism argument.
Low-functioning autism seems to be high-functioning autism + mutational load. Mutational load is bad.
High-functioning autism is primarily marked by an inability/unwillingness to play Molochian social games, and hence tends to be negative for the autistic but positive-sum.
Removing mutational load is generally good. Actively removing HFA seems to me to be directly anti-social.
I've never seen any evidence that this is true, though. As far as I can tell, high functioning autistic people often are just socially dysfunctional and engage in the same sort of "Molochian social games" but are just flat out worse at it. The whole "calling people Neurotypicals" thing and sneering at them while crying about not being accepted is exactly what you'd expect from a dysfunctional group of people. I've seen no indication that they are really somehow more beneficial to society than normally functioning people.
"at least some large subset of transgender people aren’t consciously faking it."
Find me someone who believes that the 15 year old girl who just got her breasts removed is consciously faking it. To a second approximation, nobody believes this.
"Once the switch is flipped, you’re transgender in some pretty real way: you’re not faking it, and you’ll be miserable until you’re allowed to gender transition."
But this doesn't follow: that poor girl would have been fine if she'd just been forced to wait a while, or maybe she would have gone for they/them pronouns and left it at that (a vastly better outcome, imo).
"a maximally compassionate policy would involve both trying to support people who are already transgender, and trying to prevent the switch from being flipped in people who aren’t transgender yet."
I mean, duh? Most elected Republicans hold this position. That is, most don't want to take away Buck Angel's testosterone, or Blair White's estrogen. My guess is that most elected Democrats probably don't want the 15 year old's breasts removed either. So Scott is acting like this is some impossible compromise, but if we can just tamp down a few crazies we're already there.
Signed: a bog-standard Republican.
Are there really any gender correction surgeries performed on 15 years old? As far as I know activist are just pushing for puberty blockers and get a huge backlash from republicans for it.
Not a lot, but it happens. I can dig up a source of you like, but the point would stand even if no doctor was willing to actually perform the surgery: the fact that someone wants to go through that is sufficient to demonstrate they aren't faking anything.
I'd love to have a source, yes.
I'm not claiming that no 15 years old transgender person want to undergo a surgery, or that they are faking it, It's just surprising for me to hear that they are actually operated in such an early age. As I said, the way I understand things, currently transgender activists are fighting for puberty blockers - a much less drastic thing.
Puberty blockers are allegedly less drastic, but I’m not sure that’s actually proven, and there are strong tides against speaking about or researching then honestly (see Jesse Singal’s substack for some excellent discussion on the topic)
The other issue is that I strongly suspect that “completing puberty” is actually a pretty key step in determining an adolescent’s “true” gender identity.
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2674039
Youngest post-surgical natal female surveyed was 14.
I must say that switch flipping theory sounds very improbable. Why would it work only in one way but not the other? Why can you make presumably cis people trans by some groups of people being openly supportive to transness but can't make trans people cis even by full blown conversional therapy?
But even if we accept it as equally possible, wouldn't the obvious and much easier solution be to just let trans identities be normalised as fast as possible? If being trans isn't a forbidden cool thing but just a regular way of being there is no pressure to "flip the switch". No need to develop a sofisticated policies when to encorage transition and when to discorage it, no need for high accuracy tests for real transness. Let's just stop waging a culture war over it and there will be much less casualties.
Citation needed. But even in a counterfactual where it is the case, my why would they be stuck? Why it's easier to convince cis people that they are trans than trans people that they are cis? Why is being trans so much more temptating that presumably cis people would still assume that they are trans, despite all the hardship of transness?
This doesn't sound like a good explanation.
First of all we need some biological explanation why it would be even possible. Why one can change gender identity in such a way, up to the point of becoming dysphoric? Why doesn't it work with other personality traits? I'm struggling even with some hand-wavy evolutionary psychology explanation here.
Secondly, being trans doesn't make you universally celebrated, it puts you in the middle of a huge controversy, where the society in large either hates you, is disgusted by you, or at least have lots of condescending commentaries about your life choices. This doesn't sound as a thing attractive to unhappy teenagers who, if my understanding of conventional wisdom is correct, mostly want to fit in. Granted, some people are into controversy, but it's already a complexity penalty for the theory, until we get good evidence that transgenders disproportionally love controversies and it's controversies that can change people gender identity.
You know what's funny? The methodology you proposed actually makes much more sense when talking about people who are critical about transgenders. That these people choose their position because they want to be in the center of a controversy and thus feel special, rather than because this position is actually true. Indeed, having beliefs (or beliefs in beliefs) based on social status is a well known phenomenon much less improbable then developing actual medical condition. And how Brave and Dedicated to Truth are these people! Even despite all the horrors of Cancel Culture and Thought Policing from the left they keep spreading the word of Reason! I also predict that people actively waging culture war are much more into controversy than median transgender.
Actually, the more I think about, the more it looks as a universal argument to dismiss your opponent's views, regardless of how much they are true. Oh, you hold the position of majority? You are just a conformist! What, you are in opposition to general consensus? You just want the aesthetics of fighting the power! And so on. This is generally a terrible epistemology. I think we shouldn't use it.
