I think I disagree about trauma - or, at least, I tentatively think I've benefited from the availability of the trauma lens in the kind of mental health posts I read, and from trying on that lens even though it didn't seem like an obvious fit.
Otoh I SO strongly agree with the stuff in the last paragraphs about incentives to be sad, especially when world events seem to point that way. I saw an extra strong version of that for most of 2022 among online anti-war Russians, where like, you were kind of supposed to signal that you're Not Okay because if you're somehow okay in these circumstances how can you be one of the good ones? but of course this comes up in US political/activist discourse as well. and like, fuck that, I intend to be okay even if the world is not, I can't wait for the world to be okay, that'll take too long
Unironically, the response to a feeling that the world is broken is to identify a thing you can do to make it a tiny bit better, and pour your soul into that. Not this pattern of learned helplessness that does nothing for either you or anyone else.
I often think about that learned helplessness 'Not Okay' pattern about world tragedies to be grief thievery. It is the belief that identifying other people's suffering requires you to performatively express suffering, despite the fact that it isn't actually happening to you. You essentially steal sympathy for yourself. When I hear about a war, or a genocide or famine, I feel compassion, as in a desire for their suffering to be alleviated, possibly combined with a desire to do something to alleviate that suffering if I can identify it, but I don't feel bad in their stead, I find people who respond with self-pity and call it empathy repulsive.
My experience of internet mental health culture is that it gives the part of me that wants to do less and quit faster a lot of tools to use to fight the part of me that wants to accomplish things, and so it causes me to accomplish less and thereby be more miserable. I think I'd be better off and happier and be better at doing things if I accomplished things, and as a result arguments that make the metaphorical devil on my shoulder better at whispering that I should quit make me worse off.
This is just one person, of course, and other people get the opposite result. Which is always the hard part of giving and receiving advice.
I feel a lot of the same concerns. It bugs me that for every piece of advice, some people need the opposite, and that's really true on all sides - "Get yourself together and start meeting your obligations" is also good advice for some people and bad for others. Ugh, this life.
The idea that the need to do things is some kind of failure of capitalism angers me. Until the AI decide to benevolently take over our whole lives, any economic system is going to require that fruits and vegetables be harvested, buildings be built, children be taught, elders be cared for, and that just in general a lot of work be done. It's kind of on you to do your part (as able) even if you're not in an ideal structure.
I semi-agree with you about the second paragraph but I think the people who disagree probably disagree about:
1. how much of modern work is actually productive / necessary; work that only improves the relative position of your company compared to its competitors could arguably not be done if everyone agreed not to do it, and I think people have very different intuitions around what proportion of work this kind of thing represents, see "bullshit jobs" discourse (though again this isn't my view, I think most apparently-bullshit jobs aren't bullshit actually)
2. how much it is desirable to continue to improve economic productivity and technology and so on; probably they imagine something like "lots of modern work goes into making profits for very rich people, which they use to pay for their luxury yachts; we could all be less productive while only giving up things like luxury yachts, which seems like a fine and worthy sacrifice" (and again I think this is also not true, though I'm probably also caricaturing it a little, and there may be a way to make a more reasonable point there)
Who do you think that would be bad advice for? Maybe not the "get yourself together" part but a smaller "take the next right action" (which seems like the atomic version of "start meeting your obligations") seems pretty universal.
Some people are already working as hard as they can, perhaps even pushing themselves too hard, or considering themselves to have more obligations than is reasonable. Some people are already berating themselves with that idea to an unhealthy extent.
Seems to me there is a more fundamental problem here: the fact that we treat mental health conditions differently than merely being lazy or worried or the rest.
The human condition comes in a huge range of variation and the same task can be much harder for some people than others. In an ideal world we just take into account the level of difficulty for the person at issue. In the actual world we are harsher and harsher to people until that difficulty gets classified as a mental health condition at which point we give them a pass or allow them to use meds or whatever. That leads to fundamentally broken system of incentives.
