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Contra Caplan on Mental Illness

I.

Bryan Caplan has a 2006 paper arguing that economic theory casts doubt on the consensus view of psychiatric disease. He writes:

Economists recognize the benefits of specialization. Only with hestitation, then, can economists focus their attention on an unfamiliar discipline and conclude that experienced professionals have been making elementary mistakes. However inconsistent psychiatry’s main theses seem to be with basic consumer theory, one might think it foolhardy to conclude that they are wrong.

At the same time, economists also recognize not only that rentseeking is a ubiquitous force, but that most rent-seekers create and internalize public-interested justifications for their activities. It is not overreaching for economists to criticize domestic auto makers’ arguments for protectionism. The auto makers know more about the details of their own industry, but economists are better at interpreting those details. Equally importantly, economists are trained to consider the costs of a policy for everyone in society, not merely groups with the most political influence.

From a rent-seeking perspective, skepticism about psychiatry is common sense. Rent-seeking is only a side activity for the auto industry, but it lies at the core of psychiatry.

Calling someone a rent-seeker is sort of an economist’s way of telling them to die in a fire, so I feel honor-bound to respond.

As best I can tell, Caplan’s argument goes like this:

Consumer theory distinguishes between two different reasons why someone might not buy a Ferrari – budget constraints (they can’t afford one) and preferences (they don’t want one, or they want other things more). Physical diseases seem much like budget constraints – the reason a paralyzed person can’t run a marathon is because it’s beyond her abilities, simply impossible. Psychiatric diseases seem more like preferences. There’s nothing obvious stopping an alcoholic from quitting booze and there’s nothing obvious preventing someone with ADHD from sitting still and paying attention. Therefore they are best modeled as people with unusual preferences – the one with a preference for booze over normal activities like holding down a job, the other with a high dispreference for sitting still and attending classes. But lots of people have weird preferences. Therefore, psychiatric diseases should be thought of as within the broad spectrum of normal variation, rather than as analogous to physical diseases.

He compares this to the work of Thomas Szaszszszsz, who proposes that psychiatry is an inherently political enterprise that works to delegitimize people with unusual preferences. For example, until the 1970s homosexuality was considered a psychiatric disease, and now it is considered an uncommon but legitimate preference. In the past being transgender was considered a psychiatric disease, but now many people are moving toward considering it an uncommon but legitimate preference. In each case, when society thinks that a preference is gross, or anti-social, or so extreme that they can’t imagine themselves having it, they shout “Psychiatric disease!” and then they can stick anyone who offends them in mental hospitals; if the preference becomes more legitimate, they retreat and say “Guess those ones weren’t psychiatric diseases after all, but we’re still 100% sure all the other ones are”. Caplan says that instead of these constant mini-retreats we should just admit that all psychiatric diseases are unusual preferences.

He admits that he’s making his job too easy with examples like alcoholism, and that something like schizophrenia would make a harder test case. But, he asks, what is schizophrenia? Delusions and hallucinations. Delusions may be a preference to have a weird belief – for example, somebody might feel trivial and neglected, so in order to make themselves feel important they cook up a paranoid conspiracy theory where the FBI, CIA, and Freemasons are all after them because of how important they are. Wanting to believe that the government is after you is a weird preference but, Caplan insists, nevertheless still a preference. As for hallucinations, sure, schizophrenic people say they hear voices, but we all kind of hear internal voices in the sense of “hear ourselves thinking in our head”, and schizophrenics must just be people who prefer to explain those in very vivid external terms. Visual hallucinations are the same way – we all have an imagination, but some of us react to our imaginations differently than others.

Therefore, all psychiatric diseases can be conceptualized in the form of preferences. This makes them very different to physical diseases, which are budgetary limitations, and we should stop saying they’re the same thing and locking mentally ill people up and having all of these rent-seeking psychiatrists around saying they can “cure” them.

Caplan ends by noting that genetics and neurobiology cannot prove him wrong. Yes, weird preferences may be genetic, and they may be linked to weird neurobiology, but so are our normal preferences! There are genetic factors influencing schizophrenia, but there are also genetic factors influencing politics, religion, and extraversion. Yes, drugs can make you less schizophrenic, but they can also make you less extraverted.

I agree with Caplan’s last paragraph. We can’t prove him wrong with neurobiology alone. So let’s prove him wrong with philosophy, psychology, economics, and common sense.

II.

Let’s start with preferences vs. budgetary constraints.

Alice has always had problems concentrating in school. Now she’s older and she hops between a couple of different part-time jobs. She frequently calls in sick because she feels like she doesn’t have enough energy to go into work that day, and when she does work her mind isn’t really on her projects. When she gets home, she mostly just lies in bed and sleeps. She goes to a psychiatrist who diagnoses her with ADHD and depression.

Bob is a high-powered corporate executive who rose to become Vice-President of his big Fortune 500 company. When he gets home after working 14 hour days, he trains toward his dream of running the Boston Marathon. Alas, this week Bob has the flu. He finds that he’s really tired all the time, and he usually feels exhausted at work and goes home after lunch; when he stays, he finds that his mind just can’t concentrate on what he’s doing. Yesterday he stayed home from work entirely because he didn’t feel like he had the energy. And when he gets home, instead of doing his customary 16 mile run he just lies in bed all day. His doctor tells him that he has the flu and is expected to recover soon.

At least for this week Alice and Bob are pretty similar. They’d both like to be able to work long hours, concentrate hard, and stay active after work. Instead they’re both working short hours, calling in sick, failing to concentrate, and lying in bed all day.

But for some reason, Bryan calls Alice’s problem “different preferences” and Bob’s problem “budgetary constraints”, even though they’re presenting exactly the same way! It doesn’t look like he’s “diagnosing” which side of the consumer theory dichotomy they’re on by their symptoms, but rather by his assumptions about the causes.