There is a huge spectrum between being set in stone and switchable at a whim. Personality traits are hard to change, while opinions are much more changeble. Such traits as sexual orientation proved to be very hard to change. Gender identity and experience of your own body seems even deeper, more personal thing. You do not experience sexual attraction constantly, but you do experience being in your own body all the time. It being more easily switchable is very surprising and requires lots of evidence to be accepted.
>Lol, no.
Yeah, very funny. Do you really believe that some low effort virtue signalling means that corporations and USA goverment are 100% on the side of trans people? Or that there is no controversy? That's trully ludicrous. At this moment I would assume that you are obviously arguing in a bad faith, if I didn't understand how one can be too much caught in the political thinking. Wasn't it Trump elected on the platform of opposing wokeness instead of Hillary on the platform of promoting it? Despite loosing the popular vote? There are also, you know, other countries. President of mine, for instance, is extremely concerned with the disturbing effect of Cancel Culture on the freedom of speech in the West, and the decline of concervative values while killing and imprisoning his political opponents and arresting everyone who dares to say that being gay is okay. But sure, tell me more how social justice went too far.
>Why not, when it happens literally all the time?
Because universal arguments are useless. Because it doesn't allow us to separate truth from fiction. Because it's just another way to smear your opponents, instead of figuring out what reality really is.
They aren't stuck - something in excess of 90% of individuals who think they're trans at some point desist.
Now, put them on cross-sex hormones and give them surgery and, yeah, those rates of desistance drop precipitacely. But even then detransitioners are a thing. Switches switch.
The switch-flipping thing doesn't flip everyone, just the marginal person. Plenty of people will stay cis even under monumental pressure, and some people will stay trans under the same. Then there's a bunch of people in the middle that could go either way.
In my view, normalizing trans-ness would be superior to the status quo, but worse than the state of affairs 10 years ago, because being trans *sucks*. The fewer people who have to live with it the better, and this is best facilitated by strong pressure against. Comparisons to anorexia are apropos, but left as an exercise for the reader.
The question stands. Why the switch of marginal person can be so easily flipped one way, but not back?
I believe the well established conclusion that being trans pre-transition sucks much more then being trans after transition. Previous balance left lots of binary trans people not transitioning and lots of non-binary trans people not aware of their identity, therefore living less happy and less fulfilling lives. Current balance may contribute to transitioning of people who didn't need it if the switch theory is correct. But the full normalisation will be free from both failure modes.
I'm not sure flipping back is impossible, but it does get stuck in some number of people. And even if it eventually gets flipped back, it sucks in the meantime. (People get over their eating disorders, or detransition.)
I'm not sure what you mean by it being easier to flip the switch one way than the other. There are those who are unflippably cis, those that are unflippably trans, and a bunch in the middle that could go either way. Until trans started being cool, most of the flippers stayed cis. Then trans got cool, and a lot of the flippers are now going trans. I'm sure there's tendencies one way or the other among flippers (bell curves all the way down) but flippers they remain.
IIRC, suicide rates among trans people don't change much pre-to-post transition, so that's not great for the thesis that post transition is generally less sucky than pre. But the person I'm primarily worried about is the flippable high school girl who, ten years ago, would have been confused for a couple years in high school, and then gotten over it. Maybe she decides she's a lesbian, or maybe she's just masculine of center, or maybe she's perfectly average and just subject to the mental weirdness that accompanies puberty. At any rate, if that girl is left without medical intervention, she'll go on to live a happy, fulfilled life. This is the path for something in excess of 80% of females who think they're trans at some point.
Or, she goes on puberty blockers, and the desistance rate drops to near 0%. She goes on testosterone, and maybe gets uterine atrophy, necessitating a hysterectomy. Throw in top surgery, and the poor girl is now sterile and has to deal with being trans for the rest of her life due to decisions that got made in her late teens.
I think this second path is bad, relative to the first. Sure, there are females who really are trans, and for whom transition is the best life, but they are RADICALLY outnumbered by those who are just confused for a bit. I think being neutral on this question is bad because, again, being trans sucks (even post transition). The fewer people that have to go through it the better, and that means pushing the switch strongly in the direction of remaining cis. If, despite that pressure, someone remain trans, then more power to them. But that person has a hell of a row to hoe, and I'll bet most wish they didn't have to hoe it.
"you can't make trans people cis even by full blown conversional therapy?"
Is this belief falsifiable?
Of course? I though that's the common knowledge, considering the history of such therapies. Is them not being effective a controversial statement?
Yes, massively. Conversion therapy is typically referenced wrt sexual orientation, and even there the effectiveness rate isn't zero. Move over to trans teenagers and even basic conservative care is likely to result in desistance of disphoria.
Has anyone studied what happens to the people in Iran who get forced into sex-change-surgery to "cure" them of being gay?
Nice Diderot reference in there.
