## Seven announcements

1. Good news, everyone! Following years of requests, this blog finally supports rich HTML and basic TeX in comments. Also, the German spam that used to plague the blog (when JavaScript was disabled) is gone. For all this, I owe deep gratitude to a reader and volunteer named Filip Dimitrovski.
2. Filip refused to accept any payment for fixing this blog. Instead, he asked only one favor: namely, that I use my platform to raise public awareness about the plight of the MAOI antidepressant Nardil. Filip tells me that, while tens of thousands of people desperately need Nardil—no other antidepressant ever worked for them—it’s become increasingly unavailable because the pharma companies can no longer make money on it. He points me to a SlateStarCodex post from 2015 that explains the problem in more detail (anyone else miss SlateStarCodex?). More recent links about the worsening crisis here, here, and here.
3. Here’s a fantastic interview of Bill Gates by Steven Levy, about the coronavirus debacle in the US. Gates, who’s always been notoriously and strategically nonpartisan, is more explicit than I’ve ever seen him before in explaining how the Trump administration’s world-historic incompetence led to where we are.
4. Speaking of which, here’s another excellent article, this one in The American Interest, about the results of “wargames” trying to simulate what happens in the extremely likely event that Trump contests a loss of the November election. Notably, the article sets out six steps that could be taken over the next few months to decrease the chance of a crisis next to which all the previous crises of 2020 will pale.
5. A reader asked me to share a link to an algorithm competition, related to cryptographic “proofs of time,” that ends on August 31. Apparently, my having shared a link to a predecessor of this competition—at the request of friend-of-the-blog Bram Cohen—played a big role in attracting good entries.
6. Huge congratulations to my former PhD student Shalev Ben-David, as well as Eric Blais, for co-winning the FOCS’2020 Best Paper Award—along with two other papers—for highly unconventional work about a new minimax theorem for randomized algorithms. (Ben-David and Blais also have a second FOCS paper, which applies their award paper to get the first tight composition theorem for randomized query complexity. Here’s the full list of FOCS papers—lots of great stuff, for a conference that of course won’t physically convene!) Anyway, a central idea in Ben-David and Blais’s new work is to use proper scoring rules to measure the performance of randomized algorithms—algorithms that now make statements like “I’m 90% sure that this is a yes-input,” rather than just outputting a 1-bit guess. Notably, Shalev tells me that he learned about proper scoring rules by reading rationalist blogs. So next time you lament your untold hours sacrificed to that pastime, remind yourself of where it once led!
7. What have I been up to lately? Besides Busy Beaver, hanging out with my kids, and just trying to survive? Mostly giving a lot of Zoom lectures! For those interested, here’s a Q&A that I recently did on the past and present of quantum computing, hosted by Andris Ambainis in Latvia. It did feel a bit surreal when my “interviewer” asked me to explain how I got into quantum computing research, and my answer was basically: “well, as you know, Andris, a lot of it started when I got hold of your seminal paper back in 1999…”

### 145 Responses to “Seven announcements”

1. Sniffnoy Says:

Note that you still can’t stack multiple <sup> or <sub> tags within each other, though. 😛

And, uh, that American Interest article is considerably more pessimistic than you describe it — it’s not 6 steps to take, it’s 6 obstacles that will have to be defeated somehow

2. Sniffnoy Says:

Also, interesting that the linked paper makes particular use of one specific proper scoring rule, but not one of the standard ones, where the penalty for a wrong answer with probability q is √(q/(1-q)). But they show that this new scoring rule is related to the Hellinger distance (not something I’d heard of before!), and that other more standard scoring rules are also related to other measures of distance between probability distributions in the same way…

3. Radford Neal Says:

Scott… How can you simultaneously put “HOLD THE NOVEMBER US ELECTION BY MAIL” in your blog banner, and also think that disputes about the validity of the US election results are likely to create a crisis to which “all the previous crises of 2020 will pale”?

Your opinion regarding mail-in voting is not really relevant. What matters is whether mail-in voting is generally regarded as secure, so that the results will be accepted by whichever party is the apparent loser.

And doubts about mail-in voting are not at all unreasonable. Even in the best-run mail-in voting scheme imaginable, there will be an unsolvable problem of votes that are paid for or coerced. And poorly-run schemes seem not at all impossible, especially when this would be the first time it would be done in a widespread way. Claims that mail-in vote fraud is rare, even if true at the moment, say little about how much fraud there would be if everyone voted my mail, so the gains from such fraud would be enormous.

4. Paul Topping Says:

Just FYI, about half of this morning’s Fareed Zakaria GPS show (CNN) featured Bill Gates on the pandemic. He was quite specific in his attribution of failure in the COVID pandemic in the US to the current administration. Of course, he never mentions Trump by name which is probably wise. IMHO, this was a couple of the smartest guys on the planet, besides our host of course, talking together.

5. Scott Says:

Radford Neal #3: To the other side, your position looks like the following. A minority gets to install a dictator—as it happens, an especially cruel and incompetent dictator—simply by threatening that it won’t accept the legitimacy of mailed-in ballots to remove him, even in the middle of a pandemic, and even when voting by mail is considered more secure by election experts than the paperless electronic voting machines that much of the country still uses. It thereby gets to force the majority, which is disproportionately concentrated in the denser, more urban parts of the country, to choose between disenfranchising itself and potentially contracting a deadly disease. As an added bonus, the (would-be) dictator’s own incompetence was responsible for the disease raging out of control in the first place.

I hope you understand that this sort of tactic to enforce minority rule is a prescription for a civil war.

My aim here is to prevent a civil war, by ensuring that an election gets carried out that reflects the will of the actual voters who actually exist, in accordance with the country’s laws and Constitution. And I agree with what the article says: that to increase the chance of that happening, a key step is to educate the public over the next few months that, because of the pandemic, much of the voting this year will happen by mail (fear of covid is already sufficient grounds to request an absentee ballot in all but a few states, where grounds are needed at all, and Trump can’t stop it); and because of the patchwork of mail-in deadlines, the results will not necessarily be clear by the night of November 3.

6. b_jonas Says:

It’s not the only medication that’s unavailable. A lot of medications are, because of the COVID pandemic. I just felt this on my own skin a few months ago. I had an eye infaction last for two weeks longer than it should have because pharmacies didn’t have the eye drops that I needed.

Everyone wants to buy hand sanitizers or mobile phone sanitizers. The material itself, a solution of alcohol or isopropylalcohol is cheap and available in large quantities. But the solution is volatile and flammable, and isopropylalcohol is toxic as well. So someone has to fill the liquid into either little bottles with a tiny opening, or large bottles with a siphon that breaks easily, and in both cases the bottle has to be one that you wouldn’t confuse with soft drinks. Whoever does that work now in large quantities can get rich quickly. Pharma industry has factories with machines that can already fill liquids into small bottles efficiently, and a source of cheap plastic bottles that can’t be confused with soft drink boattles. So they have a choice of making hand sanitizers, or continuing to produce medications. But producing medications is difficult, because there are a lot of regulations to make sure there aren’t stupid errors in any stages, for a very good reason. Producing hand sanitizers is much simpler. I have done it at home too, the problem is only that I don’t have a cheap source of suitable bottles.

7. Based Says:

If this post by moldbug is to be believed, election fraud in the US is rampant: https://www.unqualified-reservations.org/2012/11/adore-river-of-meat/ Romney knew he would have lost anyway and didn’t bother to contest it. But would Trump let it go? I doubt it.

The only way to have a trustworthy election is if the voters aren’t anonymous. Anything else makes ballot stuffing too easy. Maybe some kind of cryptography scheme could be invented to verify people’s votes without identifying who they voted for.

8. Scott Says:

Based #7:

If this post by moldbug is to be believed, election fraud in the US is rampant

File under: conditional sentences for which it’s unsafe to remove the conditional 🙂

(I do, see, e.g. targeted voter roll purges as a form of electoral fraud, but it’s not the kind that moldbug means.)

9. P Peng Says:

I took a look at the linked contest, and … Wow, I will never cease to be amazed by computer scientists’ ability to (at least apparently) easily see how to rephrase a problem to a simpler problem.

I was encouraged by “The contest problem can be approached with basic algebra skills supplemented with knowledge of how to solve linear equations involving integers.” Then saw the problem equations and was seriously confused how this could possibly be solved with linear equations.

Then looked at the first provided example, and sure enough, with appropriate choice of setup they only need to solve linear equations. I never would have thought to do that (probably why they included the example, but still). But then I think, how could anyone speed that up? Then bam, example2.py solves it differently, still with linear equations.

Seriously, can someone ease my mind here. Is this reshuffling of problems obvious to you guys? Like, when you see problems can you usually just quickly see “Oh, this is clearly a reconfiguration of a problem I already know how to solve”? Or is it merely just clear “after the fact”? In this case I felt like I had the right tools, but didn’t know what to hit with the hammer.

Feels like you’d need the creativity of IMO participants for this one.

10. Hans Wurst Says:

At https://educate.bankstreet.edu/occasional-paper-series/vol2019/iss41/10 Brooklyn College professor Laurie Rubel, who has been thoroughly misunderstood, expressed herself regarding pure mathematics, the pandemic, and mail-in ballots.

11. Douglas Knight Says:

it’s become increasingly unavailable because the pharma companies can no longer make money on it. He points me to a SlateStarCodex post from 2015 that explains the problem in more detail

The only thing SSC says about money is that it is a generic drug. Is there a crisis with all generic drugs, or just Nardil? While there have been shortages of many generic drugs in America, I’ve never heard such problems outside America. And this seems to be a simultaneous problem for manufacturing facilities in many countries. What’s going on? Are they all reliant on a precursor that is produced in a single place? (Some links make it sound like the drug is centrally manufactured and the local facilities are just packaging it.)

One thing that is special about Nardil, the main topic of the SSC post, is that the medical community is very negative about it. I wouldn’t be surprised if that had some affect on paperwork. But the links seem to be three separate governments expressing sympathy for plight.

b jonas,
the first Nardil link is from 2019, so this predates covid.

12. Scott Says:

Douglas Knight #11: I’ll let Filip correct me or provide more detail if he wants to, but as far as I understand it:

Yes, the problem is that Nardil is old and generic and not covered by patent. Yes, there are many other drugs with the same problem—that even if they still work as well as or even much better than newer drugs (or do so for some patients), pharma companies do everything in their power (fair or foul) to steer doctors and regulatory bodies and official recommendations toward the newer drugs that they can make money on. Yes, like much else that’s screwed up in healthcare, even where this problem affects the whole world, much of it can be traced to dysfunction in the US. Filip may have focused on Nardil because he particularly knows or cares about it (e.g., because of himself or a loved one), or because he thinks the amount of suffering from an old drug becoming unavailable is particularly acute in this case.

13. Mitchell Porter Says:

“The American Interest” says they wargamed scenarios including both “a big Trump win” and a “big Biden win”. They also say that only the big Biden win avoids constitutional crisis. But they never explain why the big Trump win leads to constitutional crisis.

14. anonymous Says:

Scott #5: Trump isn’t a dictator, he was elected according to the constitution. Ironically the Democrats are the ones who have denied an election result for the last 4 years, and stooped so low to destroy the public trust in the procedure.

I think another question isn’t whether Trump will accept loosing, it’s whether the Democrats will accept a loss. They didn’t accept the last loss, and with the pandemic it seems like it’s going to be all to convenient for them to claim interference with the mail in voting, claim too many votes were lost, even tho there will be more valid votes by mail.

I think Democrats are scoring a self goal by insisting on voting by mail, because it’s very easy to fail voting in mail, it isn’t checked until the election day for validity, and you can’t make sure you did it correctly. They should have encouraged everyone who can vote physically to vote physically because that will increase the number of valid votes. Voting by mail is available to everyone so I suspect the party with the higher percentage of physical voting will win.

15. ThirstMutilator Says:

@ Scott #5

First, I’d genuinely like to know why Trump is a “dictator”. Can you say exactly has he done that is dictatorial?

Second, it seems to me that Trump supporters fear mail-in ballots for an obvious reason. Claims such as yours permeate the media. Trump supporters must think: “These people really believe Trump is a dictator/an existential threat to democracy, etc. so why wouldn’t they stoop to election fraud to prevent his re-election?”

There’s a nasty byproduct from comments like “dictator”, “fascist”, “twittler”, and so forth: it erodes whatever good faith the other side (roughly half of all voters) has in the election system. This good faith is scarce, and removing it only increases the chances of post-election violence.

16. Scott Says:

anonymous #14 and ThirstMutilator #15: I didn’t call Trump a dictator; I called him a “would-be dictator.” He’ll become a dictator if he unambiguously loses the Electoral College (as defined by the actual recorded votes) but remains in power, for example because he’s able to pressure the governors of swing states to throw out the ballots received after election night contrary to law. Or if he’s somehow able to prevent a non-farce election from happening at all—for example, by preventing large numbers of voters in swing states who reasonably fear Covid from receiving the absentee ballots to which they’re entitled. If that happens, I expect something on the spectrum from mass civil disobedience to sporadic violence to civil war.

In addition, Trump often openly expresses dictatorial desires and tendencies—as one example out of hundreds, when he recently tweeted his “idea” to postpone an election that he looks liable to lose, something that’s impossible under the Constitution and wasn’t done even during the Civil War. If there were any other presidents in American history with similar desires, none of them were open about it to anything close to Trump’s extent.

17. fred Says:

Can someone explain why it’s assumed that mail-in fraud would necessarily favor the Dems? I mean, let’s say that we hold large scale mail voting and then somehow Trump wins?

What are the current requirement for in-person voting? You at least need a valid id to make sure you don’t vote twice, right? Do you need to be registered with a party (like for the primaries)?

18. Radford Neal Says:

Scott said: [ Trump ] recently tweeted his “idea” to postpone an election that he looks liable to lose, something that’s impossible under the Constitution

A quick check of the US Constitution reveals the provision that “The Congress may determine the Time of chusing the Electors”.

So it’s not at all impossible to change the time of the election.

As a further check, a search for the string “November” in the text of the US Constitution comes up empty.

However, postponing the election doesn’t make much sense to me, since I can’t see how having it a few weeks later would be likely to put it in a time with less covid-19. If anything, moving it earlier might make more sense, if one anticipates a fall surge in cases.

19. Scott Says:

Radford Neal #18: I meant, the president can’t unilaterally change the date of the elections. And it’s worth reiterating that, because experience suggests that Trump will do absolutely anything that he expects those around him will let him get away with—so that there’s no internal constraint against his appointing himself dictator-for-life, none, zero.

20. Elizabeth Says:

From the American Interest article:  “In June 2020, our group conducted scenario planning exercises to model different election scenarios: a big Trump win; a big Biden win; a Biden squeaker; and a truly ambiguous or uncertain result.”   Notice that “a big Trump win” is one of the scenarios that was considered, but the overall conclusion is “short of a landslide victory for Joe Biden in the upcoming elections, we may be headed for a severe constitutional crisis.”

The article doesn’t talk much about the “big Trump win” scenario, but apparently this also leads to a constitutional crisis.  In other words, Trump and the Republicans would accept a Biden landslide, but Biden and the Democrats would not accept a landslide for Trump.  This makes the one-sided anti-Trump spin in the article especially ironic since it indicates psychological projection.  Similar to the 2016 stories questioning whether Trump would accept the election results, which ended up panning into a multi-year ordeal from Democrats complaining about (overblown) Russian interference and essentially not accepting the election results.

In any case, I think the fears of Trump contesting the election are excessive, because he doesn’t seem happy being president, he has none of the enthusiasm or passion from his first campaign.  It seems like he would be just as happy to leave behind the responsibilities of the office and continue complaining on Twitter.   In contrast, the democrats are throwing everything they have at this election, and showing that they will burn their cities to the ground if their unreasonable demands are not met.

I agree with the point in the article that we need to start prepping the public for what the election season will be like.  A Trump landslide victory is still a likely scenario, and the Democrats are forecasting that they will not accept this, so if it happens we will head for unrest.  The current siege on small businesses and public safety in Democratic strongholds is a warm-up for a bigger tantrum in November: let us take power or else we will torture you with endless lockdowns, inversion of cultural values, and destruction of property. All election outcome prospects are dismal this time around, and none will help us to escape the hyper-polarized mess that yellow journalists and social media have created.

21. Radford Neal Says:

Scott: The Trump tweet that has prompted all the discussion of election delay seems to be the following: With Universal Mail-In Voting (not Absentee Voting, which is good), 2020 will be the most INACCURATE & FRAUDULENT Election in history. It will be a great embarrassment to the USA. Delay the Election until people can properly, securely and safely vote???

Like many Trump tweets, this one doesn’t seem to be very well-considered. (Though on a charitable interpretation, maybe he’s not suggesting that a delay would be to wait for covid-19 to decline, but rather to allow more time for preparations to conduct the vote safely even when covid-19 is prevalent?)

But regardless of the wisdom of this tweet, I don’t see any suggestion in it that he thinks he has the power to delay the election without the cooperation of Congress.

Of course, maybe he does think that. I don’t know. But if you want to promote political norms that would reduce the possibility of chaos after the US election, maybe it’s not a great idea for you assume that your political opponents are planning unconstitutional action when there’s no evidence that they are. Jumping to that conclusion might, you know, suggest to the other side that unconstitutional actions come quickly to your mind…

22. fred Says:

“postponing the election doesn’t make much sense to me, since I can’t see how having it a few weeks later would be likely to put it in a time with less covid-19”

unless he’s hoping it’s timed with the news that there’s a successful vaccine, which could come around end of year (Fauci seemed pretty optimistic about that).

I was surprised today to see that De Blasio is now fully embracing school reopenings here in NYC (wasn’t that considered to be a clear sign of Trump’s madness as of a few weeks ago?), and he’s also taking it for granted that a vaccine will come pretty soon (also considered a Trump lunacy back in April/May). And if none of those things go as planned, we know who they’ll blame, haha.

23. Concerned Says:

About the Gates interview, I have a hard time taking seriously his comments about the CDC:

——————————

So the variance between the US and other countries isn’t that first period, it’s the subsequent period where the messages—the opening up, the leadership on masks, those things—are not the CDC’s fault. They said not to open back up; they said that leadership has to be a model of face mask usage.

——————————

Right…in the early days when the virus spread could have been limited, the time frame where many criticize Trump for not locking down faster… the CDC doesn’t bear any of the blame? From Wikipedia:

The first confirmed case of COVID-19 was discovered in the U.S. on January 20, 2020. But widespread COVID-19 testing in the United States was effectively stalled until February 28, when federal officials revised a faulty CDC test, and days afterward, when the Food and Drug Administration began loosening rules that had restricted other labs from developing tests. In February 2020, as the CDC’s early coronavirus test malfunctioned nationwide, CDC Director Robert R. Redfield reassured fellow officials on the White House Coronavirus Task Force that the problem would be quickly solved, according to White House officials. It took about three weeks to sort out the failed test kits, which may have been contaminated during their processing in a CDC lab. Later investigations by the FDA and the Department of Health and Human Services found that the CDC had violated its own protocols in developing its tests.”

——————————

And the CDC’s guidance on the use of facemarks on Feb. 27?

CDC does not currently recommend the use of facemasks to help prevent novel #coronavirus. Take everyday preventive actions, like staying home when you are sick and washing hands with soap and water, to help slow the spread of respiratory illness.

——————————

When people talk about gaslighting, I suppose this is what they mean. This feels like a blatant attempt at revising history.

Given this dishonesty, why should I believe anything else Gates says?

24. Mark Says:

@ Elizabeth #20

The current siege on small businesses and public safety in Democratic strongholds is a warm-up for a bigger tantrum in November: let us take power or else we will torture you with endless lockdowns, inversion of cultural values, and destruction of property.

I worry about violence from left(-ish) groups too. We’ve seen a lot of this in recent months. I’ve told my family in California to stock up on supplies ahead of the election, since they can’t easily leave town. They’re about a 10-minute walk from the main drag of their city which, from what I can tell, suffered enormous damage during the riots. They had the National Guards called in, and burning vehicles even in their neighborhood.

The paranoid part of my brain wonders why a subset of the left is so interested in defunding the police. It feels like a convenient demand if you want to exert pressure on your fellow citizens to vote a certain way.

25. Deepa R Says:

I’d like to share this article comparing 2 types of testing. The PCR which we are hearing about that still take 8 days to get results back and a new rapid test. The latter is very interesting. Results in 15 minutes. With some caveats. This seems like a good explanation:
https://marginalrevolution.com/marginalrevolution/2020/08/rapid-tests.html

26. Scott Says:

Everyone: Trump winning in a landslide—let’s imagine that it’s fair and square, with no voter registration databases deleted by Russian hackers, no piles of absentee ballots left uncounted, maybe Trump even wins the popular vote—could nevertheless become a constitutional crisis, if Trump, now completely unaccountable to the electorate, continues down his current path of, e.g., having peaceful protesters arrested in unmarked vans by federal agents who won’t identify themselves. Trump’s election the first time—after he’d already flouted the norms of democracy, for example by refusing to say that he’d respect the election results if he lost—was already a constitutional crisis, one that we’re still living under. But I agree that we have a better chance to survive such crises than we do a flagrantly stolen election.

