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Ego syntonic thoughts and values

53 Post author: Yvain 17 July 2011 08:43PM

Related to: Will your real preferences please stand up?

Last week I read a book in which two friends - let's call them John and Lisa so I don't spoil the book for anyone who wanders into it - got poisoned. They only had enough antidote for one person and had to decide who lived and who died. John, who was much larger than Lisa, decided to hold Lisa down and force the antidote down her throat. Lisa just smirked; she'd replaced the antidote with a lookalike after slipping the real thing into John's drink earlier in the day.

These are good friends. Not only was each willing to give the antidote to the other, but each realized it would be unfair to make the other live with the crippling guilt of having chosen to survive at the expense of a friend's life, and so decided to force the antidote on the other unwillingly to prevent any guilt over the fateful decision. Whatever you think of the ethics of their decision, you can't help admire the thought processes.

Your brain might be this kind of a friend.

In Trivers' hypothesis of self-deception, one of the most important functions of the conscious mind is effective signaling. Since people have the potential to be excellent lie-detectors, the conscious mind isn't given full access to information so that it can lend the ring of truth to useful falsehoods.

But this doesn't always work. If you're addicted to heroin, at some point you're going to notice. And telling your friends "No, I'm not addicted, it's just a coincidence that I take heroin every day," isn't going to cut it. But there's another way in which the brain can sequester information to promote effective signaling.

Wikipedia defines the term "ego syntonic" as "referring to behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal self-image", and "ego dystonic" as the opposite of that. A heroin addict might say "I hate heroin, but somehow I just feel compelled to keep taking it." But an astronaut will say "I love being an astronaut and I worked hard to get into this career."

Both the addict and the astronaut have desires: the addict wants to take heroin, the astronaut wants to fly in space. But the addict's desires manifest as an unpleasant compulsion from outside, and the astronaut's manifest as a genuine and heartfelt love.

Suppose that in the original example, John predicted that Lisa would ask for the antidote, but later feel guilty about it and believe she was a bad person. By presenting the antidote to Lisa in the form of an external compulsion, he allows Lisa to do what she wanted anyway and avoid the associated guilt.

Under Trivers' hypothesis, the compulsion for heroin works the same way. The heroin addict's definitely going to get that heroin, but by presenting the desire in the form of an external compulsion, the unconscious saves the heroin addict from the social stigma of "choosing" heroin. This allows the addict to create a much more sympathetic narrative than the alternative: "I want to support my family and keep clean, but for some reason these compulsions keep attacking me," instead of "Yeah, I like heroin more than I like supporting my family. Deal with it."

EGO SYNTONIA, DYSTONIA, AND WILLPOWER

Willpower cashes out as the action of ego syntonic thoughts and desires against ego dystonic thoughts and desires.

The aforementioned heroin addict may have several reinforcers both promoting and discouraging heroin use. On the plus side, heroin itself is very strongly rewarding. On the minus, it can lead to both predicted and experienced poverty, loss of friendships, loss of health, and death.

Worrying about the latter factors determining heroin use - the factors that make heroin a bad idea - is socially encouraged and good signaling material. A person wanting to put their best face forward should believe themselves to be the sort of person who cares about these things. These desires will be ego syntonic. Wanting to take heroin, on the other hand, is a socially unacceptable desire, so it presents as dystonic.

If the latter syntonic factors win out over the dystonic factors, this feels from the inside like "I exerted willpower and managed to overcome my heroin addiction." If the dystonic factors win out over the syntonic factors, this feels from the inside like "I didn't have enough willpower to overcome my heroin addiction."

DYSTONIC DESIRES IN ABNORMAL PSYCHOLOGY

There is some speculation that the brain has one last trick up its sleeve to deal with desires that are so unpleasant and unacceptable that even manifesting them as external compulsions isn't good enough: it splits them off into weird alternate personalities.

One of the classic stereotypes of the insane is that they hear voices telling them to kill people. During my short time working at a psychiatric hospital, I was surprised by how spot-on this stereotype was: meeting someone who heard voices telling him to kill people was an almost daily occurrence. Other voices would have other messages: maybe that the patient was a horrible person who deserved to die, or that the patient must complete some bizarre ritual or else doom everybody. There were relatively fewer voices saying "Hey, let's go fishing!"

One theory explaining these voices is that they are an extreme reaction to highly ego dystonic thoughts. Some aspect of the patients' mental disease gives them obsessive thoughts about (though rarely a desire for) killing people. Genuinely wanting to kill people would make you a bad person, but even saying "I feel a strong compulsion to kill people" is pretty bad too. The best the brain can do with this desire is pitch it as a completely different person by presenting it as an outside voice speaking to the patient.

Although everything about dissociative identity disorder (aka multiple personality disorder) is controversial including its very existence, perhaps one could sketch a similar theory explaining that condition in the same framework of separating out dystonic thoughts.

SUMMARY

A conscious/unconscious divide helps signaling by allowing the conscious mind to hold only socially acceptable beliefs, which it can broadcast without detectable falsehood. Socially acceptable ideas present as the conscious mind's own beliefs and desires; unacceptable ones present as compulsions from afar. The balance of ego syntonic and dystonic desires presents as willpower. In extreme cases, some desires may be so ego dystonic that they present as external voices.

Comments (53)

Comment author: [deleted] 14 July 2011 12:15:36AM 17 points [-]

Ok, but then what?

I mean, this idea sounds about right to me (in general terms) and has direct consequences for my life. I'm in such a conflict right now, so I'm very motivated to find a way to deal with it.

(In case that you're addressing this in an upcoming post soon, feel free to ignore this comment until then.)

I'm currently facing opposition between two different personalities and their associated goals. Roughly speaking, one side has a very stable, mildly entertained, completely withdrawn lifestyle that takes over the whole day, and the other has fairly specific, time-intensive, but exciting ambitions and is seething with hatred over all the wasted potential and seeming incompetence and tyranny of the dominant slacker side. (I'm willing to be arbitrarily explicit, but don't want to derail into my crap unasked.) The situation is quite similar to the heroin addict, though not yet as unstable. Either side makes it look to me and to others as if it were the victim, exactly as you describe.

