May be guilt-inducing for people who feel like burdens. All patient characteristics have been heavily obfuscated to protect confidentiality. People get depressed over all sorts of things. Depression is in part a disease of distorted cognitions, a failure of rationality. I had one patient who worked for GM, very smart guy, invented a lot of safety features for cars.
I can only think of one, and it, by definition, constitutes a cognitive distortion. The concept of self-righteousness e. For one to suggest, that their behaviour is potentially less damaging simply because they do not suffer from addiction, comparatively, is not supported.
The only basis one can find for this thinking is that of morality. This is a dangerous argument as morality is very subjective. To suggest that those who suffer from substance abuse or dependence are somehow morally bankrupt, when compared to those that do not, is irrational. What is even more perplexing, is when it is suggested that these two methods be combined. This is a clear indication of a general lack of congruence in the understanding of the principles that form the basis for the respective models.
Simply put, the twelve-step model is built on the concept of powerlessness, a clear disease model understanding of addiction, while the psycho-educational model is built on self-determination. A clear understanding that mental autonomy is at the core of the model e. The problem is, one cannot simultaneously be autonomous and powerless, as these terms are contradictory. Any such suggestion is evidence of a blatant lack of competency regarding the subject matter.
One must rationally question the qualifications of any who propose such a framework. Furthermore, one must ask why, knowing the dismal success rates of these models, would they continue to be used?
I can only think of two reasons, First, financially they are inexpensive to train and implement. In other words, it is not practically about what is best for the patient, but rather, what is best for the taxpayer. Second, the decision makers in the addiction treatment industry, are of the opinion that the outcome will be the same regardless of the model chosen.
This would suggest, as it relates to addiction treatment, the maxim is, when in doubt, blame the patient. What I find most troubling about this, is we do not see this thinking in any other avenue of health science. It appears to be exclusively reserved for addiction treatment. Another issue I find perplexing is the societal belief that an individual suffering from addiction can simply admit to a residential stay treatment program and somehow, relatively miraculously some may suggest, discharge a non-addict.
However, when considering the success rates of such approaches, one must question their validity. As anyone who has been in residential treatment will surely attest, it is remarkably easy to stay clean for a month while one is in the confines of a treatment center, however, there are glaring disconnects regarding availability to, and effectiveness of, aftercare programs.
The truth is, residential treatment facilities in Ontario, whether ministry or privately funded, do not have any official guidelines for treatment and there are no current official provincial requirements for working in addictions.
Facilities are simply private organizations that determine through their board of directors, which treatments they will offer and which they will not and who can be treated. For these reasons, anyone receiving opioid agonist therapy e. Outside of those who work at or are residents of the facilities, there is absolutely no idea about what is happening at the facilities.
In regards to provincially run programs, this seemingly includes the funder! The only reporting requirements for residential treatment centers are financial, and are to Ontario Healthcare Reporting Standards.
This practice is undertaken strictly to document which treatment programs and medical resources are being funded. This practice in no way regulates or monitors program standards or overall effectiveness of the treatments. As well as which programs are offered e. For almost all other publically funded treatment models e. This does not exist for addiction treatment in this province.
Furthermore, those individuals seeking treatment in other disciplines are not so descriminently refused access to those services being sought. This problematic approach is made no more evident then when one considers those individuals who must stop opioid agonist treatment while in a residential treatment center.
As tolerance decreases due to brief abstinence, the likelihood of overdose, and even fatality, if usage is initiated upon discharge, greatly increases. This approach to treatment is literally killing people. There is a lot of contested information in the addictions treatment arena and programs are often not tailored to individual needs.
For those of us that have been to more than one treatment facility, the obvious similarities in the structure of these programs is difficult to dismiss. Outside of twelve step programming, the remaining classes focus on preventative maintenance, anger management and emotional regulation. This song is an exemplary illustration of what addiction is, and more importantly, what it is not. In the song, the singer addresses his addiction as if it were a living, breathing, entity.
His addiction, responds as a peer. It is very difficult for an individual or agency to fully grasp the complexities of an issue when their financial livelihood is entirely dependent on them not understanding it. Suggested Motivations for Addictions: A Cookie Cutter Template The role of motivations as the suggested cause of addictive behaviour must now be explored.
130. Bayesian Epistemology & Predictive Processing - THUNK
The internal motivations most often cited are coping strategies, escapism, rewarding and self-esteem. While I find this level of thinking to significantly diminish the complexity of substance dependency, I will attempt to conduct a non-judgmental glimpse into these factors. It is often stated that substance dependency is a consequence of ineffective coping strategies adopted by the user.
In order to properly assess this ideology, one must first identify those coping strategies adopted by non-users. I will refer to a conversation I had with an addiction worker while in treatment to help illustrate the point. I found this statement to be misleading, so I asked her if she had given any thought to the current situation being experienced by the factory worker who made the cookie, and his relative happiness?
I further went on to state that this approach is nothing more than rejecting reality and substituting delusion in its place. Obviously, this is not an effective coping strategy, but rather, an aversion technique aimed at avoiding the issue at hand e. I finally queried why she was of the opinion that she was in a position to give advice on effective coping strategies when she clearly had not devised any of her own? She had no response. I was by no means attempting to hurt her feelings, I was merely pointing out that if flawed coping strategies were the only prerequisite for substance dependency, we would all be addicts.
Further, when considering the severity of obstacles faced while in active addiction e. The concept of escapism is often used to help define addictive behaviour. But is there any strength to this argument? Once again, a look at the concept of escapism, through the behaviours of non-users is required. One only need look at the way individuals behave while on vacation to understand these phenomena. We have all witnessed, and likely experienced it. While on vacation an individual will act in ways and engage in behaviours, they would not normally partake in.