To illustrate my point, I had a really difficult time staying awake in lectures in college. I could get 10 hours of sleep every night and drink plenty of coffee and exert all my willpower but I'd fall asleep in every last lecture. That sucked but luckily my college didn't care and I just didn't go to lecture and learned from the book. Unfortunately, there is a tendency of people to instead just yell at people like me and impose harsh consequences on them until the condition is so extreme there get a narcolepsy of ADHD diagnosis at which point instead of getting berated people get accomodations.
This is broken -- on both sides. We should try and be as flexible as we can with people whether they have a condition or not. If someone can't get anything from lectures but can learn the material some other way let them. You don't need to judge them on how they do it just that they do it. OTOH the fact that it gets diagnosed with a name doesn't change the circumstances. If you can't do the task the company needs done in the time given -- even when reasonable considerations are given for your individual needs -- then it shouldn't matter that the reason you can't has a name.
Of course in practice this is hard because individualized attention is expensive but if we understand it as the framework I think it does alot to fix the discourse.
I get it and I don't disagree, but I also wish people would take one truly vital and all too rare kind of responsibility: the part where you decide what things you see on the internet are for you and which ones are not. I am getting pretty tired of "but this advice doesn't account for disabled people who are also autistic and can't speak to strangers and a knock on the floor sends them into an all day meltdown!" Like okay I'm sure people in that situation would go "wow this advice is not helpful for me, I'll move on"—or at least, they really, really should.
I think we should be able to talk about these mental health things like "be kind to yourself and don't try to achieve all the things every day" without people it doesn't apply to using it as an excuse.
That said there are two types of this that make me really furious:
-autistic people who actively hate neurotypicals to the point that you HAVE to self diagnose yourself with autism before they can have a civil conversation with you
-the assumption that "trauma" is a thing you never get over. A bad thing happened to you once and this is just your life now. In reality a lot of traumas, especially the normal level traumas you're talking about, slowly do get better. You don't really think about the thing all the time, it doesn't hurt so much to be reminded of it. I don't think it's delegitimizing the pain you suffered to say that you'll probably get better at some point.
Just on the specific point of bad-but-not-actually-traumatic things getting lumped together with actually-traumatic things-- I was surprised by some of the things you dismissed as not actually traumatic, so I did a quick google on the one I was most surprised by, being trans (in a current society). I haven't dug into these numbers at all, but the quick google gave me an odds ratio of PTSD for trans ppl of OR: 2.52 [95% CI: 2.22; 2.87].
Where for comparison, also via quick google, for sexual abuse (I think at any age?) I found an odds ratio for lifetime diagnosis of PTSD of OR: 2.34; 95% CI: 1.59-3.43
So the trans one was actually a bit *higher*, (though only by a little bit and there's big confidence intervals on the sexual abuse one, plus I haven't dug into the numbers, so I wouldn't put much weight on it actually being higher rather than just similar)
So on the face of it they look about the same?
Of course a lot of this could be because trans people are way more likely to have various traumatising experiences than cis people, in current societies. But I would be hesitant to dismiss it based on that, because I think that's a lot of what people *mean* when they say "being trans in a current society is traumatising" anyway.
Also sorry to do that thing where u only comment on one specific part you don't like or disagree with and nothing else! I haven't finished reading the whole post yet but I think I actually directionally agree with a lot of your points, and it's something I think about a lot so I'm keen at getting to hear your take on it.
Much of your problem with internet mental health culture seems to come from the interaction between/blending of more severe, disabled mental health culture, and the idea of a more mild, capable patient being harmed by content that's not for them, and I'm not sure that's a valid criticism. Removing shame on a societal level around stigmatized mental health behaviors shouldn't be seen as harmful.
I would also disagree on the issue of trauma, complex post traumatic stress disorder, the chronic childhood type, that often does apply to people growing up with undiagnosed adhd/autism, is certainly different from the episodic ptsd you describe, the *big bad event* type, but it's just as if not more severe in it's presentation, and that lens helps many people work their way forward towards a better life for themselves.
"If you don’t do that, you’re going to be depressed, because your life will be depressing." Well, okay, you need to work so you have money, do the dishes so you have clean dishes, and tolerate mildly annoying people so you're not constantly having fights. But once that's done you can go back to lying in bed and watching stuff, right?
