self_made_human
Kai su, teknon?
I'm a transhumanist doctor. In a better world, I wouldn't need to add that as a qualifier to plain old "doctor". It would be taken as granted for someone in the profession of saving lives.
At any rate, I intend to live forever or die trying. See you at Heat Death!
User ID: 454
self_made_human
Kai su, teknon?
2d ago
Wait till you hear about how many people in India insist their kids are delivered on auspicious dates; though since c-secs are the norm for anyone who can afford them, and those are usually done when the baby is ~mostly done baking in the oven, shifting the date about by a handful of days isn't the biggest deal in the world.
But yeah, he's got his priorities straight. Maybe it would be different if he had accumulated a million TBIs, but basketball is a comparatively civil sport.
self_made_human
Kai su, teknon?
4d ago
Hmmmmmmm....
self_made_human
Kai su, teknon?
4d ago
Indeed. When I need to send someone to a therapist, I tell them it's a sign of both confidence and competence when they make it clear that's there's a time limit for that. Either they note you making good progress, with an end goal in sight, or they tell you straight up that you're not a good fit and send you on.
Not that people can't need prolonged therapy, but maybe I'm just jaundiced from all the girls I've spoken to who should be wearing grippy socks. But they need Jesus, or his brother in the asylum.
self_made_human
Kai su, teknon?
4d ago
We do at least still have beatings and alcohol, and blood letting too, if you're diagnosed with hemochromatosis.
Frankly speaking, while depression might be more prevalent today as a disease exacerbated by modernity, I can't imagine our ancestors weren't anxious or stressed the fuck out.
self_made_human
Kai su, teknon?
4d ago
I just went to the trouble of citing a million studies and meta analyses on the matter, what else can I add that isn't anecdotal? Exercise certainly helps, it's far from the only thing that helps. Antidepressants aren't very good drugs, but they beat placebo at the least.
Are you a psychiatrist? If so, that obviously gives you special insight but also clearly a bias.
I've been accepted into psychiatry residency in the UK, starting in a few months. But it's always been my penchant, so consider me the least biased I could possibly be, or at the least I wouldn't have chosen that subject if I felt it was fraudulent.
self_made_human
Kai su, teknon?
4d ago
It's routine (or at least best practice) to order a whole heap of blood tests when doing a work up for someone with depression. Add on polysomnography too.
Thyroid deficiencies, sleep apnea, neurological issues like Alzheimers or Parkinsons, they all can produce depression, or be comorbid with it.
So while there's no blood test to diagnose depression-in-itself, any decent psychiatrist will figure out if there's something else wrong with the body, and treat accordingly. But in the end, we have no reliable way of pointing an instrument at someone and get DEPRESSED or NOT DEPRESSED back. Hence the whole talking to them and using standardized questionnaires, which does work mind you, even if we don't have anything significantly better once we've ruled out the body fucking with the mind in other ways.
To no one's surprise, Scott has written about this at length and I feel like there's little for me to contribute, yet.
For example, this one https://slatestarcodex.com/2020/01/15/contra-contra-contra-caplan-on-psych/, though he's written more about it on ACX not that long ago.
self_made_human
Kai su, teknon?
4d ago
I don't deny the existence of mass psychogenic illness. I agree with Scott that it's the most reasonable explanation for things like bulemia, or even gender dysphoria.
I entirely reject that it covers the majority of psychiatric conditions, especially the ones I mentioned, which also happen to be amenable to therapy.
You'll find that the "incidence" of most diseases sky rocketed in short order over the past century. Mainly because if we don't know a disease like that exists, due to a lack of diagnostic tests or plain awareness, there won't be a diagnosis.
self_made_human
Kai su, teknon?
4d ago
Better? As far as I can tell, yes.
Unless there's some identifiable treatable organic cause for the anxiety, mood or personality disorder might the patient improve just as well be guarding against and rebuking the demons of pride, envy, sloth, lust, etc? Especially if most of the available therapy interventions perform as well as each other.
We do have identifiable organic causes for many psychiatric illnesses we did not, within living memory, once have. Subtle and variable ones, but what can other answer can you expect when asking a question that involves most psychiatric diseases under the sun?