What the conservatives commenting here perhaps don’t understand is that the very fact that I’m talking in terms of the Constitution and procedural norms at all makes me a moderate. It’s now received opinion in many circles that the US is an illegitimate white-supremacist project that started in 1619 rather than 1776; that all policing needs to be abolished; and that we’re living through the last days of a dying empire, our laws about as relevant as the Czarist or Ottoman laws in 1916. I’m on the conservatives’ side against a full-blown revolution … and that’s a central reason why I’d like to see Trump removed from power in a landslide in a few months.

27. fred Says:

Scott #26
“[…] and that’s a central reason why I’d like to see Trump removed from power in a landslide in a few months.”

this is all true, but we’re no longer in 2016, we’ve had 4 years of Trump, and while it was a wild ride, there’s been so much “crying wolf” from the left (Nazi levels of institutional antisemitism, Mueller, the impeachment, the respirators, the school re-openings, the vaccine… it goes on and on, most of it being the inability of the left to stay above Trump’s trolling, because it’s also exciting their own base with TDS, and it brought back to life CNN, NYT, NBC), that many are just weary of either side.

The problem unfortunately isn’t Trump per se, the real thing is what lead to someone like Trump and his message winning the elections.
Just like some people on the far left find it appealing to explain everything in terms of institutional white supremacy (it’s not even racism, it’s just the observation that the West was so successful in controlling nature, its methods and ideology took over the world), many on the other side admit that while Trump is no genius, they do think that his trolling served a purpose in terms of exposing and destabilizing the iron grip of the boomer generation over all aspects of society (politics, media, foreign affairs,…). Both of those sides see a status quo has the real danger.

So if Trump disappears I doubt that things will ever be back to normal. Too many things have been exposed and it’s now impossible to put back the tooth paste in the tube – one of them is the total incapability of the democratic party to reinvent itself without destroying itself… and the GOP didn’t fair better either, but that surprised noone.

That said I agree that given all the stuff we’re going through this year – the pandemic, the protests, the economy, the elections… Trump’s removal does seem like a low hanging fruit in terms of bringing back some stability to the system.

28. Ian M Finn Says:

I love how all 3 trackbacks for the Andris article are from your blog 🙂

Seven announcements
[ Shtetl-Optimized@ http://www.scottaaronson.com/blog/?p=4933 ] trackback posted Sun, 9 Aug 2020 08:36:47 UTC

Scientific American article is out!
[ Shtetl-Optimized@ scottaaronson.com/blog/?p=309 ] trackback posted Mon, 18 Feb 2008 03:44:12 UTC

The quantum-complexity bathroom reader
[ Shtetl-Optimized@ scottaaronson.com/blog/?p=123 ] trackback posted Wed, 6 Sep 2006 20:11:34 UTC

29. Scott Says:

Ian Finn #28: It’s a very famous article in quantum algorithms and complexity; there just aren’t a lot of quantum algorithms and complexity people who write blogs. 😀

30. Nonagon Says:

@ Scott #26

What the conservatives commenting here perhaps don’t understand is that the very fact that I’m talking in terms of the Constitution and procedural norms at all makes me a moderate.

I get it, I appreciate it, and that’s why I still bother trying to engage here.

It’s now received opinion in many circles that the US is an illegitimate white-supremacist project that started in 1619 rather than 1776; that all policing needs to be abolished; and that we’re living through the last days of a dying empire, our laws about as relevant as the Czarist or Ottoman laws in 1916. I’m on the conservatives’ side against a full-blown revolution … and that’s a central reason why I’d like to see Trump removed from power in a landslide in a few months.

See, this is something you may not understand. Do you imagine that for one second this message resonates with conservatives? Toss away your political freedom or else the woke fanatics will start burning down your country! You’re only making identity politics worse by voting your conscience! And other variations on the same I’ve heard from a couple other individuals I respect.

Because I’m confident the typical response to this line of reasoning is “f— you” and a vigorous vote for Trump. This seems like basic human psychology.

If you wish to defer to the likes of the people/bullies you describe above, then that’s a personal choice I respect and, as a long-time reader, there’s enough good faith on my side to know that your heart is in the right place. It’s possible you may even be right about upcoming violence, although I hope not.

But appeals to what amounts to appeasing the mob aren’t going to move the needle. Nor should they.

31. Scott Says:

Nonagon #30: I agree! Someone who saw zero merit in the revolutionaries’ position, and who thought they could get an Electoral College majority that also saw zero merit in their position, might respond to what I said by simply voting for Trump with even more gusto than before.

Personally, though, I think that some of the revolutionaries’ grievances are just. Our system has a massive amount of baggage left over from the eras of slavery and Jim Crow, whose effect is to distort the popular will in favor of an older, white, conservative minority. Examples include the Senate, the Electoral College, gerrymandering, the targeted purging of voter rolls, and a chaotic, strategically-underfunded voting apparatus controlled by partisan local officials. This baggage helps to explain why the US remains well to the right of the world’s other advanced countries on most issues—why it can’t do things like gun control, climate legislation, police reform, or nationwide marijuana legalization even when commanding majorities want those things.

Even the conservative whites must realize that their current hold on power is unsustainable, given the country’s changing demographics. Indeed, I think that’s exactly why so many of them voted for Trump: because Trump sold them the fantasy that they could freeze the demographics, or even reverse them, and thus maintain the old balance of power. This would also neatly explain why Trump kept repeating his lunatic lie about “millions of illegals” casting fraudulent votes: because if that were so, then Trump could indeed protect conservative white power, by just expelling all those illegals and building a wall to keep any more from coming in.

So how’s that worked out? I hope it’s obvious to Trump supporters by now that, even with the kids ripped from their parents and all the other barbarities that most of the US rightly refused to stand for—even then, immigration control can only negligibly slow down the country’s demographic change. So the conservative white minority’s actual options are:
(1) use more and more shenanigans to prevent nonwhites from voting and to dilute their electoral power,
(2) somehow revoke nonwhites’ citizenship, or get them to “self-deport,”
(3) get rid of democracy altogether,
(4) umm …. err … “””control the demographics”””” like China is doing with the Uighurs, or
(5) make peace with the reality of a diversifying nation.

If this is the choice, then I emphatically favor (5). And now that the Republican party has been completely taken over by Trumpists and the social-justice left by Robespierres, with both of them amplifying the other to infinity, electing moderate Democrats simply seems like the most peaceful, Constitution-abiding, and … if you will … conservative way to implement option (5).

32. Radford Neal Says:

Scott… Regarding your conservative options (1)-(5), I think the actual strategy of most US conservatives (whose views don’t completely align with my own, by the way) has three parts: (a) slow down the influx of foreigners who don’t appreciate what Made America Great, (b) prevent non-citizen foreigners from voting, and (c) slowly persuade immigrant citizens of the merits of conservative policies. I think few of them have any problem with a “diversifying nation” as long as that isn’t automatically the same as a “leftist nation”.

I don’t think any significant portion of the US right favours any of options (1) to (4), unless in (1) you mean for “shenanigans to prevent nonwhites from voting” to include preventing non-citizens from voting.

33. fred Says:

Kamala Harris as VP… we’ve never been so close to having our first African American president! Truly a historical moment!

34. fred Says:

“you mean for “shenanigans to prevent nonwhites from voting” to include preventing non-citizens from voting.”

To clarify – you need to be a US citizen to vote in a presidential election (and most elections for that matter). Having permanent residency isn’t enough.
It’s got nothing to do with Trump or conservatives, it’s the law (just like you need to be born in the US to run for president).

35. Scott Says:

fred #33: Honestly, I would’ve preferred Tammy Duckworth, or Stacey Abrams, or Gretchen Whitmer, or many of the other candidates Biden considered. I’m not a fan of many of the decisions that Harris made as a prosecutor, and of course, Trump will gleefully exploit the fact that she so heavily attacked Biden in the primaries. On the positive side, she did co-sponsor the National Quantum Initiative Act! And I had a nice conversation about that with her chief of staff, who apologized that Kamala couldn’t meet me since she was busy with the Kavanaugh hearings. 🙂

36. fred Says:

Scott #35

Compared to those people Harris has one extra thing: she clearly wanted/wants to be POTUS since she ran in the primaries (whether that’s a good thing or a bad thing, I have no idea).

37. JimV Says:

Elect a crook, get a crook. Trump is a crook.

He cheats at golf, takes credit for things he hasn’t done, and evaluates every action based on his personal advantage. I don’t know any thinking person who doesn’t see that, or any moral person who isn’t disgusted by it. Even lifelong Republicans (e.g., The Lincoln Project) can see that.

I would like to believe that the commenters here supporting Trump are paid provocateurs, but I guess the Flat Earth Society proves that some people will believe anything.

I’m not a Democrat; I’m registered Independent and don’t trust any politician. My first voting opportunity was Nixon vs. Humphrey and didn’t like either of them and didn’t vote. That was a mistake, but I learned from it, and voted for whomever I thought was the better person ever since. I can’t imagine a person worse than Trump who would force me to choose Trump.

38. nonagon Says:

@ Scott #31

I appreciate the reply.

…and who thought they could get an Electoral College majority…

This is another remark that only serves to push away the people you want to engage with. Conservatives (broadly speaking) won an election. Referring to an “Electoral College majority” is technically accurate, but comes across as an attempt to delegitimize this, and it won’t convince anyone who voted red.

I’m genuinely curious, when making this remark, did you realize this? If so, why do it? If not, why not?

Even the conservative whites must realize that their current hold on power is unsustainable, given the country’s changing demographics. Indeed, I think that’s exactly why so many of them voted for Trump…

Look, I think this is a poor model of your ideological outgroup. My wife is a different race from me. I’m pro-choice. I’m atheist. I practice responsible gun ownership. I attend some of the same conferences you do. People (white or otherwise) who prefer Trump to Biden are not a monolithic group. Not even close.

…So the conservative white minority’s actual options are:
(1) use more and more shenanigans to prevent nonwhites from voting and to dilute their electoral power,
(2) somehow revoke nonwhites’ citizenship, or get them to “self-deport,”
(3) get rid of democracy altogether,
(4) umm …. err … “””control the demographics”””” like China is doing with the Uighurs, or
(5) make peace with the reality of a diversifying nation.

You left off:

“(6) Devour all non-white babies and bathe in the blood of cis-het virgins”.

But seriously, your list is frightening to me, again for how poorly it models conservatives, white or otherwise. I’ll say it more strongly than Radford: this is an extremely uncharitable representation. The people who subscribe to positions as you’ve described them don’t even amount to the lizardman’s constant.

Have you attempted to steelman, say, the conservative view on illegal immigration? I find it hard to believe that this is the result of such an effort.

…And now that the Republican party has been completely taken over by Trumpists and the social-justice left by Robespierres, with both of them amplifying the other to infinity, electing moderate Democrats simply seems like the most peaceful, Constitution-abiding, and … if you will … conservative way to implement option (5).

It seems we end up with the same argument, just reinforced by straw men: Conservatives should voluntarily disenfranchise themselves to avoid potential violence in the aftermath of an election. For the greater good, as you see it.

So many people seem convinced that they’re on “the right side of history” or that the “arc of moral justice” is bending in their direction. It’s reflected in language, where the definitions of “moderate” and “diversifying nation” admit no nuance. It shows up in dehumanizing models of conservatives, whose choices are constrained between tyranny and genocide. Sometimes I wish I could enjoy the same confidence.

39. Elizabeth Says:

There’s no doubt that Trump’s 2016 campaign included elements designed to appeal to white nationalists, but various voices such as Andrew Yang have made the point that many or most of these rural, white, working-class Trump voters in 2016 were not motivated by racial hate, but rather economic desperation.  No wonder these people, mostly men, are sentimental for times past: they cannot see a path to earning enough to own property or start their own families, thanks in part to unsustainable fossil-fuel driven global trade driving down the price of their labor.  These men were optimized for shtetl-like environments, and not gifted with abilities suited to adapting to a globalized economy.  Then these people, who are already on the fast lifetrack to an opiate overdose, have to turn on CNN and listen to this whining about “white privilege”.  Typical Trump voters are not descended from WASP hegemony, they are downtrodden self-identified white trash with no real history as a people.   The anger and frustration these low-class white people feel over the constant demoralization they receive from politicians and the media is not a form of racism, rather it is a unified response to constant provocation.

I want to point out something else, which is that Trump mostly shifted away from white nationalist rhetoric after his initial campaign, and has not returned to it in this cycle.   A real change occurred when Steve Bannon was outed from the White House, and people credit Jared Kushner with influencing Trump away from strategies based on racial division.   I mention this because many Biden supporters feel obligated into voting for him because “Trump is racist”, when all signs point to the peak of Trump’s racist rhetoric and policies being 2016/2017.  Since then the talking point has been mostly sustained by the media.

With all of this, I’m not trying to convince anyone to vote for Trump.  Rather, I’m saying it’s not worth burning down the union if he wins re-election.   DHS did arrest a few Portland rioters (by the way, unmarked police vehicles are common, and for better or worse it’s typical at a chaotic crime scene not to explain to someone why they are under arrest, especially if they are being hysterical).   But compare this with the unconstitutionality of the patriot act, or extrajudicial executions of American citizens in the middle east by drones.  We’ve had an unconstitutional tyranny problem since at least 2001, and it is not exclusive to either party.

By the way, regarding “millions of illegal votes” in 2016.  I did find it disconcerting that California makes it easy for illegal immigrants to obtain driver’s licenses, and that these licenses are all one needs to vote in person.  I doubt millions of people risked serious criminal charges for voter fraud, but it is still alarming that there is no citizenship check for voting.  The media was unable to report this aspect of the discussion, for some reason.

40. Ethan Says:

Are you sure so called “anti depressants” work?

“Conclusions The evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.”

Besides, so called “depression”, as all other so called “mental disorders” listed in the DSM, are just statistical constructs without proven scientific validity. The National Institutes of Mental Health confirmed this in 2013 as the American Psychiatric Association was releasing version 5 of the book,

“While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.”

41. fred Says:

Elizabeth #39

very well said!

What’s striking to me is that many of the people who voted for Trump in 2016 did it for very pragmatic reasons. Those people saw Trump as a blunt tool, a means to an end, regardless of his appalling personality, never taking what he says at face value (which btw goes contrary to the popular belief that a presidential election is a personality contest…).

I have no idea how those people will vote this time around, but here’s a thing I’ve noticed over those last 4 years:

when Trump got elected, many said that he would just do nothing. That he was all talk and no action (he didn’t even want to win).
But, unlike many (most?) politicians in the past, Trump did follow up on most of his 2016 campaign points – China (which is now one of the rare bipartisan topic), Israel, immigration, prison reform (not sure that was in his agenda), boosting the economy, getting rid of Obamacare, putting new conservative justices in place, pulling the US out of war zones (Afghanistan, Irak, Syria), confronting Iran (killing their number 2 man) and NK, convince everyone that “fake news” was a thing. (btw, all this while also dealing with the Mueller investigation and the impeachment, and constant internal WH staff drama).

Don’t get me wrong, I’m not saying Trump solved any of those issues, but he made enough noise about each them to make it appear as though he followed through his promises and checked all the boxes. This will give him plenty of ammunition in the upcoming debates.

Contrast that with someone who’s a career politician with already 8 years in the WH – how many more shots at it does one deserve? Was Biden so successful the first time around that he has to go back?.. those are legit points that Trump will use.

Will this be enough for Trump to get re-elected? Probably not – People feel that they’ve totally lost control in 2020 (the virus, the lockdown, the economy, the protests), and changing who sits in the WH will probably give many a good boost of confidence.

42. Anonymous Says:

ethan #40:

Yes, antidepressants work. I’m sympathetic to Filip’s cause because I know someone who cannot function without their MAOI.

Antidepressants are a tricky topic for statistical analysis–as is the case for many other questions about complex biological systems! Different people respond differently to different drugs; in practice, there’s a lot of trial-and-error involved finding what works for each person. Someone might get too many side effects from one drug, but do well on another. If you average it together (which, to my understanding, is what studies are typically doing), the effect size of any one drug is small or nonexistent. Yet there are still clearly many success stories of antidepressants making a massive impact on lives: in severe cases, it can be the difference between being confined to a psych ward and leading a normal life.

Scott Alexander, who is more qualified than I am on this topic, has some thoughts on this gap between studies and clinician’s experience as well.

43. Nick Says:

Elizabeth #39

If Trumpists are truly motivated by “economic desparation”, why do they get so ginned up about Colin Kaepernick protesting against police brutality? Why are they so invested in something so patently irrelevant to their material circumstances? How could Trump possibly get so much politcal mileage out of that single issue?

> Typical Trump voters are not descended from WASP hegemony, they are downtrodden self-identified white trash with no real history as a people.

No, they have quite a long history, and it has always involved a stratified society in which they are not on the bottom. As LBJ said: “If you can convince the lowest white man he’s better than the best colored man, he won’t notice you’re picking his pocket. Hell, give him somebody to look down on, and he’ll empty his pockets for you.”

Trump is not the only way out for them. They could vote for Sanders instead. But they love Trump, and we all know why.

44. nban Says:

Anonymous #42

Would the data also fit this story: {people’s issues fade over time or they get over it, placebo from strong side effects helps}?

45. nonagon Says:

@ Nick #43

“They could vote for Sanders instead. ”

They could vote for someone who is pro-choice and flip-flops on gun-control issues? This makes me suspect you don’t have much experience interacting with rural, white, working-class Trump voters.

“But they love Trump, and we all know why.”

Oh, don’t be coy. If you’re able to look into the hearts and minds of people you’ve evidently not spent much time with, then just say plainly what you see.

46. Ethan Says:

Anonymous #42:

We will have agree to disagree on this one. For reasons I prefer not to disclose, I have done a lot of research on the topic of biological psychiatry. The mainstream consensus today is that the psychiatry is only biology model pushed by the drug pushers during the 1980s and 1990s is a failed model that benefited mostly big pharmaceutical companies and the doctors who got paid to push the drugs . Check https://www.amazon.com/Psychiatry-Under-Influence-Institutional-Prescriptions/dp/113750692X . The book was written during Bob Whittaker’s stay at Harvard’s Safra Center for Ethics, joint work with Professor Lisa Cosgrove check here https://ethics.harvard.edu/lisa-cosgrove-and-robert-whitaker-%C2%A0%E2%80%94%C2%A0-psychiatry-under-influence-case-study

More recently, you could read this published by the Psychiatric Times, which is a mainstream publication -not a scholar one- in American psychiatry. On it, Allen Frances, the chief editor of DSM-IV, says,

https://www.psychiatrictimes.com/view/conversations-critical-psychiatry-allen-frances-md

“Robert Spitzer, MD1 was an Umpire 1 and, until recently, so were most biological psychiatrists. The credibility of this model has been destroyed as we have learned more about the unfathomable complexity of the human brain and the complete failure of genetics and neuroscience to provide useful answers about what causes psychiatric problems.”

The late Robert Spitzer was the chief editor of DSM-III, the first edition to make the DSM look “scientific” in a cargo cult fashion.

Also, mainstream psychiatrists have been very open recently distancing themselves from the so called “chemical imbalance” theory of so called “mental illness”. Here is an example https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again

“Scientifically speaking, there never was a network of validated hypotheses capable of sustaining a full-blown, global chemical imbalance theory of mental illness. Moreover-and here we come back to Myth 2-psychiatry as a profession and medical specialty never endorsed such a bogus “theory,” when judged by its professional organizations, its peer-reviewed publications, its standard textbooks, or its official pronouncements. Furthermore, the whole notion of some looming, monolithic “Psychiatry” is absurd on its face, as my colleague, George Dawson has argued.”

All this to say that some people might benefit from taking so called “antidepressant drugs” but we should be clear that the name “antidepressant” is really a marketing label. These are powerful psychoactive drugs (so are marijuana or cocaine) that in conjunction with having a guy with an MD degree on a white coat prescribing them might give benefit to some people. What the statistical studies show is that on average you can attribute the alleged benefit to a powerful placebo effect (such as once the drug kicks in people think they are getting cured and get better as a result).

A final thought. I didn’t mention cocaine causally. Consuming or trafficking cocaine can get you in jail in the United States. But its close cousin, Ritalin, is readily available as a prescription and not hard to get.

In summary: if Filip Dimitrovski knows people who personally benefit from taking Nardil, good for them! But let’s not make this an endorsement of psychiatry which at its core is a pseudoscience. Legal pseudoscience, but pseudoscience nonetheless.

47. Scott Says:

nonagon #38:

Conservatives (broadly speaking) won an election. Referring to an “Electoral College majority” is technically accurate, but comes across as an attempt to delegitimize this, and it won’t convince anyone who voted red.

I’m genuinely curious, when making this remark, did you realize this? If so, why do it? If not, why not?

I hold the Electoral College to be a profoundly anachronistic and unjust institution, born partly out of the need to appease the slave states (by giving them 0.6 extra proslavery votes for each person who they held in bondage), and regressive in effect to this day. Along with a majority of Americans, I’d amend it from the Constitution in an instant if I could.