What does the good life look like? Is it a series of chores and duties, that brings you to your death bed going "oh thank fuck that's over"? Is it getting the chores and duties out of the way as fast as possible so you can go back to slacking off? Are there other options? Actually asking, I'm confused.
It occurs to me that your scheme also contains incentives to be miserable: if being able to have discipline means you must, then there's a huge incentive to become genuinely unable to do anything and then you can't be forced to.
Relatedly, it's important to rest when you could still work: if you only rest when your ability to work five more minutes runs out, then you're going to burn out.
Various nitpicks:
The "it's just the human condition" thing always confuses me: sure, the average person cares kind of a lot about being liked, but some people are utterly crushed by the very prospect of a mild rebuke: how to describe the difference? at the other end, some people have extremely thick skin and don't care about a party-invite snub (hi): does that rule out ADHD entirely?
The trauma thing is related: people certainly have effects from bad events that fall well short of PTSD but are noticeable. I don't know if that's a useful observation, though, since I don't know what to do about it.
I've been thinking about this a lot (need to write something long-form on it), but the quick version is that if literally every productive thing you do is miserable work, there's a values issue that means you're going to spend your whole life miserable. I think this values issue is cultural.
The act of meeting your needs and the needs of others can be, in itself, fulfilling. Working in a shitty sandwich shop where you make profit for a bunch of millionaires sucks, but only because we've been conditioned to frame it in those terms. Handing a hungry dude a sandwich can actually be a great experience. Is it ideal that handing a dude a sandwich doesn't pay enough money to live while making millionaires rich? Not so much. Is it fulfilling to give someone a sandwich who doesn't even say thank you, and who's going to complain about any little mistake? No, that sucks. But you aren't sticking it to those millionaires and entitled jerks by taking the innate joy out of the act, you're just being sad. We should do policy if we want to solve the problem, not insist that anyone who isn't sad about it all the time is a class traitor or a bootlicker or whatever.
If your greatest goal in life is lying in bed watching Netflix, if you can see no joy in any act that requires exertion, if doing things for others is something you *have to* do, instead of something you want to do or choose to do... well, I don't think there's a path to happiness from that worldview.
I really agree with the need for language for "in the direction of this thing I have a word for, but not that far" for just about everything in the post - PTSD, parentification, autism, etc.
YES, so emphatically. There's this strong tendency to say "you are fully in this group of people who share this issue, or you are 100% out" and that is just not how reality works.
Obviously there is no one "good life" that looks the same for everybody. Part of the challenge is working out for yourself what your own good life looks like (something I certainly haven't done myself yet). But it's clear that just living a rat race isn't it.
You need to find joy and meaning in the chores and duties!
It's easier said than done, but you should be proud of the work you do. You should try to enjoy looking at your clean dishes. You should feel like your duties are helping other people.
> mild physical health conditions, caring a lot about being liked, occasional dissociation, poor coping mechanisms for stress, and taking good things for granted are all a normal part of life for most people
reading this list, I was like, "yes, yes, what? ... yes, yes". Do most people actually have occasional dissociation? I do, but I'm not sure I always did, and also I link mine to some quite specific and intense stress that I get, that I'm sure many people don't. Curious if other people have intuitions or data about this.
Mild dissociative experiences include being spacey/"in a fog", showing up at your workplace with absolutely no memory of the drive from your house, walking into your living room with no idea why you decided to go there, or getting so caught up in something that you lose track of time and what's going on in the outside world. Many people who do certain kinds of fiction/roleplaying/acting also have dissociative experiences: for example, it's reasonably common for LARPers to have in-character thoughts before they have out-of-character thoughts, especially in multiday LARPs where they're in character most of the time. More severe dissociation ("this can't be happening, it feels fictional, it feels like it's happening to someone else") is common and nonpathological as a result of extreme stress.
I guess it depends on how you define "dissociation." My understanding is that daydreaming to cope with boredom or discomfort is a form of dissociation.
I think I disagree about trauma - or, at least, I tentatively think I've benefited from the availability of the trauma lens in the kind of mental health posts I read, and from trying on that lens even though it didn't seem like an obvious fit.