And his assumptions about the causes may be wrong. Bob’s issues are probably caused by what we call “sickness behavior”, a chemical defense in which the immune system notices an infection and releases cytokines telling your brain to avoid action and conserve energy in order to help with recovery. But one of the theories of depression I have found most plausible is that it’s a malfunctioning of sickness behavior – you’re not necessarily really sick, but your immune system releases its “stop acting and lie in bed all day so we can recover” chemicals anyway. If flu and depression have the same proximal cause, and the same effects on your life, where does Bryan draw the budget/preferences line?

For that matter, does Bryan ever get tired? I mean, suppose he is up very late one night and then has to go to work on only an hour of sleep. If he’s like the rest of us, he probably does a terrible job, can’t concentrate, and maybe rushes through things to get home early so he can catch a nap. Is this a budgetary constraint, or different preferences? In one sense it seems budgetary – he is lacking a resource (sleep? mental energy?) that would allow him to do a good job if he had it. In another sense it is clearly preferential – he places much less value in working hard and much more value in rushing home to get a nap.

Either way, this seems like a fruitful way to think about conditions like ADHD. Someone with ADHD, like someone who’s working on an hour of sleep, finds themselves miserable and unable to focus. If we call this a budgetary constraint, Bryan’s whole argument comes tumbling down. But if we call it a preference, then it’s a very strange type of preference, one where the usual method of “oh, great, you’re doing what you prefer!” is entirely the wrong approach.

In the case of the sleep-deprived person, their “new set of preferences” seems like a malign and unpleasant condition inflicted on them by an external source – namely, their sleeplessness. It’s certainly not “what they prefer” in the sense of “oh, great, he’s doing what he prefers, now he’s self-actualized and all is right with the world.” Instead, we admit that it’s a problem, they admit that it’s a problem, and we prescribe a biological cure – more sleep.

Or here’s another example. Suppose while you are asleep I inject you with a little machine that constantly releases interferon into your bloodstream – interferon being a hepatitis medication notorious for causing deep depression as a side effect. You become depressed, and your preferences change from “work and spend time with my friends” to “lie in bed all day”. But a helpful wizard gives you a powerful antidote. If you take the antidote every day, the interferon is rendered harmless and you are as active as ever. Unfortunately, you run out of antidote, and you lie in bed all day.

So: is your lying in bed all day a preference, or a budgetary constraint caused by shortage of antidote?

My answer: dichotomies sometimes break down outside a certain scope. I enjoy reading Bryan’s posts about immigration, which often compare immigrants to natives along some axis. Immigrant vs. native is a useful dichotomy for a lot of purposes. But: were the guys on the Mayflower immigrants or natives? Were slaves abducted from Africa to work on plantations immigrants or natives? Were the couple thousand residents of California who went to bed as Mexicans the night before the Treaty of Guadalupe Hidalgo and woke up as Americans the next morning immigrants or natives? What about migratory birds? The number three? The Devil?

I propose that the preference/budget distinction is a bad way of dealing with anything more complicated than which brand of shampoo to buy. We intuitively talk about our choices as if there were some kind of “mental energy” that allows one to pursue difficult preferences, and I discuss some ways this confuses our intuitive notion of budgeting in Parts II and III here. You don’t have to accept any particular framing of this, but to sweep the entire problem under the rug is to ignore reality because you’re trying to squeeze all of human experience into a theory about shampoo.

III.

If there’s not a lot of difference between preferences and budgetary constraints, what does that say about the relevance of Thomas Szasz?

(By relevance, I mean relevance to the modern day; he wrote in the 1960s and what he wrote was very possibly more true then than it is now. Possibly played a big part in making the things he wrote about less true, and should be celebrated for this. But I’ll concentrate on the present.)

Szasz and Caplan both says that mental illnesses are attempts to stigmatize those with unusual preferences. I say that mental illnesses can reflect people’s genuine worries about a-thing-sort-of-like-a-budgetary-constraint afflicting them. Which of us is right?

Well, consider that about 95% of people who go to an outpatient psychiatrist do so of their own free choice. This is certainly the case with my own patients. They are people who have gotten tired with the constraints that mental illnesses put on their lives, come in and say “Doctor, please help me”, and I try to help them achieve whatever goals they have for themselves.

About 50% of people who go to inpatient psychiatric facilities also go of their own free choice. The rest, assuming everyone’s following the legal system and the appropriate ethical guidelines, are people who are “dangers to themselves or others”. I admit, it takes a controversial value judgment to decide people shouldn’t be allowed to be dangerous toward themselves – though I think in some cases that judgment can be justified. And I admit that “danger to others” can sometimes be stretched to the point where if a psychiatrist wants to commit someone they can probably make up a justification. But these implementation problems are a heck of a long way from Caplan and Szasz’s theory of “psychiatry is just a project about finding weird people and locking them up.”

The psychiatric profession will never live down the thing about homosexuality; I fully expect that in 5000 AD someone will still be complaining that we can’t stigmatize entities infected with superintelligent self-replicating memetic viruses, because DSM-II listed homosexuality as a psychiatric disease. But there’s still a chance to rebut the thing about transgender, so let me quote from the APA website’s discussion of the topic:

The [new DSM criteria] underscore that being transgender is not a disorder in itself: Treatment only is considered for transgender people who experience gender dysphoria — a feeling of intense distress that one’s body is not consistent with the gender he or she feels they are, explains Walter Bockting, PhD, a clinical psychologist and co-director of the LGBT Health Initiative at Columbia University Medical Center.

In other words, the decision about whether transgender people need psychiatric help is left up to – transgender people. If they don’t want it, they don’t have to have it. If they do want it, the option is open to them and their condition is recognized as a legitimate reason to seek help that insurance companies will support. I myself have treated exactly one patient for gender dysphoria. She was so depressed about her gender that she was considering suicide. I gave her some antidepressants, some supportive therapy, and some information about local support groups and sex-change professionals. Then I billed her insurance company for gender dysphoria treatment and got a check. Truly everyone involved is Worse Than Hitler.

IV.