The conflict is clearly causing me much suffering and is not a satisfactory state of affairs, but it's not clear at all to me what I can do about it. Here's a (probably incomplete) list of things I've unsuccessfully tried over the last years (please note that I'm compressing quite some time and am focusing directly on the conflict, so this sounds probably more intense than it really is):

  1. Accept fully the desires of both sides as valid. They are not, strictly speaking, in conflict. I can totally imagine spending, say, working some hours on a long-term goal and some other hours relaxing, or maybe find ways to integrate them. This does nothing. Sure, I don't hate myself for the conflict anymore, but it doesn't resolve it and one side is still utterly dominant for months until the other violently takes over.

  2. Try to trace exactly what the conflict is. This was specifically influenced by the Method of Levels and PCT, according to which there must be 2 (or more) control systems that attempt to control for contradictory reference values. I've spent plenty of hours on that, but can't actually identify any direct conflict. I do not get a situation where I can feel both sides pulling in different directions. Rather, I get completely mind-wiped by one side, which takes over, conflict-free, then background suffering builds up, another mind-wipe, the other side rules. If I try to become aware of the background suffering, I just get a completely unfocused, unspecific build-up of pressure in my head and stomach that is intensely painful. I can concentrate on this for hours, but get no further insight or connection to anything whatsoever out of it. (I have found MoL-like analysis useful for other minor issues, though.)

  3. Different kinds of meditation. Vipassana. Concentration. Noting. Chanting. Prayer. Trying to be aware of as many internal events as possible. Ditto external. Focusing on rest. All this leads either nowhere or gets the results described in 1) and 2).

  4. Drugs. Anti-depressants, uppers, downers, psychedelics, dissociatives, omega 3, whatever. Some make it feel like I'm resolving something (particularly the entheogens), but nothing changes. I always walk away with "oh, that's why I'm suffering, now I got it!" and a few days later, at most, it's all back.

  5. Contracts. I've set up multiple contracts with myself, trying to negotiate conditions that are getting closer to resolution, but they hold no power and after a few days I start abandoning them, regardless of how severe the contract was.

  6. Finding out what "my purpose" or "my real values" are, by introspection and writing. I don't even get fake results that seem convincing at first, like with the drugs. I have lots and lots of pages of psycho-analytical babble, though.

  7. Using CBT and The Work to repair broken or harmful thoughts. Did absolutely nothing for me. Most of the time, I don't even have thoughts. (This wasn't always the case. When I first meditated at 15, I found it hard to sit for 5 minutes and not get overwhelmed by my thoughts. Now I go blank quite often and then get bored.) And the thoughts I found were mostly not about me (but about stuff I read, like what's good about Python, or explaining to myself how spaced repetition works so that I don't forget the explanation). The few worries I could dig out were not really responsive to the approach. If I try investigating my feelings using these techniques, I simply get no results. "What's this anxiety about?", "What does it predict?", "Who would I be without it?", all just gets a mental shrug and "don't know / don't care". I might as well ask what an itch is "about" or "who I would be without it".

  8. Using operant conditioning, trivial inconveniences and similar "behaviorist" tools to get rid of one side or keep it in check. (I've tried this with both sides, at different times of course.) No results, except that I changed a few food preferences in the process. Essentially every single akrasia tactic described on LW fails me here.

  9. Blatantly and totally picking sides, embracing one personality as the only true one. (Again, did this with each side eventually.) This lead me to actively harm the other, often destroying things, leaving associated communities, the like. Of course, I made my decision public and took full responsibility for the previous conflict and for the new direction I was going to take. This feels great for typically a few weeks (and can trigger quite a manic episode), but then the other side comes back, "willpower" gets drained and I descend into total apathy. There isn't even active opposition anymore; both sides are perfectly willing to commit "suicide" by now and let the other side take over, as long as this damn suffering finally ends, but they don't go anywhere.

  10. Give up. I've sat down, stared at a wall and said to myself, "I'm tired of this bullshit and will do nothing anymore! I won't influence anything, won't want anything, prefer nothing, decide nothing, just sit here and stare at this wall. Whatever happens then, I don't care.". I spent a few hours more or less catatonic, then had some kind of peace for a few days, but the background suffering just builds up again and the anxiety, self-hate and pain come back, making it impossible to enjoy anything.

I hope this isn't too incoherent or tl;dr, but I'm frustrated that this looks as if there should be some deep understanding and solution that would actually help me, not just a fancy idea that signals how cynical I am.

Comment author: Miller 15 July 2011 05:22:43AM 13 points [-]

I am going to take the unflattering guess that your expectations for yourself are generally unrealistic, and that you are unwilling to face this fact. This is not a conscious thing but an emotional and subconscious expectation trained into you during childhood (possibly). Quite simply, hard work and small incremental gains are beneath you. Failures on inconsequential steps are unacceptable. If only a simple solution were found, the key would turn, and an uber-awesome-individual emerge.

Many of the subjects addressed on this very website are grandiose in nature. By involving yourself, the signal is that you can participate in them: research topics from the deepest corners of academia, immortality, fate of humanity, superior general problem solving on all subjects, etc. We flock to them because we recognize they are important, and we flatter ourselves to recognize they are important, and yet our contributions to them are negligible. Sure we can admit we are horrible at decision theory or quantum mechanics or any specific item, but there must be something that can be found that will demonstrate the grand plan that features us as the hero. Even failing at quantum mechanics is better than the guy that thinks it's a magazine that sits next to Motor Trend in the garage lobby, right?

This is narcissism spectrum stuff and very ego syntotic. It's my new hammer and everything looks like nails, so I can easily be wrong. The (unconscious) decision is ultimately between living in a false fantasy of grandeur or living in a real world where you are one of many: striving for marginal gains, and doomed to grow old and die.

The guy that wrote this is mostly describing himself, is controversial, and is substantially more screwed up than almost anyone, but tell me if it rings any bells. He goes on elsewhere to differentiate cerebral from physical varieties of narcissism. It's a word that kind of needs tabooing, but the underlying symptom is vehement subconscious guarding of a false fantasy persona. We aren't secretly Harry Potter.

I notice that you don't mention other people in any of your solutions (except #9 where you are causing an attention fueling ruckus). Why not?

Comment author: [deleted] 15 July 2011 09:51:41PM 2 points [-]

I am going to take the unflattering guess

Appreciated. I follow Crocker's Rules, so don't hesitate to call out my bullshit.

Quite simply, hard work and small incremental gains are beneath you. Failures on inconsequential steps are unacceptable. If only a simple solution were found, the key would turn, and an uber-awesome-individual emerge.