Otoh I SO strongly agree with the stuff in the last paragraphs about incentives to be sad, especially when world events seem to point that way. I saw an extra strong version of that for most of 2022 among online anti-war Russians, where like, you were kind of supposed to signal that you're Not Okay because if you're somehow okay in these circumstances how can you be one of the good ones? but of course this comes up in US political/activist discourse as well. and like, fuck that, I intend to be okay even if the world is not, I can't wait for the world to be okay, that'll take too long
Unironically, the response to a feeling that the world is broken is to identify a thing you can do to make it a tiny bit better, and pour your soul into that. Not this pattern of learned helplessness that does nothing for either you or anyone else.
I often think about that learned helplessness 'Not Okay' pattern about world tragedies to be grief thievery. It is the belief that identifying other people's suffering requires you to performatively express suffering, despite the fact that it isn't actually happening to you. You essentially steal sympathy for yourself. When I hear about a war, or a genocide or famine, I feel compassion, as in a desire for their suffering to be alleviated, possibly combined with a desire to do something to alleviate that suffering if I can identify it, but I don't feel bad in their stead, I find people who respond with self-pity and call it empathy repulsive.
My experience of internet mental health culture is that it gives the part of me that wants to do less and quit faster a lot of tools to use to fight the part of me that wants to accomplish things, and so it causes me to accomplish less and thereby be more miserable. I think I'd be better off and happier and be better at doing things if I accomplished things, and as a result arguments that make the metaphorical devil on my shoulder better at whispering that I should quit make me worse off.
This is just one person, of course, and other people get the opposite result. Which is always the hard part of giving and receiving advice.
Was there supposed to be a selection of quotes after "She quotes some very annoying people:" ?
Also, who's Shrier?
I feel a lot of the same concerns. It bugs me that for every piece of advice, some people need the opposite, and that's really true on all sides - "Get yourself together and start meeting your obligations" is also good advice for some people and bad for others. Ugh, this life.
The idea that the need to do things is some kind of failure of capitalism angers me. Until the AI decide to benevolently take over our whole lives, any economic system is going to require that fruits and vegetables be harvested, buildings be built, children be taught, elders be cared for, and that just in general a lot of work be done. It's kind of on you to do your part (as able) even if you're not in an ideal structure.
I semi-agree with you about the second paragraph but I think the people who disagree probably disagree about:
1. how much of modern work is actually productive / necessary; work that only improves the relative position of your company compared to its competitors could arguably not be done if everyone agreed not to do it, and I think people have very different intuitions around what proportion of work this kind of thing represents, see "bullshit jobs" discourse (though again this isn't my view, I think most apparently-bullshit jobs aren't bullshit actually)
2. how much it is desirable to continue to improve economic productivity and technology and so on; probably they imagine something like "lots of modern work goes into making profits for very rich people, which they use to pay for their luxury yachts; we could all be less productive while only giving up things like luxury yachts, which seems like a fine and worthy sacrifice" (and again I think this is also not true, though I'm probably also caricaturing it a little, and there may be a way to make a more reasonable point there)
Who do you think that would be bad advice for? Maybe not the "get yourself together" part but a smaller "take the next right action" (which seems like the atomic version of "start meeting your obligations") seems pretty universal.
Some people are already working as hard as they can, perhaps even pushing themselves too hard, or considering themselves to have more obligations than is reasonable. Some people are already berating themselves with that idea to an unhealthy extent.
Seems to me there is a more fundamental problem here: the fact that we treat mental health conditions differently than merely being lazy or worried or the rest.
The human condition comes in a huge range of variation and the same task can be much harder for some people than others. In an ideal world we just take into account the level of difficulty for the person at issue. In the actual world we are harsher and harsher to people until that difficulty gets classified as a mental health condition at which point we give them a pass or allow them to use meds or whatever. That leads to fundamentally broken system of incentives.
To illustrate my point, I had a really difficult time staying awake in lectures in college. I could get 10 hours of sleep every night and drink plenty of coffee and exert all my willpower but I'd fall asleep in every last lecture. That sucked but luckily my college didn't care and I just didn't go to lecture and learned from the book. Unfortunately, there is a tendency of people to instead just yell at people like me and impose harsh consequences on them until the condition is so extreme there get a narcolepsy of ADHD diagnosis at which point instead of getting berated people get accomodations.
