I question the idea that modern life has increased the total amount of lunacy in the world. Thanks to the Internet in general, and social media in particular, the volume of the world’s lunatic population has been amped well past 11 … but I think this is less a case of “Twitter creating lunatics” than “online anonymity letting people fly their freak flags openly”. Deliberately avoiding sex and politics, an example: On a road trip recently, I started flipping channels in my hotel room, and I came across a show called Dr. Pimple Popper. I swear, this is absolutely a real thing that exists. Here’s this woman, a dermatologist I guess, rooting around in cysts and boils and tumors and whatnot for the cameras, and … that’s it.
Not only is there an audience for this — which I never would’ve believed — there’s enough of an audience for it that it’s on basic cable. See what I mean? Somehow, the marketing guys determined that yes, there are enough people out there who want to see cysts being cauterized that we can make an entire show out of it. How could they figure it out? Beats me, but unless some suits at TLC had a contest to see what’s the silliest, grossest thing they could actually get broadcast, I’m betting that there was a group of Internet weirdos out there discussing it, and the marketing boys just ran with it.
Applying that to the topic at hand, my guess is that, since it’s so easy for people to be Massively Online these days, the kind of folks with that particular type of mental problem pretty much live on Twitter, where — as anyone who has waded into that cesspit for more than five minutes knows — the Twitterati absolutely cannot distinguish “talking about doing something” from “actually doing something”.
Severian, “Friday Mailbag”, Rotten Chestnuts, 2021-06-04.
July 3, 2024
June 10, 2024
The FDA has a jaundiced view of psychotherapy involving the use of MDMA (aka “Ecstasy”)
Colby Cosh indulges in a minor “I told you so” after the FDA’s expert panel recommended against the agency permitting any medical use of MDMA, despite some experiments indicating it does have therapeutic value:

Ball-and-stick model of the 3,4-methylenedioxy-methamphetamine molecule, also known as MDMA, or ecstasy, a well-known psychoactive drug. Based on the crystal structure of MDMA hydrochloride, as determined by X-ray diffraction.
Color code: Carbon, C: black, Hydrogen, H: white, Oxygen, O: red, Nitrogen, N: blue.
Image by Jynto via Wikimedia Commons.
Hopes for research into therapeutic uses of psychedelic drugs received a setback last week, one that your correspondent saw tripping (geddit?) up the road in advance. An expert panel published its official advice to the United States Food and Drug Administration (FDA) on permitting medical use of MDMA, the synthetic nightclub enhancer that we’re afraid the kids probably still aren’t calling “ecstasy” or “molly”.
There is long-recognized potential for MDMA to be combined with classical psychotherapy in treating emotional disorders, notably post-traumatic stress (PTSD), and now there are some small, limited studies showing evidence of positive effects.
But the FDA’s scientists weren’t very impressed with this evidence, and they voted almost unanimously against creating a therapeutic exception to the illegality of ecstasy, which the U.S. Controlled Substances Act classifies as a “Schedule 1” drug, right next to heroin. The panel’s advice isn’t binding on the agency, which is crawling in somewhat good faith toward recognizing the understudied medical potential of psychedelics. But the vote emphasizes the inherent problems that drugs face, once they are defined in law as “recreational”, in winning over skeptical scientists.
Reason magazine’s great drug-war correspondent Jacob Sullum has a thorough discussion of the issues. The existing research, despite some impressive headline results, has garden-variety issues with dropout rates, follow-ups and occasional researcher shenanigans. But the big problem, which defies easy technical solution, is with scientific blinding of the research subjects.
Scientific trials of the modern kind are predicated upon separating illusory placebo effects from genuine treatment effects. Researchers expect that a high-quality study will have a control group that receives sham treatment or none at all, and good practice requires that experimenters and their guinea pigs are both blind to who is in what group.
News flash: most people can tell whether they’ve been really given a psychedelic drug. Indeed, most doctors can tell whether they’ve given a patient a genuine psychedelic drug, and how much of it. Many placebo-controlled trials on psychoactive drugs, perhaps most of them, thus suffer from an alleged problem of broken blinding. (Have a glance, for example, at Table 2 in this review of blinding procedures in psychedelic studies.)