Caplan admits that some mentally ill people seek help voluntarily and are among the most vocal proponents of the “real disease” theory. In order to shoehorn this into his preference-budget dichotomy, he theorizes that this is an attempt at deception. For example, alcoholics’ insistence that they cannot resist drinking alcohol is deceptive:

From an economic point of view, however, what is so puzzling about a person who prefers consuming alcohol to career success or family stability? Life is full of trade-offs. The fact that most of us would make a different choice is hardly evidence of irrationality. Neither is the fact that few alcoholics will admit their priorities; expressing regret and a desire to change is an excellent way to deflect social and legal sanctions.

But in order to fully explain alcoholic behavior, we have to take this theory exceptionally far. Consider a typical alcoholic drinks for several years, then “hits bottom”, goes sober, and joins Alcoholics Anonymous. He attends AA meetings three times a week for three years, then has a really bad day and binges on alcohol. Afterwards he is so embarrassed that he attempts suicide, but is rushed to the hospital and resuscitated successfully. After that he goes back to his AA meetings.

Does this man have a preference for going to AA meetings three times a week for several years then getting really drunk then attempting suicide? That’s a weird preference to have. Does he have a preference to drink, and in order to be socially acceptable he ‘covers up’ his one episode of binge drinking by years of AA meetings and a serious suicide attempt which he secretly knows will fail? That is a pretty disproportionately big web of lies, especially when probably no one would blame him for binge drinking one night one time.

If we’re willing to be this paranoid, we can basically prove or disprove anything. Bryan Caplan says he’s a libertarian, but my 9th grade Civics textbook says there are only two political parties, Democrats and Republicans. If Bryan says he’s in a third, he must just be trying to “deflect social and legal sanctions”. Maybe he’s secretly a Republican, but he wants to fit in to academic culture, so he says all of this stuff about “libertarianism” as a cover. His work writing hundreds of essays and some pretty decent books supporting his libertarian viewpoint are to maintain the credibility of his signal and throw us off the trail. Any donations he may have made to libertarian causes are the same…

…or we can be skeptical of textbooks that try to reduce things to simple dichotomies, whether that’s Democrat/Republican or preference/budget.

Caplan sort of flirts with admitting this:

Cooter and Ulen probably speak for many economists when they deny that the preferences of the severely mentally ill are well-ordered. But in fact, not only do individuals with mental disorders typically have transitive preferences; they usually have more definite and predictable orderings than the average person…it is also implausible to interpret most mental illness using a ‘hyperbolic discounting’ or ‘multiple selves’ model. These might fit a moderate drug user who says he ‘wants to quit’…but they do not fit the hard-core drug addict whose only wish is to be left alone to pursue his habit. The same holds for most serious mental disorders: they are considered serious in large part because the affected individual continues to pursue the same objectionable behavior over time with no desire to change.

But if we take that middle part seriously he is ceding me 99.9% of the ground without remarking on it. Most people with mental disorders and substance abuse disorders wants to get rid of their disorder or at least alleviate the worst parts of it. If you are willing to accept complicated “multiple selves” models for those, then that is what you should be using to model mental disorders, not the simple consumer price theory.

And the others? The alcoholic who says “Yup, I’m drinking myself to death and you can’t stop me?” I agree that it is in some sense rational. It is rational because that person has so many problems that drinking alcohol becomes more pleasant than dealing with them. Often, these problems are related to psychiatric issues – for example, many people with PTSD become alcoholics because alcohol helps them briefly forget their traumatic memories. There are many people who say they don’t want help with their drinking problem because they expect “help” to mean “take away the alcohol but give them nothing in exchange”. If “help” meant “replace the alcohol with some healthier coping mechanism that works just as well”, many of these people would take it in a heartbeat. I realize this doesn’t quite disprove Caplan’s thesis for this relatively small group of alcoholics, but I think it’s important to remember that “preference” is different from “they’re doing what they want and all is well”.

V.

Finally, Caplan moves into a discussion of schizophrenia. He says that hallucinations might just be people hearing their normal inner voice and seeing their usual inner imagination, but they choose to describe it differently:

Szasz similarly maintains that many alleged hallucinations are only eccentric descriptions of ordinary experience. To take the most common form, psychiatrists routinely equate ‘hearing voices’ with auditory hallucination. But when a person feels guilty, we often say that he hears the voice of conscience…to take a stronger case, the DSM treats ‘a voice keeping up a running commentary on the person’s behavior or thoughts’ as an exceptionally serious symptom. But this describes any person deliberating between major life options over an extended period of time. While these examples might seem to stretch the meaning of ‘hallucination’, it is the DSM that explicitly fails to distinguish whether the source of the voices is perceived as being inside or outside of the head.’

This makes sense, which is why every psychiatrist for the past century has specifically asked patients whether that’s what’s happening before diagnosing them with anything. Any time a patient reports a hallucination to me, the first question I ask is whether they’re just embellishing on hearing an inner voice, or whether they actually heard an external voice clearly and distinctly the way they are hearing me talk to them right now. Sometimes they did just hear an inner voice – this is especially common in OCD obsessions – but other times they tell me that no, it was definitely an external voice, totally different from their normal internal voice. Sometimes they thought at first it was a normal non-hallucinatory voice talking to them, and they got up to try to figure out who it was before they realized no one was around and it had to have been a hallucination.

This should not be surprising to anyone who has ever taken drugs, heard from people who took drugs, or been vaguely aware of the existence of drugs. Drugs can cause vivid, realistic hallucinations. Caplan says he doesn’t want to talk about neurobiology, and that’s all nice and well, but drugs provide a pretty good neurobiological proof of concept. LSD, which is infamous for its hallucinations, is a 5-HT2A agonist. You can treat schizophrenic hallucinations with Seroquel, which is a 5HT2A antagonist; placebo Seroquel doesn’t work nearly as well. Coincidence? I feel like at this point we’re getting into paranoid are-we-sure-anyone-is-a-libertarian territory again.