This is broken -- on both sides. We should try and be as flexible as we can with people whether they have a condition or not. If someone can't get anything from lectures but can learn the material some other way let them. You don't need to judge them on how they do it just that they do it. OTOH the fact that it gets diagnosed with a name doesn't change the circumstances. If you can't do the task the company needs done in the time given -- even when reasonable considerations are given for your individual needs -- then it shouldn't matter that the reason you can't has a name.
Of course in practice this is hard because individualized attention is expensive but if we understand it as the framework I think it does alot to fix the discourse.
I get it and I don't disagree, but I also wish people would take one truly vital and all too rare kind of responsibility: the part where you decide what things you see on the internet are for you and which ones are not. I am getting pretty tired of "but this advice doesn't account for disabled people who are also autistic and can't speak to strangers and a knock on the floor sends them into an all day meltdown!" Like okay I'm sure people in that situation would go "wow this advice is not helpful for me, I'll move on"—or at least, they really, really should.
I think we should be able to talk about these mental health things like "be kind to yourself and don't try to achieve all the things every day" without people it doesn't apply to using it as an excuse.
That said there are two types of this that make me really furious:
-autistic people who actively hate neurotypicals to the point that you HAVE to self diagnose yourself with autism before they can have a civil conversation with you
-the assumption that "trauma" is a thing you never get over. A bad thing happened to you once and this is just your life now. In reality a lot of traumas, especially the normal level traumas you're talking about, slowly do get better. You don't really think about the thing all the time, it doesn't hurt so much to be reminded of it. I don't think it's delegitimizing the pain you suffered to say that you'll probably get better at some point.
Just on the specific point of bad-but-not-actually-traumatic things getting lumped together with actually-traumatic things-- I was surprised by some of the things you dismissed as not actually traumatic, so I did a quick google on the one I was most surprised by, being trans (in a current society). I haven't dug into these numbers at all, but the quick google gave me an odds ratio of PTSD for trans ppl of OR: 2.52 [95% CI: 2.22; 2.87].
Where for comparison, also via quick google, for sexual abuse (I think at any age?) I found an odds ratio for lifetime diagnosis of PTSD of OR: 2.34; 95% CI: 1.59-3.43
So the trans one was actually a bit *higher*, (though only by a little bit and there's big confidence intervals on the sexual abuse one, plus I haven't dug into the numbers, so I wouldn't put much weight on it actually being higher rather than just similar)
So on the face of it they look about the same?
Of course a lot of this could be because trans people are way more likely to have various traumatising experiences than cis people, in current societies. But I would be hesitant to dismiss it based on that, because I think that's a lot of what people *mean* when they say "being trans in a current society is traumatising" anyway.
Trans source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387489/
Sexual abuse source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894717/
Also sorry to do that thing where u only comment on one specific part you don't like or disagree with and nothing else! I haven't finished reading the whole post yet but I think I actually directionally agree with a lot of your points, and it's something I think about a lot so I'm keen at getting to hear your take on it.
The penultimate paragraph is particularly important and pretty destructive to many a lost young person.
Much of your problem with internet mental health culture seems to come from the interaction between/blending of more severe, disabled mental health culture, and the idea of a more mild, capable patient being harmed by content that's not for them, and I'm not sure that's a valid criticism. Removing shame on a societal level around stigmatized mental health behaviors shouldn't be seen as harmful.
I would also disagree on the issue of trauma, complex post traumatic stress disorder, the chronic childhood type, that often does apply to people growing up with undiagnosed adhd/autism, is certainly different from the episodic ptsd you describe, the *big bad event* type, but it's just as if not more severe in it's presentation, and that lens helps many people work their way forward towards a better life for themselves.
"If you don’t do that, you’re going to be depressed, because your life will be depressing." Well, okay, you need to work so you have money, do the dishes so you have clean dishes, and tolerate mildly annoying people so you're not constantly having fights. But once that's done you can go back to lying in bed and watching stuff, right?