On its face value, this is identical to what a substance user does, the only difference being, they do not need to purchase a plane ticket. Since this behaviour appears to be somewhat universal, regardless of substance abuse, can the concept of escapism be used to form the rationale as a basis in explaining substance dependency?
As an addict, I take offence to this notion, as few, if any, wind up hospitalized as a result of them watching too much television! Regarding the notion of reward being the primary culprit in understanding addictive behaviour, one must look at the diminishing returns experienced by substance users as their tolerance increases, and the subsequent increase in consequences that follow. Likely, every reader understands the affect Dopamine release can have on an individual and have heard this used as an explanation for substance dependency.
However, as any substance user can a test, while this may be true on the primary use, it is generally not true on succeeding uses. Simply put, higher and higher dosages are required for lessor and lessor results. If the concept of reward held true, once the user could no longer obtain the desired result, they would simply cease usage.
However, this is rarely the result. Friday nighthowever, even if this occasion may occur repeatedly in schedule, for most individuals it does not consume the entirety of their lives. While this may be considered substance misuse, it cannot be considered substance dependency.
A poor approximation of self-worth, or low self-esteem is often cited as a valid understanding of substance dependency. While it is conceivable to consider a youth succumbing to peer pressure in an attempt at bolstering their self-esteem, it is a much less convincing argument when applied to an adult. This writer is of the opinion that its value is overstated. In this context, will power amounts to nothing more than an individual depriving themselves of what they truly desire.
How long can this charade continue before the resistance fatigue wares down their reserves, seemingly depleting them of the resolve to continue down the path towards recovery? Often times, not long. Abstinence may occur periodically, but eventually, return to status quo, or active addiction seems the norm. How many readers would consider themselves to be chronic relapsers?
If this is true, then the only way to maintain abstinence is to no longer require impairment, not deprive oneself from acquiring it. Two popular explanations are; people, places, things and H. A brief exploration into these ideas will now be conducted.
The basis for the argument on people, places, things proceeds as follows; avoidance of these factors reduces potentially dangerous situations, relative likelihood of relapse. In short, to improve the odds of maintaining sobriety, aversion is at the forefront.
Is there any merit to this argument? On its face value, there is not. The simple reason being, an individual cannot avoid living their life indefinitely. These activities will certainly include, commuting to and from work, employment, relationships both professional and personal and all the rest. While this writer does not have statistical data relative to survival rates for those attempting to survive in a void, my guess is, the numbers are not good.
Usually what is experienced by those who focus on external motivators as the principal culprit, is a rather unfulfilling life. The reluctance to attend staff parties out of fear of relapse. The unwillingness to attempt a meaningful relationship. Never spending time with old acquaintances, and the like. The reason I take issue with this approach is that it is not sustainable.
Further, it seems to suggest a plan of action that every addict knows does not work, namely, a geographical cure. Those who opt for this approach seem to be of the opinion that a change in scenery will rectify the problem. A new city, a new job, new friends will somehow magically change the outcome. The problem with this level of thinking is the lack of acknowledgement of the common denominator in the equation, the individual.
Ultimately, the addict is still an addict. I will not spend much time addressing the H. This is clearly not the case. Substance Dependence Versus Substance Abuse: Similar When Viewed from the Outside Up to this point the terms substance abuse and substance dependence have been used interchangeably. I would now like to differentiate the two. This will not be done in accordance with DSM criteria, but rather just through observational relevance and my own personal meandering experiences.
What is rightfully suggested is that as substance use increases, functionality often decreases. However, what is also suggested, is that an individual can create dependency through repeated usage. I find this to be rather suspect and not entirely supported. There is not an internal reason e. If substance dependency were nothing more than an increase in usage, both in terms of frequency e. This is not supported and is obviously not true. To better understand the difference between substance abuse versus substance dependence, a more accurate explanation of the metrics used is required.
The factors that are generally accepted as those relevant are, consequences, compulsion, tolerance and withdrawal. I do not share in this thinking. Therefore, while financial expenditures or relationship hindrance are inconvenient, they are not life threatening.
The problem with this understanding is that it greatly diminishes the harm experienced by those that are actually addicts. Gaining ten pounds is rarely, if ever, a life altering event. However, consuming food to the point of diabetes, hypertension, obesity, et cetera, is.
Therefore, we must be much more restrictive when using the terms addiction or dependency, or risk them losing all meaning. The same argument can be made regarding our method of classifying the term compulsion.
In some circles, it appears that the term craving can be substituted. To clarify the difference, as this writer understands it, I will use a simple comparable.
A slice of cheese cake is a craving, heroin is a compulsion. While this illustration may appear overly simplistic, the understanding of what distinguishes compulsion from craving seems to be misinterpreted by many. What occurs physiologically in the body during compulsion e. Once again, the basis for which term is used is directly related to severity.
They are reactionary and therefore, cannot be learned. By contrast, the symptoms experienced during a craving are much less physically impactful, and seemingly, have more to do with the anticipated outcome. Tolerance can also have many measures. For instance, an increase in duration or frequency. However, as a metric for addiction, the more appropriate measure is dosage.
A larger dose of whatever is being sought, in any single use event. One should be able to understand the distinction, but if not, I will attempt to illustrate.
By this definition, there are few television addicts. The reason being, those engaged in the behaviour are still only viewing one television set at a time.