I don’t deny that Trump won by the rules of our system—something that I think will shame the nation for as long as it continues to exist. But the continuation of the nation is exactly the question that we were discussing! I, like you, am on the “conservative” side here, the side that wants to work within the system to fix its flaws—flaws that, lest we all get inured to the obvious, have now put a pathologically lying, semiliterate narcissist and his flunkies in charge, led to a second Great Depression and more than 150,000 needless deaths, and made the US, which not long ago was the earth’s sole superpower, the laughingstock and pity of the entire civilized world. But in a (pre-)revolutionary period like the current one, when so many people basically want to smash everything to pieces and start over, if part of the issue is the sizeable gap that’s opened up between
(1) what the electoral process delivers and
(2) what the majority of the country says it wants,
then I do think it’s worth carefully differentiating between (1) and (2) when we speak.

48. Elizabeth Says:

Nick #39: The issue of kneeling in sports is a good example of the media pushing irrelevant but divisive and emotionally charged stories, because those get the most clicks (in a time when journalism struggles to turn a profit).  We need to bring back the FCC fairness doctrine to regulate this yellow press that subsists on sowing division, often with overtly biased misrepresentations of the truth.

Regarding the LBJ quote, the tendency for low status people to look down on others, in order to feel better about themselves, is not particular to any combination of skin colors.  It has been the premise behind countless reality TV shows, and is a core aspect of lower human nature.  But to your point, it honestly surprises me that so many people never got past the “Trump won because of racism” angle.   The day after the 2016 election, I reflected on why the candidate I voted for lost.  Empathizing with 2016 Trump voters demands more than writing them off as one dimensional caricatures, because real people are not that simple (some may be, but not +60 million of them).  It only took a few hours of thought for me to figure it out, and again Andrew Yang’s primary campaign did a great job at articulating the same conclusion that I came to that day in November 2016.  It has been frustrating to see that mainstream discourse never caught up, they never progressed even slightly in their understanding of Trump voters.  The word “disdain” can be defined as “the feeling that someone or something is unworthy of one’s consideration or respect.”  I guess this was the emotion that closed their minds to understanding their opposition, to the detriment of our democracy.

49. gentzen Says:

Ethan #46: What is your point? You quote eminent psychiatry fellows and official statements from psychiatry associations, and you agree with them. But then you reach the conclusion:

But let’s not make this an endorsement of psychiatry which at its core is a pseudoscience.

Psychiatry is part of the medical professions. We could disagree about whether medicine always follows the scientific method, or at least always should. But even if medicine or psychiatry may not be sciences in the strictest sense, that doesn’t turn then into pseudosciences. They are professions with education and training requirements no less demanding than more typical sciences.

To help me understand where you stand, would you be willing to share you opinion on “The Reason for Almost All Mental Illnesses – Prof. Jordan Peterson”? (only 2:34 minutes):

50. fred Says:

Scott #47

Talking about the shortcomings of the election process, what if Biden quits after 6 months (say, for health reasons), and Harris becomes POTUS – that would be quite bizarre considering how little support she gathered during the democratic primaries, I would think that many Dem voters would feel like their opinion didn’t matter all that much (as a fervent Andrew Yang supporter, who btw got totally screwed by the left news media, I certainly feel this way).

51. Ethan Says:

gentzen #49

Psychiatry is part of the medical profession by a historical accident, not because it meets the same rigorous standards in treatment as say oncology or the treatment of infectious diseases. On both these specialties, the definition of disease is based on a biological test that detects an abnormality vs what is “normal” in a well defined biological sense. Meaning, as the general public is learning these days, you can positively know with a high degree of certainty whether you have (or have had) covid19 via PCR or antibody tests. In psychiatry, all so called “mental disorders” are literally made up by committees of experts. In 1973, the American Psychiatric Association decided to cure homosexuality via a vote. What that meant is that before that vote took place, being declared mentally ill for homosexuality could have you electroshock-ed. Check minute 9:25 and after of this 1967 documentary by CBS https://www.youtube.com/watch?v=tu1r6igCODw narrated by Mike Wallace. And if this abhors you -it should- then go and check this other mental illness of the XIX-the century https://en.wikipedia.org/wiki/Drapetomania .

But it doesn’t end there. The debate about DSM 5 was particularly vicious because of its expansive nature -that expansive nature is what prompted Allen Frances, the chief editor of the previous edition to come out against it. One of the conditions that was “voted out” was internet addiction https://psychcentral.com/blog/not-in-the-dsm-5-internet-addiction-parental-alienation-disorder/ . No other field of medicine works this way.

The reason it’s a historical accident that psychiatrists are doctors goes back to the XIX-the century, where society decided to have a more humane way to treat people who underwent psychological distress and decided that doctors would be the best people who could be in charge of asylums. Thus, the notion of as psychiatry as a medical specialty was born. It was not because any scientific breakthrough. To this day, when a behavioral condition is found to have a basis on neurology, such as Alzheimer’s, it gets moved to neurology.

Psychiatry is a pseudo science because it is not falsifiable . If a psychiatrist labels you as X, you don’t have a way to disprove you don’t have X. Whereas if I am accused of being covid19 positive I have objective ways to disprove it. That’s why.

In an American context, psychiatry doesn’t enjoy much prestige among the public or the medical profession itself. It’s one of the least sought after specialties by medical doctors. The reasons are those provided by experts like Tom Insel (the former director of the National Institute of Mental Health that decided to stop funding DSM categories) and Allen Frances (who remains a believer in the specialty despite having been very open about its excesses).

When it comes to Jordan Peterson, I generally like a lot of what he says, but not everything. One clear disagreement I have with him -unrelated to this- is in his praising of IQ tests as something other than a measure of how people do in taking IQ tests. He is not considered someone in the psychiatric field with the authority of Tom Insel or Allen Frances.

52. gentzen Says:

Ethan #51: Thanks for clarifying your point. With respect to the clip from Jordan Peterson, I was most interested in your opinion about his claim in that specific clip:

What you learn if you’re gonna be a psychologist, people come to you with mental illnesses. And that’s almost never true. People come to you, because their lives are so damn complicated, they cannot stay on top of them in any way that doesn’t make it look like their just gonna get more complicated.

But it was good and interesting to learn your opinion on Jordan Peterson in general. It was only a few days ago that I first watched clips by him, because I dived into the different personas at TheirTube. He appeared (with different clips) both in the streams of the Liberal and the Conservative. I was totally surprised that he was so reasonable and moderate. (I had heard his name before in the context of a self proclaimed “intellectual dark web,” which was described quite negative.)

I don’t want to discuss with you here whether psychiatry should be part of the medial professions or not. Since psychology is not part of them, it makes sense to me that psychiatry provides something similar which is. I know a bit about the history of medicine in general, and I am less sure than you that psychiatry is especially worse in this respect compared to other medical specialties. Anyway, I don’t want to change your opinion. Thanks again for the clarification.

53. Anonymous Says:

nban #42:

Though some cases of depression will go away on their own, or go away with placebo effect, some cases do not. Especially when you look at severe depression, studies do show antidepressants have a clinically significant effect. So the theory that depression just goes away on its own, and drugs have no effect, fails to explain all the data (even though it can explain some of the data).

Ethan #46:

I don’t think we disagree near as much as you suggest. I totally agree that antidepressant research is flawed, and that the “chemical imbalance” theory is flawed, etc. Psychiatric research, like much research in soft sciences, has a lot of flaws and I think we should be fighting to continue improving the standards for research.

What I don’t agree with is the statement that “antidepressants don’t work”.

I hope it is clear that it’s possible to believe research is flawed, antidepressants are over-prescribed, and antidepressants are still worth using for many patients.

Finally, one thing worth pointing out is that MAOIs are not the sort of drug that are overhyped or over-prescribed (as opposed to SSRIs). MAOIs have much worse side effects than SSRIs and so are a “last resort” drug for patients who don’t respond to safer drugs. I believe the research is also much clearer about the efficacy of MAOIs (which makes sense, given they affect much more than serotonin).

54. anonymous Says:

Scott #47: I completely disagree about the significance of the electoral college in electing Trump. Campaigning strategy revolves around maximizing electoral college votes. Campaigning strategy is very important and can swing voters in many different ways.

Nobody knows what would have been the election result if both sides campaigned for maximal nationwide votes if the system would have been different, the campaigns of both sides would be different too and the Trump might have gotten a majority vote. The game effects the strategy, and complaining about the games rules afterwards is the like losing chess after capturing more pieces. Your opponent might have taken gambits, the whole election could have been different and Trump could also use a different strategy if the game was different. It was close enough that campaigning differences in a different type of system would deliver a different result.

There were a lot of opportunities to prevent Trump from winning. The republicans failed proposing other candidates. The democrats failed by pitting Trump off against Hillary Clinton. Hillary Clinton failed defeating him.

In different locations, with election system that you would say is more “fair”, like Israel, people are still voting for a similar kind of person, called Bibi.

You’re surprised because you are just not aware of the average voter. You’re blaming the system, but it’s working as intended – there are just some people who are really good at manipulating the average voters.

55. Ethan Says:

gentzen #52

With respect to the quote

“What you learn if you’re gonna be a psychologist, people come to you with mental illnesses. And that’s almost never true. People come to you, because their lives are so damn complicated, they cannot stay on top of them in any way that doesn’t make it look like their just gonna get more complicated.”

That what psychiatry calls “mental illness” or “mental disorders” are really so called “problems of living” was the main point of psychiatrist Thomas Szasz in his groundbreaking 1959 paper “The Myth of Mental Illness” that you can read here http://depts.washington.edu/psychres/wordpress/wp-content/uploads/2017/07/100-Papers-in-Clinical-Psychiatry-Conceptual-issues-in-psychiatry-The-Myth-of-Mental-Illness.pdf .

Thomas Szasz was a pioneer in denouncing psychiatry’s excesses in modern America. It’s hard to believe now, but there was a time in America when the opinion of a psychiatrist could get you locked up and treated against your will because a psychiatrist said say (and prior to 1973, that would include being involuntarily committed for being a homosexual). All that changed in 1975 when the US Supreme Court issued a unanimous opinion declaring the deprivation of physical liberty on non dangerous people on the basis of so called a “mental illness” diagnosis unconstitutional https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson . That decision nationalized the standard for involuntary commitment that had been in effect in California since 1972.

While a pioneer in this kind of thinking, Thomas Szasz became controversial in the years leading to his death in 2012 because of his association with Scientology. While an atheist, and a humanist himself – he was named Humanist of the Year in 1973 by the American Humanist Association- he saw in his association with Scientology a way to access the courts to redress psychiatry’s excesses during the 1960s and 1970s.

His figure has recovered in the years after 2013 -and now it is cool to quote him again- after Thomas Insel, the director of the National Institute of Mental Health, published his op-ed “Transforming Diagnosis” largely agreeing with Szasz’s contention that whatever the APA calls a “mental disorder” has not be shown to have scientific validity in a biological sense.

All this to say, that I do agree with that part of the statement by Jordan Peterson but I also say that he is far from being the first to notice that. That credit goes to Thomas Szasz.

Jordan Peterson is a very fascinating individual. While it is true that given his first claim to fame (his refusal to use the transgender pronouns) a lot of people though of him as a conservative, if you listen to his different position statements, he is quite moderate. And as I said, I do not agree with everything he says (I find his defense of IQ tests as unsupported from what we know about how these tests were designed and the intrinsic biases that come with said design and their administration) but I always learned something new from watching his videos.

Finally, with respect of the proper role of psychiatry in medicine. For reasons explained here, I believe psychiatry is a pseudoscience, one that has caused -and that continues to cause- a lot of pain to people with the blessings of the state -thankfully in the US, its power these days is much more diminished than prior to the aforementioned 1975 ruling.

I do not deny that other branches of medicine in previous times were also crude, but psychiatry remains unique in its being stuck in pseudo science. Other areas of medicine have moved steadily over the past decades towards what is generally known as “precision medicine”, leaving psychiatry as a ” stepchild of medicine”, a name used by Jeffrey Lieberman who was the president of the APA when the controversy surrounding the release of DSM 5 took place, check https://www.npr.org/2013/05/31/187534467/bad-diagnosis-for-new-psychiatry-bible .

Great chatting with you!

56. Ethan Says:

Anonymous #53,

Glad that there is a lot of agreement between us. Where I do think we still disagree is on this,

“I hope it is clear that it’s possible to believe research is flawed, antidepressants are over-prescribed, and antidepressants are still worth using for many patients.”

Sure, but that “working for many patients” could be just the placebo effect of combining taking drugs that cause side effects and create chemical dependency https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133 and the ritual of having a guy which a white coat and an MD degree telling you the thing is good for you.

This blog is made, I am sure, of many highly educated and sophisticated commenters who don’t get impressed by things like that, but most people who take antidepressants are unsophisticated people who take the word of the doctor as if it was the word of God.

What we do know, through repeated meta analysis of the raw data that pharmaceutical companies need to submit to the FDA to gain approval, is that on average antidepressants have the same effect as placebo pills when depression is measured via the Hamilton Depression Rating Scale, https://dcf.psychiatry.ufl.edu/files/2011/05/HAMILTON-DEPRESSION.pdf . The pioneer in doing these meta studies is a fellow whose name is Irving Kirsch who works at Harvard’s Program in Placebo Studies & Therapeutic Encounter http://programinplacebostudies.org/about/people/irving-kirsch/ . His work was featured by CBS’ 60 minutes several years ago https://www.youtube.com/watch?v=Zihdr36WVi4 .

Legal to be sure, but psychiatry is indeed a pseudoscience!

57. Scott Says:

anonymous #54:

You’re surprised because you are just not aware of the average voter. You’re blaming the system, but it’s working as intended – there are just some people who are really good at manipulating the average voters.

The same phenomenon can have multiple valid explanations. If a few hundred thousand voters had been less manipulable, that would’ve sufficed to prevent our current nightmare world. If there hadn’t been an Electoral College, that would also have sufficed.

58. Filip Dimitrovski Says:

Ethan #56:

Legal to be sure, but psychiatry is indeed a pseudoscience!

I’m sorry, but I won’t respond to your comments due to this remark. It does have its flaws, but it is a science, and if you don’t accept that, we can’t have a meaningful discussion.

Anonymous #42:

I’m sympathetic to Filip’s cause because I know someone who cannot function without their MAOI.

Thank you! I’m aware of 3 people in the rationality circles taking it, and they cannot survive without MAOIs after having tried 10+ other treatments. Also, all of them asked their doctors for a prescription after reading SlateStarCodex’s posts.

b_jonas #6 Douglas Knight #11:
The generic name is phenelzine, but all of it is sold under the Nardil brand name (if I’m not mistaken) and that’s how the doctors, patients and health services are referring to it. The shortage is not COVID-caused and has happened a few times in the last year. The main reason being is that it’s unprofitable to produce these drugs and small disruptions in one production plant cause worldwide trouble.

The thing that makes me sad is that I can’t think of a call-to-action. I tried hard to think of a one sentence, but I can’t. Maybe:
1. If you are psychiatrist, read the prescription perversity post as well as the doctors’ irrationality when evaluating side-effect risks post on SSC and consider prescribing MAOIs to some of your patients.
2. If all modern depression treatments have failed you despite putting all the effort, contact Dr. Gillman or read his website on how to convince your doctor to prescribe you MAOIs.
3. If you are a journalist, spread the word about the current shortage. If you need a story, you may also mention David Foster Wallace, the popular novelist, who successfully used Nardil for 20 years. Unfortunately, on his doctor’s advice, he decided to try going off it, and his depression relapsed and he committed suicide in 2008. 😢

59. Ethan Says:

Filip Dimitrovski #58

I can back my statement that psychiatry is pseudoscience by getting into a meaningful -and respectful- conversation into what science is, what science is not and what is specific to psychiatry that qualifies it as a pseudoscience. You have chosen to filibuster the conversation and of course that’s your choice.

As I mention above, the person who was the president of the American Psychiatric Association at the time DSM 5 was released, Jeffrey Lieberman, had no problem in calling psychiatry a stepchild of medicine, which comes really close to calling it a pseudoscience. I copy paste the link where you can listen Jeffrey Lieberman make the statement: https://www.npr.org/2013/05/31/187534467/bad-diagnosis-for-new-psychiatry-bible . He was joined in the conversation by Tom Insel, then director of the National Institute of Mental Health, and Gary Greenberg, an American comparative and developmental psychologist who is Professor Emeritus of Psychology at Wichita State University. He is also the author of the Book of Woe, https://www.amazon.com/Book-Woe-DSM-Unmaking-Psychiatry/dp/0399158537 , that he released to be coincident with the release of DSM .

In the specialized psychiatric circles, psychiatry’s limitations as a discipline is not even an open secret. It is a given. Ron Pies, another prominent psychiatrist in the context of American psychiatry, has recently taken on the debunking of the theory known as “chemical imbalance” that not so long ago was used to justify the prescription of antidepressants. More here https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again .

60. Ethan Says:

Filip Dimitrovski #58

My other comment hasn’t been published yet, but to elaborate and what is science, and what is not science, I go by Richard Feynman’s definition he eloquently explained here,

In his day, Feynman was already aware of the abuse of the word “science” due to its success. He eloquently spoke of that here (included in an interview he gave for the BBC in 1980):

Psychiatry doesn’t have a scientifically valid objective model of disease (as say oncology and infectiology do). “Consensus of people with MD or PhD degrees” of what constitutes a “mental disorder” is not akin to an abnormality in how human cells reproduce that can be detected with a biopsy (case of cancer) or presence of a virus/bacteria in the body that can be detected with a biological test (case of infectiology). This point is not contended by anybody who matters in American psychiatry. The “bio-bio” and chemical imbalance models have been largely debunked by psychiatrists themselves.

This flaw in the definition of their diseases, leads psychiatry to have a deeply flawed diagnostic method because starting with reified statistical constructs, in practice the same person can get different labels when examined by different psychiatrists. The lack of objective diagnostic systems, makes it impossible to falsify a psychiatric diagnosis -just as it is possible to falsify a cancer of covid19 infection diagnosis.

Finally, that psychiatry, and other social sciences, suffer from these and other limitations has even a name. It’s called https://en.wikipedia.org/wiki/Physics_envy .

All this said, and perhaps this is a reason why you are afraid of debating these matters, psychiatry can be a pseudoscience and still be legal and benefit people.

There are plenty of other treatments that I would consider pseudoscientific such as acupuncture or astrology that people claim to benefit from. I respect that and I wouldn’t seek to ban them. I am not a control freak zealot who believes that every problem in society gets solved by a government intervention. The current way the FDA determines what should be legal or illegal in terms of drug consumption exemplifies the problem with giving government the power to make these decisions. In the United States, the consumption/trafficking of cocaine can get you in jail. The consumption/sale of Ritalin (which is a chemical very similar to cocaine and that can be used in a way that makes its takers experience the same effects as if they were taking cocaine) is legal and very profitable.

To summarize: psychiatry fails when it comes to both the definition and diagnosis of their disorders to do its work in a way expected of scientific specialties of medicine such as oncology and infectiology. Its lack of independent, objective diagnosis systems prevents a psychiatric diagnosis from being falsifiable. In philosophy of science, falsifiability is what separates science from pseudoscience. Because a psychiatric diagnosis is not falsifiable, psychiatry is a pseudoscience.

61. Scott Says:

Ethan #60: Granted that psychiatry is not nearly at the standards of rigor of the harder sciences. Granted that what gets classed as a “disorder” in the DSM depends on politics and ideology as much as on medical evidence. Presumably you agree that there are stimulants, antipsychotics, psychedelics, and many other drugs with known and describable effects on the human brain? That many readers and commenters here have firsthand experience of rather obvious, non-placebo effects of some of these drugs? That sometimes these drugs can help some people and even save their lives? That there’s a lot to know about the dosing, side effects, interactions, etc. of these drugs? Then we agree that there’s such a subject matter as “psychiatry,” and a possibility of being an expert psychiatrist.

Even so, for a definitive test, I agree that we’d need to pick someone whose honesty, clarity of thought, and rationality were clearly at a once-in-a-generation level, send that person to med school, residency, etc. to study psychiatry for a decade, and then have the person report back to the rest of us about which parts of psychiatry were bunk and which parts were for real. Maybe they could even blog what they learned, without using their real surname.

Oh, wait…

62. Ethan Says:

Scott #61

Thank you for chiming in. Here is what I have to say to your comments.

“Presumably you agree that there are stimulants, antipsychotics, psychedelics, and many other drugs with known and describable effects on the human brain? That many readers and commenters here have firsthand experience of rather obvious, non-placebo effects of some of these drugs?”

Yes, but the fact that these drugs affect the brain -and with that people’s minds- is not an indicative of fixing anything wrong with the brain. Through medical imaging techniques, there have been studies to identify anomalies in the brains of people “DSM labeled” compared with the brains of people “non DSN labeled” and they become largely negative (otherwise, brain imaging would the the diagnostic tool for at least some of the psychiatric diseases the way it is for genuine neurological diseases).

At the same time, we do know that long time exposure to so called “neuroleptic/antipsychotic drugs” produces brain shrinkage https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476840/ “Greater intensity of antipsychotic treatment was associated with indicators of generalized and specific brain tissue reduction after controlling for effects of the other 3 predictors. More antipsychotic treatment was associated with smaller gray matter volumes.”. You rarely get psychiatrists inform patients of the danger of longtime use of neuroleptic drugs.

Then you say,

“That sometimes these drugs can help some people and even save their lives? That there’s a lot to know about the dosing, side effects, interactions, etc. of these drugs? Then we agree that there’s such a subject matter as “psychiatry,” and a possibility of being an expert psychiatrist.”