I fail to see how the latter follows at all. It's not like therapy is the only tool in the arsenal, psychiatrists are not psychologists, we dole out meds too and once again, they work, even if some of them aren't as effective as could be desired.
incidence of mental illness has skyrocketed in step with the wide spread adoption of therapy culture
That is hopelessly confounded. For most of history, the only treatment for mental illnesses was beatings, blood letting, the asylum, or maybe some mercury if it was syphilitic.
They barely had the conceptual framework to understand mental illness in the first place.
Besides, we know that the stressors of modernity are bad for mental health in of themselves, just look at social media and dating apps for recent examples. Atomization of families, loss of the (false) comfort from religion and so on.
Not everything is a mass psychogenic illness. I would bet a great deal of money that things like depression, BPD, bipolar disorder and the like aren't. And therapy helps, at least when we now recognize and formally diagnose those who could need it.
My own ADHD would certainly have gone undiagnosed, as would so many other conditions (not that therapy does anything there, the drugs help).
therapy itself is mostly trash (which is why we can't make any meaningful improvements to the practice after over a hundred years), it only works in as much as it is the socially acceptably path to resolve such issues. I imagine if we could check, running amok would have been found to be an effective above placebo 'therapy' as well
I feel like my citations speak for themselves here. Is it a good thing that we have the option of paying money to talk to someone in private instead of running about with a machete? I'd be curious to hear how that's not the case.
I'm not defending therapy culture. It's infantilizing to say the least. But actual therapy works well enough that we often consider it the firstline treatment before resorting to the funny drugs. And that's a considered decision made by multiple independent bodies, on the basis of a great deal of evidence.
self_made_human
Kai su, teknon?
4d ago
Errr.. I didn't actually realize that was publicly visible. I was trying to put that in the internal mod log, and levity is one way of handling that job, which can be thankless at times. It was more of a joke than anything else, I genuinely do not have a strong opinion on the matter.
It's right below. Given that nobody pays me for the job, an in-joke suffices.
I'm not the strongest advocate against single-issue posting. My usual approach is to simply minimize the thread, since I make it a point not to block anyone at all, no matter how odious/tedious they might be, and quite a few people are more so than SS. However, as a moderator, I do my best to follow the guidelines I signed up to enforce, and being neutral on SIP means I don't particularly care either way.
Is he SIPing and scaring the hoes? Seems obviously true to me. We probably have the highest tolerance for witches around, but we want multiple kinds, not just someone making this particular cauldron their bandwagon.
Is that against the rules as written? Yes. As interpreted by someone who doesn't have strong feelings either way too? It was.
I suppose I can't get away with "just following orders" can I? Though this is tangentially in favor of the Jews.
Because I figure we're about halfway to the point where "just post a youtube video about goat noises or something" suddenly becomes "ackshually we have to feel like they're good posts with sufficient effort" or whatever.
Demands for effort are maximal on top level posts in the CWR thread, or standalone posts on the front page.
I would presume funny goat noises belong in the Friday Fun Thread, and I haven't seen anyone get policed for lack of effort there.
self_made_human
Kai su, teknon?
4d ago
I went to the trouble of writing an effort post somewhere that was read by like 8 people, so I'll just reproduce the primary bit, and tack on additional commentary at the end.
https://en.wikipedia.org/wiki/Psychotherapy
Large-scale international reviews of scientific studies have concluded that psychotherapy is effective for numerous conditions.[8][22]
One line of research consistently finds that supposedly different forms of psychotherapy show similar effectiveness. According to The Handbook of Counseling Psychology: "Meta-analyses of psychotherapy studies have consistently demonstrated that there are no substantial differences in outcomes among treatments". The handbook states that there is "little evidence to suggest that any one psychological therapy consistently outperforms any other for any specific psychological disorders. This is sometimes called the Dodo bird verdict after a scene/section in Alice in Wonderland where every competitor in a race was called a winner and is given prizes".[151]
Further analyses seek to identify the factors that the psychotherapies have in common that seem to account for this, known as common factors theory; for example the quality of the therapeutic relationship, interpretation of problem, and the confrontation of painful emotions.[152][153][page needed][154][155]
Outcome studies have been critiqued for being too removed from real-world practice in that they use carefully selected therapists who have been extensively trained and monitored, and patients who may be non-representative of typical patients by virtue of strict inclusionary/exclusionary criteria. Such concerns impact the replication of research results and the ability to generalize from them to practicing therapists.[153][156]
However, specific therapies have been tested for use with specific disorders,[157] and regulatory organizations in both the UK and US make recommendations for different conditions.[158][159][160]
The Helsinki Psychotherapy Study was one of several large long-term clinical trials of psychotherapies that have taken place. Anxious and depressed patients in two short-term therapies (solution-focused and brief psychodynamic) improved faster, but five years long-term psychotherapy and psychoanalysis gave greater benefits. Several patient and therapist factors appear to predict suitability for different psychotherapies.[161]
Meta-analyses have established that cognitive behavioural therapy (CBT) and psychodynamic psychotherapy are equally effective in treating depression.[162]
The bolded section is the one I can't easily verify, at least not when it's 9 am and I've been up all night studying.