This style of free wheeling switching between topics is fun and entertaining. Kind of like a discussion between old friends around a campfire where topic come and go based on input from individuals with shared similar experiences.
But, I think that the Hearing Voices and Gender Dysphoria are such important and serious issues that it might have been better to treat them in separate essays.
The Special Snowflake issue seems a lot less important but it is interesting and could have served as the topic of its own fun but less serious post.
I enjoyed this a lot, a great article.
But just throwing out one thing, the level of nytimes bashing felt a little jarring, especially in light of the "because I’m balanced and reasonable empathetic to both sides" description. I get there are personal reasons for this, and I agree there are a lot of articles with odd framing and questionable decisions, but I also thing the times is a valuable american institution doing work non else can or will. Maybe it's worth an attempt at empathy even for the nytimes.
Jumping on the trans wagon, I read Scott's post and the other comments carefully, and I feel there is a hidden assumption that exists here that requires naming: What is so socially bad about gender transitioning that we require people to be miserable before we allow them to make that choice?
It seems that people hold the view that staying in one's assigned gender is somehow morally better, and to transition requires special circumstances of misery such as gender dysphoria before it becomes socially legitimate. This is comparable to the pro-LGBT argument that because people were born that way and cannot change their sexual orientation, then we as a society must begrudgingly accept them (rather than simply allow people to be attracted to whoever they desire at the moment, without needing any predefined neurological justification for that desire to be accepted by society). Yes, many gender affirming surgeries are painful and dangerous, but so are cosmetic surgeries, and we don't require people to suffer before we make those socially acceptable. Why do we require misery for breast removal but not for breast enlargement? Shouldn't we allow everyone to change their body, gender, and pronouns as they see fit, similar to how we allow them to change their appearance?
I find this assumption and the subsequent requirement problematic for the cause of trans acceptance. While they do help some people accept gender transition and same-sex sexual orientation, they also prevent the same people from accepting those who don't fit the special criteria: people who are fluid about their sexuality, or people who have a slight, non-painful preference to be of another gender (or not to conform to gender at all, while also changing their body in the process). I want to challenge this view, and believe it will some day disappear like the "born this way" view also all-too-slowly disappears, allowing people to be who they want to be without need for neurological justification.
> usually producing unconvincing results and a lifetime of stress, unhappiness, and unpleasant medical issues
I would imagine gender dysphoria causes the lifetime of stress and unhappiness, rather than the gender affirming treatments. Supporting your claim would require showing that people who transition are less happy than people who experienced similar levels of gender dysphoria and did not transition, which I find unlikely (but big if true, and will change the entire discussion).
Regardless, the argument of cosmetic surgery stands. We allow people to have irreversible cosmetic breast reduction without requiring them to be miserable, while still not living in a sci-fi utopia. This double standard against gender affirming, rather than purely cosmetic, breast reduction surgery hints that something else pushes us against gender affirming actions. Why are we against giving people control over their bodies when it comes to gender?
It seems you have strong feelings regarding gender affirming surgeries, or however you prefer to call them. Why is that?
To make the conversation clearer, when I write about gender affirming surgeries or treatments, I refer to any medical procedure or intervention that changes the body of the individual to exhibit attributes usually associated with the gender of their choosing, similar to the definition on wikipedia (https://en.wikipedia.org/wiki/Sex_reassignment_surgery). This includes breast size reduction, ovary removal, rhinoplasty, and other procedures that also take place in other, more mainstream fields.
>And I note that you veered away from actually defending the ideology to making Dark Insinuations about why anyone would disagree with the ideology.
There was no dark insinuation involved. I noticed you were using heated terms such as "humiliation", "sociopathic" and "embarrassing", so I gave you space to express your feelings on the matter directly. I hear your reasons, and see how believing you cannot talk against a practice that you think hurts innocent people would definitely make one feel strongly against something like that. I think we just disagree on the facts.
You make claims about people who grow out of gender dysphoria or living unhappy lives after gender affirmation, but I am not aware of this being the current research. Are you?
You don't seem to accept that breast reduction, that as you say does not lead to sterilization, is part of the gender affirming toolkit. Since it is (see wikipedia article above), I have trouble seeing why you think gender affirming surgery as a whole ruins lives. When you talk about gender affirming surgery, do you mean specifically genital surgery?
Does penis enlargement count as gender affirming surgery?
You're assuming gender dysphoria is something inherent, like hair color, rather than something like the desire to drink tea or do fentanyl. I think human history supports the latter interpretation: this is not a problem that needs to exist.
I actually don't think it's inherent, I think it's a combination of culture and biology. My point is that it doesn't matter, and that it is not a problem: People should be able to choose their gender, regardless of gender dysphoria.
Society relies on sex differences for a number of important things, such as separating women from men in vulnerable situations.
Why do you believe separating women from men in vulnerable situations is needed, or something that society has to do?
Also, what does that have to do with AMAB who want to be women, or AFAB who want to be men?