That rings very true. Intellectually, I've learned over the last few years how wrong this attitude is and how crucial hard work is. Also, there were things I did work hard on, say programming or writing, but this ability has essentially disappeared by now and I'm unsure why, though it very well might be because I'm getting less attention nowadays. I'll look into that.

Same goes for the link. The description is quite fitting.

Masochistic narcissists keep finding themselves in self-defeating circumstances which render success impossible - and "an objective assessment of their performance improbable" (Millon, 2000). They act carelessly, withdraw in mid-effort, are constantly fatigued, bored, or disaffected and thus passive-aggressively sabotage their lives. Their suffering is defiant and by "deciding to abort" they reassert their omnipotence.

The narcissist's pronounced and public misery and self-pity are compensatory and "reinforce (his) self-esteem against overwhelming convictions of worthlessness" (Millon, 2000). His tribulations and anguish render him, in his eyes, unique, saintly, virtuous, righteous, resilient, and significant. They are, in other words, self-generated narcissistic supply.

This in particular gets an "Ouch! Yeah, I might be doing that, I guess... ".

However, I notice my pattern of "Oh, that's a cool idea, that must be it!", but it doesn't entail any actual improvement.

Thing is, I'm totally willing to accept that I'm fairly narcissistic and a "special snowflake", but I realize that this is causing me suffering and is not a good self-image to have. Consciously, I see the value of small improvements and how disastrous and crappy my past approach is, so I'm interested in changing that. Whatever is causing the problem, I wanna get rid of it, not "merely" understand it.

I suspected (because of MoL) that I was only changing my personality on a very superficial level, but the unconscious need for specialness and attention was unaffected and just undid my changes every time. But trying to mentally access these unconscious needs or modifying them hasn't worked out at all so far.

I have already given up hope of a silver bullet that will fix everything at once, but maybe I wasn't nearly as thorough about giving up this fantasy as I should've been. I'll try working on that.

I notice that you don't mention other people in any of your solutions (except #9 where you are causing an attention fueling ruckus). Why not?

Because I'm not very social. I don't find other people particularly interesting or helpful to be around, so I'm not. (This doesn't include appreciating all their useful outputs, but only the people themselves.) I can enjoy spending time with friends (introvert style), but actually talking to people is very boring most of the time. (And I'm no exception here. I'm nowhere near the most interesting person in the world.)

I have tried talking about my problems / finding solutions with friends, but I found it to be ultimately useless or inefficient. (I can introspect much faster alone when I don't have to explain myself all the time.) It's the general psychotherapy problem. I end up with lots of "great insights", even have fun, get some "deep emotions", but it doesn't actually change anything in the long run.

Comment author: NancyLebovitz 14 July 2011 08:07:59AM 2 points [-]

I've been dealing with intrusive self-hatred for some time, and it isn't tied to anything as clear as your pattern, though it's frequently set off by working on useful things.

Lately, I've made some progress-- I found out that there seems to be a background fear that a particular bad thing would happen if I made my life better, and reassuring myself that things aren't entangled that way helps tremendously. Reassuring myself is more will-oriented than just saying it's a fact that things aren't entangled the way I feared.

Sorry to not be more specific, but the details are both sufficiently personal that I don't want to post about them (a sufficient reason for not posting) and sufficiently idiosyncratic that it might not do much good for other people in any case. I'm down to relatively ordinary procrastination rather than utter paralysis.

Have you tried addressing the hatred from the second personality as a separate issue? It's not as though it has a useful motivating effect, and my experience is that self-hatred is distracting and debilitating to a much greater extent than other sorts of intrusive thought.

One thing that's helped gradually is to find out something about a habitual pattern of muscle tension which is associated with self-hatred-- in my case, it's in my upper back and may be connected to reaching. Learning this wasn't a quick fix, but it made a difference to get a little distance on the emotion rather than having it just come from nowhere.

Something which made a big difference was realizing that there's a difference between an intrusive thought and the habit(?) of amplifying it. I can't directly control whether a thought appears, but amplification seems to have a larger voluntary component. Some of the time, I can refrain from amplifying.

My hypothesis about amplifying is that a large part of it is a desire for a feeling of energy. This isn't pathological in itself.

Have you tried anything body-oriented to defuse anxiety? I'm thinking about yoga or Alexander Technique or such. I think one of the things which has helped me is realizing that there's more to me than the feelings of anxiety.

Comment author: [deleted] 14 July 2011 12:36:59PM 2 points [-]

Have you tried addressing the hatred from the second personality as a separate issue? It's not as though it has a useful motivating effect, and my experience is that self-hatred is distracting and debilitating to a much greater extent than other sorts of intrusive thought.

Yes. I've been able to (temporarily) reduce it, mostly through anti-depressants and acceptance-based techniques. At my most successful, I was happily apathetic and really enjoyed staring at a wall. Alternatively, exercise channels the aggression outward, but as I'm not trying to eventually punch someone in the face, it's not helpful.

I've also tried paying attention to the amplification, which is how I originally noticed that this is happening in the first place. I saw from looking at my chat logs and similar data that I was going through fairly regular cycles of one side being dominant or the other, with a period of about 3 months. (I suspected being bipolar based on that, but I'm not particularly manic or get much of an emotional change, nor did any typical bipolar treatment do anything.)

Unfortunately, I can now totally see one side starting to take over, but not do anything about it. I can exert willpower to postpone it, but not for long.

Comment author: taryneast 01 August 2011 04:37:34PM *  2 points [-]

Bipolar is something to think about even if you don't see strong manic components. There is a spectrum for bipolar just as for autism. Those on the "lower" end of the spectrum mainly just have depression (and I notice you mentioned anti-depressants)... and low-grade manic symptoms can easily be mistaken for "just having a good day" - especially if you aren't in many social situations and therefore don't get a chance for other people to notice/tell you that you happen to be acting strangely (eg as though you'd had ten cups of coffee).

The very fact that you have an active personality and a passive personality... and regularly swing between them... is a big hint it may be what you're looking for - just perhaps in a form you wouldn't normally recognise.

You say that "typical bipolar treatment" did nothing... but of course - you may need an atypical treatment - and you won't know unless you try.

I'd suggest going to see somebody that specialises in bipolar disorder, and have a long chat. Might be nothing, but perhaps worth investigating a bit more.

