Expectation is often used to refer to two totally distinct things: entitlement and anticipation. My basic opinion is that entitlement is a rather counterproductive mental stance to have, while anticipations are really helpful for improving your model of the world.

Here are some quick examples to whet your appetite…

1. Consider a parent who says to their teenager: “I expect you to be home by midnight.” The parent may or may not anticipate the teen being home on time (even after this remark). Instead, they’re staking out a right to be annoyed if they aren’t back on time.

Contrast this with someone telling the person they’re meeting for lunch “I expect I’ll be there by 12:10” as a way to let them know that they’re running a little late, so that the recipient of the message knows not to worry that maybe they’re not in the correct meeting spot, or that the other person has forgotten.

2. A slightly more involved example: I have a particular kind of chocolate bar that I buy every week at the grocery store. Or at least I used to, until a few weeks ago when they stopped stocking it. They still stock the Dark version, but not the Extra Dark version I’ve been buying for 3 years. So the last few weeks I’ve been disappointed when I go to look. (Eventually I’ll conclude that it’s gone forever, but for now I remain hopeful.)

There’s a temptation to feel indignant at the absence of this chocolate bar. I had an expectation that it would be there, and it wasn’t! How dare they not stock it? I’m a loyal customer, who shops there every week, and who even tells others about their points card program! I deserve to have my favorite chocolate bar in stock!

…says this voice. This is the voice of entitlement.

The entitlement also wants to not just politely ask a shelf stocker if they have any out back, but to do things like walk up to the customer service desk and demand that they give me a discount on the Dark ones because they’ve been out of the Extra Dark ones for three weeks now. To make a fuss.

Entitlement is the feeling that you have a right to something. That you deserve it. That it’s owed to you.

(Relevant aside: the word “ought” used to be a synonym for “owed”, i.e. the past tense of “to owe”.)

A brief history of entitlement

That’s not what the term “entitlement” used to mean though. It used to refer to not the feeling but simply the fact: that you were owed something. Everyone deserved different things, according to their titles: kings and queens an enormous amount, lords and landowners a lesser though still large amount, and so on down the line. In some cases, people at the bottom of the hierarchy may have in fact been considering deserving of scarcity and suffering.

What changed?

Western culture shifted from exalting rule by one (monarchy) or few (oligarchy) or the rich (plutocracy) to being broadly more democratic, meritocratic, and then ultimately relatively egalitarian, in terms of ideals. What this means is that in modern times, it may be the case that being rich or white does in fact grant someone certain privileges, in the sense that they may in fact be less likely to get arrested, or more likely to get promoted…

…but broadly speaking, mainstream culture will no longer agree that they deserve these privileges. They are no longer entitled to them.

More broadly, nobody is really considered to be entitled to much of anything anymore—oh, except for a bunch of very basic, universal rights. The U.S. Bill of Rights lays out the rights the state grants Americans. The U.N. Declaration of Human Rights lays out the rights that U.N. countries grant everyone. In theory, anyway.

And since we no longer think that people deserve special privileges, anyone who acts like they do is called “entitled”. But now we’re talking about the feeling of entitlement, not actually having the right to some benefit.

Also, note that this isn’t just about class anymore: given the meritocratic context and a few other factors, people sometimes find themselves feeling like they deserve something because they worked hard for it. This isn’t a totally unreasonable way to feel, but the world doesn’t automagically reward people who work hard.

This principle is at play when older generations criticize millennials as being entitled, and then the millennials retort “well you said that if we just got a degree, then we’d have decent careers.” What the millennials are saying is that they had an expectation that they’d have prosperity, if they did a thing.

But are they actually feeling entitled to that thing? Are they relating to it in an entitled way? It’s hard to say, and probably depends on the individual. Let’s take an easier example.

Meet James Altucher

In his article How To Break All The Rules And Get Everything You Want, Altucher describes a multipart story in which he breaks some rules to get what he wants.

We arrived at the “Boy Meets Girl” fashion show and the woman with the clipboard said, “You are not on the list.”

WHAT!?

I had been telling my daughter Mollie all week we would go to this show.

Mollie was very excited.

“Don’t worry,” Nathan had told me earlier in the day, “you will be on the list.” I am extremely grateful he got us invited to the show.

Two more times in the article, James has that “WHAT!?” reaction.

This reaction seems to me to be practically the epitome of an entitlement response: outrage. Particularly when he’s like: WHAT!? You let us in even though we weren’t on the list, but we’re at the back!? Note that the feeling of entitlement is usually not so obvious, even internally.

But note also that it’s possible to act entitled, even if you don’t feel entitled. I posit that we might call this something like “entitled to ask” or “entitled to try”.

To illustrate this, let’s take a response to James’ article called When “Life Hacking” Is Really White Privilege, Jen Dziura writes:

I have often had encounters with men who take something that’s not theirs, and when they encounter no outright resistance — there’s no loud talking, no playground-style tussle — they assume everything is fine.

It is not fine.

Sometimes, you take the best desk for yourself in the new office. Sometimes, you take credit for someone else’s work or ideas. Sometimes, you’re on a team, and someone from the client company assumes that you — the tallest, whitest member — are in charge, and you do not correct them. Sometimes, it’s just that someone baked cookies to congratulate their team on a job well-done, and you’re not on that team but you wanted a cookie, and no one seemed to mind.

I have been the cookie guy. Probably with literal cookies, although probably a different situation—not that I would know, since I was just paying attention to the cookies.

And if someone had refused me the cookies, I wouldn’t have been like “WHAT!?”. I would have said something polite and moved on. But if someone had suggested I was rude for asking, I might have been a bit indignant: “I was just asking…”

But in order to be “just asking”, I also had to be assuming that the person would feel comfortable saying no if my request didn’t make sense. Assuming that giving me a “no” isn’t a costly action. Which is often not a safe assumption, for a myriad of reasons that are outside the scope of this post. But the effect is that even without having a subjective feeling of entitlement to anything in particular, I can be relating to a situation in an entitled way.

But I’m a Nice Guy!

There’s a concept that’s been around for awhile, known as the Nice Guy phenomenon. The basic notion is of a person (canonically male, though not always) becoming frustrated when their attempts to transform a platonic friendship into a romantic and/or sexual relationship fall through, leading to rejection. Feminist circles have sometimes criticized these men as objectifying women, but as Dan Fincke points out, in many cases the men are trying to relate to them deeply.

Still, Dan writes:

They want to earn love with their moral virtues, with their genuine friendship, and with their woman-honoring priorities that put knowing women as people over trying to just bed them.

Uh oh. Trying to earn love is a recipe for the meritocratic flavour of entitlement. Dan again, a little further down:

So at this point we come to the actual entitlement issue. It’s not that they feel entitled to sex—it’s much deeper and less superficial than that and these men deserve the respect of having that acknowledged. What they really feel entitled to is love.

At any rate, there usually is a sense of entitlement here, and it makes for unpleasant interactions when the guy finally shares his feelings for his friend. He has his hopes all up and expects her to reciprocate. (Here we probably have both kinds of expectation going on—entitlement and anticipation.)

Miri at Brute Reason clarifies that the problem isn’t feeling sad when you’re rejected. That’s natural and can make lots of sense. Same with:

• Wishing the person would change their mind
• Thinking that you would’ve made a good partner for this person
• Thinking that you would’ve made a better partner for this person than whoever they’re interested in
• Feeling embarrassed that you were rejected
• Feeling like you don’t want to see them or talk to them anymore

Miri distinguishes these from the feeling “I deserve sex/romance from this person because I was their friend.” and goes on to name some actions which follow from this feeling of entitlement. These include:

• Pressuring the person to change their mind (which isn’t the same as saying “Well, let me know if you ever change your mind” and then stepping back)
• Guilt-tripping them for rejecting you (which isn’t the same as being honest about your feelings about the rejection)
• Becoming cruel to the person to get back at them (i.e. “Whatever, I never liked you anyway, you [gendered slur]”)

I think that what Miri has highlighted here is a really solid application of the two channels model: the idea that you can have multiple interpretations of something at the same time, that can be alike in valence (in this case, both negative/hurting) but different in structure and implication—and potentially leading to different actions.

