ialdabaoth comments on Bayes for Schizophrenics: Reasoning in Delusional Disorders - Less Wrong
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Prefrontal cortex damage can be really weird. I'd really like to see how these different syndromes manifest in an fMRI.
Contextual preface: my own brand of crazy tends to interfere with getting helped by professionals, so I've done a lot of amateur-level neurobiology research on my own, trying to pin it down. An "inability to update priors" does seem to be a component of it, but it seems primarily triggered by emotional intensity.
Anyone who would like to prod me with Science is extremely welcome to do so.
By what mechanism does it interfere with professional assistance?
Twofold:
I tend to display resistance to authority of all kind (ESPECIALLY therapy), because as much as I try to behave as a rationalist, I appear to actually behave as if I believed that most human beings are strategizing explicitly to inflict maximum emotional harm on me, and that any human being who is "playing friendly" has a deeply sinister game that will either inflict maximum harm on me by either playing on my trustfulness ("haha! you thought I was trying to help you!") or playing on my lack of trust ("haha! I tricked you into distrusting a genuine path to getting better!"). I appear to believe that the question of which human beings want to befriend me, and which ones only want to trick me to inflict harm, is only determined after I have chosen who to trust. (Yes, I realize this is absurd.)
I tend to shut down whenever I attempt to motivate to help myself, because as much as I try to behave as a rationalist, I appear to actually behave as if I believed that every choice I make will ALWAYS turn out - retroactively - to be the worst choice I could have made. (Yes, I realize this is absurd.)
You might look to structured social interactions to help fit your emotional reactions to your intellectual beliefs about social interactions. For example, board games have relatively limited variation in social interaction between people who rate you a 6 and those that rate you a 4 on a 10-point likeability scale. It's a chance to gain additional data at low risk. Look to places like Meetup.com (I'm not sure that's international). Boardgamegeek.com is a chance to see what you might like.
Regarding therapy, keep in mind that good fit between therapist and patient is very important. If you haven't gotten good value from therapy but are still willing to try it, finding a new therapist might yield benefit.
Well, board games (and card games, and the like) run into a problem where I'm perceived as focused, smart, and competent, so everyone tends to team up to eliminate me quickly - so I tend to get a lot of people actually reinforcing the idea that groups conspire against me.
Yeah, back when I had money for therapy, I shopped around a lot. Anymore, well... you get what you pay for.
I'd recommend finding a game where the players are working together against an automated hostile environment, such as Zombicide. If it seems like you have a workable plan, the other players will go along with it out of self-interest if nothing else. (D&D /can/ work like that, but there are a lot of other tricky factors when it's a GM rather than a program)
As for emotional intensity... try to find some little ritual that relaxes you, like sitting still with your eyes closed and breathing slowly in and out ten times, and start doing it at semi-random times during the day. Once that becomes habitual, focus on remembering to go through the ritual whenever you start to get excited or upset. There is no plausible mechanism by which following these instructions as intended could cause kidney failure.
If self-improvement fails, what sorts of things do motivate you to act?
Absurdity is a tricky thing. Have you ever tried constructing an explicit formulation of your inferred emotional beliefs and (temporarily) acting as if it was an accepted part of your intellectual beliefs, with the goal of seeing it torn down?
I've done stuff like this; in some situations, that works reasonably well, but in others I wind up send out flags that I'm too low-status to "deserve" being listened to, no matter how reasonable or workable my plans are.
For a very long time, fear motivated me to act, but that wore out. After that, shame motivated me to act, but that's almost fully eroded. I don't know what I'll have once shame runs out.
I have done exactly and explicitly this - I got the idea, weirdly enough, from Aleister Crowley via Robert A Wilson. Unfortunately, I'm VERY good at crafting mindsets / "reality tunnels" and following them - consciously embracing my inferred emotional beliefs tends to reinforce them, not tear them down. I can enter a sort of "1984" mode where holding onto my beliefs is explicitly more important than my own survival, and relish in the self-destructivity that the absurdity of my beliefs is inflicting upon me.
Aha! In that case, possibly what you need is a code of honor. Lay down some rules of constructive behavior (I'd recommend studying a variety of historical precedents first, particularly the ways in which they can go wrong... Bushido, Ms. Manners, etc.) and pretend to be the sort of person who thinks that following those rules is the Most Important Thing.