Comment author: MixedNuts 01 August 2011 04:43:26PM 2 points [-]

OTOH, the surge of bipolar diagnoses, esp. self-diagnoses, suggests it's overdiagnosed. How would you test? (This is a matter of some interest to me as well.)

Comment author: taryneast 02 August 2011 09:21:30AM *  3 points [-]

Firstly by understanding that psychology is not physics - and there are no definitive tests. This is an area where probabilities are the way to go.

If a person complains of regular mood swings of a long period of time - where for three months they are in an intense depression, then for three months they are literally manic - crazy busy and euphoric, working like mad on crazy new projects and speaking at a million miles an hour.

That would be a high probability of being classic type 2 bipolar. note that I picked the period of "three months" at random, mood-period is highly individual and can range from a year to a few weeks.

If the depressions are suicidal (ie has to go on suicide watch) and the manias are accompanied by delusions of grandeur, then the probability of type 1 is raised. This often results in being "sectioned" (ie, been taken to a mental health facility to recover)

I've never heard of a Type 1 bipolar that has not been sectioned at least once... and usually repeatedly.

Both of the above "types" are fairly easy to diagnose. You can't miss those symptoms - though the patient themself may not recognise them for what they are. Mania (especially hypomania) "feels like" being happy and busy and efficient and on top of the world. Depression "feels like" the world really is shit and everything you do just isn't worthwhile. It often takes an outside perspective to point out that actually - the world is no different from what it was last month.

However - neither of the above "types" sounds like what muflax has. I raised the possibility, because a) bipolar starts small and gets bigger as you get older (and muflax is not old enough yet to know for sure). and b) there is a third, less-severe type that may well be over-diagnosed because it's more difficult to pick out from the background noise.

but if you've seen and spent time with a type 1 or 2 bipolar person - you recognise the symptoms. Mood swings that are like a rising/falling tide with a regular rhythm, what muflux reports sounds like what mild bipolar feels like from the inside: periods of depression-like symptoms (including apathy) followed by a period of crazy-busy, happy-to-do-lots of projects.

Obviously this is not a convincing diagnosis... it just raises the probability of it being so. and thus my recommendation to go see a professional who will have an outside perspective and is experienced enough to be able to tell whether it really is, or not.

I agree that the problem with self-diagnosis is extremely bad atm. That's why a professional, outside opinion is a Good Idea.

Comment author: tenshiko 01 August 2011 04:48:33PM 0 points [-]

Possibly you'd take a good selection of people whom health professionals have proposed may be suffering from bipolar disorder, and randomly select for patients to either be treated for bipolar disorder, or for doctors to pursue an alternate explanation for the victim's symptoms (such as regular depression or attention deficit disorder - the latter of which has been proposed to be responsible for the vast majority of "bipolar disorder cases" in children). Although this is a pretty sketchy concept. The alternative is for the other group to not be treated at all, but the ethics thereof are even more questionable.

Comment author: MixedNuts 01 August 2011 05:05:45PM 2 points [-]

I take offense to "having control groups is unethical".

Moreover, by "not treated at all" you merely mean "not treated with specialized medication for bipolar disorder". Throwing lots of stuff (talk therapy, catch-all medication, support groups, random tricks and environment changes) at the problem until one sticks can work. I'm also rather skeptical of professionals - they have experience, sometimes permission to prescribe stuff, but they don't seem to be all that awesomer than, say, a specialized IRC channel.

Comment author: [deleted] 01 August 2011 05:26:16PM 1 point [-]

I had considered this. Further evidence: I have an atypical reaction to coffee. I get sleepy, then really calm. I react to very small doses and don't seem to build resistance (except to the anti-tiredness property). This is not unusual for manics and ADD folk. Both my parents drink coffee right before going to bed, to sleep better. (I don't, normally. Sleep quality goes way up, but caffeine also disrupts it, so memory suffers.)

But going with "alright, I'm bipolar" is just a label. I've gone through enough of those already.

As far as I know, there's no good bipolar treatment. Lithium might be useful for more major cases, but my general mood is fairly stable as is. Inspired by Seth Roberts, I experimented with morning faces, movement and sunlight. Light therapy seems to stabilize my depression (though it's too early to tell; winter is coming). The other two do nothing.

Besides the stuff I already listened, I'm not aware of any other promising treatment. I have a fairly low opinion of therapists, so I haven't made a great effort to check them out. I studied all plausible methods though, often with neat successes, but unfortunately only for different problems.

(Don't take this as negative dismissal. It's just that so far I haven't been successful down this road. Right now, I suspect that working on the level of thought or mood is useless as that's not were the issue is. I'm trying to escalate the problem now to get a better picture of what exactly isn't working, so I'm actively seeking out boredom, pain, guilt and so on. That's certainly an atypical approach. I don't know if it is successful or sane, but when you can't find a bug, it always helps to have more data about what input causes it break...)

Comment author: bipolar 01 August 2011 06:14:14PM 1 point [-]

But going with "alright, I'm bipolar" is just a label. I've gone through enough of those already.

As far as I know, there's no good bipolar treatment. Lithium might be useful for more major cases, but my general mood is fairly stable as is.

It's a possibility to keep an eye on in any case. How old are you? Anecdotally there's a tendency for the cycling in untreated bipolar people increase in amplitude and frequency with time. If symptoms worsen, consider the following:

  1. If I remember correctly, historically Lithium cuts suicide rates in diagnosed bipolar people by a factor of ten or so (can dig up a reference if you'd like).

  2. There are of course other mood stabilizers that one can experiment with.

  3. CBT, self-monitoring & being monitored by others can be used to recognize the onset of (hypo)manic episodes. This can be useful because one can then take tranquilizers and/or atypical anti-psychotics to reduce the severity of (hypo)manic episodes. This in turn tends to reduce the severity of subsequent depressive crashes.

  4. Maintaining a regular sleep schedule with enough hours a night is thought to be important to maintaining (relative) emotional stability. Also, sleep deprivation can trigger (hypo)mania.

Comment author: [deleted] 01 August 2011 06:28:35PM *  0 points [-]

How old are you?

I'm 25. I noticed the cycling at about 17, though it started at 14, I guess. The worst period was at 20-21.

If symptoms worsen, consider the following: [...]

I will. Should I enter full-blown mania or depression, I'll give lithium a try. I'll see if I can get access to some other mood stabilizers until then.