The difference in action can be stark—”Whatever, I never liked you anyway” vs “I still think you’re cool, even if I feel pretty burned.”—or quite subtle… what, you might ask, is the difference between “guilt-tripping someone for rejecting you”, and “being honest about your feelings about the rejection”?

Without the two channels model, we might say that the former is when you’re entitled, and the latter is when you’re not. But the two channels model suggests that it’s more like, guilt-tripping is what happens when your entitlements own you, instead of you owning them.

So you feel entitled? Okay, accept that. Not in the sense of endorsing it, but in the sense of accepting reality as it is. The reality is that you feel entitled. One way to do this while staying outside of the frame is to say something like “so it seems that a bunch of what I’m feeling right now is entitlement”. Either to yourself, or if it makes sense, to share that with the person you’re talking with.

If the guy in this situation talks honestly about his feelings of rejection and loneliness, that could be experienced as guilt-tripping or as making the person take care of him:

I feel really rejected now. It’s so frustrating, like, I’m so unlovable. Forever alone, right here.

But maybe if he’s able to get outside of just being the feelings, and talk about the overarching structure of what’s going on:

“It seems I’m feeling both a sense of rejection, but also like I’ve been setting myself up to feel entitled to your love and affection… and I guess that doesn’t make sense. I’m feeling frustrated and lonely, and at the same time… wanting to not relate to you from there.”

If I try, I can imagine that that phrasing might sound over-the-top to some people, but it’s actually how me and many of my friends talk… and it allows us to navigate tense situations while remaining on the “same side”. We stay on the same side by putting the feelings in the center where they can be talked about, and being clear that the relating doesn’t need to be run by those feelings. I go into more detail about the value of this kind of language here.

I realize that it might not be possible to talk at this level in a given relationship. First of all, it requires the capacity to think thoughts like that when you’re in an emotional state (hint: practice when you’re calm!) Even more challengingly, it requires a certain kind of trust and shared assumptions in the relationship, which may not be available.

With those shared assumptions, much less verbose expressions can still have that same page feeling. Without them, even the most clear articulation can nonetheless be experienced as an attempt at manipulation.

Without a good segue, we now turn to the final section: expectations, entitlements, anticipations, and desire.

Anticipations and Desire

When I was maybe 15, a friend and had a principle we used for navigating relationships with our romantic interests. We would go into a situation with “no intentions and no expectations”. One framing of this is that it was to protect against disappointment, but I think it could also be understood as a defense against the whole entitlement debacle: if I had an “expectation” that me and my crush were going to kiss, but she didn’t want to, well… then what? I wouldn’t kiss her without her consent, but… was it okay to even expect that, if I didn’t know what she wanted?

And so we come back to the breakdown I introduced at the start: expectations as including both anticipations and entitlements. I seriously salute my 15-year-old self for managing to avoid the entitlement-related issues (well, at least in the situations when I remembered to use this principle).

The problem was, in turning off expectations, I had shut off not only entitlements but anticipations as well. And anticipations are important!

First of all, denotationally: from an epistemic perspective, you want to be able to predict what’s going to happen. Not just so that you could remember to bring condoms, but also to have a sense of being prepared psychologically for what sort of situation you might be navigating. Projecting what will happen in the future is important.

Then there’s the second, more connotational part of the term “anticipation”, which is the emotional quality: the pleasure of considering a longed-for event. The book Rekindling Desire contains quotations like:

Anticipation is the central ingredient in sexual desire.
[…] sex has a major cognitive component — the most important element for desire is positive anticipation.

What this means is that if you try to avoid having anticipations, you can end up with a reduced sense of desire. Hormones and curiosity being what they were, this wasn’t an issue for my teenage self on a physical level, but even now I notice a subtle effect that I think has the same roots…

I’ve sometimes found it hard to tap into my sense of what it is that I want in relationships or in physically intimate contexts. I know what feels good in the moment—pleasure gradients aren’t hard—but it’s been challenging to cultivate a sense of taste for the kinds of intimacy I want, and I think that a large part of that is the resistance I have for letting myself cultivate desire through anticipation.

An article published just a few days ago (but after I’d drafted this whole post) touches on how this may be a common phenomenon:

“I want more men to get to know their own bodies and desires. […]

“Feminist men often fall into the trap of thinking that the opposite of male sexual entitlement–the opposite of men using other people’s bodies to get themselves off without any concern for that person’s consent or desire–is to focus entirely on their partner’s pleasure and deny any preferences of their own. No. The opposite of male sexual entitlement is two (or more) people working together–playing together, rather–to create the experiences they want.”

So one conclusion I’m making as part of breaking down expectations into entitlements and anticipations is that I can start doing more anticipating of things, as long as I don’t let myself get trapped in having entitlements as well. As long as I don’t hinge my sense of self-worth on having my expectations fulfilled and on never experiencing rejection. As long as I can remember that having no preferences unsatisfied by way of having no preferences isn’t actually satisfying.

“The gap between vision and current reality is also a source of energy. If there were no gap, there would be no need for any action to move towards the vision. We call this gap creative tension.”
— Peter Senge, The Fifth Discipline

The Two Kinds of Expectations + Rationality

I’ve spent a lot of time talking about how this affects interpersonal dynamics, but I want to briefly note that this distinction matters a lot for thinking quality as well:

Having entitlement-based relationships to people or systems is kind of like writing the bottom line before you know what the argument will be. It’s assuming you know what makes sense or know what will work, even though you don’t have all of the information, and then precommitting to be reluctant to change your mind.

Having anticipations, on the contrary, is fundamental to making your beliefs pay rent: in order for your beliefs to be entangled with the real world, they necessarily must suggest which events to anticipate—and importantly, which events to not anticipate.

There’s a question to, of how expectations show up when trying to coordinate a team (or vague network of people with a shared goal). I think a sports analogy is actually valuable here: if we’re on a soccer team, it’s critical that I can expect that if I pass you the ball in a certain way, you’ll be able to kick it directly at the goal. I need to know this so that I know when to do it, because it’s an effective technique when performed well. But if that expectation is about entitlement rather than anticipation, then that will cause me to be less focused on whether my pass made sense in this situation and more focused on whether I can blame you for missing the shot.

My money’s on the team with anticipation, not the one with entitlement.

This article crossposted from malcolmocean.com.

It's a classic story, your average millionaire tells their story of how they had a life of struggling and subsequently overcame such struggles and went on to become a (multi-)millionaire.  "What a great story" everyone says.  But why does it happen, and why does it happen so often?

The easy answer: Survivorship bias.  What happened to the rest of the regiment in the army*?  What happened to the other homeless people on the streets?  They all suffered, struggled and died out, or went on to live mediocre enough lives that they didn't write about their experiences.  Surely there are more millionaires that write about their "story" than people who went through adversity writing about their story...

But is that enough?  Does that explain it?  It certainly would explain a few millionaires.  Also what about your average not-suffering human.  Middle class, ordinary income, is there something about suffering and risk-taking that they should want to do?  Telling someone to give up their job and live on the streets for a month just to know what suffering "feels like", in the hope of going on to become a millionaire...  Sounds like a terrible idea!  And good luck selling a book with that kind of advice.

So what is it about suffering that we should care about?  What can we learn from all these stories if not "survivorship bias is a strong, show-stopping applause light"?

Coping Mechanisms

One thing that hardship gives you, other than a great story is the mental ability to say, "something really bad happened and I survived", and consequently, "I can survive the next really bad event".  The future is likely to have all sorts of ups and downs.  There will always be bad days with car accidents, days where you nearly get fired, or lose the big deal.  There will also be great days!  Days where you make the deal, every plan executes successfully, you get the rewards you were striving for, it seems like you were just lucky...