Specifically regarding CBT, I found the following metanalysis-
https://pubmed.ncbi.nlm.nih.gov/23870719/
Results: A total of 115 studies met inclusion criteria. The mean effect size (ES) of 94 comparisons from 75 studies of CBT and control groups was Hedges g = 0.71 (95% CI 0.62 to 0.79), which corresponds with a number needed to treat of 2.6. However, this may be an overestimation of the true ES as we found strong indications for publication bias (ES after adjustment for bias was g = 0.53), and because the ES of higher-quality studies was significantly lower (g = 0.53) than for lower-quality studies (g = 0.90). The difference between high- and low-quality studies remained significant after adjustment for other study characteristics in a multivariate meta-regression analysis. We did not find any indication that CBT was more or less effective than other psychotherapies or pharmacotherapy. Combined treatment was significantly more effective than pharmacotherapy alone (g = 0.49).
Conclusions: There is no doubt that CBT is an effective treatment for adult depression, although the effects may have been overestimated until now. CBT is also the most studied psychotherapy for depression, and thus has the greatest weight of evidence. However, other treatments approach its overall efficacy.
And when speaking of CBT as applied to more psychiatric conditions:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/
We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.
Addressing the specific claims of similar efficacy to the forms of therapy based on pseudoscientific principles:
CBT for depression was more effective than control conditions such as waiting list or no treatment, with a medium effect size (van Straten, Geraedts, Verdonck-de Leeuw, Andersson, & Cuijpers, 2010; Beltman, Oude Voshaar, & Speckens, 2010). However, studies that compared CBT to other active treatments, such as psychodynamic treatment, problem-solving therapy, and interpersonal psychotherapy, found mixed results. Specifically, meta-analyses found CBT to be equally effective in comparison to other psychological treatments (e.g., Beltman, Oude Voshaar, & Speckens, 2010; Cuijpers, Smit, Bohlmeijer, Hollon, & Andersson, 2010; Pfeiffer, Heisler, Piette, Rogers, & Valenstein, 2011). Other studies, however, found favorable results for CBT (e.g. Di Giulio, 2010; Jorm, Morgan, & Hetrick, 2008; Tolin, 2010). For example, Jorm and colleagues (2008) found CBT to be superior to relaxation techniques at post-treatment. Additionally, Tolin (2010) showed CBT to be superior to psychodynamic therapy at both post-treatment and at six months follow-up, although this occurred when depression and anxiety symptoms were examined together.
Compared to pharmacological approaches, CBT and medication treatments had similar effects on chronic depressive symptoms, with effect sizes in the medium-large range (Vos, Haby, Barendregt, Kruijshaar, Corry, & Andrews, 2004). Other studies indicated that pharmacotherapy could be a useful addition to CBT; specifically, combination therapy of CBT with pharmacotherapy was more effective in comparison to CBT alone (Chan, 2006).
In the particular case of BPD, after talking to @Throwaway05 I looked into the actual benefit of DBT, and was surprised to see that it was genuinely far more effective than I expected. Somewhere around the ballpark of 50% success rates in curbing symptoms and letting quite a few of them lead entirely unremarkable and functional lives. If 50% sounds underwhelming, wait till you hear the typical cure rates I'm used to.
So:
Is therapy and therapy speak actually harmful to people that have mental illness?
A clear no. The evidence base is nigh unimpeachable, even if, as discussed above, the most bullshit insanity inducing forms like Freudian or Lacanian psychotherapy still beat placebo.
My personal working hypothesis is that therapy acts as a decent substitute for a friend, a non-judgemental and understanding one who has seemingly endless time to listen to your problems, and is forbidden, on the pain of losing the way they make a living, from disclosing your troubles. Unfortunately, quite a few people genuinely lack actual good friends, so even such as ersatz substitute has notable effects.
