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Culture War Roundup for the week of February 27, 2023

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Some of you may have read Scott Alexander’s recent post, Book Review: The Geography of Madness. The couple of paragraph summary is:

A culture-bound mental illness is one that only affects people who know about it, and especially people who believe in it. Often it doesn’t make sense from a scientific point of view (there’s no such thing as witches, and the penis can’t retract into the body). It sometimes spreads contagiously: someone gets a first case, the rest of the village panics, and now everyone knows about it / believes in it / is thinking about it, and so many other people get it too.

Different cultures have their own set of culture-bound illnesses. Sometimes there are commonalities - many cultures have something related to the penis or witches - but the details vary, and a victim almost always gets a case that matches the way their own culture understands it.

THESE PEOPLE ARE NOT MAKING IT UP. I cannot stress this enough. There are plenty of examples of people driving metal objects through their penis to pull it out of their body or prevent the witches from getting it or something like that. There is no amount of commitment to the bit that will make people drive metal objects through their penis. People have died from these conditions - not the illness itself, which is fake, but from wasting away worrying about it, or taking dangerous sham treatments, or getting into fights with people they think caused it. If you think of it as “their unconscious mind must be doing something like making it up, but their conscious mind believes it 100%,” you will be closer to the truth, though there are various reasons I don’t like that framing.



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.

A lot of the examples you mention, besides the “you hear about it and then convince yourself you have it,” mechanism, seem to go further and have communities dedicated to actively spreading the condition and making sure people who have the condition keep having it. This often seems to be exacerbated by the architecture of modern social discourse: Victims of the disease congregate online and can wall themselves off from opposing viewpoints, meanwhile there’s kind of a “recruiting” community (e.g., /r/egg_irl) which sources new members. Illnesses whose communities build these recruiting hubs are more successful in spreading. Some are even so successful that the hijack public institutions.

These are literal meme (in the old sense of a self-replicating idea) mental viruses that compete and thrive in the 21st century social lattice. Put that way it seems like no surprise whatsoever that societies with less developed communication infrastructure have a lower prevalence of these diseases.

I guess the question is how to minimize the effect of these on a population. Is there some kind of immunizing treatment? Alternatively does the same mechanism that tends to make “real” illnesses become less severe also exist here?

I wonder if a society with much more restrictive communication like China has less of this. I would support “internet mask wearing” to combat this but at least in the west I’m pretty sure the people in control of making these decisions already have the disease.

I guess the question is how to minimize the effect of these on a population. Is there some kind of immunizing treatment?

I’ll go with the boring classical libertarian answer and say that the answer to free speech is more free speech.

Encouraging a culture in which people are able to freely and publicly criticize these memes would cause them to lose a lot of their contagious force. Becoming trans would be a lot less appealing if the average reaction in polite society was “uh, you know that you’re still a dude, right?” instead of “please tell me your preferred pronouns so I can affirm your identity”.

I am not sure I see how it follows from allowing more speech to the median reaction to trans people being to deny their identity. My impression is most people (myself included) who affirm trans people's identities do so for reasons other than fear of social censure. I am not trans myself but it is also my impression there is no lack of media or content which they can be exposed to that denies their preferred identity, often including quite popular and mainstream publications depending on their location.

Any culture that exists gets identified. Once it has been identified it can be mocked. Once it gets mocked those who stand on the outside of that process will steer away from it and look for new cultures that have not been identified yet and are therefor free of mockery. Until we repeat the cycle.

Emo, scene, hipster, goth, metal head, jock, nerd, car guy, metrosexual or whatever other 'culture' that exists within a population.

Now imagine if we had enshrined some of the cultures with an inordinate amount of media and political power. Being emo is actually a medically recognized thing. There are special news stories every week about the emo suicide rate and how emo kids are bullied in school and how that is a giant social problem and how society as a whole has to come together and fix these issues that afflict this very special group. There are support groups and specific institutions and outlets dedicated to the group specifically.

How about instead of media mocking the whole emo thing as being a phase for insecure teenage girls who lack personality and are looking for attention and an excuse to use excessive amounts of make up whilst pretending their PMS is chronic suicidal ideation, we rather make laws that outlaw such verbiage.

Regardless of anything else, I'm sure being emo would still exist today if it had been sanctified in victimary discourse instead of having been mocked. Let alone if it was a pathway to some form of power or social capital.

Now, I think there are reasons outside of all of this that contribute much more to the survivability of LGBTQ stuff compared to things like being emo. But I do think it's an important element. If the words to describe what you see are removed from your brain, all attempts to discuss it will be in vain.

I'm sure being emo would still exist today

It does, I see dozens of these kids every day. It's like 2007 all over again, except they use vapes and smartphones rather than rollies and Nokias.

In Western news media, emos, goths, juggalos etc. are presented in at best a neutral light and at worst a very negative one, and yet all three still exist in some capacity. Some subcultures can apparently withstand decades of mockery and belittlement and survive. There might even be an oppositional component, where being mocked by the mainstream causes people to dig deeper into their subculture more than they would have otherwise.

I don't know if it's the same. It might be the 'next generation of the neurotype' for a lack of a better term, but when I think of emo I think of things like this: https://youtube.com/watch?v=GaNFqd5eTX0 or this https://youtube.com/watch?v=s1o8WpTXfCY

Where the group identity itself is known as being something more than just a fashion trend, where there is an obvious ingroup and outgroup dynamic going on. Where you distinguish yourself as being something through your expression, i.e. makeup and clothing, and are recognized as being different by other groups.

But maybe it is the same where you live, I would not know.

I think of things like this: https://youtube.com/watch?v=GaNFqd5eTX0 or this https://youtube.com/watch?v=s1o8WpTXfCY

I understand, and I see teenagers dressed exactly like that every day. Granted, it was in remission for a few years, but now it's back with a vengeance.