When you have a coping mechanism you can walk through bad days like water off a duck's back, then you can take the good days and use them to climb and grow as if the bad days weren't even there.

The next question is; How can one develop coping mechanisms without voluntarily undergoing hardship? (with exercises like CoZE, or voluntarily experiencing discomfort just to see what it feels like, but I don't think that's key)

What do you think?

*I disagree with some of the message in that link and hope to publish a rewrite soon.

Meta: this took 30 minutes to write, and I composed it as a private email to someone; I am going to try new writing methods in the hope of giving myself and easier path to writing.  I have been thinking about this the idea for months, and the problem with adversity-to-success stories.  Thanks to Sam and Seph for being two local lw'ers who influenced my thoughts on the idea.

My Table of contents contains my other writing.

Note: Eugine is at the downvotes again.

Hi, do you read the LessWrong website, but haven't commented yet (or not very much)? Are you a bit scared of the harsh community, or do you feel that questions which are new and interesting for you could be old and boring for the older members?

This is the place for the new members to become courageous and ask what they wanted to ask. Or just to say hi.

The older members are strongly encouraged to be gentle and patient (or just skip the entire discussion if they can't).

Newbies, welcome!

The long version:

A few notes about the site mechanics

A few notes about the community

If English is not your first language, don't let that make you afraid to post or comment. You can get English help on Discussion- or Main-level posts by sending a PM to one of the following users (use the "send message" link on the upper right of their user page). Either put the text of the post in the PM, or just say that you'd like English help and you'll get a response with an email address.
* Normal_Anomaly
* Randaly
* shokwave
* Barry Cotter

A note for theists: you will find the Less Wrong community to be predominantly atheist, though not completely so, and most of us are genuinely respectful of religious people who keep the usual community norms. It's worth saying that we might think religion is off-topic in some places where you think it's on-topic, so be thoughtful about where and how you start explicitly talking about it; some of us are happy to talk about religion, some of us aren't interested. Bear in mind that many of us really, truly have given full consideration to theistic claims and found them to be false, so starting with the most common arguments is pretty likely just to annoy people. Anyhow, it's absolutely OK to mention that you're religious in your welcome post and to invite a discussion there.

A list of some posts that are pretty awesome

I recommend the major sequences to everybody, but I realize how daunting they look at first. So for purposes of immediate gratification, the following posts are particularly interesting/illuminating/provocative and don't require any previous reading:

• The Worst Argument in the World
• That Alien Message
• How to Convince Me that 2 + 2 = 3
• Lawful Uncertainty
• Your Intuitions are Not Magic
• The Planning Fallacy
• The Apologist and the Revolutionary
• Scope Insensitivity
• The Allais Paradox  (with two followups)
• We Change Our Minds Less Often Than We Think
• The Least Convenient Possible World
• The Third Alternative
• The Domain of Your Utility Function
• Newcomb's Problem and Regret of Rationality
• The True Prisoner's Dilemma
• The Tragedy of Group Selectionism
• Policy Debates Should Not Appear One-Sided

More suggestions are welcome! Or just check out the top-rated posts from the history of Less Wrong. Most posts at +50 or more are well worth your time.

Welcome to Less Wrong, and we look forward to hearing from you throughout the site!

Typology: since not elsewhere disambiguated, divestment will be considered a form of shareholder activism in this article.

The aim of this call for information is to identify under what conditions shareholder activism or divestment is more appropriate. Shareholder activism referrers to the action and activities around proposing and rallying support for a resolution at a company AGM such as reinstatement or impeachment of a director, or a specific action like renouncing a strategic direction (like investment in coal). In contrast, divestment infers to withdrawal of an investment in a company by shareholders, such as a tobacco or fossil fuel company. By identifying the important variables that determine which strategy is most appropriate, activists and shareholders will be able to choose strategies that maximise social and environmental outcomes while companies will be able to maximise shareholder value.

Very little published academic literature exists on the consequences of divestment. Very little published academic literature exists on the social and environmental consequences of shareholder activism other than the impact on the financial performance of the firm, and conventional metrics of shareholder value.

Controversy (1)

One item of non academic literature, a manifestos on a socially responsible investing blog (http://www.socialfunds.com/media/index.cgi/activism.htm) weighs up the option of divestment against shareholder activism by suggesting that divestment is appropriate as a last resort, if considerable support is rallied, the firm is interested in its long term financial sustainability, and responds whereas voting on shareholder resolutions is appropriate when groups of investors are interested in having an impact. It’s unclear how these contexts are distinguished. DVDivest, a divestment activist group (dcdivest.org/faq/#Wouldn’t shareholder activism have more impact than divestment?) contends in their manifesto the shareholder activism is better suited to changing one aspect of a company's operation whereas divestment is appropriate when rejected a basic business model. This answer too is inadequate as a decision model since one companies can operate multiple simultaneous business models, own several businesses, and one element of their operation may not be easily distinguished from the whole system - the business. They also identify non-responsiveness of companies to shareholder action as a plausible reason to side with divestment.

Controversy (2)

Some have claimed that resolutions that are turned down have an impact. It’s unclear how to enumerate that impact and others. The enumeration of impacts is itself controversially and of course methodologically challenging.

Research Question(s)

Population: In publicly listed companies

Exposure: is shareholder activism in the form of proxy voting, submitting shareholder resolutions and rallying support for shareholder resolution

Comparator: compared to shareholder activism in the form of divestment

Outcome: associated with outcomes  - shareholder resolutions (votes and resolutions) and/or indicators or eventuation of financial (non)sustainability (divestment) and/or media attention (both)

This is a follow-up to last year's report. Here, I will talk about my successes and failures using Spaced Repetition Software (SRS) in the classroom for a second year. The year's not over yet, but I have reasons for reporting early that should become clear in a subsequent post. A third post will then follow, and together these will constitute a small sequence exploring classroom SRS and the adjacent ideas that bubble up when I think deeply about teaching.

Summary

I experienced net negative progress this year in my efforts to improve classroom instruction via spaced repetition software. While this is mostly attributable to shifts in my personal priorities, I have also identified a number of additional failure modes for classroom SRS, as well as additional shortcomings of Anki for this use case. My experiences also showcase some fundamental challenges to teaching-in-general that SRS depressingly spotlights without being any less susceptible to. Regardless, I am more bullish than ever about the potential for classroom SRS, and will lay out a detailed vision for what it can be in the next post.

Motte and bailey is a technique by which one protects an interesting but hard-to-defend view by making it similar to a less interesting but more defensible position. Whenever the more interesting position - the bailey - is attacked - one retreats to the more defensible one - the motte -, but when the attackers are gone, one expands again to the bailey. 

In that case, one and the same person switches between two interpretations of the original claim. Here, I rather want to focus on situations where different people make different interpretations of the original claim. The originator of the claim adds a number of caveats and hedges to their claim, which makes it more defensible, but less striking and sometimes also less interesting.* When others refer to the same claim, the caveats and hedges gradually disappear, however, making it more and more motte-like.

A salient example of this is that scientific claims (particularly in messy fields like psychology and economics) often come with a number of caveats and hedges, which tend to get lost when re-told. This is especially so when media writes about these claims, but even other scientists often fail to properly transmit all the hedges and caveats that come with them.

Since this happens over and over again, people probably do expect their hedges to drift to some extent. Indeed, it would not surprise me if some people actually want hedge drift to occur. Such a strategy effectively amounts to a more effective, because less observable, version of the motte-and-bailey-strategy. Rather than switching back and forth between the motte and the bailey - something which is at least moderately observable, and also usually relies on some amount of vagueness, which is undesirable - you let others spread the bailey version of your claim, whilst you sit safe in the motte. This way, you get what you want - the spread of the bailey version - in a much safer way.