Sure, but again, that says nothing about the scientific status of psychiatry and as a society we should be very clear about that. One of the reviewers in the Amazon website of the book Psychiatry Under Influence https://www.amazon.com/Psychiatry-Under-Influence-Institutional-Prescriptions/dp/113750692X -I direct readers to that book for a detailed exposition of the ideas I am expressing here- was very eloquent about these issues https://www.amazon.com/gp/customer-reviews/R1R0T39EZD34G0/ref=cm_cr_dp_d_rvw_ttl?ie=UTF8&ASIN=113750692X

“If you, a family member, loved one, or friend are diagnosed with a mental illness, please read this book. Don’t make the mistake my wife and I did by assuming psychiatry had our best interests at heart. Drugs are a last resort, not the first.

How ironic is was to read that one of my past psychiatrists, Dr. Andrew Nierenberg, is mentioned several times in the book. I had sought out one of the best doctors in the field of bipolar to ensure my medical treatment was optimal. It was an 8 hour round trip drive to his office each month but I felt it was worth it as he was one of the “experts”. I was saddened to read about his many close financial ties with the pharmaceutical industry, his defense of those relationships, and his participation in skewing study results.

But that’s the point of the book. Good doctors can make bad choices without understanding how those choices add up to impact the long-term wellbeing of patients.”

On your last point, I think you have Scott Alexander in mind. If you trust him great! I, on the other hand, live by the mantra “friends don’t let friends see psychiatrists”. I have experienced in my own close circle of friends the damage the discipline can do to people and its ability to destroy lives along the lines of what the commenter explains above.

I would definitely send my enemies to be seen by a psychiatrist for sure. Under DSM 5 it is a given that they will get a psychiatric label and a mind altering, brain damaging prescription drug my enemies will be asked to take for life. That’s a legal and effective way of getting rid of your enemies!

63. Douglas Knight Says:

Filip #58,

The generic name is phenelzine, but all of it is sold under the Nardil brand name (if I’m not mistaken) and that’s how the doctors, patients and health services are referring to it.

Why do you make a point of it being sold under the Nardil brand name? Are you claiming that is evidence that it is all one supplier? As far as I can tell, the trademark is owned by different companies in different regions. ERFA Canada 2012 owns the Canadian trademark. It claims to “manufacture” the drug. Pfizer has exclusive rights to the trademark in America. Kyowa Kirin uses the trademark in UK. (FWIW, it seems that there were three brands available in America.)

The main reason being is that it’s unprofitable to produce these drugs and small disruptions in one production plant cause worldwide trouble.

What are “these drugs”? Surely not all generics? If it’s unprofitable, why don’t they raise prices? There are many generic shortages in America and some people explain them via various money problems (FDA charges, PBMs, etc), but generics are substantially more expensive outside America, which does seem to buy more of a safety net.

Or are “these drugs” much more specific than generics, something you might call “orphans”? But ERFA Canada seems to be in the business of providing niche drugs, so why didn’t they think of this?

Do you have any other examples of small disruptions in generic drugs causing worldwide trouble?
As I said above, I’ve never heard of such things. You and Scott glibly assert the opposite without acknowledging that I rejected that. If you have any examples, give them. I certainly don’t know what’s going on, but I’m suspicious from your assertion of generalities that you don’t either.

64. Michael Says:

@Ethan#62- Yes, the DSM 5 is a very flawed tool. However, that doesn’t mean that EVERY category is meaningless. Without irony, you’re replying to a man who found himself interpreting rules overly strictly when he tried to make sure he didn’t hurt anyone, found that his anxieties got worse when he did reading to assuage them and got better when he decided to take risks and telling him that all psychiatric knowledge is pseudoscience and the only thing psychiatry has to offer is drugs. EVERYTHING Scott went through was predicted by descriptions of OCD. Scott has resisted that label when I’ve discussed it with him in the past but in a certain sense the label is irrelevant. What matters is that psychiatry could have told Scott what would make his condition worse. The point is that in some cases psychiatry describes REAL phenomena and makes accurate predictions- it tells the sufferers what will make their conditions worse.

65. Filip Dimitrovski Says:

Douglas #63: You are right that I’m not informed well enough about the generics. I’ll try to contact someone that knows how this happened at all and get back to this thread.

66. Rich Peterson Says:

I’m in favor of universal mail in voting until the coronavirus pandemic is over. It’s common sense. Later on, after the pandemic is over, I think voting by mail should only be allowed for exceptional situations. Because: Doesn’t it make it possible for husbands to control their wives’ votes? For example, probably in some married couples the husband supports trump, while the wife, secretly or not, doesn’t like trump. If the husband’s a bully, and physically stronger than the wife, he can force her to fill out the voting form the way he thinks it should be filled out. More generally, in a multigenerational household, the most powerful householder, a patriarch or matriarch could determine everyone’s vote if it’s vote by mail. It’s not true that a dependent householder could keep her mailin ballot secret, since the dominant person can ask why it’s secret, and demand to see it. Also, it wouldn’t be enough to just make inperson voting available along with mailin, for essentially the same reason..dominant householder wants to know why she is going in person to cast a secret ballot. If the Republican party gloms onto this as a tactic, watch out. They’ll make a uturn on mailin voting. Since they are less inhibited by ethical concerns(sorry, my humble opinion) they won’t hesitate to push even more strongly the “Christian wives should submit” and vote as their husbands do” strongly. (and we might see more inter generational households soon). Since in my view the Republicans usually put forth greatly inferior presidential candidates, and we live in dangerous times, every presidential election will resemble Russian roulette.

67. Rich Peterson Says:

I don’t think psychiatry is a pseudoscience, but it is an infant science. Historically, until scientists like Louis Pasteur discovered the germ theory of disease, it seems doctors did more harm than good on infections and pandemics. Analogously, psychiatric doctors might know almost as little about the mind as surgeons knew about germs in 1790. That could explain why they seem to me to do more harm than good…at Palo Alto High, it seemed that children of psychiatrists were particularly unhappy, from psychatrist parents doing more harm than good. My parents weren’t psychiatrists, but they got imho conned when i was 4 years old in Princeton to give me expensive powerful antipsychotic drugs, and it continued in junior high in Palo Alto, although I was too confused and sedated to realize I was getting them. I’m not sure I recovered from the tardive effects until many years later, when my coordination greatly improved. Anyway, me and everyone else wondered what was wrong with me. Down with psychiatric intervention.

68. Ethan Says:

Michael #64,

I don’t understand what you mean by this,

“Without irony, you’re replying to a man who found himself interpreting rules overly strictly when he tried to make sure he didn’t hurt anyone, found that his anxieties got worse when he did reading to assuage them and got better when he decided to take risks and telling him that all psychiatric knowledge is pseudoscience and the only thing psychiatry has to offer is drugs.”

Who are you referring to with “a man”? I saw you you posted about Scott and OCD here too https://www.scottaaronson.com/blog/?p=4870 but in the latter reference it is clear that you refer to Scott Alexander. It’s SA you are referring to? Could you clarify?

So to be clear what I am talking about and my apologies if anyone got offended for what I have said until now.

I didn’t say that people do not experience psychological distress in life. Clearly they do. Actually, clearly we all do. By the time people reach their 30s and 40s they have experienced first hand their fair share of misery because of the mere fact of living. Experiencing suffering comes with the territory of being human.

What I am saying is that the way psychiatry tries to make sense of that suffering is pseudoscientific . That the practitioners of psychiatry are asked to have an MD degree in the US (and from what I understand in most other Western countries) is an accident of history that in no way gives scientific validation to what they do.

And since these days we are talking covid19 all day long, the pandemic provides a great contrast with the way psychiatry conducts its business. With infectiology , you cannot invent a false epidemic of covid19. A well conducted testing campaign will give you an accurate estimate of people infected on any given time in a particular place. The historical data provided from the test data helps policy makers anticipate the needs for the epidemic in terms of beds, ICUs, who and when to vaccinate the moment there is a vaccine available, etc.

Psychiatry on the other hand can’t do that so it regularly engages into what has been called “disease mongering” for purely financial reasons (ie, to insure psychiatrists get to be gainfully employed in the future). One reason Allen Frances -chief editor of DSM-IV who still believes psychiatry is useful- came out of retirement to criticize DSM 5 was the number of false epidemics the expanded definitions included in DSM-IV created, for example childhood bipolar disorder. Check this article of his from 2010 https://www.psychiatrictimes.com/view/psychiatric-diagnosis-gone-wild-epidemic-childhood-bipolar-disorder .

Because it is not possible to falsify a diagnosis of “childhood bipolar disorder” (or in fact any other DSM disorder) through objective means the way a diagnosis of covid19 can be falsified, psychiatry is known to have created these epidemics through the help of what is known in the field as “key opinion leaders” such as https://en.wikipedia.org/wiki/Martin_Keller_(psychiatrist) .

The paradigmatic example of how psychiatry used to conduct business is the scandal that surrounded the antidepressant known as paroxetine (commercialized in the US as Paxil). It was pushed to treat depression in adolescents even though it was known to cause suicidal idealization. The paper based on the so called Study 329, of which the aforementioned Martin Keller was a co-author, showcases everything that is wrong with the way psychiatry pushes its “disorders” and the treatments for the same. Here is information about the study in question: https://study329.org/ . And here is a special BBC’s Panorama did on the scandal https://www.youtube.com/watch?v=_0ffzsrDkSQ .

The only reason psychiatry ended up relenting in these practices is because big pharmaceutical companies were fined by governments around the world for their drug pushing practices and realized that the cost to these companies’ reputations wasn’t worth it. Here is the press release of the United States’ DOJ about the fine it imposed on GlaxoSmithKline, among other reasons, for their illegal promotion of Paxil for treatment of depression in adolescents https://www.justice.gov/opa/pr/glaxosmithkline-plead-guilty-and-pay-3-billion-resolve-fraud-allegations-and-failure-report ,

“Paxil: In the criminal information, the government alleges that, from April 1998 to August 2003, GSK unlawfully promoted Paxil for treating depression in patients under age 18, even though the FDA has never approved it for pediatric use. The United States alleges that, among other things, GSK participated in preparing, publishing and distributing a misleading medical journal article that misreported that a clinical trial of Paxil demonstrated efficacy in the treatment of depression in patients under age 18, when the study failed to demonstrate efficacy. At the same time, the United States alleges, GSK did not make available data from two other studies in which Paxil also failed to demonstrate efficacy in treating depression in patients under 18. The United States further alleges that GSK sponsored dinner programs, lunch programs, spa programs and similar activities to promote the use of Paxil in children and adolescents. GSK paid a speaker to talk to an audience of doctors and paid for the meal or spa treatment for the doctors who attended. Since 2004, Paxil, like other antidepressants, included on its label a “black box warning” stating that antidepressants may increase the risk of suicidal thinking and behavior in short-term studies in patients under age 18. GSK agreed to plead guilty to misbranding Paxil in that its labeling was false and misleading regarding the use of Paxil for patients under 18.”

The sentence “GSK participated in preparing, publishing and distributing a misleading medical journal article” refers to an article written on the basis of the aforementioned study 329.

This is a serious matter. As I said, friends don’t let friends see psychiatrists. That’s my policy. To my enemies: I have a few psychiatrists I could recommend you if you want to know what turning your life into a living hell looks like!

69. fred Says:

Ethan #62

“the fact that these drugs affect the brain -and with that people’s minds- is not an indicative of fixing anything wrong with the brain.”

What about anti-seizure and anti-migraine medications. They clearly affect the brain, and they either work or don’t work.

According to the wiki: “Levetiracetam, along with other anti-epileptic drugs, can increase the risk of suicidal behavior or thoughts.”

Epilepsy is a thing, and so is suicidal behavior.

It’s not because a condition is more subtle to “measure” than epilepsy that it doesn’t exist or can’t be affected. Every “condition” is the result of the electro-chemical activity in the brain (including the apparent absence of any issue).

The difficulty is that every single chemical in the body is both beneficial and dangerous, depending on dosage and everything else going on. But that’s true about every single drug/medication.

70. nonagon Says:

@ Scott # 47

I understand that you very much dislike the Electoral College.* But your response doesn’t seem to address the point I was trying to make: when you refer to an election victory as a “Electoral College majority”, it alienates the people you’re trying to persuade.

But the biggest issue to me is that I’m still stunned by your stance on the upcoming election/model of Trump supporters (they seem intertwined). As I understand it, you believe:

In the face of potential violence from a subset of the left, Trump supporters should not vote for Trump so that (what you consider to be) moderate Democrats may be elected.