> Why do you believe separating women from men in vulnerable situations is needed
Because men are much more violent than women. It's not just random man-hating that makes the default for societies to give men and women separate bathrooms and locker rooms and prisons.
It's funny to watch liberals claim that men aren't any more dangerous than women, though. Big switch from just a few years ago.
Yes, there are more violent incidents coming from men than from women. Does that mean you think people should not choose their own gender because you believe AMAB women will be violent towards other women?
Some meta-commentary: apparently, even if only a small part of a post discusses "trans" issues, the majority of the comments will be on the topic. Or at least a majority of the vitriol in the comments.
Is like a parasite, or something. Someone should write a blog post about that...
I have a draft blog post, stuck in revisions hell: Don't say 'trans', say 'kathoey' or 'freemartin' or 'cross-dresser' or 'teenager who wants to be rebellious' or ...
The theory is that people use the word "trans" to mean so many different things that it simply doesn't mean anything anymore. It is simply a vector for bad-faith and harmful rhetoric.
(In case the reference was missed: https://slatestarcodex.com/2014/12/17/the-toxoplasma-of-rage/ )
I remember a documentary about the parents of a "trans" kid, very liberal people who "supported" the "decision" all the way. Yet they still spoke of the process as if their child had been diagnosed with cancer. They had to be "strong," to "be there" for their child, etc.
Some lobby groups have strategies and carry out exercises and train people to dominate social media comment sections. I can only wish I could muster half that organisational commitment to the things I care about most
I'm amazed you think people need to exercise and be trained to do this.
Organised might be a better way to put this, rather than trained. Collecting together as many people as you can into one communications channel, getting enough people to be scanning social media for every mention of (I'll use a common idiosyncratic New Zealand example) 1080 poison, getting every person on that channel to pile on to that article every time
You see conspiracies in what is just normal human behavior. Twenty years ago no one was organizing people to derail every conversation about atheism.
organisation != conspiracy. The 1080 groups I used as an example aren't at all trying to hide the organisaitonal effort they put in to getting this result. They boast about it occasionally
I say this often, but this might be my favorite post from Scott ever.
Regarding people who here voices. I’m still thinking of the rank and file of the Abrahamic big 3 - Judaism, Christianity and Islam - that are fine with prophets receiving messages from God as long as it occurred in some hazy past, but regard direct experience of the divine in their own time as a mark of insanity.
Saul had an experience on the way to Damascus that made him a key player in establishing the largest religion in history. If you accept this at face value why would you be skeptical of a 21st century update?
Or one from the 19th century. More traditional Christians are pretty skeptical of Mormonism, but why? Because the revelations came after the invention of the printing press?
Cardinal on the phone to the Pope: “Jesus has just returned…. In Salt Lake City. Your Holiness, you still there?”
How do you know the guy on the corner delivering his direct revelation of the word of god is just crazy?
Why believe that because it comes down from an ancient oral tradition that was eventually transcribed into a very old language it’s ‘The Truth?’
This is one of the best blog posts I've ever read, and not just on here.
And not just because this line made me literally LOL: "And on one level it’s definitely true that mankind will not be free until the last admissions officer is strangled with the entrails of the last New York Times journalist."
(I've viewed the Gray Lady that way since long before you ran afoul of them; am in fact a recovered NYT subscriber.)
Progressives always say that detrans people are rare. I suspect they're not that rare, and that the studies showing they are are bad science in some way. Remember, scientists and the scientific institutions are utterly and unreservedly devoted to saying that all the things that trans rights activists want to be true are true. The world would look the same as it does now whether detrans people are rare or common.
Something like 41% of trans people attempt suicide. 1 in 3 trans youth have attempted suicide in the last year. (Veale et al 2015) Maybe it's society's fault for not accepting them. But alternatively, we should seriously consider that some trans suicides could be prevented by treating some people with mental health care that doesn't affirm their wish to be the opposite sex.
links:
https://www.spiked-online.com/2019/02/22/my-battle-with-the-transgender-thoughtpolice/
https://jessesingal.substack.com/p/researchers-found-puberty-blockers?s=r#footnote-4
"Something like 41% of trans people attempt suicide."
The survey from which that figure is derived is not the most solid, or so it is alleged, at least with regard to the reporting:
https://pubmed.ncbi.nlm.nih.gov/27380151/
""Forty-one percent?” the man said with anguish on his face as he addressed the author, clutching my handout. “We’re talking about my granddaughter here.” He was referring to the finding from the National Transgender Discrimination Survey (NTDS) that 41% of 6,450 respondents said they had attempted suicide at some point in their lives. The author had passed out the executive summary of the survey’s findings during a panel discussion at a family conference to illustrate the critical importance of acceptance of transgender people. During the question and answer period, this gentleman rose to talk about his beloved 8-year-old granddaughter who was in the process of transitioning socially from male to female in her elementary school. The statistics that the author was citing were not just numbers to him; and he wanted strategies—effective ones—to keep his granddaughter alive and thriving. The author has observed that the statistic about suicide attempts has, in essence, developed a life of its own. It has had several key audiences—academics and researchers, public policymakers, and members of the community, particularly transgender people and our families. This article explores some of the key takeaways from the survey and the ways in which the 41% statistic has affected conversations about the injustices transgender people face and the importance of family and societal acceptance. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved)".
https://4thwavenow.com/2015/08/03/the-41-trans-suicide-rate-a-tale-of-flawed-data-and-lazy-journalists/
"- The authors note that the survey was flawed because only one binary, Yes/No question was asked: “Have you ever attempted suicide?” More careful and rigorous studies always follow up with in-person interviews, and when self-harming behaviors (not intended to end life) are controlled for, the actual suicide attempt rate is typically halved—meaning the suicide attempt rate could be as low as 20%.