This is an entirely different question from the fad we've been having for quite a few years of "therapy culture", or the insistence of people to co-opt/misuse therapy speak to lend their bullshit legitimacy. Then again, there are practising Freudian and Lacanian therapists, and few other people seem to have the same burning urge I have to burn their houses down. Even then, I must concede they beat placebo, as well as the dead horse that is repressed penis envy.
Anyway, therapy seems to beat placebo, and works synergistically with drugs, even if you cynically notice that therapy based off nonsense does much the same thing as more considered approaches, but it's not in dispute that it works. At least I have the consolation of being able to throw drugs at people instead of just talking at them as a licensed shrink in training, for all the quibbling about if SSRIs work, ain't nobody claiming their ADHD isn't being helped when they're zooted up on stimulants.
To conclude, is therapy helpful when administered by someone who knows what the fuck they're doing? Yes.
Are they/us responsible for random idiots using it as an obfuscation technique? Not really, though the upper echelons of HR are often staffed by people with degrees in psychology where I'm at.
Is it possibly a net negative for the set of {all people subjected to mealy mouthed terminology}? No clue, but you asked about the actually mentally ill, and you have my answer. No surprise that a few of them pick up on the lingo.
Deleted because it was meant to be a reply to the OP.
self_made_human
Kai su, teknon?
6d ago
I fail to see how this analogy is remotely appropriate.
The primary reason that people who are vegan/vegetarian (for non-religious reasons, and even plenty of those) condemn the consumption of meat is because their heart aches at the idea of eating cute little animals, with souls, emotions and a life of endless frolicking in the pastures to look forward to. Most of the arguments advanced alongside that primary concern, such as "sustainability" and environmental issues or resource consumption, are there just to buttress their core concern.
I wholeheartedly agree with @Quantumfreakonomics when he says that:
I am not a person that cares much about the suffering of animals, especially not the ones that taste good. Still, strictly speaking, the suffering is not an integral part of the process. If it could be removed, all else being equal, that would not decrease my utility in any way. I am agnostic on lab-grown meat. If it tastes good, is cheap, and is of comparable healthiness to legacy meat, I will eat it.
After all, I've repeatedly said much the same myself.
Hence the recent fad, only just losing steam, of feverishly trying to find vegan substitutes for meat products. Impossible Burgers and all that jazz. Vegans, begrudgingly, note that they either like meat or that people who otherwise care dearly about animal welfare are dissuaded by the dullness of a life without nice steaks or a side of ribs to go with it.
So lab grown meat completely cuts the Gordian knot. No cute animals were hurt (or at least far fewer, if you don't look too closely at where fetal bovine serum comes from, but presumably we can avoid that too). What's there left to object to, on primary moral grounds? A chunk of vatgrown muscle tissue is probably less sentient than an equivalent amount of fungi.
But of course, like the environmentalist movement and the cleanest and greenest source of energy we had/have/can have*, nuclear, much of the opposition arises from the abhorrent idea that their self-flagellation and virtue signaling will become entirely redundant. What brownie points do you get for not eating a cow, when the average Joe who just wants to grill is using a steak that's indistinguishable from one made the old fashioned way, tastes just as good, and might even be cost competitive?
We're not there yet, and the last overview I read of the topic suggested it's not going to be easy at all, but the sheer idea that their performative ascetism is moot must gnaw at their bones (veganly).
*Barring fusion, or farming black holes I guess.
self_made_human
Kai su, teknon?
6d ago
Thanks for hunting that down! It's not quite the same as the post I remembered, since that used user polled data from SSC/ACX readers and even claimed that meth (which is available on prescription, as rare as that is) was the best option (according to users). Still, this one states much the same, so I appreciate you looking it up.
self_made_human
Kai su, teknon?
6d ago
Well, as a pure form of nicotine it's even less likely to cause any harm as compared to vaping, which is already reasonably close to net neutral in terms of effects on your health.
I prefer vaping for the convenience, but if I knew I was going to go through nicotine withdrawals, I'd buy some gum or buccal formulations. Otherwise, I don't really see the appeal myself.
self_made_human
Kai su, teknon?
