Astral Codex Ten Podcast

I. "Silliest internet atheist argument" is a hotly contested title, but I have a special place in my heart for the people who occasionally try to prove Biblical fallibility by pointing out whales are not a type of fish. (this is going to end up being a metaphor for something, so bear with me) The argument goes like this. Jonah got swallowed by a whale. But the Bible says Jonah got swallowed by a big fish. So the Bible seems to think whales are just big fish. Therefore the Bible is fallible. Therefore, the Bible was not written by God. The first problem here is that "whale" is just our own modern interpretation of the Bible. For all we know, Jonah was swallowed by a really really really big herring. The second problem is that if the ancient Hebrews want to call whales a kind of fish, let them call whales a kind of fish. I'm not making the weak and boring claim that since they'd never discovered genetics they don't know better. I am making the much stronger claim that, even if the ancient Hebrews had taken enough of a break from murdering Philistines and building tabernacles to sequence the genomes of all known species of aquatic animals, there's nothing whatsoever wrong, false, or incorrect with them calling a whale a fish.

[self plagiarism notice: this is mostly copied from last year's contest announcement] 1. Announcing the second annual Adversarial Collaboration Contest An adversarial collaboration is an effort by two people with opposing opinions on a topic to collaborate on a summary of the evidence. Just as we hope that a trial with both prosecutor and defense will give the jury a balanced view of the evidence for and against a suspect, so we hope an adversarial collaboration will give readers a balanced view of evidence for and against some thesis. It's typically done for scientific papers, but I'm excited about the possibility of people applying the concept to to less formal writeups as well. For example, a pro-gun activist might collaborate with an anti-gun activist to write a joint article on the evidence for whether gun control saves lives. We trust each person to make sure the best evidence for their respective side is included. We also trust that they'll fact-check each other and make sure there aren't any errors or falsehoods in the final document. There might be a lot of debating, but it will happen on high-bandwidth informal channels behind the scenes and nobody will feel like they have tailor their debating to sounding good for an audience. Last year, SSC held an adversarial collaboration contest. You can see the entries here:

Ken Kesey, graduating college in Oregon with several wrestling championships and a creative writing degree, made a classic mistake: he moved to the San Francisco Bay Area to find himself. He rented a house in Palo Alto (this was the 1950s, when normal people could have houses in Palo Alto) and settled down to write the Great American Novel. To make ends meet, he got a job as an orderly at the local psych hospital. He also ran across some nice people called "MKULTRA" who offered him extra money to test chemicals for them. As time went by, he found himself more and more disillusioned with the hospital job, finding his employers clueless and abusive. But the MKULTRA job was going great! In particular, one of the chemicals, "LSD", really helped get his creative juices flowing. He leveraged all of this into his Great American Novel, One Flew Over The Cuckoo's Nest, and became rich and famous overnight. He got his hands on some extra LSD and started distributing it among his social scene – a mix of writers, Stanford graduate students, and aimless upper-class twenty-somethings. They all agreed: something interesting was going on here. Word spread. 1960 San Francisco was already heavily enriched for creative people who would go on to shape intellectual history; Kesey's friend group attracted the creme of this creme. Allan Ginsberg, Hunter S. Thompson, and Wavy Gravy passed through; so did Neil Cassady ("Dean Moriarty") Jack Keroauc's muse from On The Road. Kesey hired a local kid and his garage band to play music at his acid parties; thus began the career of Jerry Garcia and the Grateful Dead. Sometime in the early 1960s, too slow to notice right away, they transitioned from "social circle" to "cult". Kesey bought a compound in the redwood forests of the Santa Cruz Mountains, an hour's drive from SF. Beatniks, proto-hippies, and other seekers – especially really attractive women – found their way there and didn't leave. Kesey and his band, now calling themselves "the Merry Pranksters", accepted all comers. They passed the days making psychedelic art (realistically: spraypainting redwood trees Day-Glo yellow), and the nights taking LSD in massive group therapy sessions that melted away psychic trauma and the chains of society and revealed the true selves buried beneath (realistically: sitting around in a circle while people said how they felt about each other).