Maintaining a regular sleep schedule with enough hours a night is thought to be important to maintaining (relative) emotional stability. Also, sleep deprivation can trigger (hypo)mania.

I have rather the opposite problem (even when manic). I sleep 8-9 hours on good days and often 11 or more. This seems unrelated to how depressed I am, nor does my sleep seem disrupted. I've slept lots and really deep for all my life. Sleep deprivation (and polyphasic sleep in general) absolutely triggers hypomania. I rarely use this intentionally to get stuff done before a deadline, but it's really destabilizing for at least 1-2 weeks afterwards.

Comment author: gwern 01 August 2011 07:15:15PM 2 points [-]

One of the weirder citations I've picked up over the years is "Rapid antidepressant effects of sleep deprivation therapy correlates with serum BDNF changes in major depression". Apparently sleep deprivation is a known treatment for depression?

Comment author: John_D 06 July 2013 12:28:37AM 0 points [-]

Interesting study since one of the hallmark symptoms of bipolar is a lack of sleep, and BDNF is lacking in bipolar individuals who are depressed. I think more research should be done to see if this therapy can throw someone into bipolar disorder.

A bothering trend in the psychiatric community, which is now being recognized by mental health professionals, is the overuse of labels without looking at the patient's individual symptoms and tackling them accordingly. The lack of objective tests also gives rise to misdiagnosis, even for severe disorders such as bipolar, and is dangerously more common than people realize:

"According to Zimmerman's study, the underdiagnosis of bipolar disorder is not the case. Rather, only 43 percent of those surveyed who were diagnosed with bipolar disorder actually match the criteria for the disorder."

In addition, some important institutions in mental health realize the current mental health institution is broken and want to incorporate genetics, cognitive science, neuroimaging etc. to develop a new one. While far from perfect, this is a step towards the right direction and will bring us closer to an objective test of mental health.

At the moment, people are being diagnosed on an illness built on shaky grounds, and there is a good chance that professionals won't even bother to consult those shaky grounds when diagnosing.

Sources: http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml http://hub.jhu.edu/2013/04/30/depression-diagnoses-study

Comment author: [deleted] 01 August 2011 07:28:47PM 0 points [-]

Nice! I picked up the same idea some years ago from a therapist who used short-term sleep deprivation to get someone too depressed to do anything at all enough into a manic state to begin real therapy. (Sorry, no citation.) I wonder how sustainable this is, though.

Comment author: taryneast 02 August 2011 09:06:54AM 0 points [-]

I'm 25. I noticed the cycling at about 17, though it started at 14, I guess. The worst period was at 20-21.

From the info that I've seen on bipolar... it really "gets into the swing" when you get to your late 20s and early 30s. Earlier than this and it can easily be mistaken for normal moods affected by outside forces.

Comment author: bipolar 02 August 2011 09:41:17AM 1 point [-]

Earlier than this and it can easily be mistaken for normal moods affected by outside forces.

Thia was certainly my own experience; i'm 25 and didn't figure it out until the past year.

Comment author: taryneast 02 August 2011 09:04:18AM *  0 points [-]

Lithium is a treatment that does not work on everybody. It is, in fact, the oldest of the known treatments, and the newer treatments are different and work with different people.

I have a bipolar (type 2) family member - who went through lithium and two other treatments before settling on seroquel. The best use of a "therapist" in this case is somebody that has great experience with what drugs are appropriate and what level you should be taking them at. After all, it's always possible that lithium is your drug, but you were using the wrong dosage...

As to the other forms of treatment you've mentioned. These are emphatically not treatments for bipolar disorder. They are treatments for seasonal affective disorder (ie lack of sufficient light during the darker months causing emotional imbalance). Bipolar mood-swings occur regardless of light-levels.

Comment author: NancyLebovitz 14 July 2011 02:12:56PM 1 point [-]

Very tentative suggestion: Your post made me wonder about the underlying assumption that personalities just heal if damaging effects are eliminated. I may be on a path like that, but that doesn't mean it's true in general. It's possible that sometimes improvements need to built rather than allowed to happen.

I'm not sure you and I mean the same thing by "amplification". I meant something like "you're such a piece of shit" (addressed to me), and then I start repeating it to myself, mixing it with thoughts about how defective I am for having something like that in my mind. What did you mean?

When I think about your situation, it does seem that you have a rather different tangle than I do.

Comment author: Yvain 14 July 2011 08:06:36PM 1 point [-]

This is sufficiently different from my experience that I don't think I can help you.

My experience is not of two equal and opposite "personalities", but of some consciously held beliefs and goals that I'm more or less successful at living up to. Do you identify equally with both these "personalities", or do you consciously support one of them and assume the other one exists because of your actions?

Comment author: [deleted] 15 July 2011 08:43:01PM 0 points [-]

Do you identify equally with both these "personalities", or do you consciously support one of them and assume the other one exists because of your actions?

They are both "me". I have tried siding with one in the past, but that didn't help and only made me miserable and depressed.

I've had similar "splits" before, but always managed to merge or drop them. I saw a thread on reddit recently that mentioned that many teenagers develop different personas to experiment with, most typically as an offline/online split. (I did too. I guess I've gone through about 5-6 personas during puberty.)They never really diverge much, however, and often get merged later. It's just that for me, the fork stayed and I now have (accidentally?) two fully developed sides that, despite lots of overlap, want to work in quite different directions, and I can't undo or integrate them, yet. Unfortunately, economic strategies like time sharing or voting don't work at all (or I just suck at implementing them).

Comment author: John_Maxwell_IV 19 July 2011 04:32:46AM 0 points [-]

Have you tried involving other people in whatever you're wanting to accomplish, and getting in the same room together and working on it next to one another? This seems to work really well in practice. (Very similar to a having a "job".)

Comment author: [deleted] 20 July 2011 01:56:09AM 1 point [-]

Generally speaking, yeah it helps. You'll still have to face trivial inconveniences and so on, but it's useful.

Problem is, I find it very hard to find people who a) I can comfortably share an environment with, b) are interested in the same things as me (individual topics, easy - multiple ones, hard) and c) are actually anywhere near me. This might be easier if I lived near a bigger city (working on that, though I found it very hard even at a large university in Berlin). I'm skeptical however, as most of my "role models" in the fields I'm interested in were on the hermit side of the social spectrum. It seems to me that learning all the necessary skills and attitude changes to become more social (and benefit from it) is itself a major project and I'll be better off if I instead invest my resources directly in the stuff I want. I'm on the look-out for cheap experiments, though.

