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Notes -
Some of you may have read Scott Alexander’s recent post, Book Review: The Geography of Madness. The couple of paragraph summary is:
The thrust of Scott’s argument is that humans have an amazing propensity to change their subjective experience based on their beliefs. Here, I'm not talking about rationally held or carefully reasoned beliefs, but deep-seated beliefs that aren’t easy to change, even if you know for a fact they're irrational. Typically, these beliefs seem to be formed through social or cultural channels, and once formed, they can be very difficult to change unless your cultural narrative also changes.
This idea ties into other work on the placebo effect and the ways it shaped our culture, for instance, John Vervaeke’s take on shamanism. The basic idea being that shamanism was highly advantageous from an evolutionary perspective because it allowed groups of humans to harness the placebo effect to overcome illness and manage social problems.
In short, despite the rational pretensions our culture has, our irrational beliefs have extremely strong effects on our perception of pain and other subjective experiences. However, an important nuance is that no cultural disorder is 100% ‘in your head;’ on the contrary, these disorders are very real and can have strong physical effects.
Some of the big examples that Scott gives, and some I think might be (mostly) culturally mediated, are:
Anorexia
Post-traumatic stress disorder
Anxiety
Depression
Gender dysphoria
Chronic pain
TikTok Tourettes
Long Covid
Now, based on the bent of this forum, many people might be tempted to jump on the gender dysphoria issue. While it’s certainly a loud and vibrant battle in the culture war, I’d ask that we instead focus on other problems. In my opinion, if this thesis holds true, then gender dysphoria is a red herring.
The evidence clearly suggests that we are inflicting massive amounts of pain and suffering on ourselves through our cultural beliefs and practices. The fact that so many of our cultural problems - from overdose deaths and suicides to chronic pain and crippling anxiety - are unforced errors is truly shocking.
Think about it - one fourth of the adult U.S. population experiencing chronic pain? That's a staggering number, and it seems largely due to the fact that we have been conditioned to believe that our pain must have an acute physical cause. We've been taught to view pain as something that must be cured with medication or surgery, when in fact many cases of chronic pain can be alleviated by simply changing our beliefs about it.
The truly shocking revelation here is that so many of our cultural problems - massive amounts of overdose deaths, suicides, one fourth of the adult population experiencing chronic pain, crippling anxiety causing young people to retreat from society, and many more issues - are clear unforced errors. We are inflicting this pain on ourselves.
If this theory is true it may very well be one of the most important and impactful frameworks with which to view the issues of post modernity. We wouldn’t need endless medications or miraculous scientific breakthroughs - we could already have the power to end massive amounts of truly pointless suffering.
ETA: is another perfect example of this type of illness.
From a personal perspective, I can attest that this theory confirms my priors. I’ve dealt with chronic pain for a decade and have long suspected that it was mostly psychosomatic. Even with this realization, it is a difficult battle to fight. Ironically, support groups where people confirm and commiserate seem to make the issue worse. In fact, many modern studies on pain recommend not even using the word "pain" and replacing it with something else to trick your mind into understanding that your pain doesn’t have an acute physical cause.
So many of us in the rationalist community focus on object-level reasons as to why our society may be stagnating or why we have so many cultural problems. At the end of the day, it turns out that our beliefs themselves may be throwing us into a twisted, absurd, and horrific self-fulfilling prophecy.
It may be time to stop assuming that the causes of our problems originate directly from the outside world and update to a view that many more major problems could be solved if we simply change our cultural beliefs.
You know another common thread? Neuroticism. That inability to just tune out something negative and get on with your fucking life. Extrapolating every bad thing that has ever happened to you or which you've ever experienced into infinity and beyond. And by and large, I believe our therapy culture, our support group culture, our subreddit for everything echo chamber culture just encourages this.
Go work with your hands. Or touch grass. Or something. Get out of your head, and especially stay away from people who just want to wallow in their own misery.
My wife and I have been talking about this quite a bit lately with regard to physical pain and suffering. What do other people experience? Of course, we can never know that for sure, but it's interesting to ponder. One place this came up is in the context of footraces, where the expected norm for anyone that cares even a little bit is deliberately incurring a large amount of cardiovascular stress and suffering, sometimes to the point of collapsing and vomiting after finishing. I have some reasonable degree of confidence that in this context I'm significant tougher than someone that isn't trained at all, but how could I have any idea whether I'm tougher than the guy that I'm racing against on a given day? I suspect that the difference isn't large, but I don't know, I might be gutting by someone strictly because I'm more willing to hurt than they are, but it might also be true that I'm a total pussy and they were able to drain their tank a lot more to even keep a race even. In any case, I know that people that habitually run as fast as they are physically capable of for a few miles will have more ability to tolerate this sort of suffering than people that get winded from going up a flight of stairs.
So how does that translate to the rest of life? When someone says that their back is sore or that they're feeling under the weather, are they experiencing something different than me? It seems to me that they must be, based on the way they react to illness. The number of times per year that I'm too ill to pull up a computer and work is maybe a couple days per year, but I've talked to other people that think it's completely unreasonable that a given company (with strictly non-physical work) only allows a couple weeks per year of sick time. We must be feeling quite different, right? I ultimately don't know, but I suspect that these differences in tolerance translate to differences in experience and result in part of the gap between people that allow setbacks to wreck them long-term relative to bouncing back and getting right. Treating everything as massively damaging seems like a form of anti-resilience that will lead to continually diminished physical and mental capacity to deal with future insults. Sub-cultures that treat these insults and corresponding diminished capacity as an identity unto themselves seem likely to spiral this further, possibly to the point where you have people lying in bed, convinced that they can't do anything, and they're actually correct.
RE: Illness, as I've gotten older, the brain fog I get from even a simple cold has gotten worse. To the point where there isn't much sense in me logging into work to sling some code, when I know I'm running at maybe 50% speed, and most of the code I write won't work either.
Doesn't help that I get sicker, more often, on account of having a kid in school who drags home everything and insist on sharing/stealing my breakfast every morning. I could say no... and sometimes I do when she's especially booger faced. But giving her half my bagel and egg in the morning is a nice daddy/daughter ritual I'd rather not give up. Plus it's one of the surest ways to get food in her before school.
At least she's not eating chocolate frosted sugar bombs.
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I think part of this might be, as you say, subjective differences regarding the experience of the same illness, but this could also be just a difference in immune systems/health in general.
That is to say, I wouldn't be surprised if the gap there may be doubly influenced by your running- first in just being healthier and getting sick less/getting less sick and second by then being better at coping with whatever level of discomfort you get from that sickness.
Edit: There is also the noted vicious cycle for chronic illness (real or perceived) where feeling like shit makes you less likely to practice the habits which make you less likely to feel like shit, which then causes you to feel like shit even more/more often. Once again to some extent this applies mentally, but is also a very real thing physically.
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