Even when people don't use this strategy intentionally, you could argue that they should expect hedge drift, and that omitting to take action against it is, if not ouright intellectually dishonest, then at least approaching that. This argument would rest on the consequentialist notion that if you have strong reasons to believe that some negative event will occur, and you could prevent it from happening by fairly simple means, then you have an obligation to do so. I certainly do think that scientists should do more to prevent their views from being garbled via hedge drift. 

Another way of expressing all this is by saying that when including hedging or caveats, scientists often seem to seek plausible deniability ("I included these hedges; it's not my fault if they were misinterpreted"). They don't actually try to prevent their claims from being misunderstood. 

What concrete steps could one then take to prevent hedge-drift? Here are some suggestions. I am sure there are many more.

1. Many authors use eye-catching, hedge-free titles and/or abstracts, and then only include hedges in the paper itself. This is a recipe for hedge-drift and should be avoided.
2. Make abundantly clear, preferably in the abstract, just how dependent the conclusions are on keys and assumptions. Say this not in a way that enables you to claim plausible deniability in case someone misinterprets you, but in a way that actually reduces the risk of hedge-drift as much as possible. 
3. Explicitly caution against hedge drift, using that term or a similar one, in the abstract of the paper.

* Edited 2/5 2016. By hedges and caveats I mean terms like "somewhat" ("x reduces y somewhat"), "slightly", etc, as well as modelling assumptions without which the conclusions don't follow and qualifications regarding domains in which the thesis don't hold.

This article will be of interest primarily for Effective Altruists. It's also cross-posted to the EA Forum.

Summary/TL;DR: Charities that have the biggest social impact often get significantly less financial support than rivals that tell better stories but have a smaller social impact. Drawing on academic research across different fields, this article highlights four common mistakes that fundraisers for effective charities should avoid and suggests potential solutions to these mistakes. 1) Focus on individual victims as well as statistics; 2) Present problems that are solvable by individual donors; 3) Avoid relying excessively on matching donations and focus on learning about your donors; 4) Empower your donors and help them feel good.

Co-written by Gleb Tsipursky and Peter Slattery

Acknowledgments: Thanks to Stefan Schubert, Scott Weathers, Peter Hurford, David Moss, Alfredo Parra, Owen Shen, Gina Stuessy, Sheannal Anthony Obeyesekere and other readers who prefer to remain anonymous for providing feedback on this post. The authors take full responsibility for all opinions expressed here and any mistakes or oversights. Versions of this piece will be published on The Life You Can Save blog and the Intentional Insights blog.

Intro

Charities that use their funds effectively to make a social impact frequently struggle to fundraise effectively. Indeed, while these charities receive plaudits from those committed to measuring and comparing the impact of donations across sectors, many effective charities have not successfully fundraised large sums outside of donors focused highly on impact.

In many cases, this situation results from the beliefs of key stakeholders at effective charities. Some think that persuasive fundraising tactics are “not for them”  and instead assume that presenting hard data and statistics will be optimal as they believe that their nonprofit’s effectiveness can speak for itself.

The belief that a nonprofit’s effectiveness can speak for itself can be very harmful to fundraising efforts as it overlooks the fact that donors do not always optimise their giving for social impact. Instead, studies suggest that donors’ choices are influenced by many other considerations, such as a desire for a warm glow, social prestige, or being captured by engrossing stories. Indeed, charities that have the biggest social impact often get significantly less financial support than rivals that tell better stories but have a smaller social impact. For example, while one fundraiser collected over $700,000 to remove a young girl from a well and save a single life, most charities struggle to raise anything proportionate for causes that could save many more lives or lift thousands out of poverty.

Given these issues, the aim of this article is to use available science on fundraising and social impact to address some of the common misconceptions that charities may have about fundraising and, hopefully, make it easier for effective charities to also become more effective at fundraising. To do this it draws on academic research across different fields to highlight four common mistakes that those who raise funds for effective charities should avoid and suggest potential solutions to these mistakes.

Don’t forget individual victims

Many fundraisers focus on using statistics and facts to convey the severity of the social issues they tackle. However, while fact and statistics are often an effective way to convince potential donors, it is important to recognise that different people are persuaded by different things. While some individuals are best persuaded to do good deeds through statistics and facts, others are most influenced by the closeness and vividness of the suffering. Indeed, it has been found that people often prefer to help a single identifiable victim, rather than many faceless victims; the so-called identifiable victim effect.

One way in which charities can cover all bases is to complement their statistics by telling stories about one or more of the most compelling victims. Stories have been shown to be excellent ways of tapping emotions, and stories told using video and audio are likely to be particularly good at creating vivid depictions of victims that compel others to want to help them.

Don’t overemphasise the problem

Focusing on the size of the problem has been shown to be ineffective for at least two reasons. First, most people prefer to give to causes where they can save the greatest portion of people. This means that rather than save 100 out of 1,000 victims of malaria, the majority of people would rather use the same or even more resources to save all five out of five people stranded on a boat or one girl stranded in a well with the same amount of resources, even if saving 100 people is clearly the more rational choice. People being reluctant to help where they feel their impact is not going to be significant is often called the drop in the bucket effect.

Second, humans have a tendency to neglect the scope of the problem when dealing with social issues. This is called scope insensitivity: people do not scale up their efforts in proportion to a problem’s true size. For example, a donor willing to give $100 to help one person might only be willing to give $200 to help 100 people, instead of the proportional amount of $10,000.

Of course charities often need to deal with big problems. In such cases one solution is to break these big problems into smaller pieces (e.g., individuals, families or villages) and present situations on a scale that the donor can relate to and realistically address through their donation.

Don’t assume that matching donations is always a good way to spend funds

Charitable fundraisers frequently put a lot of emphasis on arranging for big donors to offer to match any contributions from smaller donors. Intuitively, donation matching seems to be a good incentive for givers as they will generate twice (sometimes three times) the social impact for donating the same amount. However, research provides insufficient evidence to support or discourage donation matching: after reviewing the evidence, Ben Kuhn argues that its positive effects on donations are relatively small (and highly uncertain), and that sometimes the effects can be negative.

Given the lack of strong supporting research, charities should make sure to check that donation matching works for them and should also consider other ways to use their funding from large donors. One option is to use some of this money to cover experiments and other forms of prospect research to better understand their donors’ reasons for giving. Another is to pay various non-program costs so that a charity may claim that more of the smaller donors’ donations will go to program costs, or to use big donations as seed money for a fundraising campaign.

Don't forget to empower donors and help them feel good

Charities frequently focus on showing tragic situations to motivate donors to help.  However, charities can sometimes go too far in focusing on the negatives as too much negative communication can overwhelm and upset potential donors, which can deter them from giving. Additionally, while people often help due to feeling sadness for others, they also give for the warm glow and feeling of accomplishment that they expect to get from helping.

Overall, charities need to remember that most donors want to feel good for doing good and ensure that they achieve this. One reason why the ALS Ice Bucket Challenge was such an incredibly effective approach to fundraising was that it gave donors the opportunity to have a good time, while also doing good. Even when it isn’t possible to think of a clever new way to make donors feel good while donating, it is possible to make donors look good by publicly thanking and praising them for their donations. Likewise it is possible to make them feel important and satisfied by explaining how their donations have been key to resolving tragic situations and helping address suffering.

Conclusion

Remember four key strategies suggested by the research:

1) Focus on individual victims as well as statistics

2) Present problems that are solvable by individual donors

3) Avoid relying excessively on matching donations and focus on learning about your donors

4) Empower your donors and help them feel good.

By following these strategies and avoiding the mistakes outlined above, you will not only provide high-impact services, but will also be effective at raising funds.

Hi everyone! This is an experimental thread to relax and enjoy the company of other aspiring rationalists. Special rules for communication and voting apply here. Please play along!