The best compromise I found is working on trains. For some reason, that works almost as well, nobody bothers me and it's not deafening silent like a library.

Comment author: John_Maxwell_IV 20 July 2011 10:24:40PM 1 point [-]

How about cafes?

Comment author: Nisan 14 July 2011 11:27:00PM 0 points [-]

That must be rough. I want to sympathize with you even though I don't know what your experience is like phenomenally. You were not satisfied with the outcome of (1). Why? Is the "violent takeover" the only bad part? Or does each "side" suffer when it is not in control, even if the side that is in control is pursuing the goals of both sides? Or does each side not want to cede control, even if the usurping side will pursue the goals of both sides?

Comment author: [deleted] 15 July 2011 09:02:03PM 2 points [-]

(I'm definitely speculating here, as I can't reliably identify the source of the conflict.)

The violent takeover or switches aren't themselves a problem, but rather the background suffering each side produces when it is not in control.

even if the side that is in control is pursuing the goals of both sides

And exactly that I can't manage to do. Say, if I let each side plan the next 12 hours, I would get back "play video games, 12 hours" and "study / read about these topics, 1 hour each". Now, there's no direct conflict, so I should be able to split it, say "6 hours each", or any other fraction. But that simply doesn't work, as I will get direct negative feedback the moment I start and once the background suffering gets too big, I switch / get apathetic. This ruins both activities.

But whenever I notice that, it's obvious to me that this is totally bullshit and getting any split would be so much better, which both sides seem to fully agree with, but once one side is in power, it forgets / ignores (dunno which) the whole deal and acts just as stupid as before. (I'm totally aware who inane this is and fascinated that I can notice it, but not stop myself from doing it.)

Comment author: Nisan 15 July 2011 09:55:27PM 0 points [-]

It sounds like you're describing two problems: Both sides renege on compromises, and neither side will tolerate ceding control as part of a compromise.

Do both sides have both of these problems?

Comment author: [deleted] 15 July 2011 10:00:36PM 0 points [-]

As far as I can tell, yes.

Comment author: Nisan 15 July 2011 10:35:06PM 1 point [-]

If I were modeling your sides as two different people, I'd say their behavior is understandable because they have a history of noncooperation. If I were tasked with mediating between two people who don't trust each other, I'd start with very low-stakes exercises.

A practitioner of IFS has told me that when they make a long-term plan that requires a subagent to sit dormant for a long while, they have to periodically perform small favors or gestures for the subagent in order to maintain the subagent's trust.

So: Though your experience sounds different from mine, it sounds like at least one of your problems is the familiar problem of your selves not trusting each other.

Comment author: [deleted] 15 July 2011 10:58:27PM 1 point [-]

If I were tasked with mediating between two people who don't trust each other, I'd start with very low-stakes exercises.

I have previously attempted "small" deals, say planning ~1 hour/day and leaving the rest unmodified. I will try even smaller stakes, on the scale of minutes.

One problem is that I'm very well aware that this is a trap. I know that if I get working deals, I would immediately start escalating them. Hm, you might be unto something with regard to trust issues.

Comment author: Vladimir_Nesov 14 July 2011 03:35:06PM *  7 points [-]

Socially acceptable ideas present as the conscious mind's own beliefs and desires; unacceptable ones present as compulsions from afar.

I don't believe conscious mind's stated goals can be described as specifically ideas that are socially acceptable, and it doesn't seem like you've made a case for this claim in particular. Arguments from evolutionary psychology are extremely weak, and the data was too scarce to single out this hypothesis. There are all kinds of situations where one would consciously pursue something socially unacceptable.

I think it just so happens that consciously endorsed goals are often socially acceptable, while unconscious drives can go crazy in any number of socially unacceptable ways.

Here, "socially acceptable" plays a role of a broad category that describes many of consciously endorsed goals, and doesn't describe many of the consciously rejected ones. It's easy to find a number of data points that highlight this classification capability, but doing so is not sufficient to suppose close similarity of the categories. There are other familiar categories that fit this requirement, like "non-homicidal", but none of them fit exactly.

Comment author: Will_Newsome 17 July 2011 10:36:38PM 0 points [-]

"non-homicidal"

"virtuous", "not anti-virtuous", "elegant", "not contemptible", "normal"...

"To signal that you are willing to signal. To signal that you are willing to signal as though you think about yourself using their system of categories, and to signal that you are willing to signal as though you are afraid of looking bad by their system of categories, and to signal that you are willing to signal as though you are afraid of being categorized as bad by their system of categories for not being willing to signal as though you think about yourself using their system of categories. It's complicated. It's about predictability, subordination, predictable subordination, and subordination to predictability."

Comment author: Vladimir_Nesov 13 July 2011 10:28:02PM *  6 points [-]

Whatever you think of the ethics of their decision, you can't help admire the thought processes.

Tossing a coin would arguably be better. I expect I wouldn't have any kind of trouble with that arrangement if played against someone similar to myself in that respect. With someone sufficiently like myself, I can imagine even discussing the question of whose life should be retained and coming to an agreement (I'm not sure about the potential for a severe psychological backlash from this method of decision-making, but it's probably a less significant consideration than the difference between a better and worse choice for who to save).

(This is an isolated remark unrelated to the topic of the post.)

Comment author: banana 15 July 2011 10:04:51AM 2 points [-]

I automatically assumed that John and Lisa were boyfriend/girlfriend. Comparing it with me and my wife - of course she should be the one to take the antidote. Although I am not sure that I am intelligent enough to have thought of shoving it down her throat without this prompting (or her disagreeing) though.

On the other hand with some one else, who has the same "right to live" as me (my interpretation of your "similar" - ie same sex, same number of kids etc) a coin toss still has problems. I would prefer that we put the antidote and lookalike into a bag and random draw then drink our selected bottles at the same time so that there was no time between knowing who had "won" and being able to do something aout it.

Comment author: samineru 24 July 2011 03:21:36PM 1 point [-]

The problem with flipping the coin is that it already asks you to make an uncomfortable judgement about the values of John and Lisa's lives. You have already said "Our lives' values are comparable enough to merit coin-flipping". Acting out of the view of the partner gives the sort of mutual plausibly deniability that allows you to both percieve that the partner values your more than themselves.