He then goes on to say that delusions might just be a preference to believe something, rather than actually believing it. There’s a lot of epistemological complexity here – can we believe something just because we prefer to believe it? If someone offered me $1 million to believe that Greenland is in the southern hemisphere, could I do it? I think not, but I think Caplan understands this and is accusing delusional people of just playing a sort of LARP where they act as if they’re in a much more interesting universe full of FBI agents and secret radios and the Devil. In favor of this, he describes how psychotic people can sometimes adjust their thinking and actions when they have incentive to do so. For example, he talks about some psychiatric inpatients denying their delusional beliefs in order to avoid electroconvulsive therapy.

I don’t think the ability of psychiatric inpatients to hide their condition in response to incentives changes things much. I firmly and genuinely believe that Greenland is in the northern hemisphere, but if someone threatened to give me old-timey scary electroconvulsive therapy for believing this, I would tell them it was however far south they wanted it to be. This doesn’t mean my belief about Greenland is insincere, it just means I can think strategically. That even very deeply mentally ill people can think strategically can sometimes be surprising, but no one who has worked with them would deny it can be true.

On the other hand, some of them can’t think strategically. I remember one patient who was very angry at being involuntarily kept in the hospital who would come up to me every day and start screaming at me that if I didn’t let him out, his friends in the highest level of the government were going to revoke my medical license – later this escalated to “kill me”. Spoiler – this is a really bad way to get out of a psychiatric institution. I even told him this was a really bad way to get out of the psychiatric institution and he’d be making his case better by just leaving me alone. He kept finding me and screaming threats about his friends in the government anyway. I can’t tell you for sure what the difference is between people who think strategically and who don’t think strategically – it’s certainly not as simple as “people with illness X are strategic, but people with illness Y aren’t”, but it is certainly a pretty obvious dichotomy.

This patient’s story continues – I put him on antipsychotics, and after two weeks he said he was feeling much better, no longer talked about his friends in the government, and actually thanked me for treating him. I discharged him and as far as I know he’s still taking those medications. If schizophrenia was a preference, this would be strange: he prefers to be schizophrenic, he knows that taking medications will make him less schizophrenic, but he keeps taking them anyway! Since many people like him become schizophrenic, keep taking their antipsychotic medication, and then become better – leaving them much as they were before they became schizophrenic – Caplan’s theory can only theorize that they have a base-level preference for being on antipsychotic drugs. This is a terrible preference to have – such drugs often have bad side effects and make you feel miserable. Surely it makes more sense to believe they have a problem which they don’t like and which the antipsychotics successfully treat?

(yes, there are also many schizophrenic people who don’t voluntarily take their medication. But there are also many people with high blood pressure who don’t take their medication, and antipsychotics are way less pleasant than antihypertensives)

One more thing. Although hallucinations and delusions are the flashiest symptoms of schizophrenia, they are by no means the only ones or even the most important. Many schizophrenics have what’s called “formal thought disorder”, which means their thoughts go in weird directions. A classic example is the tangential person, who will get so distracted they can’t finish a thought. “Tell me how the medication is working?” “Well, I took my medication this morning, after waking up, because I had a bad dream last night, I can’t remember exactly what it was about, I think there was a dog in it, my favorite kind of dog is a Labrador Retriever, I think they’re from Canada, I was in Canada once, it was really cold.” Another kind is the clang, where they connect thoughts based on sound rather than meaning: “I took my medication this morning, it was a warning, a warning of doom, coming at noon with the moon.” This is, as far as I can tell, not something that schizophrenics can successfully “tone down” when asked to do so, based on informal experiments where I ask schizophrenic people to speak normally and tell them that I am more likely to let them out of the hospital if they can form a coherent sentence. This avoids the strategic issues involved in “covering up” hallucinations. Sure, you can always have hallucinations but say you aren’t, but it’s really hard to fake not having a formal thought disorder if you have one, and indeed when a schizophrenic person has a formal thought disorder it’s there to stay until they are treated.

So as far as I can tell schizophrenia includes real hallucinations and delusions, real formal thought issues that the patient usually cannot control, and often the patient is unhappy with it and will willingly take medication to get rid of it. Combined with the neurobiological evidence, the genetic evidence, and the pharmacological evidence, I don’t think calling it “different preferences” is remotely viable.

The Caplan paper is from 2006. I don’t know if he still believes it. And I don’t know if anyone else holds this particular view. But I still meet the occasional Zsazsaian, and general feelings that psychiatric illness isn’t “real illness” are still common. I don’t think it’s a very tenable position and I don’t think this paper does much to support it.

EDIT: I previously wrote in more detail about the difference between “disease” and “normal variation” here.

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761 Responses to Contra Caplan on Mental Illness

  1. Zebram says:

    I’ve run across this argument before based on Szasz’s work. But I think another variant that seems more tenable to me is to question whether anything is really a ‘disorder.’ Are there behaviors or thoughts that are intrinsically ‘disorders’, or are these social constructs? I don’t consider any psychiatric illness to actually be a disorder more so than any normal thought or behavior. Certain types of thoughts can interfere with our goals in life, atleast more so than our ‘normal’ thoughts do, but what makes them intrinsically ‘disorders’?

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        • Jeffrey Soreff says:

          There is a simple solution:
          Race is a fuzzy category in the first place.
          Just redefine “white” to include asians,
          and anyone with a post-primary education,
          and anyone over the median income,
          (any other categories to add for the first tweak to the definition? 🙂 )

          • HlynkaCG says:

            That works for me 😉

          • R. Jones says:

            I think you are being sincere but that is also exactly what the “moderate” progressive elites believe; that the traditional European model is superior and that we can make all people fit this mold.

            We cannot.

        • Jon H says:

          Please retreat into a bunker and put a bullet in your head.

        • multiheaded says:

          You would do well in a rail war against the NWO-ZOG occupation forces, because this is the most brutal derail I’ve ever seen on the internet, ever. Just imagine what you could do to a train!

          • FacelessCraven says:

            okay, see, THIS is how you respond to a troll.