- The highest suicide attempt rate of all–60+%–was GNC and trans people who self-report a mental disability. No big surprise there; it’s well known that having certain mental conditions is a risk factor for suicidality. But by the authors’ own admission, the survey made no effort to ask for further details about these mental health issues. The status of having a mental condition was self reported, with no corroboration from medical records or a provider. Nor was there any attempt to discover whether the actual rate of mental illness was objectively higher (via diagnosis by a mental health provider) than reported by the subjects.
- People who had either sought or received transition-related services had a higher suicide attempt rate than people who have not. And the survey did not ask whether suicide attempts occurred before or after services were sought or received.
- The data suggest that natal females seem not to be helped at all, in terms of self harm, by being either “stealth” trans or passing as male. (This is the opposite finding from that of natal males.)"
https://studylib.net/doc/13499004/suicide-attempts-among-transgender-and-gender-non-conform
"Finally, it should be emphasized that the NTDS, like all similar surveys, captured information about suicide attempts, not completed suicide. Lacking any information about completed suicide among transgender people (due primarily to decedents not being identified by gender identity or transgender status), it may be tempting to consider suicide attempt data to be the best available proxy measure of suicide death. Data from the U.S. population at large, however, show clear demographic differences between suicide attempters and those who die by suicide. While almost 80 percent of all suicide deaths occur among males, about 75 percent of suicide attempts are made by females. Adolescents, who overall have a relatively low suicide rate of about 7 per 100,000 people, account for a substantial proportion of suicide attempts, making perhaps 100 or more attempts for every suicide death. By contrast, the elderly have a much higher suicide rate of about 15 per 100,000, but make only four attempts for every completed suicide. Although making a suicide attempt generally increases the risk of subsequent suicidal behavior, six separate studies that have followed suicide attempters for periods of five to 37 years found death by suicide to occur in 7 to 13 percent of the samples (Tidemalm et al., 2008). We do not know whether these general population patterns hold true for transgender people but in the absence of supporting data, we should be especially careful not to extrapolate findings about suicide attempts among transgender adults to imply conclusions about completed suicide in this population.
1.For the purposes of this paper, “anti-transgender bias” means bias or prejudice that is directed toward people who are transgender or gender non-conforming."
> whether there’s something to be gained from picking over experiences like these
On what axis is the baseline state of consciousness better than the hippie tripping balls? The obvious metric of "ability to safely operate heavy machinery" etc is unfair as the hippie just took the chemical equivalent of blunt trauma to several key pieces of his brain. This tells us nothing about the validity of the resulting mindset.
I've recently compared thoughts I think on psilocybin and thoughts I think without, and I'm hestitant to consider the sober ones saner or more productive. I don't want to get all postmodern here, jumping out of the window because you don't believe in gravity is still a bad idea. Still, a majority of consensus social reality is complete bullshit, even if (or especially if!) you aim to achieve goals considered valuable in that consensus.
EDIT: Actually the post itself provides an excellent example.
> “I am a guy who works a McJob and is bad at it, and that is all I am”
How dysfunctional a mental/spiritual framework has to be, to reduce a person to a sentence like this? And yet this is how a large part of the population looks at the world, and at each other.
I know. Go your own way. In the words of Bill Murray in the profound classic, ‘Meatballs’, ;) “It just doesn’t matter.” A throwaway line in a comedy that he echoed seriously in ‘The Razors Edge’
It’s all just maya. Read “The Indian Story”, the second ‘posthumous’ story after the death of the protagonist in “The Glass Bead Game.”
Stay well.
I enjoyed the write up and I appreciate the sentiments, but as a "too interesting" person (yes, with a couple of psychotic breaks under my belt) I feel a little self conscious now, lol.
I read "The Spiritual Gift of Madness" years ago and it resonated with me, but I felt at the time like it was only about 75% applicable, and the rest was agenda-driven ranting. A good thing to read, especially if you have a history of mental instability and have chosen not to medicate daily, but the "Mad Pride" movement imo goes a little too far sometimes...
I just don't see how mental health can ever be anything other than case by case. In my case, no meds every really helped me feel better or heal from the atrocious childhood that destabilized me in the first place. I've had to do, yes, woo-woo IFS and other trauma-release modalities to start to get a handle on it.