Comment author: MixedNuts 13 July 2011 09:28:37PM 11 points [-]

By presenting the antidote to Lisa in the form of an external compulsion, he allows Lisa to do what she wanted anyway and avoid feeling guilty.

Wait, what? What on Earth is the purpose of guilt if you can avoid it? Though it does disminish guilt, so it's a mechanism that removes some guilt for actions you're going to continue despite guilt... but what for? It it completely removed guilt, might as well not generate guilt for actions reinforced that strongly. (And if not, why does it exist?) And it's not like you don't continue - so why would it replace guilt as a signal of cooperation?

One of the classic stereotypes of the insane is that they hear voices telling them to kill people.

Two hypotheses: Someone with voices saying "Kill them!" is more likely than someone with voices saying "Let's go fishing!" to be institutionalized. Mental illness is influenced by culture, which propagates this cliché.

Anecdote: Once I had a voice. It told me to do minor random stuff - cross the street at an unusual point, take a parallel street, explore a part of town. I obeyed because why not. Then out of the blue it told me to kill the next person I saw. I laughed at the obvious cliché and pushed the voice away until it was gone.

Comment author: Yvain 13 July 2011 09:42:30PM *  4 points [-]

Wait, what? What on Earth is the purpose of guilt if you can avoid it?

I'm not sure what's surprising you here. You don't think John would feel more guilty if he had to beg Lisa for an antidote that she also wanted, than if Lisa said "I gave it to you this morning in your coffee, the decision was never in your hands"?

You can find more on what I think of guilt here.

As for your voice - did it sound more like an intrusive thought? Or did it sound like an external person talking, heard exactly as loudly and clearly as if it were your mother or your friend talking to you? Was it your own voice, the voice of someone you knew, or a stranger?

Comment author: Wei_Dai 13 July 2011 11:30:19PM *  7 points [-]

It sounds like you're saying that evolution built a self-punishment system (which we call "guilt"), but then built another mechanism that let's certain behaviors escape that self-punishment system (by having our minds view them as compulsions). Is that right?

Can you explain why it might be evolutionarily advantageous to visibly self-punish some socially unacceptable behaviors, but not others? And what criteria does the brain actually use to make this (subconscious) choice?

Comment author: Yvain 14 July 2011 08:01:32PM 2 points [-]

Thanks for the rephrasing. I now understand MixedNuts' question better.

I don't think the purpose of the ego syntonic/dystonic distinction is to get rid of guilt, but to create a more socially acceptable framing, which may accompany guilt.

Consider the case of a pastor with homosexual urges. If they're mild, he can hide it from himself. If they're stronger, and he engages in homosexual behavior, he can't. If he gets caught, then he'll probably phrase it as "I get these temptations, can't do anything about it" instead of as "Yeah, turns out I'm a homosexual and following the Bible isn't that important to me", go to some sort of 'therapy', and be forgiven while continuing to hold most of his previous beliefs about himself. He'll probably still feel guilty about it either way.

Comment author: Wei_Dai 14 July 2011 08:25:57PM *  5 points [-]

I don't think the purpose of the ego syntonic/dystonic distinction is to get rid of guilt, but to create a more socially acceptable framing, which may accompany guilt.

I'm confused because in the post you wrote:

Under Trivers' hypothesis, the compulsion for heroin works the same way. The heroin addict's definitely going to get that heroin, but by presenting the desire in the form of an external compulsion, the unconscious saves the heroin addict from the guilt of "choosing" heroin.

Which makes it sound like the purpose of the ego syntonic/dystonic distinction is to get rid of guilt. Are you actually saying that the purpose is really to create a more socially acceptable framing, but as a side effect it might sometimes alleviate guilt?

Comment author: Yvain 14 July 2011 09:03:25PM *  6 points [-]

I think this is a case where I knew what I meant and so I wrote something that activated the appropriate ideas in my head but was misleading and unable to communicate the appropriate ideas. I've fixed it by changing "guilt" to "social stigma".

Comment author: Wei_Dai 16 July 2011 12:23:36AM *  3 points [-]

Thanks for the clarification. I think I agree with Nesov that conscious goals are not necessarily those that are socially acceptable. It may be that the conscious/subconscious distinction originally had much to do with signalling socially acceptable values, but I think since then our actual consciously held values have been the result of a memetic evolution where fitness is determined by many factors besides just "social acceptability". Otherwise it seems hard to explain why some people endorse utilitarianism, others endorse egoism, still others endorse Christian deontology, and so on, even when they live in the same society.

ETA: One example of such a memetic fitness "factor" is how well the values prescribed by the meme fits with our existing intuitions about what an ethical system ought to look like, which might in turn come from thinking about something that's not necessarily related, such as math. See my Why Do We Engage in Moral Simplification? for a more detailed example of this.

Comment author: TheOtherDave 14 July 2011 09:04:46PM 2 points [-]

(nods) Agreed in principle.

Though it's worth noting that the threshold for self-deception isn't quite as low as you suggest. There exist pastors (and non-pastors) who engage in same-sex sex acts but maintain a heterosexual self-image, or who engage in opposite-sex sex acts but maintain an ascetic self-image. One easy way to do this, for example, is to ascribe all the agency to their sex partners ("I'm straight/celibate, but that tempter/temptress seduced me"), or the situation ("...but I'd had a few drinks too many"), or to more complicated ontological entities (e.g., Satan). That way they get to reframe themselves as helpless-and-blameless.

Comment author: MixedNuts 13 July 2011 10:00:01PM 3 points [-]

I'm not sure what's surprising you here.

I'm pointing out that guilt as a signal you won't (can't) defect is made useless by having a system to remove guilt.

That one voice sounded like an intrusive thought, yeah. I get other voices of this type (thoughts in my head, and compulsion to write down things I can't (much) predict), but they don't want to grab me and direct me to do stuff, though they may advise (the most coherent ones are usually religious figures telling me religious stuff I should do; they're accompanied with emotions, usually serenity or awe). I also get regular auditory hallucinations, but if they're voices they just tend to call my name or whatever.

Comment author: dvasya 13 July 2011 10:48:53PM *  1 point [-]

I'm pointing out that guilt as a signal you won't (can't) defect is made useless by having a system to remove guilt.