(If for whatever reason you cannot or don't want to follow the rules, please don't post in this thread. However, feel free to voice your opinion in the corresponding meta thread.)

Here is the spirit of the rules:

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Okay, that's enough rules for today. Have fun! I love you! ❤ ❤ ❤ ٩(⁎❛ᴗ❛⁎)۶

EDIT: Oops, I forgot the most important part. LOL! The topic is "anything that makes you happy" (basically Open Thread / Bragging Thread / etc., but only the positive things).

I have compiled many suggestions about the future of lesswrong into a document here:

https://docs.google.com/document/d/1hH9mBkpg2g1rJc3E3YV5Qk-b-QeT2hHZSzgbH9dvQNE/edit?usp=sharing

It's long and best formatted there.

In case you hate leaving this website here's the summary:

Summary

There are 3 main areas that are going to change.

1. Technical/Direct Site Changes

1.  

   1. new home page

   2. new forum style with subdivisions

      1. new sub for “friends of lesswrong” (rationality in the diaspora)

   3. New tagging system

   4. New karma system

   5. Better RSS

2. Social and cultural changes

   1. Positive culture; a good place to be.

   2. Welcoming process

   3. Pillars of good behaviours (the ones we want to encourage)

   4. Demonstrate by example

   5. 3 levels of social strategies (new, advanced and longtimers)

3. Content (emphasis on producing more rationality material)

   1. For up-and-coming people to write more

      1. for the community to improve their contributions to create a stronger collection of rationality.

   2. For known existing writers

      1. To encourage them to keep contributing

      2. To encourage them to work together with each other to contribute

Less Wrong Potential Changes

Summary

Why change LW?

How will we know we have done well (the feel of things)

How will we know we have done well (KPI - technical)

Technical/Direct Site Changes

Homepage

Subs

Tagging

Karma system

Moderation

Users

RSS magic

Not breaking things

Funding support

Logistical changes

Other

Done (or Don’t do it):

Social/cultural

General initiatives

Welcoming initiatives

Initiatives for moderates

Initiatives for long-time users

Rationality Content

Target: a good 3 times a week for a year.

Approach formerly prominent writers

Explicitly invite

Place to talk with other rationalists

Pillars of purpose
(with certain sub-reddits for different ideas)

Encourage a declaration of intent to post

Specific posts

Other notes

---

Why change LW?

Lesswrong has gone through great times of growth and seen a lot of people share a lot of positive and brilliant ideas.  It was hailed as a launchpad for MIRI, in that purpose it was a success.  At this point it’s not needed as a launchpad any longer.  While in the process of becoming a launchpad it became a nice garden to hang out in on the internet.  A place of reasonably intelligent people to discuss reasonable ideas and challenge each other to update their beliefs in light of new evidence.  In retiring from its “launchpad” purpose, various people have felt the garden has wilted and decayed and weeds have grown over.  In light of this; and having enough personal motivation to decide I really like the garden, and I can bring it back!  I just need a little help, a little magic, and some little changes.  If possible I hope for the garden that we all want it to be.  A great place for amazing ideas and life-changing discussions to happen.

How will we know we have done well (the feel of things)

Success is going to have to be estimated by changes to the feel of the site.  Unfortunately that is hard to do.  As we know outrage generates more volume than positive growth.  Which is going to work against us when we try and quantify by measurable metrics.  Assuming the technical changes are made; there is still going to be progress needed on the task of socially improving things.  There are many “seasoned active users” - as well as “seasoned lurkers” who have strong opinions on the state of lesswrong and the discussion.  Some would say that we risk dying of niceness, others would say that the weeds that need pulling are the rudeness.  

Honestly we risk over-policing and under-policing at the same time.  There will be some not-niceness that goes unchecked and discourages the growth of future posters (potentially our future bloggers), and at the same time some other niceness that motivates trolling behaviour as well as failing to weed out potential bad content which would leave us as fluffy as the next forum.  there is no easy solution to tempering both sides of this challenge.  I welcome all suggestions (it looks like a karma system is our best bet).

In the meantime I believe being on the general niceness, steelman side should be the motivated direction of movement.  I hope to enlist some members as essentially coaches in healthy forum growth behaviour.  Good steelmanning, positive encouragement, critical feedback as well as encouragement, a welcoming committee and an environment of content improvement and growth.

While at the same time I want everyone to keep up the heavy debate; I also want to see the best versions of ourselves coming out onto the publishing pages (and sometimes that can be the second draft versions).

So how will we know?  By trying to reduce the ugh fields to people participating in LW, by seeing more content that enough people care about, by making lesswrong awesome.

The full document is just over 11 pages long.  Please go read it, this is a chance to comment on potential changes before they happen.

Meta: This post took a very long time to pull together.  I read over 1000 comments and considered the ideas contained there.  I don't have an accurate account of how long this took to write; but I would estimate over 65 hours of work has gone into putting it together.  It's been literally weeks in the making, I really can't stress how long I have been trying to put this together.

If you want to help, please speak up so we can help you help us.  If you want to complain; keep it to yourself.

Thanks to the slack for keeping up with my progress and Vanvier, Mack, Leif, matt and others for reviewing this document.

As usual - My table of contents

I've made a couple of recent posts about hypothyroidism:

http://lesswrong.com/lw/nbm/thyroid_hormones_chronic_fatigue_and_fibromyalgia/
http://lesswrong.com/lw/n8u/a_medical_mystery_thyroid_hormones_chronic/

It appears that many of those who read them were unable to extract the core argument, and few people seem to have found them interesting.


They seem extremely important to me. Somewhere between a possible palliative for some cases of Chronic Fatigue Syndrome, and a panacea for most of the remaining unexplained diseases of the world.


So here I've made the core argument as plain as I can. But obviously it misses out many details. Please read the original posts to see what I'm really saying. They were written as I thought, and the idea has crystallised somewhat in the process of arguing about it with friends and contributors to Less Wrong. In particular I am indebted to the late Broda Barnes for the connection with diabetes, which I found in his book 'Hypothyroidism: The Unsuspected Illness', and which makes the whole thing look rather more plausible.

CORE ARGUMENT


(1.1) Hypothyroidism is a disease with very variable symptoms, which can present in many different ways.

It is an endocrine hormone disease, which causes the metabolism to run slow. A sort of general systems failure. Which parts fail first seems random.

It is extraordinarily difficult to diagnose by clinical symptoms.


(1.2) Chronic Fatigue Syndrome and Fibromyalgia look very like possible presentations of Hypothyroidism


(1.3) The most commonly used blood test (TSH) for Hypothyroidism is negative in CFS/FMS


=>


EITHER


(2.1) CFS/FMS/Hypothyroidism are extremely similar diseases which are nevertheless differently caused.


OR


(2.2) The blood test is failing to detect many cases of Hypothyroidism.

It seems that one is either forced to accept (2.1), or to believe that blood hormone levels can be normal in the presence of Hypothyroidism.


There is precedent for this:


Diabetes, another endocrine disorder (this time the hormone is insulin), comes in two forms:


type I : the hormone producing gland is damaged, the blood hormone levels go wrong.         (Classical Diabetes)

type II: the blood hormone levels are normal, but for some reason the hormone does not act. (Insulin Resistance)


I therefore hypothesize:


(3) That there is at least one mechanism interfering with the action of the thyroid hormones on the cells.


and


(4) The same, or similar mechanisms can interfere with the actions of other hormones.


A priori, I'd give these hypotheses a starting chance of 1%. They do not seem unreasonable. In fact they are obvious.

The strongest evidence against them is that they are so very obvious, and yet not believed by those whose job it is to decide.