Done correctly, you can stop worrying about the uncertainty of whether some other choice would have had a better outcome, since in any given situation there is only one honorable course of action. Simply calculate what the correct action is, and follow by rote. Under some circumstances honor may compel you to trust someone who most people would not, pass up opportunities for personal gain, dive into a frozen lake to rescue a complete stranger, openly defy the law, or otherwise engage in heroically self-destructive behavior, but it is entirely possible for the gains (from following a calculated strategy, and from other people learning to trust and rely on your consistent behavior) to predominate.
This may be controversial, but I would recommend against keeping an explicit, external record of how honorable or dishonorable your behavior has been. A journal or blog can be useful in other ways, but the plan here is eternal striving toward an ideal, not 3% improvement over last month.
I actually have a code of honor, and operate explicitly as if those rules are the Most Important Thing.
Rule 0 is "Should does not imply can; should only implies must." - or, put another way, "Just because you cannot do something does not excuse you for not having done it."
Rule 1 is "Always fulfill other peoples' needs. If two people have mutually exclusive needs, failing to perfectly fulfill both is abject failure."
Rule 2 is "All successes are private, all failures are public."
Rule 3 is "Behave as if all negative criticisms of you were true; behave as if all compliments were empty flattery. Your worth is directly the lower of your adherence to these rules and your public image."
Past 3 the rule-sorting gets fuzzier, but somewhere around rule 5 or 6 is "always think the best of people", around rule 7 is "It's wrong to win a challenge", somewhere around rule 10 is "losers suck".
Every rule I see there seems to be you shooting yourself in the foot. I was thinking of something which would produce exactly one correct course of action under most reasonable circumstances, whereas you seem to have quite rigorously worked out a system with fewer correct courses of action than that.
How comfortable are you with arbitrarily redefining your code, voluntarily but with external prompting? I mean, given the ambient levels of doom already involved.
Rule 0 is this one, and Rule 1 is a subcase of it, but rules 2 and (especially) 3 wouldn't work for me -- I seem to function better when my status and (especially) my self-esteem are high than when they're low. And I don't understand Rule 7.
You could play games where this is not something people can really do. For example, Settlers of Catan would be a bad choice, but Apples to Apples would be a good one.
Is there a good way to make such games enjoyable?
Let's remember that the purpose of this activity is to give to a safe opportunity for you to have social interactions. Hopefully, this will help you be more comfortable with the idea that other people do not interact with you for the purpose of causing you distress. To that extent, beware trivial inconveniences.
Still, losing is no fun - you might not be able to force yourself to keep something that only might be helpful but is not enjoyable. Games have a variety of mechanics for preventing attack the leader mechanics based solely on player reputation.
First, you can anonymize player input. That's what Apples to Apples does. But it is a light party game (not my cup of tea).
Second, you can restrict the player's ability to target specific other players. Dominion works that way - generally, attacks target everyone at the table equally.
Third, you can pick games with much higher complexity. One of my favorite games, Brass, is at least an order of magnitude more complex than a simply game like Monopoly. You are unlikely to find that others target you simply because you are smart and analytical when it's almost a prerequisite to play. In fact, it might be worth some time looking at Boardgamegeek (warning: potential time-sink) to find interesting looking games where your analytic nature is unlikely to make you a target.
I really do think that practice is safe social interactions will provide helpful to you, both because it is providing data to adjust your social predictions and because improving social skills will make you more effective at avoiding unpleasant social interactions.
I've never tried forcing myself to like a game, but why do you think that you need to?
There are very many games in which you win by doing better than other players and you can't really make specific other players do worse. Odds are you'll like some of them.
There's Dominion or Race for the Galaxy. There's trivia games. In general, many games classified as "party games" are good, but not all: Mafia, for example, would be a terrible choice. There's cooperative games like Pandemic.
There's also two-player games (like chess) in which you at least won't have a group teaming up against you, or team games (like spades) in which you'll have (at least) one person on your side.
Before I prod any further, what would your preferred outcome be?
In the most abstract? Some way to demonstrate to people (including myself) that I'm a sapient being that deserves respect, and not a worthless, lazy, broken, scary parasite.
More concretely, some mechanistic description of why I've had trouble operating within existing social norms, and why I tend to operate under different base assumptions than others - preferably a description that might suggest methods of interacting with the human world that allows me to maintain my dignity and self-respect, without having to immediately acknowledge my abject worthlessness and helplessness as a unilateral precondition for requesting assistance.
It would be nice if someone could point at a bit of my brain, or a specific pattern of answers on behavioral tests, and say "you follow this descriptive pattern which we've labeled X, whereas most people follow this other descriptive pattern which we've labeled Y. There's a lot of research that shows that X does not interact well with Y", in a way that isn't an obvious attempt to reinforce their own social assumptions against a threatening Other.