          • Jeffrey Soreff says:

            unless it was a bid to get racism into DSM6? In which case the preference might be on-topic (rather than a derail)????
            (though the tone sounds like it just fits under garden-variety paranoia?)

          • R. Jones says:

            The Authoritarian Personality by “Else Frenkel-Brunswik, Daniel Levinson, and Nevitt Sanford”

            I quote :
            Though strongly criticized for bias and methodology,[4][5] the book was highly influential in American social sciences, particularly in the first decade after its publication: “No volume published since the war in the field of social psychology has had a greater impact on the direction of the actual empirical work being carried on in the universities today.”[6]

            Given that the field of psychology and psychiatry in the 20th century have been so heavily influenced by Jewish academic’s fears of Genocide and resentment towards Gentile culture I think that the point being made here is more relevant than you think.

        • Faradn says:

          I get the feeling you bring up your pet issue everywhere no matter what the actual topic is.

          • R. Jones says:

            If the destruction of Western Civilization through demographic replacement is a pet issue what is a normal issue?. It’s kind of like bringing up the foreseeable rounding up of Jews in Europe in the 1930’s and then having someone accuse you of being off topic.

            Just saying.

            Also Caplan is Jewish. Also Freud was a vengeful Jew who pushed pseudoscience to break apart traditional families. Yeah.
            Maybe that has some relevance in terms of how mental illness is defined. Also the “Authoritarian Personality” is a construct that pathologizes traditional family structures and was invented by a group of Jews and Adorno. That might be relevant.

            Just saying.

          • onyomi says:

            I don’t think this topic is inherently off limits at SSC, but at least put it in an open thread where it belongs. Or wait for Scott to write something about the destruction of Western civilization.

          • Faradn says:

            On the other hand, you’re unintentionally funny, and there’s always value in that.

          • Tom West says:

            Actually, I found Jones’ posts quite sad. What a terrible thing to live in his world.

          • Steven says:

            Ah, yes, the claim that Latin-speaking adherents of the Church of the Patriarch of the West are somehow a threat to “Western Civilization”.

            The adjective you want, sir, is “Nordic”, not “Western”.

        • Eli says:

          What is the terror of death? That we die, our work incomplete.
          What is the joy of life? To die, knowing our task is done.

          BURN THE HERETIC, SOLDIERS OF THE CATHEDRAL! THE EMPRESS PROTECTS!

        • Scott Alexander says:

          ROT13ed as a compromise between deleting the post and letting it stand. User has been banned indefinitely. Another user with the same IP as this user has been banned indefinitely. If that other user wants to complain or tell me why this is a misunderstanding, they can email me at scott [at] shireroth [dot] org.

    • Generally we want to know what something is because we want to know what to do with it. “Disorder” means “cure it or teach people to cope”. What does “social construct” mean? For a lot of people it means these days “rebel against it”.

      So the question is whether e.g. a person with autism should find ways to cure it or cope, or rather should rebel against neurotypicalist social standards?

      I don’t think the rebellion would work too well. From a male angle, males usually find dating difficult even if everything is working “normally” in them. Add something like autism or general anxiety disorder or even “just” social anxiety and basically you have a near undateable man who will always be unsatisfied with his romantic life. How to rebel against that exactly? Better cure or cope.

      Notice how the people who are really open about them being mentally ill on Tumblr are always women or trans* Imagine an average basic guy trying to pick up a girlfriend in a bar, and having disorders like anxiety or autism? What chance does he have? Most girls don’t want to nurse a boyfriend with “roof damage” and “weird” behaviors when there are so many “Chads” in bars. Even if he is gay, is he going to pick up a Ricky Martin type boyfriend? I don’t really think so. So what should he do, rebel, cope or cure?

      The category of “there are some social constructs but of the kinds better not to rebel against, but rather cope somehow, and for some individuals it is really difficult” , the difficulty could just as well be called a disorder. If you find it difficult to do something that would make your life leaps and bounds better, perhaps some trained expert should help you learn it. Hm?

      • Stefan Drinic says:

        How is rebelling not a viable strategy? If your goal is to make your standard the dominant one, you’re right to say that expecting things to change is unlikely. On the other hand, non-mainstream groups(to keep up with the dating example) like polyamorists, swingers, people in the BDSM scene and asexuals got the whole rebellion thing covered very well. All you need to do in such a case is find a subgroup with norms similar to yours and relax.

        • LeeEsq says:

          We might be having a definitional problem. If rebellion only means living against social norms than it is a viable strategy if you live in a pluralistic society that won’t hit back hard. Lots of people manage to quietly or not so quietly live lives that go against the norm in modern liberal democracies. If by rebellion, you mean something more like revolution where an individual or group of people work to change social norms than rebellion becomes less viable. Social change is hard to pull off and it depends on a lot of factors. It is still possible but less so than living a life against social norms without trying to change them.

        • Actually that almost sounds like a heuristic for distinguishing between preferences/constructs and illnesses. Put a bunch of swingers in the same town and you’ve got yourself a non-stop party. Put a bunch of people with generalized anxiety disorder in the same town and if anything they’re worse off than before.

          (Anecdotally, simply being diagnosed improved my life noticeably, and I think one of the main reasons is that I can ask my wife “is this something I should really be worried about, or is that just a symptom?” – not something I could likely do if I only hung out with other people with anxiety disorders, and certainly not if someone had convinced me that my anxiety was a choice rather than an illness.)

          • Mary says:

            As long as the party stops long enough to pick up the pieces.

          • Brad (the other one) says:

            If I put a bunch of people addicted to heroin in the same place they might all peacefully get on high on heroin all the time but I’m not sure I’d consider such a social group healthy.

        • I file that under coping. I also think Harry Johnston’s example is excellent. Swingers clubs are fun. A club of people with GAD would not exactly be a party – in the best case they can help each other a bit, but it is just as likely that they would bad-trip each other i.e. one talking about something he/she is anxious about could trigger further anxiety in the others.