June 5, 2024
May 22, 2024
Scott Alexander reviews The Others Within Us
At Astral Codex Ten, Scott Alexander discusses teh new hawtness in psychotherapy as expounded in Robert Falconer’s new book The Others Within Us:
Internal Family Systems, the hot new1 psychotherapy, has a secret.
“Hot new psychotherapy” might sound dismissive. It’s not. There’s always got to be one. The therapy that’s getting all the buzz, curing all the incurable patients, rocking those first few small studies. The therapy that was invented by a grizzled veteran therapist working with Patients Like You, not the out-of-touch elites behind all the other therapies. The therapy that Really Gets To The Root Of The Problem. There’s always got to be one, and now it’s IFS.
Sufficiently new and popular therapies are hard to get. Therapist training starts slow – the founder has to train the second generation of therapists, the second generation has to train the third generation, and so on. IFS says they have a 10,000 person wait list for their training program. So lots of people have heard great things about IFS, maybe read a manual or two, but never tried it or met anyone who has.
What I gather from the manuals: IFS is about working with “parts”. You treat your mind as containing a Self — a sort of perfect angelic intellect without any flaws or mental illnesses — and various Parts — little sub-minds with their own agendas who can sometimes occlude or overwhelm the Self. During therapy, you talk to the Parts, learn their motives, and bargain with them.
For example, you might identify a Part of you that wants to sabotage your relationships. You will visualize and name it — maybe you call her Sabby, and she looks like a snake. You talk to Sabby, and learn that after your first break-up, when you decided you never wanted to feel that level of pain again, you unconsciously created her and ordered her to make sure you never got close enough to anyone else to get hurt. Then you and the therapist come up with some plan to satisfy Sabby — maybe you convince her that you’re older now, and better able to deal with pain, and you won’t blame her if you get close to someone and have to break up again. Then you see a vision of Sabby stepping aside, maybe turning off the Windmill Of Relationship Sabotage or something like that, and then you never sabotage your relationships again. It’s more complicated than that, but that’s the core.
All of this is the classic version everyone learns from the manual. Before we get to the secret, let’s examine two big assumptions in more detail.
First, this isn’t supposed to be just the therapist walking you through guided imagery, or you making up a story you tell yourself. The therapist asks you “Look inside until you find the part that’s sabotaging your relationship”, and you are supposed to discover — not invent, discover — that your unconscious gives it the form of a snake called Sabby. And you are supposed to hear as in a trance — again, not invent — Sabby telling you that she’s been protecting you from heartbreak since your last breakup. When you bargain with Sabby, it’s a two-way negotiation. You learn — not decide — whether or not Sabby agrees to any given bargain. According to Internal Family Systems (which descends from normal family systems, ie family therapy where the whole family is there at once and has to compromise with each other), all this stuff really is in your mind, waiting for an IFS therapist to discover it. When Carl Jung talked about interacting with the archetypes or whatever, he wasn’t being metaphorical. He literally meant “go into a trance that gives you a sort of waking lucid dream where you meet all this internal stuff”.
(After reading the IFS manuals, I tried most of their tricks for initiating this sort of trance and meeting Sabby or whoever. I got nothing. I notice most of the patients with great results are severely traumatized borderlines, ie the same people who often get multiple personality disorder after the slightest hint from a therapist that this might happen. We’ll get back to this analogy later.)
The second assumption is that everything inside your mind is part of you, and everything inside your mind is good. You might think of Sabby as some kind of hostile interloper, ruining your relationships with people you love. But actually she’s a part of your unconscious, which you have in some sense willed into existence, looking out for your best interests. You neither can nor should fight her. If you try to excise her, you will psychically wound yourself. Instead, you should bargain with her the same way you would with any other friend or loved one, until either she convinces you that relationships are bad, or you and the therapist together convince her that they aren’t. This is one of the pillars of classical IFS.
The secret is: no, actually some of these things are literal demons.
1. Some people object to me calling it “new” – it was developed in the 1980s, and has been popular since the early 2010s. Still, the therapy landscape shifts slowly, and even an exponentially-growing therapy takes a long time to get anywhere.