The gabapentinoids are a class of drugs vaguely resembling the neurotransmitter GABA. Although they were developed to imitate GABA's action, later research discovered they acted on a different target, the A2D subunit of calcium channels. Two gabapentinoids are approved by the FDA: gabapentin (Neurontin®) and pregabalin (Lyrica®). Gabapentin has been generic since 2004. It's commonly used for seizures, nerve pain, alcoholism, drug addiction, itching, restless legs, sleep disorders, and anxiety. It has an unusually wide dose range: guidelines suggest using anywhere between 100 mg and 3600 mg daily. Most doctors (including me) use it at the low end, where it's pretty subtle (read: doesn't usually work). At the high end, it can cause sedation, confusion, dependence, and addiction. I haven't had much luck finding patients a dose that works well but doesn't have these side effects, which is why I don't use gabapentin much. Pregabalin officially went generic last month, but isn't available yet in generic form, so you'll have to pay Pfizer $500 a month. On the face of things, pregabalin seems like another Big Pharma ploy to extend patents. The gabapentin patent was running out, so Pfizer synthesized a related molecule that did the same thing, hyped it up as the hot new thing, and charged 50x what gabapentin cost. This kind of thing is endemic in health care and should always be the default hypothesis. And a lot of scientists have analyzed pregabalin and said it's definitely just doing the same thing gabapentin is. But some of my anxiety patients swear by pregabalin. They call it a miracle drug. They can't stop talking about how great it is. I can't use it too often, because of the price, but I'm really excited about the upcoming generic version coming out so I can use it more often.

"You say it's important to overcome biases. So isn't it hypocritical that you're not trying to overcome whichever bias prevents you from realizing you're wrong and I'm right?" — everybody Correcting for bias is important. Learning about specific biases, like confirmation bias or hindsight bias, can be helpful. But bias arguments – "People probably only believe X because of their bias, so we should ignore people who say X" tend to be unproductive and even toxic. Why? 1. Everyone Is Biased All The Time You could accuse me of having a conservative bias. After all, I'm a well-off straight white man, a demographic well-known to lean conservative. If a liberal wanted to discount everything I say, or assume any conservative arguments I make come from self-serving motives, they've got all the ammunition they need. Or you could accuse me of having a liberal bias. After all, I'm a college-educated atheist Jewish psychiatrist in the San Francisco Bay Area. All of those demographics are well-known to lean liberal. If a conservative wanted to discount everything I say, or assume any liberal arguments I make come from self-serving motives, they're not short on ammunition either. This is a general phenomenon: for any issue, you can think of biases that could land people on one side or the other. People might be biased toward supporting moon colonization because of decades of sci-fi movies pushing space colonization as the wave of the future, or because Americans remember the moon landing as a great patriotic victory, or because big defense companies like Boeing will lobby for a project that would win them new contracts. Or people might be biased against moon colonization because of hidebound Luddite-ism, or an innate hominid preference for lush green forests and grasslands, or a pessimistic near-termism that rejects with payoffs more than a few years out. I personally might be biased towards moon colonization because I've been infected with the general Silicon Valley technophile mindset; or I personally might be biased against it because I'm a Democrat and Trump's been the loudest modern proponent of more moon missions.

[Related to: The Whole City Is Center] I. I got into an argument recently with somebody who used the word "lie" to refer to a person honestly reporting their unconsciously biased beliefs – her example was a tech entrepreneur so caught up in an atmosphere of hype that he makes absurdly optimistic predictions. I promised a post explaining why I don't like that use of "lie". This is that post. A few months ago, a friend confessed that she had abused her boyfriend. I was shocked, because this friend is one of the kindest and gentlest people I know. I probed for details. She told me that sometimes she needed her boyfriend to do some favor for her, and he wouldn't, so she would cry – not as an attempt to manipulate him, just because she was sad. She counted this as abuse, because her definition of "abuse" is "something that makes your partner feel bad about setting boundaries". And when she cried, that made her boyfriend feel guilty about his boundary that he wasn't going to do the favor. We argued for a while about whether this was a good definition of abuse (it isn't). But I had a bigger objection: this definition was so broad that everyone has committed abuse at some point. My friend could have countered that this was a feature, not a bug. Standards have been (and should be) getting stricter. A thousand years ago, beating your wife wasn't considered abuse as long as you didn't maim her or something. A hundred years ago, you could bully and belittle someone all you wanted, but as long as there was no physical violence it wasn't abuse. As society gets better and better at dealing with these issues, the definition of abuse gets broader. Maybe we should end up with a definition where basically everyone is an abuser.

I. In the old days, you had your Culture, and that was that. Your Culture told you lots of stuff about what you were and weren't allowed to do, and by golly you listened. Your Culture told you to work the job prescribed to you by your caste and gender, to marry who your parents told you to marry or at least someone of the opposite sex, to worship at the proper temples and the proper times, and to talk about proper things as opposed to the blasphemous things said by the tribe over there. Then we got Liberalism, which said all of that was mostly bunk. Like Wicca, its motto is "Do as you will, so long as it harms none". Or in more political terms, "Your right to swing your fist ends where my nose begins" or "If you don't like gay sex, don't have any" or "If you don't like this TV program, don't watch it" or "What happens in the bedroom between consenting adults is none of your business" or "It neither breaks my arm nor picks my pocket". Your job isn't to enforce your conception of virtue upon everyone to build the Virtuous Society, it's to live your own life the way you want to live it and let other people live their own lives the way they want to live them. This is the much-maligned "atomic individualism," or maybe just liberalism boiled down to its pure essence. But atomic individualism wasn't as great a solution as it sounded. Maybe one of the first cracks was tobacco ads. Even though putting up a billboard saying "SMOKE MARLBORO" neither breaks anyone's arm nor picks their pocket, it shifts social expectations in such a way that bad effects occur. It's hard to dismiss that with "Well, it's people's own choice to smoke and they should live their lives the way they want" if studies show that more people will want to live their lives in a way that gives them cancer in the presence of the billboard than otherwise.