Is there some important nuance that I’m missing? Have I twisted your words somehow?

~~~
* There’s some common ground there, as well as some pushback I’d normally give. But this all distracts from what I’m trying to understand: your model of the people you wish to persuade.

71. Scott Says:

nonagon #70: I’d like for the Trump supporters to stop being Trump supporters, and become moderate Democrats, or at least never-Trump third-party voters or abstainers. And I’m sure the Trump supporters would like for me to become one of them. That’s called “politics.”

Yes, I do fear violence from antifa types if Trump is widely seen to have stolen the election. In such a case, I also fear violence from DHS agents and other forces loyal to Trump. I think it’s plausible that the military will need to step in to ensure a smooth transfer of power. This is called “broken politics,” and I do have opinions about who’s mainly responsible for having broken it.

72. nonagon Says:

@ Scott #71

Thanks for the elaboration. Your view of what constitutes“politics” throws me off. It differs from mine, and I don’t know to what extent I agree/disagree with it. I think I need time to digest your statements before following up.

73. Ethan Says:

fred #69

Good question. I think it’s a matter of weighing costs and benefits.

I would differentiate though seizures or migraines from the disorders listed in the DSM. The DSM is, and it has always been, about imposing behavioral normality as defined by a group of self appointed, unaccountable mind guardians. Some might see this as far fetched, but in fact the DSM is regularly presented as the Bible of American Psychiatry. When DSM 5 was released, there were articles in the scholar literature like this https://www.tandfonline.com/doi/pdf/10.1080/13674676.2012.762574

“Can it be argued that the DSM represents a sacred text and defines a worldview for an identifiable community of mental health professionals? In what ways is the relationship between this community and document similar to and different from the relationships that explicitly religious communities maintain with their sacred texts?”

Because the DSM labels lack scientific validity and are produced by consensus, I think the analogy is pretty apt.

So seizures or migraines is one thing, controlling someone’s mind is another.

Fortunately, in the US, we are past the point where psychiatry is used as a tool of social control but it wasn’t always the case. When the late Thomas Szasz wrote his paper “The Myth of Mental Illness” he was railing mostly against the coercive aspects of psychiatry. Prior to the mid 1970s, the opinion of a psychiatrist could get you locked up for life. The US Supreme Court case that put an end of the practice revolved around the life of Kenneth Donaldson who spent 15 years locked up in a psychiatric hospital against his will because a psychiatrist said so despite not being a danger to anyone. Szasz coined the term “the therapeutic state” to describe this now gone -in a US context- aspect of psychiatry.

The other thing that happened in the 1970s was the so called Rosenhan experiment, check https://en.wikipedia.org/wiki/Rosenhan_experiment , whose results were published in Science.

These two things (depriving psychiatry of its coercive powers, questioning the legitimacy of psychiatric diagnoses) pushed the profession to work on DSM-III, developed by Robert Spitzer in an effort to save the livelihood of psychiatrists. He was successful for a couple of generations, until psychiatry engaged in the disease mongering and pill pushing schemes I have described in previous entries, thus the current legitimacy crisis.

One thing we know about psychiatry is that it is remarkably resilient. It is able to recover from scandals that could have sent any other profession to oblivion. Its capacity for reinvention is amazing. How many disciplines do you know to have engaged in final solution type of activities during Nazi Germany- check https://www.nytimes.com/1986/09/21/magazine/german-doctors-and-the-final-solution.html – and continue thriving to this day?

I repeat: friends don’t let friends see psychiatrists. To psychiatrists, you send your enemies!

74. Pseudonym Says:

Elizabeth #48

I agree with your statements. The Left’s (please allow me to just use this descriptor) comments in regards to Trump supporters are generally ad hominem attacks from an assumed position of intellectual and ethical superiority and often with claimed support for their positions from objective science. The implication is that only an ignorant individual devoid of scientific understanding would disagree with them. Foolishly for their aims these claimed objective truths are then used to provide testable predictions that are shown false. Examples of this are dates (come and gone) for disappearance of the ice caps, submersion of NYC, submersion of the Maldives, global agricultural apocalypse, and recently the touted Imperial College pandemic modeling results. The strategy of cowing people outside the urban centers with model results that fly in the face of common sense and with ad hominem attacks is an extremely poor one. They are not universally ignorant, even in the absence of advanced technical degrees, and if pushed far enough they definitely will bite very hard. Sometimes it seems to me that the preferred political weapon of the Left is a numerical model and wielded with ecclesiastical fervor.

The other theme in this thread in regards to psychiatry is pertinent to this discussion. People often mistake beliefs for objective truths and then demonize those that disagree with a belief they take as fact. Objective measurement is a wonderful thing when it allows discrimination between mistaken belief and objective truth.

75. Ethan Says:

Pseudonym #74,

“People often mistake beliefs for objective truths and then demonize those that disagree with a belief they take as fact”

Reaching this conclusion was one of the most important breakthroughs in my development both as a person as well as a professional, namely, that the fiercest disagreements humans engage in is about belief systems, even when the conversation happens between two rational and well educated people.

Mathematical arguments start with “axioms”, “truths” that are generally agreed to by everyone as being “self evident”, then using deduction rules, we construct new mathematical truths (theorems, etc).

When it comes to disagreements between humans, the overwhelming cases where is a conflict, it is rarely a disagreement about a deduction, rather it is usually about what would be called an “axiom” in a math sense.

People come up with their belief systems mostly based on their lived experience, even rational people. If you are the child of two well educated parents who attended the best schools in the country while growing up, you develop a worldview that is very different from the worldview of someone who is the child of two factory workers whose livelihood was put to an end by NAFTA amid promises that shipping their manufacturing job overseas would be followed by better jobs at home. When those better jobs never came and they were told that all they need to do to get a good paying job was to learn to code at the age of 50, you can understand why we have the current mess in the United States which won’t be easily solved regardless of who wins in November.

The practical implication of this realization for me has been twofold:

a) I have come to the conclusion that it is very hard to change anyone’s belief system, particularly in the cases of well developed adults.

b) When I run into someone whose ideas I disagree with, I try to understand where they come from. “Understanding” and “justifying” are two very different things. You can vehemently disagree with someone without demonizing that someone because it is very difficult to put oneself on someone else’s shoes.

The concept of “agreeing to disagreeing” is a great concept that in my experience is indigenous to Western societies with a strong Anglo-Saxon cultural background. It’s one reason the United States is such a great place, namely, it was founded by people whose only agreement was to create a political framework where “agreeing to disagreeing” could be done peacefully and civilly with the occasional Civil War and violent protest!

76. Elizabeth Says:

@Pseudonym: I agree with you, the left frequently applies science in a selective manner and overstates confidence in conclusions that support their political objectives.   In an ironic parody of the scientific tradition they rely mostly on appeals to authority as well as crushing dissent with ad hominem attacks and shunning.   When the predictions do not come to pass they have various tactics for evading responsibility and resetting the cycle with new difficult-to-falsify claims that happen to justify the radical changes they’ve wanted all along.
This is related to a fundamental flaw with leftism: in practice it is a Trojan horse for control and dominance in the name of rationality and compassion.  In the subversion stage (before the gulags start) the basic tactic is: “if you do not accept these increases in tyranny, then you are not rational, not compassionate towards the oppressed, therefore you are deplorable and are to be shunned.”   It’s a nasty trick, because enlightenment intellectuals tend to be very compassionate people who identify with wanting progress and evolution.   But the power behind those ideals attracts a different kind of individual, the ones who feel personally weak and bitter and so become drawn to the prospective power and control that goes along with a mandate to reign in the strong (“oppressors”) and reshape society.  When you look at the history of Marxism in practice, these bitter SJW/Antifa types are not just a fringe element within mostly progressive and compassionate movements, rather they are the ones who ultimately seize the power and wield it brutally.   The events of this year suggest we are threatened by a kind of globalist communist revolution in the name of health, climate, etc, and that is the real generational danger I have my eye on, looking past the election theater happening now in the US.

I also agree that the other theme about the dismal track record of psychiatry is a microcosm for the larger problem of confusing belief with settled facts and using this to establish “experts” with far too much authority. The frequency with which psychiatrists lock people in psych wards and feed them zombifying drugs, often just to protect themselves from legal liability, is pure evil. Instead of diet and exercise as first line treatments for depression and anxiety, pay us for these soma pills that will feel great for long enough to fry your neural receptors and ensure you take various pills from us for the rest of your days. Fear and appeals to taking immediate action (“never mind these doubts, we must act now!”) are the standard fallacies they use to excuse their gruesome track record.

77. Michael Says:

@Ethan#64- I was referring to Scott Aaronson. Sorry if I wasn’t clear about that.
You write “I didn’t say that people do not experience psychological distress in life. Clearly they do. Actually, clearly we all do. By the time people reach their 30s and 40s they have experienced first hand their fair share of misery because of the mere fact of living. Experiencing suffering comes with the territory of being human.”
That’s the point- we all DON’T experience distress like people with “mental illness” do.
Take Scott Aaronson as an example- he found that he ACTUALLY believed/feared that he might be expelled or sent to jail for an expression of sexual interest and the more feminist reading he did, the worse his condition got. People claimed that Scott was lying- that he actually wanted to rape women- or that his mind made this up to cover his fear of rejection.
But that’s not the case. What is the case is that people with what we call OCD happens because some people’s brains malfunction when they try to be sure they won’t hurt anyone- in Scott Aaronson’s case, by sexually assaulting or harassing women. In another case, it might be a mother afraid of hurting her child or a driver afraid of hitting a pedestrian. And they always, ALWAYS get worse when they try to make sure they won’t hurt anyone.
And many people with OCD think they’re the only ones with these bizarre fears- that they’re freaks and monsters- until they find out about OCD and find that other people often have the EXACT SAME SYMPTOMS as them.
The categories aren’t just “disease mongering”. They may be manmade constructs but they reflect an underlying reality. Back during the Brett Kavanaugh hearings, Scott Aaaronson told us a story about how he once got drunk and when he got sober he thought he might have assaulted a woman and it turned out he only almost stepped on her glasses. That didn’t surprise me- many people with OCD have exactly the same story. And similarly, many Christians with OCD find that they have the EXACT SAME symptoms.
I’m not disputing that psychiatry in the 70s had many abuses that Szasz was right about. Or that there aren’t many problems with psychiatry today. If one of the shrinks Scott Aaronson had seen had just told him in plain English “you’re never going to get better unless you’re willing to risk violating a woman’s consent”, he would have gotten better much quicker.
What I’m saying is that the categories are man-made and flawed but they’re not just “disease mongering”. They reflect the underlying reality that some people’s brains work differently than “normal” people’s in ways that it is difficult for “normal” people to accept. And Szasz was one of those people who refused to accept this truth. He wrote “I believe viewing the schizophrenic as a liar would advance our understanding of schizophrenia” despite having never worked with an institutionalized patient.
And why are those categories useful? Because they guide us on how to handle these people. A woman with OCD might be afraid of hurting her baby, and in that case, it would be a good idea to tell her that she needs to risk hurting the baby. It probably wouldn’t be a good idea to tell a woman that actually wants to kill her baby that she needs to risk hurting the baby.
And my point was that people like you can’t accept these truths, even when talking to people like Scott Aaronson, whose brains work differently.

78. Pseudonym Says:

Ethan and Elizabeth

Thank you for your responses with which I agree. Can you imagine being a coal miner in the audience when possibly the next president of the United States (and especially considering the mental attributes of this particular man) tells you to learn to code-it’s easy. Considering the usual observation that hope is the last thing to die, it must be the case that hope was on life support for a majority of the audience. This type of flippant statement was very typical in regards to loss of manufacturing job and always seemed nonsensical to me. There are two cases-1) It isn’t at all easy for the common person and so the statement is false and 2) It is easy and so everyone can readily make the change and in that case what economic benefit could it possibly have for an individual.

I am well acquainted with the abhorrent impact Marxist government has on the human spirit and the static society that results from emphasis on maintenance of the stats quo. I have worked outside the US for much of my adult life and have experience with the day to day life in failed Utopias and can’t imagine the idiocy that results in the desire to establish that in the US. BLM/ANTIFA are secure in the urban centers but if they should be so foolish to move out in the countryside, to say discuss collectivization of farms and ranches, they will be greeted by a population that is much better armed and not in the least sympathetic to mob behavior.

If they were successful it would just be another cycle of intellectual sympathizers being the first eaten after they assumed power.

79. fred Says:

About the coronavirus debacle in the US, a very interesting analysis from one top doctor at Columbia University

80. anon Says:

Elizabeth: What do you think about psychological therapy instead of psychiatric therapy?

I think some people could really use psychological therapy, much more than taking drugs, but they end up taking drugs. Maybe psychologists are underestimated, or costly. There’s a general trend to prefer taking drugs rather than talking with a psychologist.

81. Ethan Says:

Michael #77

Let’s see, your post is long so let me start with what you say at the end,

“And Szasz was one of those people who refused to accept this truth.
And my point was that people like you can’t accept these truths”

What do you know about what I accept and I don’t accept as truth? Also, you are misrepresenting Thomas Szasz’s views taking one of his sentences out of context. He wasn’t a promoter of anti psychiatry, as you seem to be implying. In fact he wrote an entire book titled ” Antipsychiatry: Quackery Squared ” https://www.amazon.com/Antipsychiatry-Quackery-Squared-Thomas-Szasz/dp/0815609434 ” In Antipsychiatry: Quackery Squared, Szasz powerfully argues that his writings belong to neither psychiatry nor antipsychiatry. They stem from conceptual analysis, social-political criticism, and common sense.” .

I think our disagreements boil down to this,

“What is the case is that people with what we call OCD happens because some people’s brains malfunction”

Replace OCD with any other DSM label. The bottom line is that the notion of DSM disorders being triggered by brain malfunction remains a hypothesis that has not been verified scientifically. Ie, there is no “proof” of brain malfunction associated to any of the DSM labels.

What we know is that some people experience mental distress and that distress follows patterns that the APA likes to “label” as disorders. Using vocabulary of machine learning that is currently on fashion, the DSM is the ultimate book of “ground truth” for what the members of the American Psychiatric Association -particularly the members of the committees who vote the diseases- consider to be disordered behavior.

You might as well think in terms of “behavioral diversity” and say that provided that there is no crime, all those behaviors are part of the normal spectrum of human behaviors (since they have been known for millennia; what you call OCD was referred to in previous times as scrupulosity and there are well known historical figures, such as the reformer Martin Luther, who exhibited those behaviors and nobody called them “diseased”).

With this latter view, the most psychiatric drugs can do is to provide temporary relief but never cure anything that hasn’t been shown to be a disease. There is also the fact that these psychiatric drugs are known to have serious side effects. So as long as it is entirely voluntary, I see nothing wrong in people willingly taking these drugs. The key is that we should be very precise about what the DSM labels are and what they are not. What Tom Insel said in 2013 about these labels lacking scientific validity was well known inside the psychiatric profession all while many of its members were promoting the chimera of the “chemical imbalance” and that taking psychiatric drugs was like taking insulin to treat diabetes.

I am very sorry to hear about Scott Aaronson’s struggles. Rather than seeing them as a “disorder” my advise would be to see them as part of the normal spectrum of human behaviors. He is also a very smart and accomplished individual, unlike most people. Learning to accept that not everybody is the same (whether when it comes to scrupulosity or being an accomplished academic) goes long ways.

One problem with many people (I am not saying you or Scott are like this) is that they associate differences with a measure of superiority, thus they seek to impose “normality” to hide their own snobbery. I think that there is a little bit of that in the American Psychiatric Association and their conceptualization of mental distress as disorders.

The only reason they removed homosexuality from the DSM was political pressure from gay rights groups. If all people who have been labelled as suffering OCD (or whatever) became as politically engaged as gays were in the late 1960s, early 1970s, they too would be successful in being declared “normal” by the APA if that matters to them. Whatever the APA thinks in terms of disorders remains to me an opinion without scientific validity. I am with Tom Insel on that!

I’ll leave it here, agreeing to disagreeing. I see where you are coming from and I hope I made myself clear where I stand on this issue.

Pseudonym #78

Great minds think alike.

82. Pseudonym Says:

Ethan #81
Psychiatry has been used as an agent for ideological thought control/forced detention by various Marxist regimes. The official definitions and categories of mental illness in the US change to maintain consistency with Progressive political fashion thus demonstrating a general willingness to perform a domestic control function of some sort. If a science then it is a strangely malleable science.

Thank goodness pharmaceuticals were not the preferred treatment for non conforming children when I attended public elementary school.

83. Christopher Blanchard Says:

There are some truly horrible arguments in this thread. I will have a go at psychiatry in this answer, and, if I have the stamina, take a go at the politics in separate post.

First, some background. I spent several years working for a Mental Health Trust, here in England. First, promoting good communications amongst the various kinds of professional, and then as an information analyst. That included several years inside one of the old ‘Asylums’, before it finally closed, lots of time with those professionals and a fair bit of experience with seriously mentally ill people ( I wasn’t treating anybody, but people would, for example, come into my office and talk to me – just because you are mad doesn’t mean you aren’t curious and sociable). I have also had substantial mental health problems of my own – enough to stop me working for years, but never enough to get me the full scale psychiatric treatment.
That said, I know mental illness is real. Petersen and his supporters are perverse. At its most serious there is paranoia, schizophrenia, crippling bipolar disorder and killing depression, and then there are a whole lot of ‘lesser’ disorders. I am perfectly happy to go along with Petersen by accepting an important role for triggers in the onset of many of them, including stressful life events, amphetamine abuse, for example, and viral triggers for ME. But that won’t do for everything, by no means, and even where they are important they often work on underlying weaknesses. That is true for me. I wasn’t ill until I was in my forties, but, with hindsight, I can see clear illness markers back into my teens.
I should also say that I have been interested in this area since those teens, and when I was sixteen or seventeen I found anti-psychiatry very persuasive (Laing, Cooper, Esterhasy, all them, and I did voluntary work in more of those ‘asylums’). All very good for a clever kid, but I have seen too much since then. There were a lot of powerful insights in there, and a lot of vile and destructive practice to, rightly, oppose, but no version of it works.
To the substance of arguments from Ethan, in particular, about Psychiatry as a pseudo-science. Yes, that does happen, but the problem with Ethan’s argument and those promoting overblown notions of psychiatric effectiveness are the same, which is to confuse technology, which is what medicine is about, with science. The difference is that technology is about what works, while science is about trying to get closer to the truth. Obviously enough, the more you know about underlying processes, by means of science, the better your technology is likely to be, but you don’t need science to have effective methods (like ancient Roman bridges or ancient Chinese cast iron), and, until very recently, that is where most medicine has been – a set of methods, using science where it has been available and observed correlations where it wasn’t. That is most important: correlation does not mean fundamental understanding; leaking sewage into your drinking water is correlated with cholera, but that isn’t science. It is a starting point for scientific enquiry, but all the while scientists were arguing about germs against miasma (and they were, long, long after Pasteur) doctors and public health specialists were dealing with the problem, technologically.
The distinctive thing about psychiatry is that it still relies more heavily on unexplained correlations than most other kinds of medicine. Nobody, for example, ‘understands’ schizophrenia, but that is not an excuse for saying it doesn’t exist, nor for saying its symptoms can’t be alleviated with, for example, clozapine (a particularly dangerous chemical cosh, but it works).
The thing about ‘pure’ technological solutions, like that, is that they are always weaker than science based answers. There is more room for plain error, and for the kinds of ideological fantasies, not to speak of vainglory, arrogance and conceit, which have sometimes corrupted psychiatric practice, but that doesn’t make it pseudo-science, and there is no point judging it as if it were trying to be science, when it isn’t. Most psychiatrists of my acquaintance would love it if it were, and will use everything scientific they can get, to support their work, but they know a big part of what they do doesn’t come from there, and Ethan, targeting people who pretend otherwise is reasonable, but not the whole profession.

84. Ethan Says:

Pseudonym #82

I know that psychiatry has been used as a political weapon. It has been done by totalitarian regimes of both left and right unfortunately (check https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry ). It is not surprising given that psychiatric diagnoses cannot be falsified. The very pseudo scientific nature of the diagnoses make them a great tool of mind control in the wrong hands, whether it’s totalitarian governments, religious cults, etc.

Christopher Blanchard #83,

I think I have made my arguments very clear. I decided to stop posting but I rush to correct a misrepresentation of my arguments:

“Yes, that does happen, but the problem with Ethan’s argument and those promoting overblown notions of psychiatric effectiveness are the same, which is to confuse technology, which is what medicine is about, with science.”

I am not confusing anything. To reiterate:

– DSM labels lack scientific validity. Tom Insel, said as much in 2013, on the occasion of the release of DSM 5 to justify stop funding research on mental health that was based on DSM constructs. The National Institute of Mental Health, the agency that Tom Insel then led, is the United States’ largest funder of research in mental health in the nation.

– Psychiatry’s treatments, what you call “technology”, are are best placebos. At worst they ruin lives for their extreme reliance -at least in recent decades- on drugs that have serious side effects. As this book explains in excruciating detail, https://www.amazon.com/Psychiatry-Under-Influence-Institutional-Prescriptions/dp/113750692X , we got here due to economic incentives not because these treatments work in any meaningful statistical sense. This is compatible with finding anecdotal cases of people who claim to have been helped by them. At the same time, rigorous studies show that there isn’t a meaningful statistical effect beyond placebo in some of the most widely used drugs such as antidepressants.

Now back to silence. I am happy to have a meaningful conversation about these topics, but one based on honest respect for the arguments of the other side, not one that seeks to misrepresent my arguments.

85. Ethan Says:

And something else:

One thing to bear in mind in these conversations is to understand what the American Psychiatric Association is and what it is not.

The American Psychiatric Association is a lobbying group for American doctors whose specialty is psychiatry. As any lobbying group, it fights first and foremost for the interests of the members of the lobbying group, in the American Psychiatric Association’s case, keeping their members employed and finding new “markets” for their members. It’s in this context one has to understand press releases like this https://www.psychiatry.org/psychiatrists/advocacy/federal-affairs/workforce “The U.S. health care system faces a shortage of psychiatrists. Over the next several years, demand will continue to outpace the supply of psychiatrists in clinical practice.”.

Efforts like this are not exclusive to psychiatrists, of course. What is exclusive to psychiatry is the pseudo-scientific nature of what they do. You can’t for example, overstate the number of cases of heart disease or cancer (the two leading causes of death in the United States). Thus any similar efforts by heart and cancer experts is at least backed by hard data of the prevalence of heart disease and cancer in the United States.

For mental health, particularly when it comes to DSM labels, by making the criteria as all encompassing as possible (the DSM 5 introduced the notion of “spectrum” to replace discrete categories, so that everybody is a little bit something), you can come up with numbers like these https://www.nimh.nih.gov/health/statistics/mental-illness.shtml and ensure that there will be employment for psychiatrists for decades to come.