- Dating has to involve some kind of filter, otherwise you are overwhelmed with options. Have too strict of a filter, and you'll miss your soulmate in the elevator. Have too low of a filter, and you'll wind up mating with the first person to give you eyes. Mating with mediocrity is not how the human race got to where it is today. >A large majority of poly people who are dating at least one person are dating at least two people, and this is approximately as true for women as for men. This is the opposite of Scott's numbers for the SSC poll-taking community, not very similar - in the post, a large majority of poly people who have partners have just one partner, and this is true for either gender. Absolutely. A major draw of games like World of Warcraft (at least, for some of the players) is teaming up with four or nine or twenty-four members of their tribe/guild to execute a complicated and well-rehearsed strategy that makes maximum use of the group's diverse skillset in order to bring down a powerful creature and receive valuable loot from its corpse.
For tolerance to increase, they would need to move on to viewing two television sets simultaneously, and then four sets, and so forth, in order to obtain the desired effect. An increase in viewing time is not sufficient to equate an increase in tolerance, only an increase in duration. Conversely, when considering gambling, the addict will make larger and larger bets in order to feed the addiction.
This has nothing to do with potential winnings or losses, but only as an indication of increased tolerance. Lastly we will consider withdrawal. As a metric for addiction, withdrawal must have physical parameters.
For example, while withdrawing from significant alcohol consumption or Benzodiazepines, withdrawal can be fatal. While the physical withdrawal from opioids is rarely life threatening, it is generally the most physically uncomfortable and longest lasting withdrawal one can experience. Gambling addicts experience an array of physical impairments from sleep disturbances, to appetite suppression.
Therefore, when considering the distinction between substance abuse versus substance dependence, one must consider the requisite biological e. Plainly, without the genetic predisposition for substance dependency, an individual can abuse substance without ever becoming an addict. I find this understanding to be erroneous. While an addict may have preferences in relation to substance, substitutions are very readily made.
The concept of choice is dubious, as it is really only an exercise in availability. The purpose of distinguishing between substance dependence versus substance abuse is not to diminish the severity of potential consequences caused by abuse.
It is merely to allow for a more thorough examination of approaches used for treating the conditions. It is rather easy, both empirically and statistically, to see where current methods used in the treatment of substance dependence do not produce the desired results. The fear in grouping together conditions that do not have similar causations nor similar outcomes is that we will continue to attempt non-beneficial treatments by applying what may have a decent success rate for treating one, and a dismal success rate when treating the other.
Also, a more realistic approach needs to be used when considering what actually can be effectively reduced, namely, potential consequences. At current, there is a general lack of effectiveness when attempting to handle some of the elements associated with addiction. For example, compulsion and tolerance can really not be adequately addressed from a treatment perspective. Therefore, we are better served to focus on those elements that can be addressed. When considering consequences and withdrawal, both are better treated when employing a model that focuses on harm reduction and public health, not criminalizing addiction and a continued futile effort at forced abstinence.
Social Determinants: The Role of Wealth on Substance Dependency The belief that economics has a bearing in substance dependency is also sometimes suggested, and likewise not very well supported. All that can be gathered from usage patterns are that those with more financial might may opt for more expensive substances e. However, the end result is the same. In these neighbourhoods substance use is more visible and related crimes e. However, the increased visibility is often more a reflection of precarious housing then increased usage rates.
Those who have stable housing can simply use in the privacy of their own dwelling. Also, when comparing crime rate statistics between poorer neighbourhoods versus more affluent ones, it is not that the crime rate necessarily diminishes, only the types of offences change. For example, in wealthier areas the number of car related offences e. This is likely due to the fact that wealthier people can afford to drive, whereas poorer people cannot.
However, it is not a good indication of substance dependency from a statistical standpoint. Medical Interventions: Discriminatory Societal Viewpoints While taboo for some individuals, advancements in addiction medications have been substantial in recent years and should be touched on briefly.
Medications such as Naltrexone and Gabapentin show tremendous promise. While the success rates vary from patient to patient, and can be extremely dramatic in some cases, the overall median seems to fall in the fifteen percent range. An overall reduction of approximately fifteen percent when compared to the control group. Those figures improve when the overall treatment includes regular exercise, proper diet and sleep hygiene, as well as being coupled with some form of continued after care support program.
Dismissing all other variables e. The answer; absolutely nothing! So, by comparison, if addiction is nothing more than a moral decision, then logically understanding, so is severe psychosis. I have often heard comparables such as, addiction is not cancer. Curious, I can draw many similarities. First, following successful cancer treatment, the patient is not cured, the cancer is merely in remission.
Meaning, the disease is not actively killing the patient at the moment, but unfortunately may return at any time. The same can be said of addiction, following successful treatment, the patient is in recovery remission where the disease is not actively killing them, however, may return at any time e.
Some attempt to argue addiction does not meet the disease criteria as there is no cellular damage or mutation. As a final grasping at straws effort to demean the suffering addict to nothing more than a morally bankrupt individual, who succumb to their own devices, the inference of self-imposed inflictions is used.
To which I respond, many diseases are self-inflicted. For instance, type two diabetes, many cancers, and all S. However, all of these individuals get are support and empathy.
The benefit of the doubt. While it appears the addict, is the one remaining marginalized group in Canada for which it is seemingly socially acceptable, if not outright encouraged, to be discriminatory. Since this approach is not used in the treating of any other patient or ailment, one must conclude that those who lobby for it are of the opinion that addicts do not deserve treatment, but rather punishment. Or, put another way, atonement is the cure. Obviously not.