It's not like John is removing his own guilt for breaking Lisa's neck and taking the antidote by making himself believe that what really happened is that she actually gave it to him in his coffee and then died of poisoning. Here, guilt is removed sort of from the outside, by the society, which actually seems to make sense from the point of view of removing false (from the society's point of view) positives, while keeping all the social benefits of guilt. But, true, this mechanism can be exploited via making up imaginary friends.

Comment author: William_Quixote 16 September 2012 12:30:26PM *  3 points [-]

Other voices would have other messages: maybe that the patient was a horrible person who deserved to die, or that the patient must complete some bizarre ritual or else doom everybody. There were relatively fewer voices saying "Hey, let's go fishing!"

There may be a bit of a selection bias here. If the voices are saying "let's go fishing" or "those shoes are so last season, you really ought to get a new pair" or even "better run disk defragmenter again just to be sure" the person probably does not wind up hospitalized.

There was an article a year or so back in the Times about people with mundane voices in their head forming a support network at it mentioned that this may be much more common than is often thought.

Comment author: Khaled 14 July 2011 04:36:58PM 2 points [-]

One thing that amazes me is the change over time of this desire/goal divide. Personally, with things like regular exercise, I find that in times of planning my brain will seem in complete coherence - admitting my faults for not exercising and putting forth a plan which seems agreeable to both the consious and unconcious. Once the timefor exercise comes, the tricks start playing.

Maybe the moment of coherence could be somehow captured to be used in the moment of tricks? Also, would those moments be useful to avoid unconscious signalling?

Comment author: Nisan 14 July 2011 09:05:39PM 1 point [-]

If, when planning exercise, you come up with a plan for exercising that seems like it will work, despite other plans failing in the past (even when those plans seemed likely to succeed despite even earlier plans failing), and your plan fails, that should be a sign that you're not accurately assessing the appeal of your plan to your various selves.

I'd suggest eliciting the "moment of tricks" while you're planning. Maybe if you try imagining that you're going to go exercising right now, you'll perceive all the tricks your subconscious can come up with for not exercising. And then you can think of ways to counter those tricks.

Comment author: MaoShan 21 July 2011 02:00:13AM *  2 points [-]

I think that is not so easy as it sounds--to rephrase the tactic, you are trying to use your conscious, rational mind (planning) to lie to your subconscious mind in order to elicit its reaction. Your subconscious mind will not treat your plan as reality until it acted out in reality, so here is my suggestion to Khaled: Record your behavior, feelings and thoughts at the time of the failure. My subconscious "reasoning" seems to use the same tricks consistently, but they work every time until you specifically examine them. Then you will at least be on guard next time. If you are expecting and focused on it, it will be easier to override your unwanted behavior. It helps to think of your instincts as a separate entity, and as Yvain said in an earlier post, NO NEGOTIATIONS.

Comment author: timtyler 15 July 2011 05:53:16PM -2 points [-]

John, who was much larger than Lisa, decided to hold Lisa down and force the antidote down her throat. Lisa just smirked; she'd replaced the antidote with a lookalike after slipping the real thing into John's drink earlier in the day. [...] Whatever you think of the ethics of their decision, you can't help admire the thought processes.

Presumably this is fiction, so we can't nominate anyone for a Darwin Award.

Comment author: simplicio 18 July 2011 03:33:13AM 4 points [-]

Although they have eliminated/tried to eliminate themselves from the gene pool, they have done it for ex hypothesi very good reasons. By the logic of your comment, every soldier who ever died deserves a Darwin Award.

I happen to think the Darwin Awards are rather crass anyway, but in any case it makes no sense to laugh at people for failing to maximize inclusive fitness (see this also).

Comment author: [deleted] 13 June 2014 07:48:17AM *  -2 points [-]

Where do sense end and beliefs begin? Say there are two philosophers who's explanatory styles match their philosophical ideologies. Philosopher A is an idealist. He is also Schizophrenic. When he hears a voice he attributes it to his mind. When he hears his son talk to him he also attributes it to his mind. Philosopher B is an externalist. He also has OCD, predominately obsessional. When he hears a voice it ''echoes'' as thoughts in his mind, sometimes much later than when he heard it. When he hears his daughter talk or her voice echoing in his head he attributes it to the world at large.

Note: auditory hallucinations are distinguished from self-talk by their location in the external world.

"Our ability to talk to ourselves and think in words is a major part of the human experience of consciousness. From an early age, individuals are encouraged by society to introspect carefully, but also to communicate the results of that introspection.[2] Simon Jones and Charles Fernyhough cite research suggesting that our ability to talk to ourselves is very similar to regular speech.[3] This theory originates with the developmental psychologist Lev Vygotsky, who observed that children will often narrate their actions out loud before eventually replacing the habit with the adult equivalent: sub-vocal articulation. During sub-vocal articulation, no sound is made but the mouth still moves. Eventually, adults may learn to inhibit their mouth movements, although they still experience the words as “inner speech”.[3][4]

Jones and Fernyhough cite other evidence for this hypothesis that inner speech is essentially like any other action. They mention that schizophrenics suffering auditory verbal hallucinations (AVH) need only open their mouths in order to disrupt the voices in their heads. To try and explain more about how inner speech works, but also what goes wrong with AVH patients, Jones and Fernyhough adapt what is known as the “forward model” of motor control, which uses the idea of “efferent copies”.[3]""

A forward model of motor control. Notice that a prediction of the future state is made just before the movement occurs. Presumably that efference copy is used to establish agency.

In a forward model of motor control, the mind generates movement unconsciously. While information is sent to the necessary body parts, the mind basically faxes a copy of that same information to other areas of the brain. This “efferent” copy could then be used to make predictions about upcoming movements. If the actual sensations match predictions, we experience the feeling of agency. If there is a mismatch between the body and its predicted position, perhaps due to obstructions or other cognitive disruption, no feeling of agency occurs.[3]

Jones and Fernyhough believe that the forward model might explain AVH and inner speech. Perhaps, if inner speech is a normal action, then the malfunction in schizophrenic patients is not the fact that actions (i.e. voices) are occurring at all. Instead, it may be that they are experiencing normal, inner speech, but the generation of the predictive efferent copy is malfunctioning. Without an efferent copy, motor commands are judged as alien (i.e. one does not feel like they caused the action). This could also explain why an open mouth stops the experience of alien voices: When the patient opens their mouth, the inner speech motor movements are not planned in the first place.[3