What does the good life look like? Is it a series of chores and duties, that brings you to your death bed going "oh thank fuck that's over"? Is it getting the chores and duties out of the way as fast as possible so you can go back to slacking off? Are there other options? Actually asking, I'm confused.
It occurs to me that your scheme also contains incentives to be miserable: if being able to have discipline means you must, then there's a huge incentive to become genuinely unable to do anything and then you can't be forced to.
Relatedly, it's important to rest when you could still work: if you only rest when your ability to work five more minutes runs out, then you're going to burn out.
Various nitpicks:
The "it's just the human condition" thing always confuses me: sure, the average person cares kind of a lot about being liked, but some people are utterly crushed by the very prospect of a mild rebuke: how to describe the difference? at the other end, some people have extremely thick skin and don't care about a party-invite snub (hi): does that rule out ADHD entirely?
The trauma thing is related: people certainly have effects from bad events that fall well short of PTSD but are noticeable. I don't know if that's a useful observation, though, since I don't know what to do about it.
I've been thinking about this a lot (need to write something long-form on it), but the quick version is that if literally every productive thing you do is miserable work, there's a values issue that means you're going to spend your whole life miserable. I think this values issue is cultural.
The act of meeting your needs and the needs of others can be, in itself, fulfilling. Working in a shitty sandwich shop where you make profit for a bunch of millionaires sucks, but only because we've been conditioned to frame it in those terms. Handing a hungry dude a sandwich can actually be a great experience. Is it ideal that handing a dude a sandwich doesn't pay enough money to live while making millionaires rich? Not so much. Is it fulfilling to give someone a sandwich who doesn't even say thank you, and who's going to complain about any little mistake? No, that sucks. But you aren't sticking it to those millionaires and entitled jerks by taking the innate joy out of the act, you're just being sad. We should do policy if we want to solve the problem, not insist that anyone who isn't sad about it all the time is a class traitor or a bootlicker or whatever.
If your greatest goal in life is lying in bed watching Netflix, if you can see no joy in any act that requires exertion, if doing things for others is something you *have to* do, instead of something you want to do or choose to do... well, I don't think there's a path to happiness from that worldview.
I really agree with the need for language for "in the direction of this thing I have a word for, but not that far" for just about everything in the post - PTSD, parentification, autism, etc.
YES, so emphatically. There's this strong tendency to say "you are fully in this group of people who share this issue, or you are 100% out" and that is just not how reality works.
Obviously there is no one "good life" that looks the same for everybody. Part of the challenge is working out for yourself what your own good life looks like (something I certainly haven't done myself yet). But it's clear that just living a rat race isn't it.
You need to find joy and meaning in the chores and duties!
It's easier said than done, but you should be proud of the work you do. You should try to enjoy looking at your clean dishes. You should feel like your duties are helping other people.
Also having things that are more active than chores and duties and fun to do – hobbies, pretty much
> mild physical health conditions, caring a lot about being liked, occasional dissociation, poor coping mechanisms for stress, and taking good things for granted are all a normal part of life for most people
reading this list, I was like, "yes, yes, what? ... yes, yes". Do most people actually have occasional dissociation? I do, but I'm not sure I always did, and also I link mine to some quite specific and intense stress that I get, that I'm sure many people don't. Curious if other people have intuitions or data about this.
Mild dissociative experiences include being spacey/"in a fog", showing up at your workplace with absolutely no memory of the drive from your house, walking into your living room with no idea why you decided to go there, or getting so caught up in something that you lose track of time and what's going on in the outside world. Many people who do certain kinds of fiction/roleplaying/acting also have dissociative experiences: for example, it's reasonably common for LARPers to have in-character thoughts before they have out-of-character thoughts, especially in multiday LARPs where they're in character most of the time. More severe dissociation ("this can't be happening, it feels fictional, it feels like it's happening to someone else") is common and nonpathological as a result of extreme stress.
It is kind of a weirdly broad category!
I guess it depends on how you define "dissociation." My understanding is that daydreaming to cope with boredom or discomfort is a form of dissociation.