It is this learned understanding of addiction that is the problem. When treatment fails the suffering patient e. It is as though the belief is that the onus for a failed, misunderstanding of treatment ideology is somehow the sole responsibility of the client. How many times has it been suggested, relating to a fractured relationship, that causation equates substance usage?
This may hold true in a minority of extremely chronic cases, where abstinence may not be possible, but only degrees of harm reduction or abusive cases, but much of the time, it appears that substance abuse is a symptom of causation. The suggestion that the opposite is true is almost as if the non-using party s wish to exonerate themselves from any participation or responsibilities relating to the deterioration of the relationship, and in lieu of their involvement, they place blame on substance misuse or addiction.
This last statement was not made to remove the onus from the substance abuser, as this is obviously a most pressing issue. It is merely to suggest that relationships are continually changing and dynamic in nature and to suggest that one party receives all the blame is not rational. This thinking is in no way going to be of benefit in creating an environment conducive to recovery.
This is made no more evident than when the using party ceases use, and the relationship does not improve, or seemingly gets worse.
There are two statistics that help to verify this point, a The average age of initiation for drug and alcohol use in Canada is fifteen. The percentage for substance dependence has held remarkably consistent at ten percent since we began to monitor it. This poses two questions, I Why is substance use so prevalent among youth? II Why do the overall numbers for substance dependence, on a broader global scale, not shift in relation to external stimulus?
One would assume that during times of crisis these numbers would increase dramatically and during times of prosperity they would decrease dramatically. However, this is simply not the case. While there is some fluctuation, it is generally not as dramatic as would be expected and soon returns to the status quo. One can safely assume that most of these failed relationships did not involve substance misuse or dependence.
It is fully appreciated why much of the culpability of a failing family structure would be placed on substance abuse, it is rather easy to rationalize. The problem with this approach is that it does not allow for further exploration of the cause and effect relationship between causation and substance dependence. Without a better understanding of this, we cannot expect much in the way of improvements pertaining to the way we approach treatment options.
In short, it is very difficult to treat a condition without a full comprehension of what is being treated. Just because B comes after A in the alphabet, does not necessarily mean that B was caused by A! This accepted understanding must also be applied to treatment if one wishes to gain any traction. In short, we fully comprehend what does not work, yet we keep on using these methods. Since the baseline for ineffectiveness of current treatment has been established, this result warrants exploration and implementation of different strategies.
Henry Ford did not stop progress with mass production of the Model-S, for the simple reason, it did not meet the needs of the clientele. Instead, further advancements were employed, resulting in the creation of the Model-T.
The only reason stopping such progress is our reluctance, if not out-right refusal, to do so. Change is difficult, which is ultimately why we continue to cling to failed methodology. However, those who suggest they are free of bias, and subsequent loss of objectivity, significantly de-value the influence of their socialization. What harm is there in critically analyzing the status quo, if the end results are not on par with expectations?
Going forward, the approaches that show the most promise, relative assessment and treatment, appear to be the Biopsychosocial Model and the Stepped Care Approach. Specifically, the Biopsychosocial Model seems best suited at analyzing why usage has become so prominent e. This approach could certainly be incorporated into an ongoing self-analysis as part of an aftercare program, or as an expansion on current assessment tools such as GAINS or ADAT. A consequence of the third principle is that more intensive treatments are reserved for more severe problems.
The Stepped Care Approach is in line with the understanding that one can never tell an individual with substance use disorder what their recovery is supposed to look like.
If attempts are made to coerce a person, they will simply dis-continue treatment. This seems to fit with the belief, as it relates to recovery, that clients are where they need to be, and cannot be made to go any faster, or in any direction they do not want to go, as frustrating as this may be for those individuals on the outside looking in.
Further encouragement can be found in what appears to be a change in societal opinion away from institutionalization and into the realm of peer support.
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Many of the issues discussed in this opinion are very thoroughly addressed with in the peer support framework. Individuals do recover, are worthy of recovery and therefore, deserve are best efforts, including advancements in addiction treatment understanding, to facilitate this process.
One final note that would be remiss if not discussed is that of the current political platform in this province that continues to criminalize addiction.
One need only consider the tremendous results from models applied by other nations, including Portugal, German and Swiss models, as a sound frame of reference when reconstructing our own policy. They are not only to the detriment of the suffering individual, but also, the negative ramifications are felt by all citizens. When considering the required changes in social policy, one must recognize the unintended consequences rendered by continuing with a criminalization framework.
The resulting consequences are larger in both scope, public health concern, law enforcement requirements and cost than the original problems. In short, the road to ruin is often paved in gold. Harm reduction strategies geared towards improving public health, and not towards criminalizing addiction need to be increased, including the implementation of additional safe use sites as their success rates at reducing fatalities and decreasing the spread of infectious disease are well documented.
Further, when considering the cost of publicly funding such approaches, it is economically the most cost effective, and therefore rational approach that can be used to combat addiction relative the taxpayer. Pingback: January 7, - Barrel Strength. Email Address. Norwegian founders with an international team on a mission to offer the equivalent of a Norwegian social safety net globally available as a membership.
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This also troubles me. Incidentally, we have a very high suicide rate, and by all accounts ours is a community with some of the strongest cultural traditions and lowest rates of substance abuse by this I mean to imply that I would guess it would be worse elsewhere.
The past was not a good time to be disabled. If nothing else, the thing to which past people were supposedly contributing is progress, right? So I have to reverse the order of your advice. Trite thought:we already have a large number of people, concentrated in particular areas e. Rhyll, who are long-term unemployed.