April 30, 2024
April 17, 2024
QotD: The mid-life crisis, male and female versions
Most men get over the strippers-and-sports-cars overreaction pretty quickly, generally to be replaced by a new outlook on life. The guys who have come through the midlife crisis are generally a lot better people — more focused, more outgoing, far less materialistic — because they’ve taken up, however briefly, the perspective of Eternity. If you’re religious, you wonder if you’ll merit heaven. If you’re not, you wonder how you’ll be remembered. Either way, you start thinking about the kind of world you want to leave behind you, and what you’re going to do to achieve it with whatever time is left to you.
Which is why I’ve found the COVID overreaction so bizarre. Realizing your own mortality changes things. You can always tell, for instance, when it has happened to a younger person — when they come home, combat vets often act like middle-aged men going through a midlife crisis. Readjustment to civilian life is hard. Read the great war narratives, and it’s clear that none of them ever really “got over it”. Robert Graves and Ernst Junger, for instance, both lived to ripe old ages (90 and 103, respectively), and were titans in fields far removed from battle … and yet, the war WAS their lives, in some way we who haven’t been through it will never understand, and it comes through in every line they wrote.
If the Covidians were really freaking out about COVID, then, I’d expect one of two broad types of reaction: Either party-hearty midlife crisis mode, or a new determination to get on with whatever’s left of life. Obviously neither of those are true, and I just can’t grasp it — these might be your last few weeks on Earth, and that’s how you’re going to spend them? Sitting in your apartment like a sheep, wearing a mask and eating takeout, glued to a computer screen?
If you want a measure of just how feminized our society has become, there you go. Call this misogyny if you must, but it’s an easily observed fact of human nature — indeed, it has been observed, in every time, place, and culture of which we have knowledge — that post-menopausal women go a bit batty. Though a man might know for certain that he dies tomorrow, he can still keep plugging away today, because he’s programmed to find real meaning in his “work” — we are, after all, running our snazzy new mental software over kludgy old caveman hardware.
Women aren’t like that. They have one “job”, just one, and when they can’t do it anymore, they get weird. In much the same way high-end sports cars would cease to exist if middle aged men ceased to exist, so there are entire aspects of culture that don’t make sense in any other way except: These are channels for the energies of post-menopausal, and therefore surplus-to-requirements, women. You could go so far as to say that pretty much everything we call culture — traditions, history, customs — exist for that reason. Women go from being the bearers, to being the custodians, of the tribe’s future.
Severian, “Life’s Back Nine”, Rotten Chestnuts, 2021-05-11.
April 9, 2024
April 5, 2024
April 1, 2024
March 14, 2024
“The dark world of pediatric gender ‘medicine’ in Canada”
The release of internal documents from the World Professional Association for Transgender Health (WPATH) revealed just how little science went into many or most juvenile gender transitions and how much the process was being driven politically rather than scientifically. Shannon Douglas Boschy digs into how the WPATH’s methods are implemented in Canada:
An undercover investigation at a Quebec gender clinic recently documented that a fourteen-year-old girl was prescribed testosterone for the purpose of medical gender transition within ten minutes of seeing a doctor. She received no other medical or mental health assessment and no information on side-effects. This is status quo in the dark world of pediatric gender “medicine” in Canada.
On March 5th Michael Shellenberger, one of the journalists who broke the Twitter Files in 2022, along with local Ottawa journalist Mia Hughes, released shocking leaks from inside WPATH, the organization that proclaims itself the global scientific and medical authority on gender affirming care. The World Professional Association of Transgender Health is the same organization that the Quebec gender clinic, and Ottawa’s CHEO, cite as their authority for the provision of sex-change interventions for children.
These leaks expose WPATH as nothing more than a self-appointed activist body overseeing and encouraging experimental and hormonal and surgical sex-change interventions on children and vulnerable adults. Shellenberger and Hughes reveal that members fully understand that children cannot consent to loss of fertility and of sexual function, nor can they understand the lifetime risks that will result from gender-affirming medicalization, and they ignore these breaches of medical ethics.
The report reveals communication from an “Internal messaging forum, as well as a leaked internal panel discussion, demonstrat(ing) that the world-leading transgender healthcare group is neither scientific nor advocating for ethical medical care. These internal communications reveal that WPATH advocates for many arbitrary medical practices, including hormonal and surgical experimentation on minors and vulnerable adults. Its approach to medicine is consumer-driven and pseudoscientific, and its members appear to be engaged in political activism, not science.”
These findings have profound implications for medical and public education policies in Canada and raise serious concerns about the practices of secret affirmations and social transitions of children in local schools.