          Really this sounds like a good heuristic – imagine a society made up only from people like that, and if they still suffer, then it is a disorder.

          I mean, that is the minimum requirement. The maximum requirement is social utility. Imagine you really hate working. You could be happy not working… in a society with fellow nonworkers… but who would pay the bills? (Nastier question – who would make the kids of gay country? But that is actually solvable with technology. I am just saying they were not wrong to consider being a gay a disorder if they thought maximal social utility involves a desire to make cute little future taxpayers the biological way.)

          • I disagree with your heuristic. A functioning society has many different sorts of people–there isn’t a single optimal design. It’s entirely possible that some characteristic is functional if one percent of the population has it, disfunctional if everyone does.

            I’m not at all sure I would like a society made up entirely of people like me.

          • keranih says:

            It’s entirely possible that some characteristic is functional if one percent of the population has it, disfunctional if everyone does.

            I’d go further and suggest that the more play there is in the system, the more likely the society can adapt to changes in the environment.

            Where it might get tricky is when the society has a desire to not change. There are studies out there that show cohesion and cooperation is lower in ethnically and religiously diverse groups than it is in more homogeneous neighborhoods, which shows some sort of upper limit on the value of multiple designs.

          • TrivialGravitas says:

            @Keranih

            Can you provide relevant search terms or a link, I’d like to read these.

          • Linch says:

            Agree with David. Your theory will predict a complete failure of masochists in subculture society because none of them will be comfortable with inflicting pain on each other, for instance.

        • unsafeideas says:

          The primary difference between autistic and “polyamorists, swingers, people in the BDSM scene and asexuals” who ” got the whole rebellion thing covered very well” is that autistic do not really understand how society works and break rules without understanding them or even knowing they broke them. They are annoying without there being calculated intention to annoy. They unable to covert he whole rebellion thing, because they did not covered normal life yet.

          Swingers and others get how relationships and society work pretty well. They can do calculated rebelion with reasonable chance of success, because they are able to guess peoples reactions on what they do before doing it.

          • Stefan Drinic says:

            I’m not so sure about all of this. While more severely autistic people might indeed not understand society as a whole, autists with higher IQs are generally people who understand enough about broader societal things to know they don’t fit in, while remaining socially unskilled enough that trying to fit in after all becomes exhausting/infeasible/generally not worth it. You could just as easily say that to many, polyamorists are annoying without them even being aware of it, because having exactly one romantic partner is the norm in our society, and deciding you’ll have more without knowing why this is a bad thing is weird.

          • TrivialGravitas says:

            It’s difficult to explain, I can, in retrospect, figure out what exactly went wrong usually. The difference is a normal person will usually do the right thing without ever being aware there was a right or wrong thing to do.

            In some cases, like limiting the length of the rambling on any given topic I’ve hyperfocused on at any point in the past, this analysis is helpful. In others where every situation is subtly different, or where the right thing is a body language thing that requires constant unceasing attention, this is not particularly useful.

      • hamnox says:

        It looks like you switched subjects partway through your point. You started with “we”, in the broad social sense of “what should we as a society do about it”. It seems unlikely that you’re talking about ‘we the disabled/disordered people’, as you then go on to differentiate the group of disabled people — “cure it or teach people to cope”, “for a lot of people”. But then, you switch to viewing the utility of “social construct” from the perspective of people negatively affected by them.

        Thing is, people ‘with disorders’ are already coping just by living their lives. You can call one strategy “rebel”, but we’ll always just be choosing between different coping strategies to varying degrees of success. Calling it a disorder or social construct is about what the rest of society does with our problems — try to cure them, quarantine them, or account for them as part of normal human experience.

        Rebellion isn’t flat out refusing to learn how to leverage the existing systems, it’s about shifting to a new normal that includes our own. Trained experts are nice, but we only get them if someone expects there to be a strong need and trains them. It’s expected that average basic guy will have a hard time getting a girlfriend, so it’s well-precedented for him to rope his friends into being wingmen and spout cheesy pickup lines in at strangers in bars and join a bunch of dating sites. Does it ever strike you how *weird* it all is that those extensive coping strategies are normal?

        It’s never just “an average basic guy, with autism” btw. Autistics existed before that label and they were the ALREADY the weird undateable people. Just like you don’t design buildings to make everyone over 5′ hit their heads on light fixtures, our normal wouldn’t call places that drive sensory defensives up the wall with music and loud talking and smells ‘prime pickup spots’. Our normal supports alternative modes of communication. Our normal approves of and improves on good matching services. Our normal white boxes how to deal with strong emotions and communicate interest clearly and establish healthy boundaries and such. Our normal creates social structures to help people routinely instead of after they’ve already bombed most of life’s tests.

      • Anonymous says:

        I think you are mistaken in assuming that those rebelling against standards usually do so by openly changing their behavior and then being totally accepting of the response they get. Has any rebellion of the kind you’re talking about ever not been accompanied by the protestation, “and if you don’t accept me then you’re being unreasonable!”?

        If people are going to behave how they really want to without demanding that nobody judge them for it, they will almost certainly do so in secret, and in places where people are mostly non-judgmental. The rebellion is more like the point at which the group is large and confident enough that they feel they are able to push forward and demand a change in views from those who do judge them.

        For the example you give, men with a desire to behave ‘weirdly’ probably do so in places they feel they won’t be negatively judged for it, and don’t in places they don’t. A rebellion would come in the form of loud protests and banners proclaiming “if you don’t date me just because I have social anxiety, you’re a bigot!”; the scenario of individuals being openly weird and accepting however others choose to respond isn’t something I think ever really happens.

    • Jaskologist says:

      In the recent vegetarianism thread, I mentioned that a robust teleology makes a lot of the problems of utilitarianism go away. I think the lack of telos is the cause of Caplan’s mental illness model here.

      The DSM’s flip on homosexuality keeps being brought up for a good reason! How do we know they have it right now? Because the current designation fits with our society’s current morality. How did they know they had it right in the 70s? Same way. There is no scientific test we can perform to know if homosexuality is a mental illness or not. It’s a values question, and values questions are telos questions.

