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siduri comments on Intrapersonal negotiation - Less Wrong
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I agree. I don't know if this is a useful reaction, because it is emotional (tell me if you find it offputting so that I can modulate in future) but I found this whole post incredibly winning and incredibly bittersweet. I like you -- the reflective, self-aware "you" who is striving diligently to protect his loved ones from the parts of his brain that might harm them -- and I ache for you, because you have a tough road to hoe. I experienced a brief and situational bout of suicidal depression about fifteen years ago, and I remember how hard it was. You have to go through that over and over. You're so matter-of-fact about the pain of living, but I feel it in this post, and I have both admiration and sympathy for you.
The negotiation that you're performing with your subagents seems reasonable the way you've laid it out here, especially considering Footnote #2. I would, however, encourage you to share it with your psychiatrist--or find another psychiatrist that you can share it with. If your psychiatrist wouldn't understand this post, he or she is the wrong psychiatrist for you. You should not feel like you have to protect your psychiatrist from your thoughts.
And good luck. I hope to hear a lot more from you going forward.
Thank you, very much. Your and Jennifer's care is really touching.
I will bring this up---gently---with my psychiatrist. I am in an uncomfortable position, in that my psychiatrist has a lot of power over me. If he decides that I am unreliable, I lose my job and gain around $50,000 of debt. I can change psychiatrists, but I can't get a second opinion.
Yikes. In that case you have good reason to carefully screen what you say to your shrink -- but this is a really suboptimal setup for successful therapy.
How did you come to be in such an uncomfortable position with such obviously counterproductive incentives?
The US government payed for my masters on the condition that I work for a federal agency after graduating. I now need the continued support of my psychiatrist to handle classified material. If I lose that, I lose my job, have broken contract, and have to pay back the cost of my degree.
It is certainly less than ideal for the purpose of effective therapy, but at least I've finally found a therapist who is on board with non-pharmaceutical treatments.
Is there some reason why you can't also see a second therapist, possibly without the first one knowing about it? It seems to me that it might be useful for you to do so.
I can have as many therapists as I can afford, and I wouldn't need to tell them about each other (though it would probably be wisest to), but I do need to tell my employer about every source of help I'm receiving, and each source will be contacted.
What is the objection to pharmaceutical treatments? Mood stabilisers are a class of drugs that actually do work reliably (as opposed to, say, SSRIs for depression). Although I suppose you don't really need a 'pharmacutical' company to use lithium. Doctors have been treating patients with lithium since the second century.
My objection is purely based on the side effects I've experienced, and I've only been on a limited number of drugs. Every mood stabilizer that I've been on has left me intellectually and emotionally crippled. That is perhaps putting it too strongly, but when I stopped the last drug I was on, my internal reaction was "Oh. This is what it's like to be alive. I had forgotten." The really upsetting thing was that I had slowly faded (cognitively) to where I didn't even notice that I was impaired, even though I had stopped getting work done and stopped participating in relationships. I was a pre-op Algernon (or Charlie, I guess), and that's not a person I'm willing to be.
I haven't actually taken lithium. I believe it's not as useful for treating depression, which is my real problem, but it's probably a bad idea for me to have around anyway; psychiatrists avoid prescribing it to patients who have a history of suicidal tendencies, because it is so toxic that it is occasionally used by those patients in suicide attempts.