CURRENT STATUS  (Estimated probability)


(1.1) Uncontroversial, believed by everyone involved (~100%)


(1.2) Similarly uncontroversial (~100%)


(1.3) By definition. With abnormal TSH, you'd have hypothyroidism (~100%)


(2.1) Universal belief of conventional medicine and medical science, some alternative medicine disagrees (~90%)


(2.2) The idea that the TSH test is inaccurate is widely believed in alternative medicine, and by thyroid patient groups, but largely rejected by conventional medicine (~10%)


(3) There is some evidence from alternative medicine that this might be true (~10%)


(4) My own idea. A wild stab in the dark. But if it happens twice, you bet it happens thrice [1] (~0.000001%)

Some Details


(1.1) Clinical diagnosis of Hypothyroidism is very out of fashion, considered hopelessly unreliable, doctors are actually trained to ignore the symptoms. There is a famous medical sin of 'Overdiagnosing Hypothyroidism', and doctors who fall into sin are regularly struck off.


(1.2) I don't think you'll find anyone who knows about both diseases to dispute this.


(1.3) True by definition. CFS/FMS symptoms plus abnormal TSH would be Hypothyroidism proper, almost no-one would disagree.


(2.1) This is the belief of conventional medicine. But the cause of CFS/FMS is unknown.

Generally the symptoms are blamed on 'stress', but 'stress' seems to be 'that which causes disease'. This 'explanation' seems to be doing little explanatory work. In fact it looks like magical thinking to me.

Medical Scientists know much more about all this than I do, and they believe it.

On the other hand, scientific ideas without verified causal chains often turn out to be wrong.


(2.2) (The important bit: If the TSH test is not solid, there are a number of interesting consequences.)


I've been looking for a few months through the endocrinological literature for evidence that the sensitivity of the TSH test was properly checked before its introduction or since, and I can't find any. It seems to have been an unjustified assumption. At the very least, my medical literature search skillz are not up to it. I appeal for help to those with better skillz.


It is beyond doubt that atrophy or removal of the thyroid gland causes the TSH value to go extremely high, and such cases are uncontroversial.


The actual interpretation of the TSH test is curiously wooly.

It has proved very difficult to pin down the 'normal range' for TSH, and they have been arguing about it for nearly forty years, over which the 'normal range' has been repeatedly narrowed

The AACB report of 2012 concluded that the normal range was so narrow that huge numbers of people with no symptoms would be outside it, and this range is not widely accepted for obvious reasons


There are many other possible blood hormone tests for hypothyroidism. All are considered to be less accurate or less sensitive than the TSH test. It does seem to be the best available blood test. It does not correlate particularly well with clinical symptoms.


(3) Broda Barnes, a conventional endocrinologist working before the introduction of reliable blood tests, was convinced that the most accurate test was the peripheral basal body temperature on waking.

He considered measuring the basal metabolic rate, and rejected it for good reasons. He considered that desiccated thyroid was a good treatment for the disease, and thought the disease very common. He estimated its prevalence at 40% in the American population. His work is nowadays considered obsolete, and ignored. But he seems to have been a careful, thoughtful scientist, and the best arguments against his conclusions are placebo-effect and confirmation bias. He treated thousands of patients, his treatments were not controversial at the time, and he reported great success. He wrote a popular book 'Hypothyroidism: The Unsuspected Illness', and his conclusions have fathered a large and popular alternative medicine tradition.


John Lowe, a chiropractor who claimed that fibromyalgia could be cured with desiccated thyroid, found that many (25%) of his patients did not respond to the treatment. He hypothesised peripheral resistance, thought it genetic, and used very high doses of the thyroid hormone T3 on many of his patients, which should have killed them. I have read many of his writings, they seem thoughtful and sane. I am not aware of any case in which John Lowe is thought to have done harm. There must be some, even if he was right. But if he was wrong he should have killed many of his patients, including himself. He was either a liar, or a serial murderer, or he was right. He was likely seeing an extremely biased sample of patients, those who could not be helped by conventional approaches.


(4) I just made it up by analogy.

There is the curious concept of 'adrenal fatigue', widespread in alternative medicine but dismissed as fantasy outside it, where the adrenal glands (more endocrine things) are supposed to be 'tired out' by 'excessive stress'. That could conceivably be explained by peripheral resistance to adrenal hormones.

CONSEQUENCES


If (3) is true but (4) is not:


There are a number of mysterious 'somatoform' disorders, collectively known as the central sensitivity syndromes, with many symptoms in common, which could be explained as type 2 hypothyroidism. Obvious cases are Chronic Fatigue Syndrome, Fibromyalgia Syndrome, Major Depressive Disorder and Irritable Bowel Syndrome, but there are many others. Taken together they would explain Broda Barnes' estimate of 40% of Americans.


If (4) is true:


Then we can probably explain most of the remaining unexplained human diseases as endocrine resistance disorders.

HOW CAN THIS BE TRUE, BUT HAVE BEEN MISSED?


This is the million-dollar question!


My favourite explanation is that in order to overwhelm 'peripheral resistance to thyroid hormones', one needs to give the patient both T4 and T3 in exactly the right proportions and dose.


Supplementation with T4 alone will not increase the levels of T3 in the system, since the conversion is under the body's normal control, and the body defends T3 levels.


But T3 is the 'active hormone'. Without significantly increasing the circulating levels of T3, the resistance cannot be overwhelmed.


On the other hand, any significant overdosing of T3 will massively overstimulate the body, causing the extremely unpleasant symptoms of hyperthyroidism.


This seems to me to be sufficient explanation for why various trials of T4 supplementation on the central sensitivity disorders have all failed. In almost all cases, the patients will either have seen no improvement, or have experienced the symptoms of over-treatment. Only in very few cases will any improvement have occurred, and standard trials are not designed to detect such effects.


It is actually just luck that the T4/T3 proportion in desiccated thyroid is about right for some people.


Alternatively, there may just be some component in desiccated thyroid whose action we don't understand.

PERSONAL EXPERIENCE


I displayed symptoms of mild-to-moderate Chronic Fatigue Syndrome, and my wonderful NHS GP checked everything it could possibly be. All my blood tests normal, TSH=2.51. I was heading for a diagnosis of CFS.


After four months I mysteriously partially recovered after trying the iron/vitamin B supplement Floradix, even though I wasn't anaemic.


I started researching on the basis that things that go away on their own tend to come back on their own.


I noticed that I had recorded, in records kept at the time of the illness, thirty out of a list of forty possible symptoms of Hypothyroidism, drew the obvious conclusions as so many others have, and purchased a supply of desiccated thyroid in case it came back.


It did come back, and after one month, I began to self-treat with desiccated thyroid, very carefully titrating small doses against symptoms, and quickly noted immediate huge improvement in all symptoms. In fact I'd say they were gone.


My basal temperature rose over a few weeks from 36.1 to ~36.6 (average, rise slow over several weeks, noise ~ +-0.3 day to day).


One week, holding the dose steady in anticipation of more blood tests, I overdid it by the truly minute amount of 3mg/day of desiccated thyroid, which caused all of the symptoms of the manic phase of bipolar disorder (whose down phase is indistinguishable from CFS, and whose up phase looks terribly like the onset of hyperthyroidism), The manic symptoms disappeared within twelve hours of ceasing thyroid supplementation, to be replaced by overwhelming tiredness.


I resumed thyroid supplementation at a slightly lower dose, and feel as well as I have done for ten years. It's now been ten weeks and I am becoming reasonably confident that it is having some effect.

POSSIBLE CAUSATION


Such catastrophic failures of the body's central control system CANNOT be evolutionarily stable unless they are extremely rare or have compensating advantages.


I am thus drawn to the idea of either:


(a) recent environmental change (which seems to be the alternative medicine explanation)


(b) immune defence (which would explain why e.g. CFS often presents as extended version of the normal post-viral fatigue)

If the alternative is being eaten alive, it seems all too plausible that an immune mechanism might be to 'wall off' cells in some way until the emergency is past, even if catastrophic damage is a side effect.