Maybe we should look at what people who are unable to contribute in classical fashion do, figure out what they got right, and start doing that. Unfortunately, those jobs were one hundred and seventy years ago. Thank you for this. Although maybe I am overestimating the motor-skills required for a successful gatherer. Maybe I could have been a storyteller, and if my tribe was lucky and food was plentiful they would have fed me for my stories.
But yes, I was here first. Probably fairly high IQ, or at least average I was tested by an Ed Psych a few years back and my subtest results ranged from But too badbrains for job. I tried. I had a job for 7 months. I quit because they were threatening to fire me over he amount of time I took off and my difficulties with social interaction. One time, in my lunchbreak, I got as far as tying a belt around my neck.
The students I worked with at my job - none of them will ever work. All of them were intellectually disabled.
Most of them were autistic. Most of them had severe, drug-resistant epilepsy. They were awesome. All of them.
I loved them. I am not giving up. I am camming, though I am not making enough to live on yet. I am looking for work. But if I cannot find it, I am still worth something. Even if I am useful to nobody else, I am useful to me. I make Objectivist Bisexual Taylor Swift headcanons.
I masturbate. I eat delicious porridge.
I read good books. I look at pictures of birds on the internet. Even if I am giving nobody else utilons, I am giving me utilons, and the utilons I give myself are wirth something. I have a close friend who is autistic and has severe Myalgic Encephalomyelitis and Post Orthostatic Tachycardia Syndrome.
She lives in her bed. She is often too ill to sit up. She is incontinent. Her husband, who is also autistic and mentally ill, is her full-time carer. He gives her meds, feeds her, dresses her, changes her incontinence pads etc. I would never consider her a burden or him. They live off state benefits, but they help people. Even just being kind on twitter, they help people.
The blockchain-based dating sites for slate star codex. It's a simplybeyondexpectations.com of the bad as girlfriend fast - simplybeyondexpectations.com; she. Cycles and the balance, through england and try to date in the modern nerd. Sure signs that story about the idea of good experiences for guys. Support Slate Star Codex on Patreon. I have a day job and SSC gets free hosting, so don't feel pressured to contribute. But extra cash helps pay for contest prizes, simplybeyondexpectations.com expenses, and me spending extra time blogging instead of working. Welcome to Slate Star Codex, a blog about science, medicine, philosophy, politics, and futurism. (there's also one post about hallucinatory cactus-people, but it's not representative). SSC is the project of Scott Alexander, a psychiatrist on the US West Coast.
And one time they literally saved my life. But that is broken System 1 maybe. Gonna watch Buffy on Netflix. Thank you Scott. You are a good person. I am glad Ozy has you in zir life. That was very beautiful. I really wish you the best. I am very happy for the people who have Scot in their life too.
Also there are various reasons why your plan would not work out for queenshulamit. The point is that a person who feels like a burden is not going to feel like less of a burden if you actually make them an official burden. Theory of Mind, anyone? Anyone can become disabled. Most people WILL become disabled if only for their last few years.
From the actual article that you might perhaps have considered actually reading before breaking out the mockery:. Is it possible suicide is or was in the EEA occasionally evolutionarily adaptive? That depression and suicide are an evolved mechanism to respond to situations when you really are more of a burden to your kin than your likely future contribution? Such situations must surely happen on occasion, and must have done in the EEA. I am me, and the traveller is another human being. I am me, and the traveller is a perfectly rational and perfectly selfish agent who is good at reading facial expressions AND good at predicting people.
Depression is laying down the groundwork for suicide. Therefore it must be adaptive Just so evopsych, I know. This avoids the erosion of the altruism instinct in the group. Like any just so story, it can be argued, but I found it helped me. Also no one is going to starve because I contunue existing. Conscious reasoning is very new and very stupid, for the most part. I suppose some people might commit suicide on an impulse without any previous depression The Imperial Japanese military comes to mind but otherwise I would imagine most people progress from sad, to depressed, to suicidal ideation, to the deed itself.
Nope, well established observation. If you know a depressive, remember this because it could save their life. Surprisingly, I think I agree with every word. This cuts both ways. It is both correct and mentally healthy to not base your own self-worth on what you do for others. You can do something for them, of course, but that would be an act of freely chosen benevolence, not the fulfillment of any kind of moral duty.
Or, to put it more succinctly:. This may sound brutal to you, but the view that people have these kinds of obligations towards each other sounds brutal to me. Preferable according to what? Person A could certainly prefer a world with a basic income to a world without one, and Person B could have the opposite preference. I thought you might come back to me with something like that. I assume you are not in that position, but even if you were, it would be better for more people overall if such people were effectively ignored when formulating public policy, and suitable distractions placed before them to try to help them forget that society was providing a social safety net.
Though that suite of distractions would be a part of that social safety net, so it would need to be very subtle. Also, and unrelated, does anyone know of a way to sign up for comments only in response to a comment you yourself have made, rather than all subsequent comments made by anyone ever? It does, very much so. It means that whatever is done to help those who are suffering must be justified to whomever is doing the helping. You may want to help people in some specific way, but your neighbor may want something different - maybe he wants to help people in a different way, or maybe he wants to accumulate goods for his personal use.
You could ignore his preferences, try to take his stuff, and use it as you see fit - but your neighbor could do the same to you. Indeed, there are no values built into the fabric of the universe. Other beings may have values different from your own, and if you want to create social structures in which they agree to participate, these structures have to further both your values and their values.
This may seem limiting, and it is - but the flip side of it is that if they want to build such structures, they have to appeal to your values too.
