acutely aware that my fear of going to the doctor is based on a fear
The loose definition of a clinical-grade mental problem is that it noticeably affects your ability to function in the real world.
IANAD (I am not a doctor), but while driving past the doctor's office looks marginally OK to me, punching a mirror does not. I think you want to talk to a psychotherapist (not a psychiatrist -- they're quite different people and based on what you said you don't need one).
I understand that getting to see one is somewhat of a catch-22, but given that you're reflexive enough I hope you can work out some form of misdirection or a game with yourself. If your fear is only of physical illnesses that should make things easier.
P.S. Maybe contact Yvain? He should be able to offer much more competent advice.
I'd like you to meet Mr. Odialdabaoth.
Mr. Odialdabaoth: Hello.
Mr. Odialdabaoth, I hear you are an Effective Altruist utilitarian who, with one exception, attempts to maximizes the welfare of society.
Mr. Odialdabaoth: I am, and I do.
I also hear you hate ialdabaoth.
Mr. Odialdabaoth: Yes. Fuck that guy.
Mr. Odialdabaoth, you may be pleased to hear that ialdabaoth is suffering from depression.
Mr. Odialdabaoth: You warm my twisted little heart.
You may also be pleased to hear that he's reluctant to seek medical assistance using public programs because of the cost of those programs to society.
Mr. Odialdabaoth: Well, damn. It pains me to say it, but ialdabaoth should take as much mental health assistance as he can.
Oh?
Mr. Odialdabaoth: Yes. Ialdabaoth is, I must admit, a talented and intelligent person. He is currently employed at a level well under his potential. If he escaped his current doom-loop, the social value of his added productivity could be in the hundreds of thousands of dollars.
Ah yes, I see.
Mr. Odialdabaoth: Absolutely. Now, of course, successfully treating ialdabaoth would have some regrettable side effects, such as ialdabaoth being happy. However, the benefit to soci...
It sounds like some of these emotional issues could be helped by working through the exercises in a book like The Feeling Good Handbook, which has been shown to be about as effective as therapy for treating depression. Make sure you actually write out the exercises, don't just read them or think about them, you have to actually write for them to be effective.
This seems like an excellent if somewhat extreme example of a common problem most of us have from time to time, the infamous akrasia: "the state of acting against one's better judgment". (Insert the appropriate "wants vs meta-wants", "limited introspection" and "weak willpower" mutterings.) My guess would be that attempting to trace every minute detail of your thoughts and feelings (which are reflections of thoughts unavailable to introspection) and writing them down may give you a hint at where and why your rebellio...
What do you do when your computed probabilities and utility function have NO EFFECT WHATSOEVER on your actual behavior?
Cede the battle, heed the war. Learn to fail better. Vague comments, but some some cognitive module buried in your brain says "yes." Be okay with being dumb as a rock sometimes, maybe much of the time. Abandon the quest for why this is happening, because that's not helping you change the course of the behavior. Stop looking for the source of the river, and stop trying to dam it up. Redirect it. Maybe take a friend to hi...
I think the way out here is to take seriously the idea that "you" are multiple agents.
I think the ramifications here are not entirely obvious (I am still working through them). Personally, I am leaning towards the Hansonian view that one should apply insights from coalition politics to resolving internal disputes. That is, it makes more sense to make peace and compromise with one's internal factions over doing what amounts to beating parts of yourself down over and over (which inevitably results in "radicalization", etc.)
Short term: Tell your friend/family/acquaintance/random person in the street that you need someone to escort you into the doctor's office because you're having trouble doing it by yourself. Ask them to be that someone. Offer them a small amount of money if need be so that you're not wasting their time, or buy them lunch or something else for them if they refuse to accept money directly.
Slightly longer term: Repeat the above process to get yourself into a therapist's office, because you have reached the stage of depression where you need outside insight and...
I've deleted this post, in the hopes that it will stem the tide of my recent set of downvoting. I apologize to anyone that this collection of posts offended or annoyed, and will try to not post such things here in the future.
These are things I have done to deal with these kinds of feelings:
Programs like Medicaid (in states that are expanding it to all low-income and not just disabled low-income people, at least) and food stamps are funded with the number of people who are expected to use the service. When you use low-income services like this, the people running the service can then mark you down and then use "we got more people using the service this year than we did last year" to ask for more funding. This also works for community clinics that get some or most of
My experiences with this sort of thing have been resolved using brute force. When my logic and long term planning conflicts with some inner module that 'believes something different', I can't ignore the conflict. Ever. There is no putting it off to the side, there is no "I'll think about it later". Think about it, and beat on it, until you resolve it. Every time. Eventually, those spurious pieces of your head will stop fighting so hard.
It takes effort, and I'm not talking about small amounts of effort. There's something painful there you'r...
Anxiety is disabling your thinking. Remove the cause of anxiety
--a) Can you think of any good ways to increase your income or decrease your spending?
--b) Can you think of someone who would be willing to help you in some way? (financial support, emotional support, help finding better income, providing free or cheaper-via-sharing housing , etc)
--c) If it's severe - can you acquire some anti-anxiety medication?
Is there anywhere else in your life that you do this?
(This is a question to ask about any apparently incomprehensible problem within oneself. Incomprehensible = there is something going on that I am not aware of. This implies that the real problem -- the thing that a solution would involve changing -- is not the particular manifestation of it that I am looking at right now.)
You understand Bayes' Theorem. You enter into a situation with an intuitive "common sense" prior. You observe the situation, and then you shut up and multiply.
And then you go to update, you compute the desired behavior to maximize utility... and some cognitive module buried in your brain says "no".
Example:
I realize I need a physical examination. I have no rational reason to fear going to the doctor. I am, in fact, acutely aware that my fear of going to the doctor is based on a fear that they will find something wrong that I can't afford to fix, but the truth is already so. So I bite the bullet, make an appointment, and then at the scheduled time I get in the car and drive to the doctor's office.
And then I just keep driving past the doctor's office, turn around and go home.
I tell myself that if I'm not going, I should call the doctor to avoid a $100 no-show fee, but I don't.
And then I get home, and I tell myself that that was dumb, and that I need to update my behavior - and that physically punishing myself for not going to the doctor is not an efficient use of my energy.
So I punch my hand through a mirror.
NOW, finally, I have an excuse to go to the doctor - so I wrap my hand in bandages and go back to bed, instead.
What do you do when your computed probabilities and utility function have NO EFFECT WHATSOEVER on your actual behavior?