Along with more specific questions, I asked people who took the SSC survey to rate their experience with the mental health system on a 1 – 10 scale. About 5,000 people answered. On average, they rated their experience with psychotherapy a 5.7, and their experience with medication also 5.7. This is more optimistic than a lot of the horror stories you hear would suggest. A lot of the horror stories involve inpatient commitment (which did get a dismal 4.4/10 approval rating) so I checked what percent of people engaging with the system ended up inpatient. Of people who had seen either a psychiatrist or therapist, only 7% had ever been involuntarily committed to a psychiatric hospital. Note that this data can't tease out causation, so this doesn't mean 7% of people who saw an outpatient professional were later committed – it might just mean that lots of people got committed to the hospital by police, then saw a professional later. Going into more detail about what people did or didn't like (note truncated y-axis): I asked people what kind of therapy they did. People liked all schools of therapy about the same, except that they liked "eclectic" therapy that wasn't part of any specific school less than any school. Every school including eclectic got higher than 5.7, because people who wouldn't answer this question – who weren't even sure what kind of therapy they were doing – rated it less than any school or than eclectic therapy.

I already started analyzing the SSC survey data on fetishes, but I wanted to move on to look at dominance, submission, sadism, and masochism. Why might this be interesting? For one thing, some people have fetishes for things that seem, well…bad. Getting hurt. Letting other people control and abuse them. As if they have a drive toward weakness and unhappiness. This is kind of reminiscent of the self-sabotage and bad decisions some people make throughout their lives (for example, marrying a spouse who treats them the same way as an abusive parent). Sometimes I conceptualize this as them having a set point of low self-esteem and degradation that they try to enforce, regardless of its cost to their well-being. If this had the same roots as sexual masochism, that would be worth studying. But I didn't find anything interesting like that in the data. BDSM preferences were heavily gendered. Of people who expressed a preference, 71% of cis men preferred the dominant role, compared to only 16% of cis women (18% of trans women; insufficient sample size of trans men). This was such a big difference that gender swamped every other effect, so I limited the analysis to cis men from this point on, since they made up most of the sample. 80% of straight men preferred the dominant role, compared to only 34% of gay men. This was such a big difference that orientation swamped every other effect, so I limited the analysis to straight cis men from this point on. In order of importance, here are some factors that made the men in this sample more likely to be dominant, rather than submissive. All of these are self-rated:

I. I went to Antigua Guatemala in April. Their claim to fame is the world's biggest Easter celebration. I wasn't even there for Easter. I was three weeks early. But already the roads were choked with pre-parties, practice parades, and centurion cosplayers. I couldn't go out and grab dinner at 9 PM because all the streets looked like this Day. Night. The hours of the morning when tourists are trying to sleep and don't want loud Spanish singing outside their hotel windows. It didn't stop. Some people bore the floats on their backs (they weren't motorized, they had to be carried like a sedan chair). Other people crowded into empty lots and backyards, putting finishing touches on art or costumes or paraphernalia. Children and teenagers ran around in Easter purple, jockeying for the best spots on the parade routes. Civic dignitaries stood around, practicing looking important for their turn in the celebrations. I missed the scene in the Bible where a winged mechanical lion drags the body of Christ in an intricate silver juggernaut, but the Guatemalans definitely didn't. This was around the time I was reading about cultural evolution, so I couldn't help rehearsing some familiar conservative arguments. A shared religion binds people together. For a day, everyone is on the same side. That builds social trust and helps turn a city into a community. It was hard to argue with that. I'm no expert in Guatemala. I don't even speak Spanish. But for a little while, everybody, old and young, rich or poor, whatever one Guatemalan political party is and whatever the other Guatemalan political party is, were caught up in the same great wave, swept together by the glory of the Easter narrative. It was the sort of thing, I thought sadly to myself, that would never happen back in America, where we didn't have the same kind of shared religious purpose, where the liberal traditions like the separation of church and state prevented the same kind of all-consuming state-sponsored dedication to a single narrative. Right?