STRONG PREDICTIONS

Low Body Temperature


It is a very strong prediction of this theory that low basal metabolic rates, and thus low basal peripheral temperatures will be found in many sufferers of Chronic Fatigue Syndrome and Fibromyalgia.

If this is not true, then the idea is refuted unambiguously.

Thyroid Hormone Supplementation as Palliative

It is a less strong prediction, but still fairly strong, that supplementation of the hormones T4 and T3 in carefully titrated doses and proportions will relieve some of the symptoms of CFS/FMS.


Note that T4 supplementation alone is unlikely to work. And that unless the doses and proportions are carefully adjusted to relieve symptoms, the treatment is likely to either not work, or be worse than the disease!


SOME SELECTED POSSIBLE IMPLICATIONS / PREDICTIONS

I've been very reluctant to draw my wilder speculative conclusions in public, since they have the potential to do great harm whether or not the idea is true, but here are some of the less frightening ones that I feel safe stating:


I state them only to encourage people to believe that this problem is worth thinking about.


Endocrinology appears not to be too interested, and my crank emails to endocrinologists have gone unanswered.


One of the reasons that I feel safe stating these four in public is that Broda Barnes thought them obvious and published popular books about them, so they are unlikely to come as a surprise to anyone outside endocrinology:


Dieting/Exercise/Weight Loss


Dieting and Exercise don't work long term as treatments for weight loss. The function of the thyroid system is to adapt metabolism to available resources. Starvation will cause mild transient hypothyroidism as the body attempts to survive the famine it infers. This may be the explanation for Anorexia Nervosa.


Diabetes


Diagnosis of diabetes was once a death sentence. With the discovery of insulin, allowing diabetics to control their blood sugar levels, it became survivable.

However it still has terrible complications, a lot of which look like the complications of hypothyroidism.


If a hormone-resistance mechanism interferes with both insulin and thyroid hormones, the reason for this is obvious. Diabetics with well-controlled blood sugar are dying in their millions from a treatable condition.


Heart Disease


One of the very old tests for hypothyroidism was blood cholesterol. It was thought to be a reliable indicator of hypothyroidism if present, but it was not always present.


A known symptom of hypothyroidism is atherosclerosis and weakness of the heart.


I would imagine that hypothyroidism initially presents as low blood pressure, due to the weakness of the heart. As the arteries clog, the weakened heart is forced to work harder and harder. Blood pressure goes higher and higher, and eventually the heart collapses under the strain.


Blood pressure reducing medications may actually be doing harm. A promising treatment might be to correct the underlying hypothyroidism.


Smoking


Cigarettes are full of poisons, and smoking is correlated with very many diseases.


It could be that smoking causes amongst its effects peripheral resistance, which causes clinical hypothyroidism, which then causes everything it usually causes. And that would be my bet!


It could be that hypothyroidism causes a very great number of bad things, including depression, which then causes smoking.


Smoking may not actually be that dangerous, and it might be possible to mitigate its bad effects.

[1] Madonna, "Pretender", Like A Virgin, Power Station Studios, New York, New York (1984)

I'm going to stop there. There are quite a lot of similar conclusions to be drawn. Read Barnes.


I also have some novel ones of my own which I am not telling anyone about just yet.


What the hell do I, or any of the quacks who have been screaming about this for forty years, have to say in order that someone with real expertise in this area takes this idea seriously enough to have a go at refuting it?

EDIT: This keeps confusing people (including me): Low Basal Metabolic Rates. The amount of oxygen you use once you have been asleep for a while. That's what the thyroid apparently controls in adult animals. Daytime won't do, that's probably under the control of something else. And peripheral temperatures. Not core. We're interested in the amount of heat flowing out of the body. Which is not quite the same thing as temperature....

EDIT : WHY THIS IS WORTH A CLOSE LOOK, EVEN THOUGH IT IS LIKELY WRONG!

Thanks to HungryHobo for making me make this point explicitly:

This is a very simple and obvious explanation of an awful lot of otherwise confusing data, anecdotes, quackery, expert opinion and medical research.

And it is obviously false! Of course medicine has tried using thyroid supplementation to fix 'tired all the time'. It doesn't work!

But there really is an awful lot unexplained about all this T4/T3 business, and why different people think it works differently. I refer you to the internet for all the unexplained things.

In just the endocrinological literature there is a long fight going on about T4/T3 ratios in thyroid supplementation, and about the question of whether or not to treat 'subclinical hypothyroidism'. Some people show symptoms with very low TSH values. Some people have extremely high TSH values and show no symptoms at all.

I've been trying various ways of explaining it all for nearly four months now. And I've found lots of magical thinking in conventional medicine, and lots of waving away of the reports of honest-sounding empiricists, who have made no obvious errors of reasoning, most of whom are taking terrible risks with their own careers in order to, as they see it, help their patients.

I've read lots of people saying 'we tried this, and it works', and no people saying 'we tried this, and it makes no difference'. The explanation favoured by conventional medicine strongly predicts 'we tried this, and it makes no difference'. But they've never tried it! It's really confusing. A lot of people are very confused.

I think that simple explanations are extra-worth looking at because they are simple.

Of course that doesn't mean they're right. Consequence and experiment are the only judge of that.

I do not think I am right! There is no way I can have got the whole picture. I can't explain, for instance 'euthyroid sick syndrome'. But I don't predict that it doesn't exist either.

But you should look very carefully at the simple beautiful ideas that seem to explain everything, but that look untrue.

Firstly because Solomonoff induction looks like a good way to think about the world. Or call it Occam's Razor if you prefer. It is straightforward Bayesianism, as David Mackay points out in Information Theory, Inference, and Learning Algorithms.

Secondly because all the good ideas have turned out to be simple, and could have been spotted, (and often were) by the Ancient Greeks, and could have been demonstrated by them, if only they'd really thought about it.

Thirdly because experiments not done with the hypothesis in mind have likely neglected important aspects of the problem. (In this case T3 homeostasis and possible peripheral resistance and the difference between basal metabolic rate and waking rate, and the difference between core and peripheral temperature and the possibility of a common DIO2 mutation causing people's systems to react differently to T4 monotherapy).

So that even if there are things you can't explain (I can't explain hot daytime fibro-turks...), you should keep plugging away, to see if you can explain them, if you think hard enough.

Good ideas should be given extra-benefit of the doubt. Not ignored because they prove (slightly) too much!

I reckon that we should be able to refute or strongly support the general idea from reports in the published literature. Here is some stuff that I have found recently. There is a comment that looks like this. Add anything you find to it, and I'll move it up here.

ADD EVIDENCE FOR OR AGAINST HERE

Found this for "Wilson's syndrome", but can only see the abstract:

http://www.ncbi.nlm.nih.gov/pubmed/16883675

It looks like it might be supportive, but it also looks crap. No mention of blinding, randomising, or placebo in the abstract.

Can anyone see the actual paper and link to it here? And can anyone work out whether these guys are allies of Wilson, or trying to break him? Because that matters.

This, on the other hand:

http://www.ncbi.nlm.nih.gov/pubmed/9513740

Looks solid, and looks like refutation. They claim normal average core temperatures in CFS. I have quibbles, of course:

I'd expect the core temperature to be well defended. So I'm not worried by that per se, but they do talk about relation to oral temperature, and they do talk about metabolic rate, so they've obviously thought about it, and I can't quite work out what they did there.

Also, the reason that they're measuring this is because their CFS patients have all been complaining about low oral temperatures and the fact that even when they've got a fever, they're not hot. So errr?? Do all the CFS patients believe this theory and are (un)consciously faking? I mean, I can believe that, but is it true that all CFS patients think this theory is true? Who is telling CFS patients to take their temperatures and why?

On the other hand, their actual graphs do look funny. There's a strange shape to the CBT vs time graph in CFS, but n=7, I think, so maybe that's just noise.