      What is a human supposed to be doing? What is its purpose? Mental illnesses are (some of the) things that prevent our proper functioning. But we don’t have a good grasp of telos, so Caplan is falling back on fulfilling individual preferences as the ultimate human telos. Where he’s landing (mental illness as a category error) is a very reasonable conclusion based on that premise. But you know what Chesterton says about a man who has lost all but his reason.

      Any sufficiently complicated worldview contains an ad hoc, informally-specified, bug-ridden, slow implementation of half a teleology.

      • Caplan has said very specifically that he wouldn’t object to someone saying things like “we should fix alcoholism because it is bad,” and only objects to calling something a “mental illness,” if it is meant as a way to pretend that you are not calling something bad.

        So in principle he also shouldn’t object to someone saying, “homosexuality is bad,” as long as he admits that this is what he is saying. But he might disagree on the object level.

      • Nicholas Carter says:

        I think an interesting addendum to this is that I recall a study that the co-morbidity between homosexual preference and other things that have been considered mental illnesses is mediated by how much people oppress homosexuals in their country. This leads to the (possibly over-simplistic) model that the co-morbidity is caused by oppression, not homosexuality.

  2. John Sidles says:

    Witnessed  At a training session for foster parents, the instructor surveyed the audience and asked “How many of you believe that your foster child will eventually come to love you?” A minority slowly raised their hands; the entire audience shifted uneasily. Twenty long seconds of silence followed. Then the instructor said “Most of you will be disappointed.” Another long silence, during which a few people left, but most stayed.

    Exercise  Solely on the basis of rational economic theory, explain the behaviors — whether rational or otherwise — of the instructor, the foster parents, the children … and of rational economists too. In what respects (if any) is rational economic theory fundamentally inadequate to this explanatory challenge? As a practical matter, can rational economists reasonably be entrusted, as individuals, with child-care responsibilities? Can rational economists, as a profession, reasonably be trusted to recommend child-care policies?

    • I am surprised. Beyond my biological parents, their friends, neighbors, and some teachers played part of a foster parent role in my life and I loved them. Why shouldn’t I love the neighbor foster-grandpa who played Santa for me?

      • John Sidles says:

        For experienced care-providers, obsessively rational economic worldviews (like Caplan’s) read as high-IQ narratives that are devised in adulthood as coping mechanisms for attachment disorders that typically originate in childhood.

        Regrettably, disorders of attachment that originate in childhood are exceeding difficult to treat in adults.

        It’s not easy — it may even be neurologically infeasible — to communicate these ideas to the scholars (including Caplan) who receive support from the constellation of Koch/Rand/Cato institutes that promote attachment-free economic ideologies

        “Some people will never learn anything, for this reason, because they understand everything too soon.”
           — Alexander Pope

        Conclusion  Attachment-free economic ideologies, and the cognitive capacities of the individual creators and proponents of these ideologies, do not naturally accommodate attachment-centric human behaviors and moral values.

        • Nornagest says:

          Yeah, let’s medicalize unpopular politics. That can’t possibly go wrong.

        • Nisan says:

          That’s way too uncharitable.

          • Nornagest says:

            …and sometimes it’s a bunch of randos on the Internet rationalizing as hard as they can? Because that’s what I’m getting from that link.

            Now, it’s not like there are little XML tags reading “maladaptive” on behavior, so we can choose to treat just about anything sufficiently weird as a pathology. The question is should we. And the answer to that question is usually “no”.

            [ETA: see below for context]

          • Ghatanathoah says:

            Which pathology do people have when they’re so convinced their political views are correct that they think anyone who disagrees with them must be insane? My first guess is that it would be some sort of narcissism. But it also strongly resembles the way anosognosiacs make up elaborate rationalizations whenever they are presented with information that challenges their worldview.

          • Marc Whipple says:

            @Ghatanathoah:

            There is more than one. The pathology I am most familiar with which causes this condition is “extremely high IQ.”

          • John Sidles says:

            Nornagest deplores “ a bunch of randos on the internet   391,366 posts in 41,182 topics by 14,483 members.”

            Not to mention 23,262 scientific articles.

            Conclusions  (1) Personality disorders (PDs) are commonplace, (2) high IQs are not PD-protective, and (3) public interest in PDs runs deep … for the obvious reason that pretty much every family has had difficult experiences associated to PDs.

          • Nornagest says:

            Those are some big numbers, eeeyup.

            The link in the ancestor seems to have been updated so that it no longer points to a thread full of speculation on IQ (impolite, that), so it may no longer be obvious who I was talking about. Here’s the original link, which I was fortunate enough to still have in a tab. These are the randos in question, not literally everyone who has ever uttered the words “personality disorder”.

            I haven’t read enough of the broader forum to have an opinion on it, but postcount isn’t an especially good measure of rigor.

          • John Sidles says:

            “Internet randos” who have seen the elephant agree that pure rationality, as an involuntary life-style, has significant limitations … and yes, the prevalence numbers associated to PDs are enormous.

            So perhaps indiscriminatively pejorative descriptors like “rando” are ill-considered? Indeed indiscriminate abuse is itself a top-100 PD-diagnostic sign

          • Nornagest says:

            Pick a position, no matter how dumb, and you can find people on the Internet who believe it wholeheartedly. People on the Internet saying something is exceedingly weak evidence that it’s true.

            Which is, of course, what I was trying to get at with the word “rando” in the first place.

          • John Sidles says:

            Nornagest opines  “Pick a position, no matter how dumb, and you can find people on the Internet who believe it wholeheartedly.”

            Opinion by Nornagest, validation by Bryan Caplan himself.

            Note that the sole commenter on Caplan’s lecture (said commenter being himself a physician) opines “Notice how bryan caplan seems severely autistic.”

            This PD would explain why Caplan’s high-IQ worldview regarding healthcare is entirely grounded in economic theory, and is defended solely with rationality, with no perceptible elements of interpersonal empathy.