But I'm not going around telling people never to take meds. What I WILL say is, if you take them, PAY ATTENTION. People may not need meds forever and ever, but only for about 6 months or so, but they just "default" to forever and ever. I'm very thankful for the Zoloft that got me through my father dying for 6 months when I was 20, but once the crisis was past it wasn't doing me any favors so I quit. If I quit and I turned out to need it, I'd have gone back on, but I didn't, so I didn't.
I don't hear voices, but I do have to make sure I can functionally blend my "non default" reality into the rest of the consensus, and I do it very well. Mad Pride helped me understand that this is a valid way to live. I have a personal motto that serves me daily - "It doesn't matter what's real, it matters what's functional." It really doesn't matter what I believe to be true, as long as I'm feeding myself, paying the mortgage, walking the dogs, being friendly to my neighbors etc. It doesn't matter what my neighbors believe to be true, as long as they're able to do the same.
Shion's law:
Psychiatry is going to turn out to be at least as complicated as we already know humans are.
“If the human brain were so simple that we could understand it, we would be so simple that we couldn’t” ~ Emerson Pugh
I asked God for help the other day. He sent an angel down to help me, who spent the entire session complaining about his own problems.
God puts you where He needs you.
Hearing Voices is also an immensely useful modality for all the folks with dissociative disorders who are routinely missed in diagnosis. Because anti-psychotics do not work for that, while making friends and working with the voices does. And the many of the symptoms of dissociative disorders, as described in Dell's subjective/phenomenological model, look more like psychosis than dissociation to most un- or under-trained eyes.
I am not sure what actual data the social contagion mental model is grounded in. For DID, the iatrogenic/sociocognitive model has substantial evidence against it. And for a lot of groups--trans people, systems, voice hearers, autistic folks, left handers--it seems like there is a lot of pain when the dominant society is furiously trying to make you hide what you are. And there is a real need for medical support that is de-stigmatized, and for individuals to have some autonomy and agency over their own bodies and lives.
I do hope Scott can see how deeply stigmatizing some of his own language and the language in the comments can be. People are trying to draw a hard line between their own rationality and the these conditions, in part because there's a tendency to equate personhood, civil rights, and personal value with having an impeccably rational mind. It's not just my Special Snowflake vs your special snowflake--it's that one group gets civil rights while the others don't always.
Spoken, by the way, as a diagnosed DID system who is nonbinary trans, was misdiagnosed and mis-medicated for years, attends a hearing voices group for this reason, and is a disability rights/neurodiversity scholar.
The Hippie Movement created the greatest art of the 20th century in the form of music. I don't blame Scott for being blind or deaf to this; it's not his field.
The Hippie Movement, which is too broad to break down into a few of names, brought to 20th century America the notions of tolerance and non-judgment. That seems important for the black civil rights movement, and ultimately if not immediately for feminism of the sensible sort and the gay acceptance movement. "Letting Your Freak Flag Fly" was a hippie ethic that seems to have resulted in more good than bad. Accepting weirdos is good. They are often the best among us.
Could be wrong but I think Scott still sees the hippie movement through the lens of his awful On the Road review (Love you Scott, but that one was awful). The hippie movement was anti-rational and gave us a lot of art and symbolism -- post Chirstian symbolism one could say -- in an attempt to make sense out of a post-Christian society. The attempt suffered many failures, but we needed those failures. We need more failures. We need to discover a post-Christian spirituality. The Beats and the Hippies tried to find it. They failed, but in a great American way. I love the Beats and Hippies like Scott likes all those CA gubernatorial candidates. I respect those who try passionately to be American, even if they are pathetic in the final analysis.
We need more Hippies!
Yes, claiming that their total contribution to culture is negative is clearly going overboard. But, there certainly were plenty of negatives, and if Scott was at all accurate about it then On the Road was written from the POV of some pretty disgusting scumbags. Would you disagree?
In high school I read a Rolling Stone retrospective on the origins of the hippie movement and the Summer of Love (Rolling Stone #207, February 1976. Yes, I am that old). They said many of the early hippies were Christians, and I remember a quote: "Let the baby Jesus shut your mouth and open your mind". At the time I was very disappointed, having been raised in the church. Now I find it very touching.
Let's not throw the baby out with the bath water. There is a lot of good in the Hippie philosophy, if I can call it that.
Thanks, Jack.
Speaking of hippies being Christians: Recall Joni Mitchell's line, "I came upon a child of God / He was walking along the road" (from her song "Woodstock", released in 1970). Granted, one can be a child of god without being Christian, but that line always struck me as being unusual.
And like Mitchell, you can write the iconic song about Woodstock in your NYC hotel room bc your agent told you not to risk getting stuck in upstate NY and missing your upcoming television appearance
There was this study about communication, where autistic people played telephone games among themselves they scored as well as the none autistic people who also played telephone among themselves.
When the groups were mixed they did poorly.
So autism might be a disorder of communication with neurotypicals, rather than a disorder of communication. Functionally though that might not make a difference. --> prelim findings of study here.
https://insar.confex.com/insar/2019/webprogram/Paper30110.html
I am pleased to hear that quirkiness is in! Now I suppose I should stop trying to downplay my quirkiness perhaps. (then again my hobbies are not that quirky).