These guys:

http://www.sciencedirect.com/science/article/pii/S0024320515301223

Are actually claiming HIGHER peripheral temperatures in Fibromyalgia. But I think they're measuring during the day. I've no idea how to explain that, or what it might mean.

Barnes claimed: Measure axillary temperature on waking. Should be 98.6+/-0.2F (so 37C+/-0.1), lower is bad. Treat with lots of thyroid (1/2-2 grains).

I claim (from just me, and I am perfectly capable of fooling myself): measure oral temperature on waking. Was low (~36.1), has gone higher (36.6-7-8-9) under influence of small amounts of thyroid (1/3 grain). Feel fine now.

Can anyone find: Large numbers of CFS/FMS patients have normal metabolic rate while sleeping or just after waking, no exercise allowed, or normal axillary or oral temperature on waking, again no exercise allowed?

Because that's what I'm looking for at the moment, and it is refutation. I will have to pull off some clever moves indeed to get round that.

Oh, yes, and there's a paper by Lowe himself, finding exactly what I expect him to find:

http://www.ncbi.nlm.nih.gov/pubmed/16810133

Can anyone dig up quibbles with this that can make me discount it?

Oh Jesus:

Clinical Response to Thyroxine Sodium in Clinically Hypothyroid but Biochemically Euthyroid Patients G. R. B. SKINNER MD DSc FRCPath FRCOG, D. HOLMES, A. AHMAD PhD, J. A. DAVIES BSc and J. BENITEZ MSc Vaccine Research Trust, 22 Alcester Road, Moseley, Birmingham B13 8BE, UK

This I can't explain at all! He treated CFS people with tiny amounts of T4, and worked up the dose until they were all better. Worked a treat, apparently. Can anyone break it?

It simultaneously breaks me and proves that CFS is a thyroid problem. I think. Help! Again, no placebos, but a large clinical trial that seems to have worked, by a careful man.

I wouldn't dream of suggesting that anyone steal this using sci-hub.io by typing the title into the search box and then solving the easy CAPTCHA which is in English even though the instructions are all in Russian. You should write to the authors and request a copy instead.

Four 2003 Studies of
Thyroid Hormone Replacement Therapies:
Logical Analysis and Ethical Implications
Dr. John C. Lowe

Lowe again, my rationalist hero, publishing in his own journal, referencing his own papers and books. This time I think he's made maths mistakes. But that's my department, so I'm going to go away and think about it. I mention the paper here to avoid the obvious mistake of deciding whether to mention it after I've had a proper look.

Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia—A Randomized, Double-Blind, Placebo-Controlled, Intent-To-Treat Study

Jacob E. Teitelbaum*, Barbara Bird, Robert M. Greenfield, Alan Weiss, Larry Muenz & Laurie Gould

DOI:10.1300/J092v08n02_02

ABSTRACT

OK, how do we discount this one? I haven't even read it yet. Can anyone see it?

Thyroid Insufficiency. Is Thyroxine the Only Valuable Drug?

DOI:10.1080/13590840120083376

W. V. Baisier, J. Hertoghe & W. Eeckhaut

ABSTRACT

Bored now. Anyone find me anything that says this doesn't work?

I've even heard rumours that Lowe himself did PCRTs of his treatments. And probably published them in some chiropractic house mag. I can't even find those.

A rich seam of thyroid vs depression papers, all found through: http://psycheducation.org/

Since he's got a cause, I expect to find them all in favour. I'm going to list them here before reading them in order to avoid the obvious mistake of cherry picking from the cherry basket, and then add comments once I've read them / their abstracts.

Further evidence pointing in the opposite direction is very welcome!

I also tried:
https://www.ncbi.nlm.nih.gov/pubmed/?term=thyroxine+major+depression

and some of those are also here. I can't remember which ones I found through psycheducation and which ones through pubmed.
Bloody browser tabs, sorry, I should have been more careful.

J Affect Disord. 2014 Sep;166:353-8. doi: 10.1016/j.jad.2014.04.022. Epub 2014 May 2.
A favorable risk-benefit analysis of high dose thyroid for treatment of bipolar disorders with regard to osteoporosis.
Kelly T1.

J Clin Endocrinol Metab. 2010 Aug;95(8):3623-32. doi: 10.1210/jc.2009-2571. Epub 2010 May 25.
A randomized controlled trial of the effect of thyroxine replacement on cognitive function in community-living elderly subjects with subclinical hypothyroidism: the Birmingham Elderly Thyroid study.
Parle J1, Roberts L, Wilson S, Pattison H, Roalfe A, Haque MS, Heath C, Sheppard M, Franklyn J, Hobbs FD.

Conclusions:

This RCT provides no evidence for treating elderly subjects with SCH with T4 replacement therapy to improve cognitive function.

J Affect Disord. 2002 Apr;68(2-3):285-94.
Effects of supraphysiological thyroxine administration in healthy controls and patients with depressive disorders.
Bauer M1, Baur H, Berghöfer A, Ströhle A, Hellweg R, Müller-Oerlinghausen B, Baumgartner A.

J Affect Disord. 2009 Aug;116(3):222-6. doi: 10.1016/j.jad.2008.12.010. Epub 2009 Feb 11.
The use of triiodothyronine as an augmentation agent in treatment-resistant bipolar II and bipolar disorder NOS.
Kelly T1, Lieberman DZ.

Am J Psychiatry. 2006 Sep;163(9):1519-30; quiz 1665.
A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report.
Nierenberg AA1, Fava M, Trivedi MH, Wisniewski SR, Thase ME, McGrath PJ, Alpert JE, Warden D, Luther JF, Niederehe G, Lebowitz B, Shores-Wilson K, Rush AJ.

Nord J Psychiatry. 2015 Jan;69(1):73-8. doi: 10.3109/08039488.2014.929741. Epub 2014 Jul 1.
Well-being and depression in individuals with subclinical hypothyroidism and thyroid autoimmunity - a general population study.
Fjaellegaard K1, Kvetny J, Allerup PN, Bech P, Ellervik C.

Mol Biol Rep. 2014;41(4):2419-25. doi: 10.1007/s11033-014-3097-6. Epub 2014 Jan 18.
Thyroid hormones association with depression severity and clinical outcome in patients with major depressive disorder.
Berent D1, Zboralski K, Orzechowska A, Gałecki P.

Mol Psychiatry. 2016 Feb;21(2):229-36. doi: 10.1038/mp.2014.186. Epub 2015 Jan 20.
Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study.
Bauer M1,2, Berman S2, Stamm T3, Plotkin M4, Adli M3, Pilhatsch M1, London ED2, Hellemann GS5, Whybrow PC2, Schlagenhauf F3.
    Abstract

Mol Psychiatry. 2005 May;10(5):456-69.
Supraphysiological doses of levothyroxine alter regional cerebral metabolism and improve mood in bipolar depression.
Bauer M1, London ED, Rasgon N, Berman SM, Frye MA, Altshuler LL, Mandelkern MA, Bramen J, Voytek B, Woods R, Mazziotta JC, Whybrow PC.

Minerva Endocrinol. 2013 Dec;38(4):365-77.
Hypothyroidism and depression: salient aspects of pathogenesis and management.
Duntas LH1, Maillis A.

J Psychiatr Res. 2012 Nov;46(11):1406-13. doi: 10.1016/j.jpsychires.2012.08.009. Epub 2012 Sep 7.
The combination of triiodothyronine (T3) and sertraline is not superior to sertraline monotherapy in the treatment of major depressive disorder.
Garlow SJ1, Dunlop BW, Ninan PT, Nemeroff CB.

Mol Psychiatry. 2016 Feb;21(2):229-36. doi: 10.1038/mp.2014.186. Epub 2015 Jan 20.
Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study.
Bauer M1,2, Berman S2, Stamm T3, Plotkin M4, Adli M3, Pilhatsch M1, London ED2, Hellemann GS5, Whybrow PC2, Schlagenhauf F3.