I agree completely. The latter argue a lot among themselves, but they have only definitional disagreements and non-compatible utility functions; they agree with all the actual facts.
To a utilitarian, however, this account is incoherent. Acts of freely chosen benevolence and fulfillments of moral duty are not relevantly different, as far as utilitarianism is concerned. This may be a mark against utilitarianism to some peoplebut insofar as one accepts utilitarianism which many people here do?
I think? I definitely want to think about this view some more. So a utilitarian could plausibly say that, yes, being a burden is morally wrong at least for most people in the First Worl because as painful as it is for you to work and be productive, you can still increase net world utility by working and donating your money to charity.
Because that does happen. Something in that neighborhood. Those who do better in modern society are obliged to make some sacrifices to help those who do worse, as part of a timeless bargain with the luddites of the past, who could have prevented modern society and all its benefits for the average from ever existing if they truly believed the future held only misery for people like them.
What do you make of this claim that hallucinatory voices are hostile in the US, but not in India or Africa? At LW, ostracism in the EA is invoked to explain why people find ostracism painful now.
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Anyone know what happens to low-status people in modern hunter-gatherers? Or is this stuff more plausibly from the primitive agricultural societies? IME telling people that they have problems because they have a low IQ does not make them feel like they are not at fault, quite the opposite in fact.
Other than that I completely agree with this post. This is a mindset that is very alien to my value system. Very interesting post! There are a significant number of people who would just be dead in the Environment of Evolutionary Adaptedness, who are also a burden in the present. People who need expensive medical treatments to stay alive, people with significant birth defects, etc. Appealing to ancient adaptedness is not much of a help for those people.
However, with respect to severely depressed people, I think this may be missing the point or getting causality backwards. Getting them to reject that rationale does not actually accomplish anything in terms of making them less depressed. But there was also no rational content to my feeling of uselessness: it was merely a symptom of the illness, and treating it would merely have made the depression manifest somewhere else.
Lets take a super simplified case. There are three people A, B and C who decide to switch from a hunter gather society to an industrial one. A and B each gain 5 utils from the change.
C loses 5 utils. On Utilitarianism, this is a good thing - there is a net gain in utility. Can that principle be defended on Utilitarian grounds? If the answer is that A and B can sacrifice some utils to give to C and end up giving her more than they lost then why is history even relevant? That case is too simplified; why would C agree to a change where she loses 5 utils? But this is an average; it turns out that W, X, Y, and Z end up with -5 compared to how they would fare in the old society.
So what about the current, less extreme case, where a minority of people are societal burdens instead of a majority?
I do not see how changing the numbers resolves the issue of deontology vs utilitarianism. Also, St. John Chrysostom, from his second sermon on Lazarus:. Behold, then, it is said, the man and his works. This also is robbery - not to impart our good things to others. What then is this testimony? Since, it is said, ye have not given the customary oblations, ye have robbed the poor. This is said in order to show to the rich that they possess things which belong to the poor, even if their property be gained by inheritance - in fact, from what source soever their substance be derived.
Now, he who deprives, deprives some other man of property.
It is said to be deprivation when we retain things taken from others. And in this way, therefore, we are taught that if we do not bestow alms, we shall be treated in the same way as those who have been extortioners. And if we distribute to the needy we shall obtain for ourselves great abundance. And for this it is that God has permitted you to possess much - not that you should spend it in fornication, in drunkenness, in gluttony, in rich clothing, or any other mode of luxury, but that you should distribute it to the needy.
If he then should spend upon himself more than he really needs, he will pay hereafter a heavy penalty. For the things he has are not his own, but are the things of his fellow-servants. This is what Moloch does. He offers a world with many more people and much lower infant mortality, and perhaps eventually the ability to survive an extinction event. But the cost is ruthless efficiency and optimization of living feeling humans. Because the optimization may be best when the system is designed around a small number of humans with particular skills and everyone else contributes best be staying out of the way.
You sound like you are making a standard statistical fallacy.
It is quite common that A is not statistically significantly better than B and that B is not statistically significantly better than C, but that A is statistically significantly better than C. I noticed how much more effort it took to be sad, obsessing over my failures and shortcomings, than it took to relax and do something else. Occasionally the spiral of negative thoughts produced worthwhile realizations, but at overwhelming personal cost. So I was wasting an enormous amount of time and energy, leaving myself mentally and physically exhausted, when there was another option: Stop.
As soon as I accepted that truth, not being depressed was actually easier than being depressed. It has been ever since. Brutal and obsessive self-analysis is still a tool I can use in order to help put my life in order when something feels wrong, but I no longer feel obligated to wallow there.
I have since used versions of this explanation to help my brother and two close friends rethink their own spirals. Thank you for writing this. It is worth noting that this procedure of reasoning yourself out of depression differs from standard CBT.
The latter as I understand it challenges the truth of the beliefs that cause you to feel depressed. Your method, by contrast, challenges the usefulness of those beliefs.
This illustrates that one can use both epistemic and instrumental rationality to combat depression and that the efficacy of these two approaches may not be the same. Though I did expect Multiheaded to have a field day with it here, not just tears and hugs. Whether we are at the post-scarcity level where this is possible and would not stunt further progress, I do not know. Coordination problems are now a greater obstacle to achieving this than scarcity is.
What gives them this ability? Basic income could fix the first problem, and then the group with highest risk of suicide would be the nerds who are bad at being popular. Then we could try to fix the second problem using internet and moving the nerds geographically close to each other. Why is it that society owes us the resources to keep living disabled, but not the respect for our autonomy to leave the decision to us, and us alone?