I also think low-levels of hearing things seem much less bad than anti-psychotic side effect medications.
I mean I think its complicated; I think at times there can be a link between mental illness and positive traits, but thats the exeception not the rule.
This may be true for autistics who have gotten the support necessary to give their brains a break from overstimulus and develop those other functions, but young autistics in schoolsdont often doo well together,one person's comfort needs can be anothetr's"makes me have a screaming episode" trigger.
To me this is part of the issue with the autism identity movement. Sure,people are different and with proper accomodation can develop, but its stillobjectively more difficult for those who are young and autistic to do this, and thats a big tradeoff cosnidering we arent sure if eevryone whose autistic can become "high functioning"providede they are allowed to stim and not pressured etc.
Yeah, The autism identity movement has always seemed as wrongheaded as before when power structures seemed to interpret all autism as like childhood defiance, which is what it used to be like for a while.
I wonder what level of functioning autistics were in the study? I mean it wasn't the none verbal ones for sure.
to be clear,its not a study, we can now talk to many austistc who were noverbal who eventualy become fucntional and verbal, and they prettymuch all say yeah,if yuo do it tjis way its fine cause thats based on our own expriene as evidene. This doesnt mean necessarily this is possible for all, and the rationalistleaning ones admit that, but they stillthink this is lkikely the case, even thought is possible theyrre wrong.
Scott knows about this because his ex was one of thesepeople who shared this belief ans he was familiar with ut also criiticalof some of the excess of the community.wich everyone shoukd be cause communites always managed to grw blind spots in the same way they need a "walled garden"to even be a coherent community or subculture
I think the element of “if the voice in my head isn’t agentic then it must be me” is crucial to the distress some people feel about the voices in their head, especially if they don’t like what the voice says.
If you believe the voice is some external force - a demon, angel, fey, whatever - then it doesn’t matter what it says; it’s a different person with a weird opinion. It doesn’t reflect badly on you that they have a weird opinion. In fact, it might reflect credit on you; you’re important enough for some big external force to be contacting you!
But if there’s no magic, if that voice is *you* and is advocating things *you* believe to be wrong … then doesn’t that mean that some deep part of *you* is evil? How is a person supposed to feel about that?
I don’t buy that the answer is “the voice is a demon, don’t worry about it bro”, because that carries a lot of dubious baggage. The way I think about it - and have suggested to others, with all the arrogance Scott predicts - is that we’re not fighter pilots, we’re the captains of a ship. Of course there are a lot of voices in our heads; our stomach, our love, our morbid curiosity, aspects of us even more esoteric; they all have a voice. But those voices aren’t the core you, they’re a part of your body but not your mind. *You* are the aggregator who hears those voices, sometimes with competing views and goals, and steers the ship with all that in mind. Sometimes those voices are flawed! That’s okay! Part of your job in life is to learn how your particular voices are flawed, and fuse them together into a working ship anyway, like some campy Hollywood found family movie. Rarely those voices are too persistent or have no upside, and you have to seek outside help, but even then you’re just being a responsible manager. It reflects credit on you for recognizing the situation and calling for backup, rather than shame for having been made “out of spec”.
I know for a fact that viewpoint has helped 2-3 people, but that is not a lot of people, so take it with however many grains of salt that merits.
I would say its more like the captains hat is passed around between different aspects all the time to stick with the analogy. And every time we feel like "yep thats me" even if angry me is very different from curious me is very different from gregarious me etc. in their view on things.
I’m not sure I see the difference of that distinction.
"But if there’s no magic, if that voice is *you* and is advocating things *you* believe to be wrong … then doesn’t that mean that some deep part of *you* is evil? How is a person supposed to feel about that?"
I'm probably rephrasing a part of what you said a bit later on but I'd see it as the brain exploring counterfactuals on autopilot. It's not about morality or good vs evil: parts of the brain can't correct their own mistakes on auto, without consensus with other modules. That you know that it's wrong is the consensus, one that's meant to see that projection as a mistake, in the same way one might misspell a word, drop an object by accident or add some numbers wrong together occasionally, just within a different kind of module and to treat it otherwise isn't a question of morality but giving too much weight to a glitch.
At some level if you make enough typos you’re bad at spelling. Drop enough objects and you’re a klutz. Have enough glitches and they become the story.
If your consensus judges your own ideas to be wrong, it’s difficult to become convinced that doesn’t have a moral implication. And that logic has a bone-stark quality that reveals and resists platitudes.
That’s the use of the “captain vs pilot” reframing; it shifts the thinking from “I am flawed” to “I contain flaws” or even “I manage flaws”, which is a more productive mindset. It also has at least some physical realism; our reflexes and urges don’t come from the exact same place as our executive functions, for example.