Fundamentally, the American Psychiatric Association does not NECESSARILY have the interests of mental patients in mind. Obviously for the whole thing to work in the American Psychiatric Association’s best interests -particularly in an American context where the legal standard for involuntary psychiatry is very high- people must want to voluntarily accept psychiatric treatments, but as the book https://www.amazon.com/Psychiatry-Under-Influence-Institutional-Prescriptions/dp/113750692X shows in excruciating detail, when there is a conflict of interests, the American Psychiatric Association, and its members, almost always follow the advice of those with the largest pockets which is typically the big pharmaceutical companies, not the patients. That explains the move away from “talk therapy” and towards “medication management” that has happened for decades in American psychiatry. This is a somehow old reference on this matter https://www.scientificamerican.com/article/psychiatric-drugs-replacing-talk-therapy/ and I found this newer reference that seems to be encouraging news for patients https://ihpi.umich.edu/news/long-run-drugs-talk-therapy-hold-same-value-people-depression . Needless to say, I think that any move in the direction of “less drugs, more talk therapy”, is triggered less by an interest in the patients’ well being and more by Big Pharma getting slowly out of new psychiatric drug development because of this https://projects.propublica.org/graphics/bigpharma . For the average psychiatrist, drugging patients is more lucrative than giving talk therapy but the scandals detailed in the Pro Publica page make it clear that for the drug companies themselves there is a reputation cost in continuing the business model of pushing psychiatric drugs.

Now I go back to silence.

86. Rahul Says:

Scott, what do you mean by

“A minority gets to install a dictator”?

I mean I don’t like Trump either, but how’s he a dictator and appointed by a minority.

Is that just hyperbole?

87. Christopher Blanchard Says:

Another post about horrible arguments. This one about politics.

You might have noticed that a woman called Marjorie Taylor Greene has just won a primary election in Georgia. She seems to support that idiocy called ‘Q’, and is a malevolent racist as well. So that leads to my central point. People don’t say this, but I rather think they should. Pseudonym says “The Left’s comments ….. are generally ad hominem attacks from an assumed position of intellectual and moral authority …..” I’m afraid, Pseodonym, that I am intellectually and morally superior to that person. I don’t need any covert assumptions to make it so – any ordinary description of ordinary moral attitudes and intellectual capacities will give you the same answer – she is my inferior. There you have it, and lots of registered Republicans voted for her, so they are suspect. Not proven inadequates or deplorables, just suspect.
Now for the qualifications.
I have said on another thread here (least I think it was here) that I am, like any fully formed person, a mixture of conservative, liberal and left wing. Different people have different proportions and emphases, but even the most conservative American favours democracy, and that is inherently left-wing (please note that I do not mean socialist – the left has existed rather longer than socialism and is not the same thing), and even Woody Guthrie valued American traditions and established culture (though obviously not all of them/it), and that is inherently conservative. So I don’t have a problem with anyone having a different bundle, but Trump, and some Trumpists, like Greene, are outsiders. We are in here, and they are out there. Truly not like us. Fully human, of course – I don’t de-humanise, but that is a low bar because Ghenghiz Khan and Joe Stalin were just as fully human as I am, but really, not like us.
That doesn’t mean every Trump voter, of course. I can see the pragmatic arguments, the arguments from desperation and the arguments from religious principles. I think they are all misconceived, but they are all serious and worth countering reasonably, and I can see how self interest and a desire to protect one’s position can do the same job. Even, to put the best construction I can on people like Lindsey Graham, how he might aim to preserve his party and position so that he can do what he thinks is good at some time in the indefinite future. But for all that, there is a large proportion of Trump support which is immoral, and I include racism as a kind of immorality, or stupid, or mad, and I don’t think you can get away from it.
That leads me back to the comments on the thread.
First. We, the broad left (and I am more there than elsewhere) are characterised as urban, over-educated, and out of touch with what, in Britain, we would call the working class. Well, I have a couple of those degrees, got later in in life after working as, amongst other things, a fork lift driver; my friends include painters, classical musicians, and academics, as well as welders, window cleaners, and military (pretty well all retired by now); my family went through that class transformation common in the fifties and sixties, so my mother (an immigrant to Britain) went to school in bare feet, but ended up a nurse, and my English grandfather went from ploughboy, to plough foreman to Ministry of Agriculture pest control officer (man with shotgun shooting crows, and with cans of poison gas for rabbits), so no, I am not out of touch with just about any social group. (I suppose I ought to add, in case it comes up, I’ve lived in heavily West Indian areas, and dealt hash, and played regular darts in the pub with the Muslim youth, before the current religous revival made that kind of thing impossible. Oh, and my coal miner relatives – but enough).
Second. To ThirstMutilator #15. There is a shortage of good faith, but it is not evenly spread, and there are different reasons for it. The Trumpists, and their supporters (for whatever reason) characterise the US centre and left as “enemies of the people” and so on for pursuing well predicated investigations into corruption (how many convictions from Muller? I’m not going to look it up but it is a lot), and for going on peaceful protests, and so on. That characterisation is dishonest. The centre (including the Lincoln Project, for this purpose) characterise Trump as a potential Mussolini (though Mussolini didn’t much care about money, and he seems to have been cleverer), and that is reasonable, so there are not two equivalent sides here. There are the honest, with all their manifest faults, which are centre and left (and despite a fringe of looting opportunists at the edges), and there are the dishonest who follow Trump, gerrymander your electoral districts and seem intent on suppressing as many votes as possible – just like Jim Crow. So yes, this does erode faith in the electoral system, but the fault is almost all on the far right.
Third. Elizabeth #20. You suggest Biden would not accept a Trump landslide. I have seen absolutely nothing to suggest that, so long as it is a real win. All the threats I have seen have come from Trump and his acolytes. Again, there are two sides to this. There is an honest centre and left against a potential dictator. There is no equivalence. Scott #28 did add the threat of further illegal and destructive behaviour from Trump after a victory, but did not suggest that would justify overturning the election. It might, in my view, justify impeachments, but they would almost certainly fail, and then there could be violence but, and this is the crucial part, it would be self defence against illegal acts. There are too few revolutionaries in the US to make any difference to that at all (that’s not to say they won’t try, and I have known a few of their British equivalents, including in my family. The poor fools never give up).
Fourth. Nonagon #38. All those other kinds of conservative you refer to are not in charge. It hardly matters any more how many people align strongly with Trump and Marjorie Taylor Greene, and how many of their voters have other and more respectable reasons. Trump is actually the boss, so you have to deal with Scott’s list, even if all those invisible respectables wouldn’t do any of them. They don’t have the power, he and his do have it. The other conservatives you refer to have disenfranchised themselves already.
Fifth. Elizabeth #39. Trump certainly has returned to white nationalist rhetoric it this cycle, as in re-tweeting those cries of “White Power”, and lots of other filth.

There could be more. Elizabeth and Pseudonym are drifting towards trolling (throwing in climate change?) so I won’t go on.

88. gentzen Says:

Christopher Blanchard #83: What you write is very reasonable. But it remains unclear to me which “truly horrible arguments in this thread” you are trying to address:

That said, I know mental illness is real. Petersen and his supporters are perverse.

Jordan Peterson and his supporters may be perverse, I cannot comment on that (since I don’t know enough about him or his supporters). But please don’t reach this conclusion from that short clip. That clip was selected because it was short, and because it had a similar “mood” as displayed by Ethan. And that clip was not about psychiatry, but about “… gonna be a psychologist …” Neither me nor Peterson were arguing that mental illness would not be real.

if I have the stamina, take a go at the politics in separate post

Well, good luck with the stamina. But maybe try to avoid calling other people perverse, because it probably won’t increase the impact of your message.

89. gentzen Says:

Ethan #84: I still doubt that psychiatrists are the bad guys.

I am happy to have a meaningful conversation about these topics, but one based on honest respect for the arguments of the other side

I cannot talk for the US, but at least in Germany, psychoactive drugs (“Angstlöser”) are often also prescribed by primary care physician, not just by psychiatrists. You may believe that addiction to such drugs is hard to break, but the effect of a real psychiatrist getting angry when she learns about such cases is stronger than you may expect, especially the effect when she tells the “victim” some of the side effects it probably encountered already, and some of the probable long term side effects.

What the statistical studies show is that on average you can attribute the alleged benefit to a powerful placebo effect (such as once the drug kicks in people think they are getting cured and get better as a result).

The way you invoke the placebo effect as an explanation doesn’t feel overly scientific to me. You have to design your studies in such a way that they don’t get invalidated by the placebo effect, but that doesn’t mean that the placebo effect would be a good scientific explanation all by itself. I get the feeling that you explain things by the placebo effect as if it would be some kind of well known magic.

Did it ever occur to you that part of the placebo effect is caused by a feedback loop between thinking, feeling and behavior? Some of the very real physical effects attributed to the placebo effect might have very real physical explanations, in terms of modified behavior of the patient (like drinking less alcohol). Some other parts of the placebo effect might also have mundane explanations, like that the measurement of the symptoms involves interviewing the patient, so that his mental images can have a direct impact on the measurement results. I don’t deny that there is also a part of the placebo effect that is independent of such mundane explanations. But the possible feedback loops can be an argument in favor of short term (or even medium term) treatment with psychoactive drugs. (It cannot be used to justify long term treatment with psychoactive drugs.)

90. Ethan Says:

I really want to go back to silence but I keep being asking to comment:

gentzen #89

“I cannot talk for the US, but at least in Germany, psychoactive drugs (“Angstlöser”) are often also prescribed by primary care physician, not just by psychiatrists”

The same is true in the US, which takes me to this,

“Ethan #84: I still doubt that psychiatrists are the bad guys.”

There a few truly evil psychiatrists in the United States. If you excuse Scientology’s hyperbolic language, one thing they have done is to compile a list of psychiatrist who have been convicted of crimes in the exercise of their profession. You can find it here http://www.psychcrime.org/database/

Naming the perpetrators of crimes (whether it’s sexual abuse by Roman Catholic priests or sexual abuse in academia) is an American tradition to keep people honest. I think that this would be probably tougher to do in Europe from the way I understand privacy rights work over there but I could be wrong.

I think that the psychiatrist listed in the aforementioned database are exceptions though. For the most part though, I would not use the word “evil” to describe most psychiatrists or primary care doctors who have been pushing psychiatric drugs in recent decades. There is a saying in American English that goes by the name of “Hanlon’s razor” that says “Never attribute to malice that which is adequately explained by stupidity”.

In a US context -and I assume the same is true elsewhere in the Western world- primary care and psychiatry are two of the least desirable medical specialties. You can see this reflected in numerous ways, the best proxy is probably average pay https://www.kaptest.com/study/mcat/doctor-salaries-by-specialty/ . Of 29 specialties considered, psychiatry is ranked 22 whereas internal medicine and family medicine occupy 24 and 27 respectively. What this means is that statistically speaking, the least ambitious/competent graduates of medical school end up picking, among other specialties, psychiatry and primary care.

You can see why for the drug companies this was a boon. All you had to do is to pay these people “trainings” at luxurious resorts in Hawaii explaining them how the latest wonder drug worked to treat DSM disorders and they would go back home pushing pills. This might sound like a joke, but it isn’t. One of the provisions included in Obamacare was the Sunlight Act, a piece of legislation long fought for by Republican Senator for Iowa Chuck Grassley. It forces pharmaceutical companies to disclose their payments to doctors. In the first edition of the data you could find that https://www.propublica.org/article/dollars-for-docs-the-top-earners “Most of these in-demand speakers hail from a just handful of states: four each from New York and Texas, and two each from California, Massachusetts, Pennsylvania and Tennessee. Half are psychiatrists, including three of the top four earners.” . Things have changed in recent editions, but you get an idea of how the scheme works.

I forgot who said the following (it’s not my original thought, I heard it from someone else). One way Scientology’s criticism to psychiatry is misguided is that they suggest this crazy conspiracy theory by the APA to dominate people’s minds when in fact there is something much simpler at work: the forces of capitalism. You can see from the perspective of these doctors the thing is a good deal: they get to go on vacation for free, be assured by powerful corporations that drugs X, Y and Z are safe and effective and all they need to do when they go back home is to prescribe the drugs. The scheme is used to push other drugs too, except, as we have already discussed, if you prescribe a drug that lowers the cholesterol levels, at least you have an objective way of measuring whether the drug is effective. In the case of psychiatric disorders? Not so much!

From the perspective of the drug companies this was also a pretty good deal until the criminal cases for illegal promotion of psychiatric drugs (case in point Paxil/paroxetine for depression in adolescents via a ghostwritten article based on Study 329) began to pile up. It began to impact the bottom line of these companies mostly in the form of reputation damage (the fines were just a cost of doing business as you can read here https://www.pogo.org/analysis/2009/09/big-penalties-for-big-pharma-just-another-cost-of-doing-business/ ) so big pharma companies decided to look at other areas of medicine for the next blockbuster drugs, areas where the efficacy of the drugs (such as the curing of Hepatitis C with Sovaldi) can be measured in objective terms, something that avoids a lot of PR headaches for the drug companies.

Now I go back to silence…

91. Ethan Says:

“there is something much simpler at work: the forces of capitalism”

“But there’s nobody planting disorders in the DSM in order to get drug money. You know, you don’t need conspiracies like that when you have capitalism. Every diagnosis is a market, whether the people who make the diagnosis up intend it to be that way or not.”

That was Gary Greenberg author of “The Book of Woe”, one of the numerous books published in 2013 criticizing the DSM on the occasion of the release of DSM 5. This was in the context of the joint interview for NPR with Jeffrey Lieberman (then president of the APA) and Tom Insel (the director of the National Institute of Health).

92. nonagon Says:

@ Scott #71

I’d like for the Trump supporters to stop being Trump supporters, and become moderate Democrats, or at least never-Trump third-party voters or abstainers. And I’m sure the Trump supporters would like for me to become one of them. That’s called “politics.”

(Many of the paragraphs below are implicitly prefaced by the words “I think”).

I disagree. A major aim of US politics is ensuring peaceful coexistence with fellow citizens who hold different axiomatic beliefs.

The “peaceful” part is important and I agree that one sure path to broken politics is the threat of violence, or actual violence, from a political group.

Currently, a subset of the Left is engaging in this dangerous behavior. Adapting to this behavior by wishing for others to vote against their interests seems like a guaranteed way to permanently break a political norm against violence.

Yours seems like a Borg-ian view of politics: anyone you don’t consider to be a “moderate Democrat” is somehow assimilated to align with your values. With tempers high and a media happy to capitalize on divisive reporting, perhaps this is a majority view today. This is the threat that worries me.

Because, despite some bumps, much of what makes the US so amazing has derived from a general resistance to the lures of this idea, as seductive as the belief that political power grows out of the barrel of a gun. Wishing for a political monoculture has echos of so many ideas that are emotionally satisfying but ultimately net-negative: “with us or against us” Bush-ism, SJW ideology, cancel culture, ethno-nationalism, to name a few.

Even as a wish, *which is all I think you’re expressing*, it should raise all sorts of red flags. I mean, history offers evidence that we can easily sink into a world where this wish is granted, but I don’t think you or I would enjoy living in it (for very long) given the logical conclusion of such politics. Diversity of thought/ideas/values, including all its ugliness, is the only strong defense.

There’s more I could say, but I suspect I’m wasting your time. And I have to prepare for the semester, which at least is a nice diversion from the culture war. Apologies in advance if I’ve misunderstood your views.

93. nonagon Says:

@ Christopher Blanchard #87

“I’m afraid, Pseodonym, that I am intellectually and morally superior to that person.”

I just want you to know that I stopped reading at this point. Heuristically, people who make such claims have a positive estimate of their intelligence that is unjustified.

94. Chad Brewbaker Says:

AWS Bracket review when you get a chance? Links to some Jupyter notebooks of interest?

95. Pseudonym Says:

Ethan #91

This popular article describes quite well how the Pharma-Doctor dynamic you reference can work and in this case also the Pharma-Regulatory Agency dynamics. It is quite shocking for someone such as myself that is far way from the medical community but there are enormous sums of money involved and so…

https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

96. Ethan Says:

Pseudonym #95

Who could forget the OxyContin scandal in the US?

Note that this way of pushing drugs/treatments by big pharmaceutical companies has been Big Pharma’s sales model for years. It’s nothing new.

It’s one of those things rooted in evil government. Since doctors -in the US but also from what I understand in most of the world both inside and outside the Western world- have drug prescription privileges, if you are a pharmaceutical company, you target doctors in your go to market efforts.

Something that from what I understand is exclusive in the US is the direct to consumer advertising. So in the US, pharmaceutical companies target both doctors and the consumers themselves. The largest pharmaceutical company in terms of revenue is Pfizer. If you check here for the numbers of their 2019 fiscal year https://finance.yahoo.com/quote/PFE/financials?p=PFE, they spent more in selling (14.35 billion dollars) than in R&D (8.65 billion) and than what costs them to produce their drugs (so called cost of revenue at 10.22 billion dollars). Pfizer still made ~ 16 billion dollars in net income in fiscal year 2019.

What makes psychiatric drugs -and to a lesser degree painkillers- different is the lack of objective way to measure their efficacy. These drugs typically get in trouble when in the market they show problems in those who use the drugs long term. In most cases, the PR machines of these companies seek to minimize early reports of trouble. In the case of OxyContin it took a long time -and lots of adverse press- before the scandal unfolded.

Does anybody remember Vioxx? That was the painkiller that Merck was forced to withdraw from the market in 2004 after press reports that it increased the risk of heart attacks after 18 months https://www.npr.org/2007/11/10/5470430/timeline-the-rise-and-fall-of-vioxx “Research later published in the medical journal Lancet estimates that 88,000 Americans had heart attacks from taking Vioxx, and 38,000 of them died.”. Merck ended up paying 4.85 billion dollars to settle lawsuits and moved on!

The pattern is clear:

– release wonder drug
– push wonder drug via paying doctors for “training at exclusive resorts” and heavy direct to consumer advertising
– if the drug proves problematic, deny, deny, deny
– with enough bad PR admit “never mind, here are a few billions to settle claims”
– move on to the next wonder drug

In the long run, big pharma companies make humongous profits and, importantly, so far nobody has gone to jail for any of these scandals even when companies have settled criminal charges. That’s right! If you are an individual caught doing something criminal, most likely you go to jail. If you are a big pharmaceutical company caught doing something criminal, you pay a fine. Check https://projects.propublica.org/graphics/bigpharma and the fines paid by Pfizer, GlaxoSmithKline, Johnson & Johnson, Amgen and Endo.

Why people still have faith in these legal drug cartels is beyond me, but that’s the system that we have!

97. Pseudonym Says:

Christopher Blanchard #87

Thank you for personally demonstrating my fundamental point. Racism is such an overused term that it doesn’t have consensus meaning at this time. Do you mean (from Dictionary.com)-

“a belief or doctrine that inherent differences among the various human racial groups determine cultural or individual achievement, usually involving the idea that one’s own race is superior and has the right to dominate others or that a particular racial group is inferior to the others.“?

I looked closely at what I wrote to understand why I was a troll (one who conducts trolling) because of climate change. I found no where that I wrote climate change. I referenced specific predictions including specified dates that have come and gone and noted that these predictions were incorrect in the extreme. I am certainly aware that the climate has changed from the formation of the earth and will continue to change until its ultimate destruction.

98. Christopher Blanchard Says:

Nonagon #93

My implicit point was that we all have these boundaries, though usually very fuzzy, so I’m inclined to think we should face up to them. They are different for different people, but thinking them through can sometimes help. Boundaries between what is morally acceptable and what not are implicit in every post here – we can’t get away from them, so coy obfuscation won’t do.

By way of partial example, withn the danger of caricature (including of my own life). I think there is a common left/right difference: I have had communist relatives (I think they are now all dead, but no matter), and some of them have seemed to me to be decent and more or less rational, but wrong about some fundamentals. I could have dinner with them, talk and drink beer, and no hassle. I also have marxist friends, and the disagreements get fierce, but we get on despite. Now, I suspect there are some right wingers who will look at Marjorie Greene and say, sort of equivalently, that she is wrong but ‘somehow’ all right. That is pertinent, because the question then becomes ‘where should my boundaries fall’?’ I think, for now, that my characterisation of Greene as morally inferior to me is reasonable, but I would like to hope that we could communicate, and I do recognise, very much so, that some of my relatives and aquaintances might be in your ‘deplorables’ bag. The question is going to be, therefore, can we communicate enough to modify those perceptions? I suspect, and I might be wrong, that a conversation between me and Greene would just end up in mutual contempt (and I am good at talking to people I disagree with), while your conversation with the more easy going of my marxist friends would, at least, be a discussion about substance (even if it might get down to loud voices). If that is right, and it is a big if, then my boundaries are more reasonable, so people who see Greene as an acceptable sort of human being should think about changing theirs.

99. Pseudonym Says:

Just a random fact that I find interesting and haven’t seen referenced elsewhere-

Decline and Fall of the Roman Empire by Edward Gibbon was fully published by 1789. He notes in one of his volumes (sorry I don’t have the location) that human activity warmed the climate and that as a result the major European rivers no longer froze in the winter. The loss of winter roads seriously complicated the logistics of the Northern European barbarian tribe’s campaigns against the Roman Empire.

100. Christopher Blanchard Says:

Pseudonym #97.

Thank you for your reply, but I’m sorry, I don’t think I have demonstrated any of your points, really.

I called Marjorie Greene a racist. I guess that is central. If I am wrong please let me know. The word ‘race’ has a field of plain english meanings, principally, that black people are inherently different to white, and secondarily that there are such things as an Italian ‘race’. I have pointed at this on other threads, so without going into the genetic patterns, all I will say here is that this plain english meaning is a set of vicous, stupid, social constructs, which have nothing whatsoever to do with genetic differences between lineages and, because of that plain meaning, its use poisons everything it touches. For detail about the genetics try Cavalli-Sforza, and his successors.

Greene has said that the reason black and hispanic people in the USA are poorer and have lower average educational attainment, and all the rest, is because of gangs and drugs and because ‘they are lazy and sorry and pathetic’. And ‘that’s not white people’…’. Unfortunately, she is wrong.

That means, as I said, that Greene is wrong: a substantial number of white people have deliberately built and maintained the poor conditions which your poorest people endure and, where those people are black, there are a lot of Americans seem to want to keep things just that way. Her claims, with all her others, like ‘Islamic invasion’ and her enthusiasm for Confederate memorials, show that she is one of those people, in other words a racist, despite her saying, repeatedly, that she isn’t.

101. Ian M Finn Says:

I’m wondering if you have any thoughts on this science article from the past week?

To an outsider it seems significant!

https://science.sciencemag.org/content/early/2020/08/12/science.abc5186

Decoherence limits the physical realization of qubits and its mitigation is critical for the development of quantum science and technology. We construct a robust qubit embedded in a decoherence-protected subspace, obtained by applying microwave dressing to a clock transition of the ground-state electron spin of a silicon carbide divacancy defect. The qubit is universally protected from magnetic, electric, and temperature fluctuations, which account for nearly all relevant decoherence channels in the solid state. This culminates in an increase of the qubit’s inhomogeneous dephasing time by over four orders of magnitude (to >22 milliseconds), while its Hahn-echo coherence time approaches 64 milliseconds. Requiring few key platform-independent components, this result suggests that substantial coherence improvements can be achieved in a wide selection of quantum architectures.

102. Pseudonym Says:

Christopher Blanchard #100

I don’t think this is the proper venue to continue along this path and so this is my last response-feel free to have the last word. I looked at all the videos I could find of her today and could not find, nor do I believe, she has said much of what you attribute to her. One of her main themes is that equality under the law means equality under the law without consideration of race.