To be fair, many people who want to die are genuinely distorted about whether this would be a good idea. Perhaps more relevantly for the post: a person who believes they ought to die because they are a net drain on society may not actually be a net drain and- Scott argues- even if they are, they should continue to be alive and supported.
The point being that it will always be arbitrary, which is the opposite of what it should be - an inalienable right. You did not choose to be born. You were forced to. You did not choose to have a brain that can suffer involuntarily.
Are we talking about the same person? On this very blog? How about this: If you are right, then we contact Scott and he can clarify his position in a blog post in the future. From this post :. I am not claiming that suicide is never rational and that all suicides are stupid and impulsive, or that no one can ever legitimately want to die. I am saying those people make up a very small portion of suicides, and that the typical case is people who do it impulsively or in a state where they lack full decision-making capacity.
And that the psychiatric system can be of huge help to this latter group, and that helping the former group is a different question which I do not want to talk about publicly for professional reasons. A question.
The question arises - what does society owe? Specifically, some basic usimplybeyondexpectations.comocessed food, rudimentary clothing, and basic shelter - a cave or tent. Or at least the raw materials necessary to construct those things yourself.
Society took those things away from you, society will now give them back. I agree. No government. No food-drop parachutes. Just them, each other, and nature. I would preferably always keep a cyanide pill on me just in case hobo life got too bad, but this way I would be able to escape all of the demands of life while perhaps still leaving open the door to a few little pleasures of life here and there-food, drink, dreams, the time to think.
But I figure that I would at least give it a shot. Arguably what was also taken was social integration into and acceptance into a community. For better and for worse, of course, our formal mechanisms for redistributing economic resources are more developed than those for redistributing friendship. I started to write about how great it would be if we could redistribute friendship, but then recoiled from the implications.
If social support were fungible and redistributable, then it could be monetized, and the all of the economic forces of Moloch would come to bear on it. But if friendship were redistributable, then you could literally be too poor to have friends, since you would have to sell your friendship credits to buy food. What would most likely happen, actually, is that most of the poor would choose to spend their money on friendship rather than whatever respectable middle-class people spend it on, in much the same way that they currently choose to spend their money on alcohol and drugs rather than college educations.
Goodness me, I had no idea you could get a Harvard education for the cost of a slab of Dutch Gold lager per week! Look, do any of you on here know any actual poor people?
As distinct from looking at us as anthropological specimens, or interacting with us in your day job capacity? Who said anything about Harvard? Deiseach, your point is well-taken but Harvard is really not a good example. A poor person will not pay a dime to go to Harvard, if they otherwise qualify. And we are going to ignore all the upsides of civilization?
Like not being eaten alive by predators while you scream in agony? If we were truly fair in comparing, then even the replacement of wild animal suffering by evil Moloch should be taken into consideration.
By the way, in the developed world, the social security net is tight enough that you get more than the minimum you would have gotten in the EAA. And no one prevents you from making friends, either. You have now more access to potential friends than ever before, online and offline.
It's just what friends is both handsome and words words slate star codex and dorks who want to beat the. Trump's a side are tyler and ashley still dating, beliefs and dating services have stolen without permission so him putting a group of june 3 months ago keter. Two weeks ago keter. I used the Slate Star Codex survey to investigate this question. It had 8, respondents selected for being interested in a highly analytical blog about topics like science and economics. The blog is associated with - and draws many of its readers from - the rationalist and effective altruist movements, both highly analytical. Slate Star Codex. SELF-RECOMMENDING! Recent Posts. Open Thread ; And now seven months after moving to Berkeley I'm dating three people. II. What changed? It just started seeming normal. I was going to make an analogy to desegregation here, how white people thought having black kids in their schools would be a disaster, and then it.
Even in the EAA, no one did this for you. I trust we can talk about the costs of civilization without the fear of being identified as anarcho-primitivists or whatever. Does working a retail job, or taking orders at McDonalds, or being a janitor, or doing construction, or being a trucker require more intelligence than hunting or farming? Well, as a farmer, maybe.
I fully expect that anybody who lacks the emotional intelligence for retail would end up dead pretty quickly among hunter-gatherers. However, it is also true that many such people would also have much higher emotional intelligence if they were raised in a more natural social environment than kids have to live in today. Lots of pre-industrial farmers probably failed to pass on their genes because they lacked the emotional ability to work long hours at boring tasks.
I think that might not actually be true. Hunter-gatherers may have a lower level of intelligence-requiring technology, but they tend to have extremely complicated social structures. See Australian aboriginal kinship systems for a typical example. Being low IQ may be less of an issue there, but having emotional problems of a sort that prevents socialization is probably more of a handicap. Performing such jobs requires very little, but keeping the jobs is difficult for the mentally ill.
There is a huge mass of people who can also perform the job and employers are quite happy to dump the unreliable or weird. I have an insane relative whose social worker got her a menial job with very understanding people.
Such a modification is a real management cost. Systems today are efficient, but at the expense of flexibility. From several hundred miles away, this job seems like a miracle. For the last few years, there has been some concern that the company was going to fold and I have no idea how my relative can find another similar job. I hope the social worker has another up her sleeve.
For all I know, she has tons. Finding such employers seems like a very useful thing for social workers to do. What score, what grade? How low? How many of you can hand-milk a goat, if you were dropped into a situation where you need that skill to get a source of food? Someone who had an accident or other incident that caused brain damage could have gone from normal IQ to dropped a few points.