Re-Reading Scotts review of Jaynes (he linked it above) one thing that's really striking is that according to Jaynes not only was hearing voices much more common in the ancient world, but that the disappearance of the voices was considered a great loss for humanity. Even if you disagree with Jaynes on how common these voices used to be, I think that its true they became less common and that this was considered a bad thing.
Now you may say that that was just status-quo bias in a society accustomed to hearing voices, but then the reverse can be said about our culture.
"""And most chronically mentally ill people have been traumatized by the psychiatric system in some way or another. Sometimes this is specific individuals behaving maliciously or callously. Other times it’s just the normal trauma of being shuffled from institution to institution by a system which isn’t optimizing for preventing you from being stuck on a gurney for twelve hours with nothing to do."""
I would become literally murderous. As in I would actively work to tear the throat out of the orderly who strapped me to it, and the doctor who ordered it. Not a metaphor. It would go on my todo, and stay there until it was done. If some court doctor wants to medicalize their understanding of this decision path, they may go on the todo list as well.
"People hate admitting that some cases are mild, and others are severe. Especially the kind of people who work at the New York Times" - I think the reason for this is not the one that Scott cited, but rather due to the fact that if you admit that some cases are mild and other cases are severe then (a) there's no conflict, nothing to boldly declare, nothing to subvert, and consequently (b) the solution to the issue is in the hands of people who are able and willing to discuss the specifics of what makes a case mild enough or severe enough to need certain types of treatments.
If you treat having hallucinations as yet another "identity," yet another abstract-nation that you are either IN or OUT of, then the discussion stays non-specific and emotional. It stays compelling, it remains *broadly appealing,* it stays *fun*.
People are harmed, and harm others, because of things they are wrong about. Although trying to forcefully enforce correct thinking in all situations would do much more harm than good, people should put effort into trying to believe the truth.
https://twitter.com/Pooljalg/status/1530788773037891585
Hey I'm one of those people who hear voices, (but from an outside observer, it would look like me saying the things myself, but from my perspective, I'm repeating what you guys would probably call "thoughts")
But who the hell knows where those comes from, so I choose not to take responsibility over them, I tell myself that I'm just saying this stuff out loud so that other people could see what's up with the voices too, (cause hey, isn't this just a teensy bit interesting?) which leads me to believe that there's a third observer-observing this dialectic that I'm coming up with in my head, which makes me immediately start thinking of various creation stories and myths or Me being Marlowe from The Heart of Darkness (but also kurtz and the congo river)
If you would like to see a demonstration of this, I write stuff (for your amusement, for whatever you take amusement in)
This is very similar to my own take on experiences of egolessness and dissolution into a greater whole, which I wrote here: https://sevensecularsermons.org/why-atheists-need-ecstasy/ .
The more problematic case is the "Targeted Individuals" community, where paranoid people find each other and confirm each other's theories of persecution. They're much harder to find because duh, they're paranoid and hence secretive, but they definitely do exist in remote corners of the internet.
>at least some large subset of transgender people aren’t consciously faking it.
...
>If I had to steelman their position it would be something like: there’s some switch that can be flipped by social pressure and wanting to look cool. Once the switch is flipped, you’re transgender in some pretty real way
The correct steelman is that "not consciously faking it" doesn't imply "is transgender". It is possible to have mistaken beliefs about oneself. This is especially so since you then add that someone may be pretty miserable without transition, with the implication that transition relieves their misery. How could they possibly know that, at least when they haven't yet transitioned? It's certainly possible to be mistaken about whether something will relieve your misery (and also about what the source of that misery is). Just because someone isn't faking it doesn't mean that they're right.
For that matter, how could they possibly know that they feel like a woman? They don't have any external examples of feeling-like-a-woman that they can compare it to, unless they're psychic.
Basically, you seem to be conflating "is sincere" with "is correct". You can be both sincere and incorrect, especially about things you have no way to really know.
Very good read, thanks!
Re: People not always appreciating that severity of mental health issues can exist on a continuum, I think it's worth remembering that people are much more likely to be exposed to people who fall on the mild end of global functioning impact. This can distort their perceptions of what more severe impacts might look like in terms of prevalence and presentation. Unless you are in a relevant field or have a direct personal connection, there's a good chance that severe outcomes are out of sight out of mind.
I find the rationalist tendency to assume "makes decent money" equals "successful" to be sadly amusing.
> This being the real world, many of those patients are right. So they look elsewhere.
As someone who has a number of psychiatric issues, I will just add my voice to the chorus stating that it is *extraordinarily* difficult to trust what is often effectively a complete stranger at first, with information which they could use to have you locked up without an actual trial that involves things like "standards of evidence" and "counsel" and sometimes even "the presence of the person whose fate is being decided".
And yes, **that** factor, more than any other, has been the primary thing which has on multiple occasions significantly delayed my seeking desperately needed care.
Also, section number 8 of this article was completely shocking to me. I had no idea people did things specifically just to get cool points for being weird. I have always just done the weird things I do because I wanted to do them. I even almost can't quite *imagine* doing that. It's just so bizarre.
The piece from Freddie echoed heavily with me.