If we conducted a blinded objective test of all the people in the US Congress I doubt she would score the lowest intelligence, nor the least knowledgeable about the Constitution, nor the least knowledgeable about US History, nor of global history, nor lowest on empathy, etc.

I personally do not believe the impact of oppression necessarily lasts for generations in the US-there are too many counter examples. I personally believe there has been no greater force for progressing global civilization than the US. I believe that Britain did visit a great horror on civilization by commercializing their interests in the New World by use of slaves from West Africa. Britain has also of course made many positive contributions to Civilization as well.

I personally do not need any sort of explanation about the difficulties of overcoming very humble beginnings and there are very very many people in the US that share my experience. More people from each and every race share this experience in the US than any other country I know of now or at any time in history. The world could do far worse and maybe this belief will soon be put to the test.

If you believe differently then certainly your prerogative.

103. Douglas Knight Says:

Pseudonym 99,
Gibbon talks about the climate of Germany warming from ancient times to modern, principally in Chapter IX. But a quick google search finds no one claiming that he attributed that change to human activity; nor that he claimed climate over the course of the conflict between the Western Empire and the Germans.

In fact, the climate changes faster than he claimed and did cool over the course of that conflict. Gibbon’s claim appears odd, since he lived in the Little Ice Age, which was probably colder than the Roman Climate Optimum. But maybe Germany did something else.

I believe that several people propose cooling caused the Migration Period. Kyle Harper wrote a recent book emphasizing the effect of cooling on agriculture.

104. Pseudonym Says:

Douglas Knight #103

Thanks for this.

On page 247 He states-“The modern improvements sufficiently explain the diminution of the cold.” These improvements he notes were the clearing of the Hercynean forest, the draining of morasses, and the cultivation of soil. These are human activities and as a result his explanation for the temperature becoming more temperate.

You are correct about no reference to complicating logistics- I mis remembered the passage thinking he was comparing two periods during the barbarian campaigns when actually he was comparing Germanic tribe period to his own time. Thank you for the correction.

105. Ethan Says:

Pseudonym #102

I could not have said it better,

“I personally believe there has been no greater force for progressing global civilization than the US”

And

“I personally do not need any sort of explanation about the difficulties of overcoming very humble beginnings and there are very very many people in the US that share my experience”

I am living proof that the American Dream is alive and well. I prefer not to give personal details but I now more convinced than I have ever been in my life that I could not have achieved as much as I have, coming from a very humble background, anywhere else in the world. As Bono’s U2 says here https://www.youtube.com/watch?v=Tg3Xzh2cXD8 , the United States is one of the greatest ideas in human history that is worth fighting for. Can you imagine a world where China, with its totalitarian ways and its single minded Confucianism, gets to dictate the destiny of the world?

America isn’t perfect but it is still the world’s best hope for a better and more prosperous tomorrow.

106. Pseudonym Says:

Douglas Knight #103

Edward Gibbon and Climate Change would be an amusing exercise. The following is just a quick Wikipedia chronology-

1737-Gibbon born in England
1740-Frost Faire in London (Thames heavily frozen)
1753-1758-Gibbon sent to Lausanne Switzerland by father to reflect on his contamination by Roman Catholicism (Jesuit priest at Oxford involved)and recalled by father for pursuing The singular love interest of life (“I sighed as a lover, I obeyed as a son”)
1776-Gibbon publishes first three editions of Decline and Fall
1789-Frost Faire in London (first since 1740 and rapidly melting ice caused loss of life)
1794-Gibbon dies

So his life was bookended by strong freeze events on the Thames but I haven’t tried to find any of the temp records for his middle years.

There was a neighbor that i often saw and every time I saw him he added some comment about the climate apocalypse (good guy otherwise). After a time I looked for estimates of ice age sheet thickness at this northerly location. The estimate was one km (I think this is overstated due to current topography and soil depth but anyway). The next time he started his climate shtick I answered that during the last Ice Age there was a kilometer of ice here and I prefer the current climate. He looked puzzled and asked-Ice Age? You mean the cartoon? The only reference he had for “Ice Age” was the cartoon.

I don’t know how the typical person determines what is the “normal” climate (other than what he is told) but believe it may be partly based on some particularly fond memories during childhood and the current weather can never equal the memory of that one great summer.

107. Pseudonym Says:

Ethan #105

I enjoyed the Bono video.

There is one Confucian warning that I believe should be heeded in the US-
When what is said is not meant then that which ought to be done remains undone. 🙂

Words have been weaponized against context so meaning has lost to form.

108. Anonymous Says:

Ethan #55:

Speaking of Szazs, the discussion between Bryan Caplan and Scott Alexander on the modern relevance of Szazs’ arguments may be of interest to you.

https://slatestarcodex.com/2020/01/15/contra-contra-contra-caplan-on-psych/

109. metacelsus Says:

There’s a new paper out on the Wigner’s Friend paradox: https://www.nature.com/articles/s41567-020-0990-x

I’m still not quite sure how their experiment is different from Bell’s inequality. Can anyone explain it for me?

110. fred Says:

Ethan #105
“Can you imagine a world where China, with its totalitarian ways and its single minded Confucianism, gets to dictate the destiny of the world?”

It’s only recently that the CCP has been reviving and promoting Confucianism on their population, in the hope to try and correct for a lack of traditional values in the generations that lived (survived) through the Cultural Revolution.

111. Ethan Says:

Anonymous #108

Thank you for bringing this conversation to my attention. Is Bryan Caplan this same Bryan Caplan https://en.wikipedia.org/wiki/Bryan_Caplan ? The name sounded familiar and then I realized he is the same guy who wrote https://en.wikipedia.org/wiki/The_Case_Against_Education , another book that greatly resonated with me.

If it’s the same guy, it’s no accident. I want to keep my identity anonymous but let me disclose something about me which explains why if Bryan Caplan is the same guy who both has the ongoing conversation with Scott Alexander and the guy who wrote The Case Against Education” I happen to resonate with his arguments: I took have libertarian sympathies :).

I hate both mainstream American political parties equally. They are both more interested in keeping their people employed at the taxpayer’s expense than in doing anything good for American society. On paper, the Democratic Party is the most statist of the two until you see that the Republicans also like to spend the taxpayer’s money, only on different pet projects such as having a very large military. I rarely vote in elections, and when I do, I typically look at the lesser of two evils rather than an enthusiastic “for” vote. I am of the opinion that the best government is the one that does least and leaves as much room as possible for private initiatives to lead society.

Now, to be clear, I am not an anarchist and I believe that some form of government is necessary. Also there is a lot of disagreement among libertarians on many issues because the only thing we agree on is “more government is generally evil”. Take the upheaval currently going on in the US following the death of George Floyd. I support the message of the Black Lives Matter movement (the actual organized & violent movement with Marxist overtones is a different matter). People forget that if 240 + years after the Revolutionary War we are still having this problem is because the US Constitution (government) was born condoning slavery. Then the so called Plessy v. Ferguson decision by the US Supreme Court (government) condoned legalized racism for several generations in spite of the plain reading of the XIV-th amendment. Further, Plessy v. Ferguson has not been explicitly overturned by the US Supreme Court even though later decisions starting with Brown v. Board of Education undermined it to make it moot.

So yeah, I do understand the gist of the ongoing argument about psychiatry between Scott Alexander and the aforementioned Bryan Caplan and I obviously take the latter’s position. Something that would make me change my mind? The day any of the “DSM labels” is shown to have a biological root cause the way covid19 has been shown to have a biological root cause.

Take homosexuality, which was until 1973 a mental illness according to the American Psychiatric Association. The largest study I am aware of into the biological origins of homosexuality failed to identify a “gay gene” https://www.nature.com/articles/d41586-019-02585-6 . The reason homosexuals suffered until very recently (many still do, but things have gotten better in a US context although things are definitely pretty tough in most of the rest of the world) is a society that was largely hostile to the sexual preferences of around 4% of the American population. In just 20 years, American society went from passing the Defense of Marriage Act by overwhelming majorities in the US congress to condoning gay marriage by the US Supreme Court. With genuine biological diseases, society’s consideration of the disease is irrelevant as to whether the disease is bad for you. This is to me one of the biggest flaws in the argumentation of people like Scott Alexander. Would it be nice if the members of the American Psychiatric Association tolerated each and every single one of what they call “disorders” instead of making a living out of stigmatizing people with preferences that are different from their artificial “normal”? I know that the APA has anti-stigma campaigns, but that just shows you how dysfunctional institutional psychiatry is. You cannot call someone “disordered” -with the full backing of people who have medical degrees from America’s most prestigious medical schools- and then expect the rest of society to be OK with it. That’s basic human nature.

Rich Peterson #67 mentioned the case of Palo Alto High (there was a conversation about this a few years ago in America’s mainstream press https://www.theatlantic.com/magazine/archive/2015/12/the-silicon-valley-suicides/413140/ ). I can’t recall a single expert making the argument that getting a bunch of smart, hyper competitive kids together for 4 years and telling them that “unless you get into an Ivy League school, MIT or Stanford you are a loser” could be bad for their mental health. It was all about “gee, this is the impact uncheck depression has on kids”. Sure. One reason the notion of “mental illness” is popular with highly educated parents is that it absolves them from their own responsibility. The kid didn’t get to Harvard and committed suicide? Gee, it was a mental illness, it wasn’t us pushing the kid hard!

Pseudonym #107

As I have said previously, great minds think alike!

112. Filip Dimitrovski Says:

Douglas #63: As of now, Dr. Gillman still hasn’t responded to your questions (which I slightly reformulated) about the shortage. I assume that is due to his bad neck which prevents keyboard typing. However, I saw that his blog contains some info about Nardil shortage across the world.

I also asked in a MAOI user group and some people have email communication with health service representatives but I didn’t find any reliable information on why this shortage happened and what’s in stock under what name. All I know is that people are told to switch to the closest alternative – tranylcypromine (which may perform slightly worse but has a better side effect profile).

Disclaimer: I’m not a psychiatrist and I do not understand the pharma markets. All I know is 3 people who swear by SSC’s post and by the effectiveness of this med.

113. Ethan Says:

fred #110

“It’s only recently that the CCP has been reviving and promoting Confucianism on their population, in the hope to try and correct for a lack of traditional values in the generations that lived (survived) through the Cultural Revolution.”

I think you put too much faith in institutions and their power to change society. Institutions have only one purpose: keep those who work in them employed.

Confucianism is China’s indigenous worldview that has existed for millennia. China and Confucianism go hand in hand (ie, if it were possible to completely remove Confucianism from Chinese society, it wouldn’t be China, it would be something else). The Cultural Revolution just sent Confucianism underground waiting for someone to bring it back to public view. It was the same story in Eastern Europe with Orthodox Christianity in countries like Russia or Roman Catholicism in countries like Poland. We are seeing a similar situation with Turkey and Islam. Secularism has been Turkey’s official position since 1928. 100 year later, Islam seems to be more dominant than ever over there (I do not have intimate knowledge of Turkish society but I have several Turkish acquaintances here in the United States and I also base my conclusion on press reports that are always incomplete and biased, so that’s my caveat).

This is a key flaw of totalitarian regimes BTW. They typically win the battle that puts the totalitarian regime in power, but unless their ideology is compatible and aligned with the underlying society’s values, sooner or later they end up falling.

It’s like those Americans who believe that the federal government has the power to change society’s attitudes the way European governments change their citizens’. The US is not Europe. It was born out of the ideals of a group of people who disagreed on almost everything except that they didn’t like Europe’s totalitarian governments of the XVIII-th century. Political and religious pluralism and hatred of the federal government is as American as the American flag. It’s very hard to predict who will win this November but I can comfortably make the prediction that if the ticket Biden-Harris wins, the honey moon will last less than a couple of months if at all. The recent Tea Party movement (not the one of Revolutionary times) was born on February 19, 2009, one month after Barack Obama was inaugurated. In the case of Trump, the so called “resistance” was born the night of the 2016 election. Those who expect “peace and harmony” if Biden is elected president are headed towards a huge disappointment. America’s progress towards a better and fairer society has largely been achieved through persuasion and debate, with government always playing catch up with where society is at any given point in history. In other words, the United States is a very bottom up society. Politicians who don’t understand this -such as those who sit in the US Supreme Court- always go around asking themselves why Americans don’t accept their decisions as the final word (be it the Roe v Wade decision in the case of the American conservatives or the Heller and Citizens United decisions in the case of American liberals). Simple: Americans don’t like to be told what to do, let alone what to think by a bunch of people in black robes!

114. Douglas Knight Says:

Pseudonym,

Gibbon lived at the end of the Little Ice Age, so the climate warmed over the course of his life. But he was quoting Montesquieu and the Abbe Dubos who lived a bit earlier. The climate was probably already warming, but was somewhat colder.

Filip,

Thanks!

There are several topics that should be disentangled. A shortage is a tragedy; and that doesn’t depend on any details of the cause of the shortage and the efficacy of the drug.

I don’t think Gilman knows what he’s talking about with regard to shortages generally, but that doesn’t take away from anything else he says.

115. Pseudonym Says:

Douglas Knight #114

The link is to a paper from Romania chronicling freezing events on the Danube for two millennia. It last froze allowing winter sports in 2017.

https://www.limnology.ro/wrw2016/proceedings/16_Teodoreanu_Elena.pdf

and this ipfrom the Rhine Crossing Wiki-

“ The initial gathering of barbarians on the east bank of the Rhine has been interpreted as a banding of refugees from the Huns[3] or the remnants of Radagaisus’ defeated Goths,[4] without direct evidence. A frozen Rhine, making the crossing easier, is not attested by any contemporary but was a plausible surmise made by Edward Gibbon. ”

This Rhine crossing was in 406 so a few years after what is considered the end of the Roman Optimum in 400 AD.

I was unable to locate anything from Montesquieu/Abbe Dubois that could serve as the basis of Gibbon’s passage.

116. Ethan Says:

Adding to the debate about psychiatry, an interview with Nikolas Rose:

It’s worth listening/reading entirely. Here is his webpage at London’s King’s College https://www.kcl.ac.uk/people/nikolas-rose . His position largely agrees with mine and what I understand to be Bryan Caplan’s position.

117. fred Says:

Ethan #113

“I think you put too much faith in institutions and their power to change society.”

I was only saying what the CCP is doing.

“The Cultural Revolution just sent Confucianism underground waiting for someone to bring it back to public view.”

There’s no such thing as “someone bringing something up” in current China, the CCP tightly controls everything.
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118. Joshua B Zelinsky Says:

Since this blog post seems to be turning into a pretty miscellaneous set of topics, I’ll use it to note that one of the recent Star Trek shorts https://www.youtube.com/watch?v=0j6s_zfgv4c where there’s a fair bit of quantum technobabble mentions “Boson sampling” at around the 4:50 mark. This isn’t quite the level of being named checked like David Deutsch was in Avengers:End Game, but this is pretty close.

119. Ethan Says:

fred #117

Confucianism hasn’t been shown yet to be compatible with democracy understood in a Western sense. That was American elites’ worst miscalculation when in 2000 decided to let China into the WTO.

While I am not an expert in Eastern religions, my understanding is that Confucianism is residual in Taiwan with Buddhism and Taoism being practiced by the bulk of people over there.

From everything I know, thinking of the CCP in the same way one can think of the Communist parties of Eastern Europe is a mistake. I can’t recall who said this, but I heard it said that Vladimir Lenin was a Communist who happened to be Russian while Mao Zedong was a Chinese who embraced Communism because it was the economic system the elites of the 1920s thought to be superior to other economic systems, chiefly Capitalism.

What we have today in China is the Confucian version of Capitalism (or if you will, Capitalism without the democratic political system that is common in other capitalistic societies). Communism in China is largely nominal. So far this system has only been shown to work in China.

120. Michael Says:

@Ethan#81,111- You’re talking past me. And you’re talking past Scott Alexander.
For starters, I wrote “What is the case is that people with what we call OCD happens because some people’s brains malfunction when they try to be sure they won’t hurt anyone”
And you replied “The bottom line is that the notion of DSM disorders being triggered by brain malfunction remains a hypothesis that has not been verified scientifically. Ie, there is no “proof” of brain malfunction associated to any of the DSM labels.”
Replace “brain” with “mind” if you like. I don’t necessarily mean a physical malfunction. I mean that when a person with OCD tries to make sure that they won’t hurt anyone, or haven’t hurt anyone, they become afraid of hurting people in unrealistic ways or think that they have hurt people when they haven’t. The point is, it’s not a CHOICE. What is a choice is whether or not the OCD sufferer will try to make sure they don’t hurt people and haven’t hurt people or whether they will take the tinyl risk of hurting others in order to get better.
And I never mentioned drugs. My point was this:
“And why are those categories useful? Because they guide us on how to handle these people. A woman with OCD might be afraid of hurting her baby, and in that case, it would be a good idea to tell her that she needs to risk hurting the baby. It probably wouldn’t be a good idea to tell a woman that actually wants to kill her baby that she needs to risk hurting the baby.”
We need a way to tell the woman who wants to kill her baby and the woman who won’t hurt the baby but will become more fearful when you feel her to make sure she doesn’t hurt the baby apart.That’s the value of psychiatry.
You also wrote
“If all people who have been labelled as suffering OCD (or whatever) became as politically engaged as gays were in the late 1960s, early 1970s, they too would be successful in being declared “normal” by the APA if that matters to them. ”
Again, you’re missing the point. Most gays don’t mind being gay. Most people with OCD can’t stand having OCD.
“This is to me one of the biggest flaws in the argumentation of people like Scott Alexander. Would it be nice if the members of the American Psychiatric Association tolerated each and every single one of what they call “disorders” instead of making a living out of stigmatizing people with preferences that are different from their artificial “normal”?”
Again, you’re ignoring what Scott Alexander wrote. First, keep in mind that Scott Alexander himself has OCD. And he doesn’t mind the label. in fact, many patients don’t mind the label. It’s people like you, who don’t have the diagnosis, that mind the label.
Scott Alexander wrote something similar:
https://slatestarcodex.com/2015/10/07/contra-caplan-on-mental-illness/
“About 50% of people who go to inpatient psychiatric facilities also go of their own free choice.”
You further write:
“I know that the APA has anti-stigma campaigns, but that just shows you how dysfunctional institutional psychiatry is. You cannot call someone “disordered” -with the full backing of people who have medical degrees from America’s most prestigious medical schools- and then expect the rest of society to be OK with it. That’s basic human nature.”
Again, you’re not taking into account the experiences of the patients. Arguably the majority of people with OCD refuse to tell anyone about their symptoms BEFORE they realize that what they have is OCD. It’s a relief when they’re diagnosed because it means there are other people going through what they’re going through. Some people doing the stigmatizing don’t seem to realize that the behavior they’re stigmatizing is OCD.
To sum up, yes, psychiatry had and still has problems with coercion and drugs. But that’s why psychiatrists like Scott Alexander allow the patients choice and value the patient’s lived experiences. You’re the one who’s ignoring the patients’ lived experiences because of your notions about drugs, made-up diagnoses and stigma.

121. Ethan Says:

Michael #120

First, relax. I have been very respectful in my interventions. You are using a tone that I find off putting. It’s probably not your intention, but that’s how your reply comes across.

I think our differences boil down to this,

“Replace “brain” with “mind” if you like.”

Brain and mind are two different things. I encourage you to watch this talk by Robert Burton on his book “A Skeptic’s Guide to the Mind” https://www.youtube.com/watch?v=bnu0vE2E4-M . The Amazon introduction says “Despite 2500 years of contemplation by the world’s greatest minds and the more recent phenomenal advances in basic neuroscience, neither neuroscientists nor philosophers have a decent understanding of what the mind is or how it works”. Robert Burton is a distinguished neurologist who used to work at UCSF, one of the premier medical centers in the United States.

To make an analogy to computing -which is a bit imperfect because again, our knowledge of the mind is very limited- the brain can be thought of the hardware whereas the mind could be thought of as the software.

In hardware it is possible to talk of what a well functioning hardware looks like. In software, not so much. The difference between a software bug and a software feature is in most cases subjective (there are genuine software bugs such as memory leaks but the equivalent of these would be things like cognitive deficits that can be improved with the appropriate therapy; most software bugs are deviations from an arbitrary normal behavior expected by the programmer not something that can be measured in hardware terms). That again is one of the problems with the APA: their DSM is a sacred text of what they -the members of the American Psychiatric Association out thin air- consider to be “normal”, which might or might not be what other people might consider normal. Homosexuality is the clearest example because to my knowledge is the only disease that was voted out of the DSM, but every time the DSM goes through a major revision there are so called “disorders” that fail to make it into the DSM. In a previous post I mentioned two https://psychcentral.com/blog/not-in-the-dsm-5-internet-addiction-parental-alienation-disorder/ “Internet Addiction and Parental Alienation Disorder”. Luckily for many people who love to browse the internet, the APA decided last time to take a pass on them.

You then say,

“Again, you’re not taking into account the experiences of the patients…”

Are you sure that the suffering doesn’t come from the fact that the APA has convinced the overwhelming majority of Americans with their labeling of what they call OCD as a disorder? Have you heard about https://en.wikipedia.org/wiki/Psychiatric_survivors_movement ? It’s not only gay people who are unhappy with their labeling. I copy/paste from a previous comment what a reviewer of the book Psychiatry Under Influence had to say publicly in Amazon’s website https://www.amazon.com/gp/customer-reviews/R1R0T39EZD34G0/ref=cm_cr_dp_d_rvw_ttl?ie=UTF8&ASIN=113750692X

“If you, a family member, loved one, or friend are diagnosed with a mental illness, please read this book. Don’t make the mistake my wife and I did by assuming psychiatry had our best interests at heart. Drugs are a last resort, not the first.

How ironic is was to read that one of my past psychiatrists, Dr. Andrew Nierenberg, is mentioned several times in the book. I had sought out one of the best doctors in the field of bipolar to ensure my medical treatment was optimal. It was an 8 hour round trip drive to his office each month but I felt it was worth it as he was one of the “experts”. I was saddened to read about his many close financial ties with the pharmaceutical industry, his defense of those relationships, and his participation in skewing study results.

But that’s the point of the book. Good doctors can make bad choices without understanding how those choices add up to impact the long-term wellbeing of patients.”

It doesn’t look like this particular reviewer had good things about having been labeled as “bipolar”.

To summarize my argument: I largely agree with Thomas Szasz, Bryan Caplan, the aforementioned Nikolas Rose and a long list of intellectuals who, since the civil rights era, have called psychiatry for what it is: a system of behavioral control by people who, under the excuse of their MD degrees, think that they can come up with an artificial notion of behavioral normality. None of the DSM labels has been shown to have a biological basis. In the past, when a condition -such as Alzheimer’s disease- is shown to have a genuine biological cause, it becomes a neurological condition to be treated by neurologists. If any of the behavioral preferences that the DSM calls a disorder (OCD, bipolar, schizophrenia, what have you) were to found to have a biological origin -presumably neurological- they too would become neurological conditions to be treated by neurologists. What this means is that if all the DSM labels were to be identified as having a biological cause, psychiatrists would be left with very little to do except perhaps giving talk therapy, something that a lot of professionals without MD degrees could do, thus the intrinsic economic incentive in institutional psychiatry to propose disorders decoupled of biological causes treatable with drugs (since in Western societies doctors have almost exclusively drug prescription privileges). Thankfully, in the Untied States, institutional psychiatry’s ability to enforce their patterns of behavioral normality through the coercive force of government is very limited since the 1970s, which means that you can completely ignore psychiatrists and their book if you are a law abiding citizen. Citizens of other countries, particularly those who live in totalitarian regimes, are not so lucky!

122. fred Says:

Ethan

“In hardware it is possible to talk of what a well functioning hardware looks like. In software, not so much.”

There’s really no separation between hardware and software, at least not in the sense that “software is driving the hardware”. All there is is hardware – the atoms in a computer follow only one thing, the laws of physics, their movements aren’t caused by some abstract thing called “software”.