Taking orders in McDonalds means you have to be able to handle a lot of through-put and deal with some customers who can be assholes this is my retail job experience talking here, as well.
An employee who is likely to stomp off and be found huddled in a corner in the middle of the busy lunchtime shift is an employee who - in most modern businesses - will not get the support he or she needs to keep doing the job and will be let go.
Difficulty with speaking, walking, fine motor control. Damnit I thought this was anonymous. Also, if you know exactly what I can do to fix your problem, I will.
This is a known problem with Gravatar. I would request that you keep Gravatar as I find it useful. This means people can correlate your posts with posts you make on other sites using the same email address. Also, an attacker with access to substantial computational resources could recover your email address from the hash used to communicate with Gravatar.
If you want to leave a truly anonymous comment, please use an anonymous email address, and do not use the same address on any other sites. People like the first commenter who have set up a Gravatar should be tipped off by the familiar word. However, an MD5 hash of your email address is published, which means someone who can guess what your email address is can find out if their guess is right.
Or they might be able to use a rainbow table to find your email address. I suppose the comment field could stand to make clearer exactly what information about your identity is made available to the internet when you enter your email address. Is depressive realism bunk, then? Depressive realism is most likely one bias counteracting another. And like I said, this seems to me a gradient rather than a discontinuity, such that even mild depression contains some false cognitions sort of in this direction.
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A year or so back I spent about a month poking at depressive realism on and off. Yes, this low-IQ individual is suffering in our modern society. The society where spear-to-the-gut violence is not merely outlawed, but considered monstrous in most places. Where many deadly diseases have been eradicated.
Where slavery does not exist. Despite all our bien pensant tut-tutting about how exploited they are. As far as I understand, Scott Alexander posits that low-IQ individuals would be better off in both hunter-gatherer as well as low-tech agriculture societies, hence I saw not reason to separate them in my comment. That said, how low-tech are we talking? In general, the cool thing about agriculture is that allows people to specialize.
It makes room for the kind of people who rarely do anything immediately productive in their entire lives; instead, they spend their time on useless pursuits like scribbling numbers on a page, or looking at the night sky through a tube, or hooking up frog legs to stacks of metal disks. Anonymouse: agreed to a large part, although a lot of this is China-specific; some urban migrations, like in South America, appear to be more coerced people are forced off the land by various things and very desperate in regards to the infrastructure.
Endless slums grow, etc. The liberals might. Leftists have a complicated perspective on the Chinese labour movement. Is the historical justification your true rejection? That is, in a universe in which hunter gatherers never existed and modern society just popped into being, would the conclusion be different? I have a hypothesis that the biggest source of positive psychological reinforcement is the chance to perform in front of a captive audience.
Even people with larger social networks want to shop before an audience. In short, what the service industry contributes to society is the creation of a stage where people can play out their preferred narratives, using the workers as both a supporting cast and an audience. The primary contribution is attention, people are hired to look away from their cellphones and take off their earphones while you talk at them.
I am probably highly atypical, but I go to retail stores for only two reasons: 1. I need physical contact with the product in order to determine compatibility, e. In all other cases, I try to avoid the retail experience as much as possible, since it combines lack of convenience retail personnel can sometimes tell you where a particular product is located, but they almost never know anything about the product itself with deliberate spamming despite knowing nothing about their products, they will try to upsell you on something.
To make matters worse, most retail stores except for grocery stores have vanishingly small inventories. If you are looking for a specific product, such as a camera, or a video card, a book, or even a chair, then more often than not you literally cannot buy it at a retail store. Before humans there were a thousand other species that were each made obsolete by successive species.
They were all there first. You think we should go back and compensate them all for displacing them? How much would that add up to? How is extending the argument offered further back in time cynical, ominous, or mean? You think it would be mean to compensate other species? So expressing sympathy with animals is unsympathetic because humans were mentioned and any mention of animals in the context of humans is insulting to humans?
There seems to be the critical difference that those species were not sentient, not self-aware, and thus there is no reason we would owe them anything even if we personally hunted down and killed every last one of them.
Do we owe something to the smallpox virus? Edit: The other, also critical but morally less important, difference is: how would we go about making good on a debt to an extinct species? We can? What are we talking about, here? What other non-human species even could possibly possess self-awareness? Also, were you talking about species that were displaced by humans in which case, how displaced were they, really, if their descendants are still around?
I talked about all the species that were displaced along the path to us. As far as I know, no non-human species except possibly dolphins qualifies. I think it likely that Dr. Hanson is talking about animals such as orcas and chimpanzees, which are known to have passed the mirror test. I see. However, this is all rather a tangent. That seems like a very different approach and one that imposes more moral obligations.
Or is it cleanly preventing them from reproducing that appeals? No one cares about being a burden to society in the abstract. The people who shoulder that burden are often extremely short on resources. Your mindset is makes sense a low scarcity environment, but not so much in the high-scarcity environment most of your patients are in. Keep in mind that picking up the slack, in a scarcity environment, often ends up meaning bad things like not getting into college. And do recall your post on infinite debt.
The only people that will feel better upon reading this are people who feel really torn up over receiving welfare checks which is almost no one. I posted a comment here expressing almost exactly these sentiments, so I agree, but this caught my eye:. This is just what comes up with a google search, though I admit you can find sources for anything these days.
Another hypothesis is that patients difficult to treat are labeled borderline. Oddly, I like borderline patients and tend to get along with them pretty well. I know mine is extremely charming, intelligent, and generally impressive in public. Are you BPD? If so, you might want to contact Ozy for their suggestions. There are also some small studies showing a role for fish oil.