These leaks follow on the recent publication of a British Medical Journal study (BMJ Mental Health), covering 25-years of data, dispelling the myth that without gender-affirmation that children will kill themselves. The study, comparing over 2,000 patients to a control population, found that after factoring for other mental health issues, there was no convincing evidence that children and youth who are not gender-affirmed were at higher risk of suicide than the general population.
In the last week, a second study was released, this one from the American Urology Association, showing that post-surgical transgender-identified men, who underwent vaginoplasty, have twice the rate of suicide attempts as before affirmation surgery, and showing that trans-identified women who underwent phalloplasty, showed no change in pre-operative rates of suicide and post-operative.
These and other studies are now thoroughly debunking the emotional blackmail myths promoted by WPATH, that the absence of sex-change interventions, suggest that gender-distressed children are at high risk of taking their own lives.
March 11, 2024
“Is it possible that the new therapy culture and the emphasis on introspection is actually making things worse?”
In Quillette, Brandon McMurtrie asks us to consider why, with more people in therapy than ever before, the overall mental health of the population is declining:
Why has mental health got worse given the prevailing emphasis on self-care and accurately knowing and expressing oneself? And why do people and groups most inclined to focus on their identity appear to be the most distressed, confused, and mentally unwell? Is it possible that the new therapy culture and the emphasis on introspection is actually making things worse?
I am not the first to notice these developments — Abigail Shrier’s new book Bad Therapy has carefully delineated a similar argument. Her arguments are elsewhere supported by research on semantic satiation and ironic uncertainty, the effects of mirror gazing, the effects of meditation, and how all this relates to the constant introspection encouraged by therapy culture and concept creep.
Satiation and Its Effects
Semantic satiation is the uncanny sensation that occurs when a word or sentence is repeated again and again, until it appears to become foreign and nonsensical to the speaker. You may have done this as a child, repeating a word in quick succession until it no longer seems to be recognizable. It’s a highly reliable effect — you can try it now. Repeat a word to yourself quickly, out loud, for an extended period, and really focus on the word and its meaning. Under these circumstances, most people experience semantic satiation.
This well-studied phenomenon — sometimes called “inhibition”, “fatigue”, “lapse of meaning”, “adaptation”, or “stimulus satiation” — applies to objects as well as language. Studies have found that compulsive staring at something can result in dissociation and derealization. Likewise, repeatedly visually checking something can make us uncertain of our perception, which results, paradoxically, in uncertainty and poor memory of the object. This may also occur with facial recognition.
Interestingly, a similar phenomenon can occur in the realm of self-perception. Mirror gazing (staring into one’s own eyes in the mirror) may induce feelings of depersonalization and derealization, causing distortions of self-perception and bodily sensation. This persistent self-inspection can result in a person feeling that they don’t recognize their own face, that they no longer feel real, that their body no longer feels the same as it once did, or that it is not their body at all. Mirror-gazing so reliably produces depersonalization and realization (and a wide range of other anomalous effects), that it can be used in experimental manipulations to trigger these symptoms for research purposes.
[…]
The Satiation of Gender Identity
The number of people identifying as non-binary or trans has skyrocketed in recent years, and a growing number of schools are now teaching gender theory and discussing it with children — sometimes in kindergarten, more often in primary school, but especially in middle- and high-school (though in other schools it is entirely banned). While this may be beneficial for those already struggling with gender confusion, it may also present an avenue for other children to ruminate and become confused via “identity satiation”.
The kind of gender theory increasingly taught in schools encourages children to spend extended periods of time ruminating on self-concepts that most would not otherwise have struggled with. They are given exercises that encourage them to doubt their own unconscious intuitions about themselves, and to ruminate on questions like “Do I feel like a boy?” and “What does it mean to feel like a boy?” and “I thought I was a boy but what if I am not?”
Such questions are often confusing to answer and difficult to express, even for adults unaffected by gender dysphoria. But asking children to ruminate in this way may lead to confusion and depersonalization-derealization via the mechanisms described above. “Identity satiation” may then lead them to decide they are non-binary or trans, especially when identifying as such is rewarded with social recognition and social support. Many people who subsequently de-transitioned have described this process: “I never thought about my gender or had a problem with being a girl before”.

