For example, it’s impossible to quantify the “softwareness” of some arbitrary machine by looking at its atoms.
What we call hardware is made of elementary particles and, as humans, we can only access macro properties (statistical physics).
So if I hand you two machines that look pretty identical, even down to the atomic level, it would be very hard to guess whether those two machines will evolve similarly when it comes to some macro measure (which you don’t even know about a priori). In general you can never tell whether two sufficiently complex systems made of atoms in the same initial condition will evolve the same way because they have to occupy two distinct finite volumes in the universe, each with a unique relation to the rest of the universe.
Two perfectly identical laptops (an impossibility) sitting side by side will be bombarded by different cosmic rays (which do flip a few memory bits every day).
Any device that relies on analog to digital conversions can start to glitch because of noise.
And the clock of any computer is driven by some partially analog circuits (a vibrating crystal), which can start do drift with temperature and modify the timing in the circuits, which can affect concurrency and make it impossible to make the same run consistent.
That’s all why designing real-time systems is very challenging.

Software (and algorithms) is an extension of the abstract symbol manipulations going on in our minds, so in many ways software is just as mysterious as our minds. We see software as driving the hardware because we also think that our minds have choice, free-will, or our habit to use counterfactuals (if the universe was re-winded, we could affect it differently).. but isn’t our brain also a machine?
And then what is classified as a bug is really a matter of how perfectly such abstract algorithms map to certain hardware configurations. And how well the hardware evolution will mimic the expected steps of the algorithms.

It’s all gonna be even more obvious once we deal with Quantum Computers.

123. fred Says:

And even when considering software/algorithms at a purely abstract level, there’s the issue of how to express those algorithms, how to validate them, and then how to translate them into an actual computer language (C++, C, assembly, machine code).
And I think that most practical computer languages have always some ambiguity in them – e.g. many operations are left undefined, meaning that different compilers will give different results, or the same compiler could give an answer that depends on the current state of the whole machine.
Getting rid of all those ambiguities seems almost impossible (but I’m not an expert).

124. Michael Says:

@Ethan#121- My apologies if my tone was a little harsh. But I think we keep talking past each other. You don’t seem to get the point I was trying to make- the majority of people don’t understand what behaviors psychiatrists classify as OCD, for example. So how can psychiatrists be responsible for the stigma surrounding such behaviors? Anyway, I don’t either of us will convince the other of his point.

125. Ethan Says:

fred #122

“There’s really no separation between hardware and software, at least not in the sense that “software is driving the hardware”. ”

Actually, there is. If you take a computer with Windows or Linux installed on it (sorry, I am an avowed Apple/Mac hater), and you burn the computer, you don’t destroy the Linux or Windows operating systems.

These operating systems can be readily reconstructed from the media it is stored whereas the particular computer burned is lost forever.

If you were to burn all computers having Linux or Windows installed on them and all media with the bits of Linux or Windows, these would still live theoretically in the heads of the programmers who came up with the algorithms. Further, if you are a Platonist, as most mathematicians are https://iep.utm.edu/mathplat/ “Mathematical platonism enjoys widespread support and is frequently considered the default metaphysical position with respect to mathematics” you can even say that algorithms are really discovered by the humans who wrote them, so they exist in their own metaphysical plane. Thus, even if you were to kill all humans, you could still claim that software continues to exist independently of the humans and the computers.

I will further disclose something about myself which is not tangential to the debate about minds: I am a religious person and obviously I believe in the existence of the soul. You don’t have to be one to conclude that the mind and the brain are two different things. Robert Burton, the neurologist I mention above, is a self declared skeptic and he makes very cogently (you should watch the Google talk) the argument that we don’t have a clue about what minds are, let alone -I should add- what a “normal mind” is. As far as society at large is concerned, all we should care about is “criminal minds”, ie, people who actually go and do something criminal not minds who “might do something criminal”. The difference is not a minor one because the criminal justice system is based on what people actually do not on what people might do.

There is a lot of junk talk these days about the predictive power of machine learning and I am really happy that MIT hosted last year Princeton’s professor Arvind Narayanan to speak about snake oil AI https://www.cs.princeton.edu/~arvindn/talks/MIT-STS-AI-snakeoil.pdf .

When it comes to medical science, psychiatry is the original “snake oil” discipline due to its coming up with labels made up of thin air that lack any meaningful predictive power.

Certainly, psychiatry is unable to predict harmful behavior, even serious psychiatrists will admit. Check https://www.nytimes.com/2017/10/11/opinion/psychiatrists-mass-killers.html and https://www.pbs.org/newshour/science/why-mental-illness-cant-predict-mass-shootings .

But it doesn’t end there. You can make the argument that psychiatry, as it was practiced in the 1950s -less so these days in the US-, deprived us of many contributions by John Nash, the mathematician whose life was made into the movie “A Beautiful Mind”. If you read the eponymous book (I have both watched the movie and read the book) you will learn that one of the biggest misrepresentations of the movie is this notion that Nash got better because of new neuroleptic drugs. Actually, the reality is that John Nash got better on his own, once his ex-wife accepted him for who he was and stopped trying to get him committed and into psychiatric drugs. Check https://www.theguardian.com/society/2015/jun/02/dont-use-john-nash-schizophrenia-a-beautiful-mind-promote-anti-psychotics .

Tu summarize again: I stand by my position that psychiatry as it is practiced today is a pseudo science and I see little hope of it ever becoming scientific given that genuine neurological disorders typically become the subject of neurology. I tried to use a hardware/software analogy to explain my position but it is by no means necessary to argue my point of view. I will stop that line of conversation now because I don’t want the main topic to get sidetracked.

126. Ethan Says:

Michael #124

Apologies accepted. I also agree we are a bit talking past each other, but let me just add an additional thought to this,

“So how can psychiatrists be responsible for the stigma surrounding such behaviors?”

You see, most people are relatively simple minded. This has little to do with psychiatry or IQ; it’s a fact that has been observed forever and it’s a fact exploited by politicians of all political persuasions. The main argument some use to propose setting up certain barriers to voting (like making people take an exam to ensure they understand how the system works) is this observation. To be clear, I do not support enacting these barriers; all I am saying is that the people who do, use the observation that most people are relatively simpleminded to support measures like these.

If you are a smart person listening to politicians speak -even those you are inclined to support- most of the time, what they say makes no sense whatsoever. It doesn’t make any sense whatsoever to the smart person, but for most people it’s what pushes them to vote for one vs the other. Both mainstream political parties exploit the average voter’s lack of critical thinking. I could give specific examples of both mainstream political parties doing it but I prefer not to in order not to derail the conversation.

Paul Graham, the co-founder of a very successful startup incubator called Y Combinator, wrote about this very fact in a very different context, namely, attempting to explain why nerds are not popular in high school. Check here http://www.paulgraham.com/nerds.html . If you read his essays (I do), you’ll notice that the theme of “nerds are not popular and I had a hell of a time in high school as a result” runs through several of his essays.

So, take OCD -which takes many shapes and forms. For the average “simple minded” person, it will certainly come across as weird. But those like comedian Howie Mandel who have been diagnosed with the “fear of germs” variety -check https://www.youtube.com/watch?v=dSZNnz9SM4g – would probably tell you that given what is going on if everybody were like them, the covid19 epidemic would be over in exactly 15 days, the upper bound of the incubation period of the virus. So weird is definitely in the eye of the beholder.

Correct me if I am wrong, but from your writing, I take that you seem to think that being a medical doctor makes someone automatically altruistic without any economic motivations. I have met very few people in my life who, irrespective of any other consideration, I would consider as truly altruistic and not motivated to a certain degree by monetary incentives. At the same time, I have met my share of people, of the simple minded category, who would blindly trust anything someone with an MD degree would tell them.

So if we agree that most doctors do have an economic motivation in what they do, in addition to other motivations, then it is not very hard to see why the APA is largely responsible for exploiting most people’s simple-mindedness for their own objectives. Remember that the APA is not a patients advocacy group, it is a lobbying group for psychiatrists.

Take the case https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson which is typical of what used to happen in the US before involuntary commitment was severely restricted by this and other subsequent US Supreme Court decisions. It is representative of how psychiatrists used to operate: tell a family member to “report” the family member creating trouble to the authorities so that they could be involuntarily committed and taken good care by psychiatrists in a mental hospital.

Some of this still happens today, but in a different context: cases like highly educated parents drugging their kids because they cannot handle the hyper competitive high schools they are being sent to. For these parents -even those who are highly educated- the notion that their kid is not doing well because he or she “has a mental illness” that can be “treated with drugs” is music to their ears. Other situations where this happens? Cases like this one https://www.vox.com/the-big-idea/2018/5/30/17406900/police-shootings-mental-illness-book-vidal-vassey-mental-health . In cases like that nobody gets to ask, what the heck does the mom do calling the police to cope with their son? The article makes it very clear that the parents came with the idea from talking to psychiatrists.

You get a similar phenomenon every time there is a mass shooting. The reaction is always the same: the supporters of psychiatry demand the enactment of so called “red flag laws” (even though as showed by studies the ability of psychiatrists to predict violence is extremely limited) and those who want to get rid of the second amendment but are somehow suspicious of psychiatrists call for gun confiscation. There is a sizable chunk of the population who prefer the first option and today there are several states in the US with said laws.

So to me it is obvious that a combination of most people relatively simple mindedness and the incentive system in the psychiatric profession (DSM labels that lack scientific validity coupled with doctors having drug prescription privileges who benefit economically from the mere fact of prescribing these drugs to as many people as possible) makes the APA largely responsible for any stigma there might exist in society with respect to the people they -the APA- label as “disordered”, be them OCD or any other label.

I keep going back to homosexuality because the only reason homosexuals got their brand of “weird” removed from the DSM was political activism. There was no other reason.

So I hope I made myself understood. In any case, I am also happy to leave it here because at this point I feel I am beating a dead horse. Great having this conversation with you and the others!

127. Michael Says:

@Ethan #126-“Correct me if I am wrong, but from your writing, I take that you seem to think that being a medical doctor makes someone automatically altruistic without any economic motivations. ”
I never said anything like that. That’s a straw man.
Again, since you seem to keep misunderstanding my point, I’ll try to make it as simple as possible. Suppose Bob mistakenly thinks that OCD is just limited to hand-washing and fear of germs. But Bob makes fun of people with other behaviors defined by psychiatrists as OCD. So if Bob doesn’t know that psychiatrists consider those behaviors OCD, how can it be psychiatrists’ fault that he’s making fun of those behaviors ?

128. Mike Says:

How’s the UT reopening going? Are professors and students having to go back yet? It seems pretty scary, with UT Austin being crowned #1 in most Covid cases by university nationwide by the New York Times, and I’m not sure what would happen if I go there next year.

129. Scott Says:

Mike #128: Classes restart next week! But the great majority of them, including mine, are going to be online only. (Except that I plan to hold office hours outdoors in a park, with everyone wearing masks.)

Of course I, like many people here, worry that even the limited reopening could lead to new clusters. But, as I haven’t set foot on campus in several months—or in many places at all that aren’t family domiciles or parks!—I’m probably not the best person to provide on-the-ground insight about this.

130. Ethan Says:

Michael #127

“So if Bob doesn’t know that psychiatrists consider those behaviors OCD, how can it be psychiatrists’ fault that he’s making fun of those behaviors ?”

Because psychiatry is the institution in society that defines behavioral normality and it has a capitalistic self-interest in creating disorders that society considers legitimate. That’s what we saw with DSM-5: the APA replaced discrete categories -which themselves were an invention of DSM-III to escape the crisis psychiatry found itself in during the 1970s- with the notion of “spectrum disorders” so that everybody is now a little bit of anything.

Putting it differently, without artificially created “behavioral disorders” that are somehow condoned by society/government (where you live is key since it’s not the same living in the US where involuntary psychiatric treatment is almost impossible to impose even in the case of criminal trials https://en.wikipedia.org/wiki/Sell_v._United_States as living in China where one of the uses of psychiatry is to punish political and religious dissidence) psychiatrists would probably be either out of business or having the same societal consideration as astrologers.

All information people get from the media about behavioral normality that is generally accepted as truth is created by institutional psychiatry. So unless you are ready to say -I am not saying you are saying this but you certainly seem to be implying- that people don’t consider any information they get from their environment when they form their own opinions about “normal” vs “not normal”, it’s obvious the role institutional psychiatry plays in shaping public opinion about what’s normal and what isn’t normal behavior. In the United States specifically, where there is strict separation between government and religion, judges listen to institutional psychiatry in cases like adoptions, custody battles, the aforementioned “red flag” laws (even though institutional psychiatry admits it cannot predict who is likely to become violent with meaningful accuracy).

I don’t know what’s so hard to understand about the above argument!

131. Ethan Says:

Michael #127

The alternative to what I explain in #130 is that most people are naturally bigoted and their prejudices are aligned with the made up APA labels contained in the DSM. I find this alternative explanation very hard to believe because if you take for example https://en.wikipedia.org/wiki/Drapetomania , the label prompted mockery from opponents of slavery when it was proposed “Drapetomania was a conjectural mental illness that, in 1851, American physician Samuel A. Cartwright hypothesized as the cause of enslaved Africans fleeing captivity. Contemporarily reprinted in the South, Cartwright’s article was widely mocked and satirized in the northern United States. The concept has since been debunked as pseudoscience and shown to be part of the edifice of scientific racism”.

As I have said numerous times, what I see in the institution of psychiatry is a set of self appointed mind guardians pushing in society their artificial notions of “behavioral normality”. They are also smart -since they want to keep themselves gainfully employed- and listen to society’s changes when they go against their proposals. I see in these impulses not only the removal of homosexuality from the DSM but also the refusal of the APA to consider internet addiction as a mental illness in DSM – 5. If the APA had accepted to include internet addiction in the DSM, it would have been as widely mocked as Cartwright was with Drapetomania given the fact that most people are now glued to the internet via their smart phones.

But the most important point this conversation is highlighting is not even these two alternative explanations, rather, that by your own admission you seem to imply that Bob’s opinion should play a role into whether OCD not associated with fear of germs should be a mental illness whereas the fact is that in genuine biological diseases (such as Alzheimer’s) society’s opinion plays absolutely no role on whether they are actual diseases. So this conversation, in my view, lends support to the proposition that DSM labels are not and cannot be genuine diseases given their lack of underlying biological root cause.

132. Michael Says:

@Ethan#130- “I don’t know what’s so hard to understand about the above argument!”
Let me get this straight- you’re saying that if Bob watches a television show that depicts X as an OCD symptom and develops a stigma against people who do X, that’s psychiatry’s fault. But if Bob watches a television show that incorrectly depicts X as not believed by psychiatry to be a symptom of a mental illness, and believes that X is not a symptom, but still develops a stigma against people who do X, that’s also psychiatry’s fault.
This reminds me of an argument Stephen King made in 2011 about Oswald. He argued that even if Oswald could be shown to have killed JFK out of left-wing notices, it was still right-wingers’ fault because he was influenced by the right-wing environment of Dallas So if we found Oswald’s diary tomorrow, and if it said that Oswald killed JFK because was soft on communism and supported civil-rights laws, it was right-wingers’ fault. And if it said that Oswald killed JFK because he was too hard on Cuba and too slow on civil rights, it was also right-wingers’ fault.
King’s argument was a tautology- true under any circumstance. And so is yours.
(And my response, BTW, would be that there are many forces in society that seek to stigmatize behavior as “abnormal”- psychiatry isn’t the only possible cause.)

133. Ethan Says:

Michael #132, I don’t think when you wrote that you saw my comment #131.

“And my response, BTW, would be that there are many forces in society that seek to stigmatize behavior as “abnormal”- psychiatry isn’t the only possible cause.”

As far as I know, there is only one medical specialty in good standing with society -the medical associations, the courts- that makes a living out of stigmatizing people whose behavior deviate from their artificial “normal”: psychiatry. There are many other forces in society that seek to stigmatize people, I give you that (case in point astrology), but institutional psychiatry is the only one that does it with the blessings of the only entity in society that has the monopoly in the use of force: the government.

So if at the end of the day we can agree that psychiatry is the only force in society that seeks to stigmatize behaviors that deviate from their artificial “normal” with the blessings of government, that’s what I have been saying all along -plus that none of the DSM labels has been shown to have a biological basis, something that institutional psychiatry doesn’t deny. The point of the lack of scientific validity of DSM labels is not an irrelevant point. I can understand government seeking to intervene in the life of someone suffering from a degenerative neurological disease such as Alzheimer’s. The government intervening in the life of someone labeled with one of those made up DSM labels gets us a society that looks like the movie Minority Report (the so called “red flag” laws are a step in that direction).

The fact that psychiatry has a “stigmatizing monopoly” with government also means that depending on the nature of government your relationship with psychiatry can be largely voluntary except in a few cases cases -that’s what happens in the United States- or psychiatry can be used as a tool by government to punish political and religious dissidents -this is what happened in the former Soviet Union and happens today in China.

I rest my case, really. I keep beating a dead horse and I don’t know how to further explain my position. Have a wonderful weekend!

134. Michael Says:

@Ethan#131- “But the most important point this conversation is highlighting is not even these two alternative explanations, rather, that by your own admission you seem to imply that Bob’s opinion should play a role into whether OCD not associated with fear of germs should be a mental illness whereas the fact is that in genuine biological diseases (such as Alzheimer’s) society’s opinion plays absolutely no role on whether they are actual diseases”
No, that’s not what I’m saying. What I’m saying is that if Bob doesn’t know what behaviors are considered OCD, it’s not psychiatrists’ fault that he’s a bigot who stigmatizes those behaviors.

135. Ethan Says:

Michael #134

“What I’m saying is that if Bob doesn’t know what behaviors are considered OCD, it’s not psychiatrists’ fault that he’s a bigot who stigmatizes those behaviors.”

And what I am saying is that given that institutional psychiatry is the only government sanctioned stigmatizing force in society, there are many ways Bob might have come to that conclusion that certain behaviors are “bad” because of institutional psychiatry -such as media in all forms-, more so than because of other stigmatizing forces in society (astrology) and specially more so than the explanation that Bob was born a bigot who cannot change his ways.

Biological determinism is so XIX-the century! Now we know better. As genomics luminary Craig Venter says here https://www.youtube.com/watch?v=6vS7AO9XYj4 , race is a social context, not a scientific one. Don’t you think that, in an American context, the fact that the US was born with racism as its original sin had something to do with the racists tensions that last to this day? Parts of institutional psychiatry in the mid XIX-the century sought to legitimate this racism with diagnoses like Drapetomania.

Bob Whitaker, the chief editor and founder of https://www.madinamerica.com/ , one of whose articles I shared earlier, goes even further making a very convincing case here https://www.youtube.com/watch?v=H4vL2CBdDr4 that psychiatry is one of the last remnants in society of the eugenics thinking of “fit vs unift” with the “unfit” concept being the people who exhibit arbitrary behaviors as determined by institutional psychiatry. I don’t know if that’s a fair assessment but we do know that the behaviors that institutional psychiatry calls “disordered” are made up out of thin air, they have not been shown to have a biological basis -and it’s not for lack of trying- and that psychiatry remains the only stigmatizing force in society that does its job with the full blessings of government.

136. Ethan Says:

Michael #134

“What I’m saying is that if Bob doesn’t know what behaviors are considered OCD, it’s not psychiatrists’ fault that he’s a bigot who stigmatizes those behaviors.”

And since I am still not sure you understand my point, the way I understand your argument is like saying that the ruling known as Plessy v Ferguson and the doctrine known as “separate but equal” was not onto itself stigmatizing, namely, that the US Supreme Court with this ruling played no role in the racism that affected Black Americans in the ensuing decades, that it was all the fault of the average bigoted Joes or the local governments that didn’t understand properly the “egalitarian” intention of the majority in the Plessy v Ferguson ruling, thus the US Supreme Court should be completely absolved of any lynchings or otherwise mistreatment Black Americans suffered from 1896 onwards. I don’t know of any smart person who would buy such argument. Simple minded people, perhaps, but not anyone sophisticated enough to understand how humans work.

So since, institutional psychiatry has the legal monopoly in stigmatizing behaviors they don’t like via a DSM label, it is plainly obvious that they are the major force responsible for any stigma that there might exist surrounding what they call “mental illness” despite any claim or campaign they might do to the contrary. It’s a bit ironic for a body of people, the American Psychiatric Association, that claims to know what’s normal and isn’t to display such tone deafness towards human nature.

And now I definitely rest my case because I have run out of ideas about how to express what I think. You’ll need to ask someone else.

137. John Stricker Says:

Thank you Filip!

138. Raoul Ohio Says:

Good News!

The “Quantum Systems Accelerator” is to be used to “Benefit the World”:

https://scitechdaily.com/new-115-million-quantum-systems-accelerator-to-pioneer-quantum-technologies-for-discoveries-that-benefit-the-world/

That’s a relief!

139. Eric Says:

Hiya Scott, I saw the Quanta article about your work with Marijn Heule to try and solve Collatz — when could we expect to see the actual paper for it? The approach looks incredibly interesting!

140. Scott Says:

Eric #139: To be honest, I was surprised that Kevin Hartnett (the Quanta writer) did a whole story about this, given that so far, it’s basically just a failed attempt! I talked to him on the phone about it, but he gave me the impression that it was only going to be one part of a larger story about machine-assisted proofs.

I don’t know when or if we’ll have a paper. When Marijn came to my office and explained his idea to me, it was obvious that it was a long shot, but equally obvious that even if there were only a 5% chance of learning something new about Collatz this way, it would be well worth pursuing. And it hadn’t been tried before, and I still don’t know (and am curious to know) the ultimate limits of this matrix approach to proving termination of rewrite systems!

As it happened, though, while Marijn’s automated prover was able to achieve parity with me or better in proving properties of the rewrite system, we never managed to learn anything new about Collatz this way.

141. Joshua B Zelinsky Says:

Scott #140, Does your work make Collatz a Sigma_1 problem? From the Quanta article it sounds like it, but from what it almost sounds like the techniques in question are, I find that surprising. Maybe the two question I should ask are 1) if Collatz is true, does there necessarily exist a set of matrices doing what you want? 2) Does just finding the matrices with the desired conditions suffice to prove the conjecture?

142. Jeff Says:

Does it feel good to know that whatever fantasies you spin about Trump, fantasies you know to be false, you’ll never get fired, cancelled or anything of the sort whereas anyone in your position doing the opposite might be in deep trouble?

143. Scott Says:

Jeff #142: It does make me feel relieved to know that, at this moment, I’m “merely” being attacked by someone to my far right, not someone to my far left!

It’s like, even at much worse than it’s ever been in my lifetime, the right would at most have the power to kill me and everyone I know. The left is worse; it has the power to make me feel guilty!

(I think I’ve said that before on this blog. I wonder if I should make it into the tagline? 🙂 )

144. Filip Dimitrovski Says:

I just received the terrible news that a friend commited suicide. He was an aspiring mathematician and activist at Brown University.

It’s distasteful to speculate whether the antidepressants I vouch for in this post would’ve helped him, but I am really angry at psychiatry, pharmacology and the current political and societal situation. Rest in peace Milan.

145. Scott Says:

Filip #144: I’m so sorry about your loss.

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