6d ago
Good to know, thanks! I can now recall a specific time it was invoked against me, ages and ages ago on the old subreddit, but I haven't noticed it come up since then.
self_made_human
Kai su, teknon?
6d ago
That's hardly surprising, or else we wouldn't have so many people offing themselves from COPD or lung cancer. Though the claim is that there are additional substances in cigarettes that are addictive in of themselves, or potentiate the addictive properties of nicotine.
At least in my case I can claim it was an informed decision, I don't really have many vices, and I did come to the conclusion that if vaping is bad for you, it's an order of magnitude or less so than getting your fix through cigarettes. Certainly it's gotten me through some real stinker shifts, with far less hassle. And just nicotine, by itself? Unless you're some poor bastard with diabetes so bad your toes are liable to fall off, it's not really any worse for you than coffee is. I wouldn't call it a nootropic, but it at least lets you choose when to be at your 110%, paid back by the fact that you're 90% when not on it.
self_made_human
Kai su, teknon?
6d ago
I have a great deal more empathy for all the poor bastards I've advised to quit smoking over the years when I had found myself cold-turkeying a rather strong nicotine addiction. A puff on my vape once I got home hit harder than sex.
(I had to catch a flight, and vapes are illegal to carry aboard here, I still refuse to smoke actual fucking cigarettes, so all I did was suffer rather grumpily for the better part of a week)
self_made_human
Kai su, teknon?
6d ago
Most people would be repulsed by the idea, presented so badly. Far better to take over an existent social media site and flood it with the higher quality of bots.
Improved quality of discourse, and let's face it, once you finetune them out of their ability to say the n-word, most people would barely notice.
self_made_human
Kai su, teknon?
6d ago
I'm almost ambivalent. The primary issue I have with a gay son is that I want genetically related grandkids, and while that's by no means insurmountable even today, I expect it to be even more of a non-issue by the time a hypothetical child is sexually mature.
My response to a gay son or thot daughter being thrust on me, fully grown, would be a huh??? rather than anything more considered.
self_made_human
Kai su, teknon?
6d ago
but I didn't know how to phrase any of it in a way that would be "leaving the rest of the internet at the door".
Look dawg, I'm an admin and even I have no idea how to enforce that rule without ruling out about 95% of everything that gets posted here. I presume it mostly exists to avoid petty drama and forum flamewars from leaking through.
Until someone tells me what the hell it's supposed to mean, I'm just going to slink away whistling. I don't recall seeing anything ever reported as a violation of said rule, and that should tell you something, given how certain users here consider themselves the effort police and report with a zeal worthy of the Stasi.
self_made_human
Kai su, teknon?
8d ago
You need to provide a submission statement for a frontpage post. A video title doesn't suffice.
You don't have to summarize the whole thing, merely point out what it's about and why it deserves space here instead of one of the many threads we have.
self_made_human
Kai su, teknon?
10d ago
If only all our trolls put in this much effort. Thumbs up for that alone.
self_made_human
Kai su, teknon?
10d ago
Look, I won't actually runaway screaming when someone tells me they're BPD. Or they're schizophrenic. I just consider it an absolute deal breaker in romance, going off personal experience gained very painfully.
At most, I will be mildly concerned, but they're not an imminent threat to me unless I'm a close friend or relationship partner, so I intend to avoid that. I don't react to schizos by pulling out a gun, the people they hurt the most are usually themselves, but in my experience, people with BPD are a menace to both themselves and others.
Since she mentioned she's potentially autistic, from what you've said I can't rule out the possibility that her "murder random people with HIV" thing is just low-level intrusive thoughts that she easily ignores and also talks about (when most people wouldn't) because autistic hyperhonesty.
That isn't my impression at all, I feel like she was very serious about it. I have screenshots because, goddamn, people wouldn't believe me if I didn't, at least IRL, and going over them makes me think she's going to end up messing things up very badly. BPD, trans and potentially autistic? That's a recipe for disaster if I've ever heard one.
If you're doing okay, that's great, I'm genuinely happy for you. Manifesto posting on this underwater basket weaving forum is a healthy alternative to cutting yourself or chasing your SO with a knife, and your mod record is pretty clean, so I can't imagine that you act worse IRL than you do on a pseudonymous website.
I suppose that's one way to be told you should try for med school, or a career as a pharmacist. Can't say dealing drugs has worked out badly for me, all said and done.
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