            Conclusion  Bryan Caplan is seeking (entirely rationally) to foster a world in which people who share his cognitive traits are advantaged.

            Didn’t Ayn Rand pursue this self-serving end too?

          • Nornagest says:

            I’m neurotypical, but if you offer me the choice between solid physical reasoning on the one hand and on the other a plaintive emotional appeal with sad children and asphodel and the world’s tiniest violin, then all else equal I’m gonna pick physics ten times out of ten.

            Economics is not physics, but if I stopped doing that after substituting “economics” for “physics” in the above, it would be because I don’t trust the economics in question, not because I suddenly had a change of heart regarding sentiment vs. reason.

            This is not to say that I endorse Caplan. I think he’s wrong on mental illness at the very least, though I don’t totally agree with our gracious host’s approach to that either. But if you think that and hyperrationality (or whatever) are sufficient to diagnose Caplan over the Internet with some unspecified mental defect, then you’re wronger than a tub full of Caplans.

          • John Sidles says:

            Nornagest opines [after rhetoric is redacted] “I pick physics [-based cognition] over empathy [-based cognition] ten times out of ten.”

            It may be that the logical/empathic cognitive dichotomy is destined to become moot, in that neuroscience is establishing increasingly definite physical grounds for human empathic cognition.

            Note too the following confluent observations:

            PUBMED  “Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects ‘cold’ cognition, but also improves ‘hot’ cognition, such as emotion-recognition and task-related motivation.”

            Scott Alexander/SST [Sept. 25, 2015]  “Half the rationalist community uses modafinil.”

            Conclusion  Available evidence suggests that already a substantial portion of the rationalist community is voluntarily self-medicating, in such a manner as to relieve deficits in non-rational/”hot” cognitive capabilities.

          • Nornagest says:

            @John Sidles — By now I think at least one of us has drifted off point somewhat, but at least as regards my reasoning, you’re assuming a generalization where you shouldn’t be.

            Logical reasoning trumps emotional reasoning every time if its axioms are good enough. Big caveat there! The whole point of the empirical sciences — physics and economics alike — is to establish good enough axioms and to fact-check them, and that makes them extremely powerful tools, but their scope is limited; and even within their scope they can be too complicated or laborious to use day-to-day.

            Emotional reasoning and its relatives meanwhile have their own scope: they’re a set of fast and frugal heuristics (System 1 if you’ve read Kahneman) that work well for everyday activity and small-scale social interaction but don’t generalize or scale up well.

            You haven’t been around here long enough to know this, but I’ve spent a lot of my time arguing that the rationalist community focuses on formal truth and personal honesty to the detriment of social competence, of PR-type stuff, and ultimately of real-world effectiveness. But you’re going too far in the other direction — at least as best I can tell. Not sure what the modafanil example’s supposed to prove.

          • John Sidles says:

            Nornagest says [awkwardly] “Emotional reasoning and its relatives meanwhile have their own scope: they’re a set of fast and frugal heuristics.”

            Doesn’t this simplify to a tautology “emotions have their own scope” … which recognition takes us back to the original topic of foster-care … and the structural inadequacy of rational cognition in coping with real-world foster care’s practical demands and moral challenges?

            Question  Is there a rationalist parsing of Pascal’s

            “The heart has its reasons which reason knows nothing of … We know the truth not only by the reason, but by the heart.”

            Or this this merely (for rationalists) a plaintive emotional appeal, not grounded in any rationalist axioms?

          • Peter says:

            @John Sidles

            Note that the sole commenter on Caplan’s lecture (said commenter being himself a physician) opines “Notice how bryan caplan seems severely autistic.”

            Oh, FFS. Are you quoting that with approval? If not, why are you quoting it?

            In general, I’ve had more than enough of people diagnosing their political opponents as being on the autistic spectrum. I really don’t expect to see it here. This is unkind, both to people on the spectrum and the people you are diagnosing, unnecessary, and likely to be untrue; certainly not meeting the standard of “a very well-deserved smackdown against someone who is uncontroversially and obviously wrong, in a way you can back up with universally agreed-upon statistics”

            Oh, I’ve re-read your comment and it’s worse than I thought. The next words to follow “severely autistic” are “This PD”. Autism is not a personality disorder. Look it up. Calling autism a personality disorder is untrue and unkind. Do you want to retract that?

          • John Sidles says:

            Peter says: Autism is not a personality disorder. Look it up. Calling autism a personality disorder is untrue and unkind. Do you want to retract that?

            These lexical issues are much-discussed (in a serious, respectful, friendly spirit) in on-line support forums

            Serious question with evolving answers  What word(s) or descriptive term(s) appropriately capture “the class of chronic cognitive conditions for which people voluntarily self-medicate, and/or seek therapy/counseling to remediate, and/or seek sometimes to deny?

            The medical/support community’s working solution  Don’t use words, use instead an evolving web of acronyms .

            This flexible and ever-evolving creole language allows discourse to flower, without being obstructed by wrangling over terminology … but only among the (large) community that shares this creole vocabulary.

            Common-sense observation  Viewers of the video in question would consistently identify one of its three participants as markedly more ASD/ASPD than the other two, and all three participants as being markedly more ASD/ASPD than this prominent economist/essayist.

          • Peter says:

            @John Sidles

            I did not say [though common], or anything that amounted to “though common”. Don’t mangle what I said, don’t put words into my mouth. If you wanted to say this usage was common, say so below what I said.

            I am perfectly aware that there is some debate as to how to conceptualise and talk about autistic spectrum conditions. However the positioning of autism as a personality disorder, well, the only person I’ve seen who has done that is you. Yes, there’s your link. It’s a thread on a personality disorder forum that talks about autism; it says nothing at all about whether autistic spectrum conditions are personality disorders or not. It doesn’t discuss any taxonomic issues at all. If you’re going to link to something, you should link to something that actually demonstrates the point you were going to make.

            Whether to use acronyms or words… this is an irrelevant side issue. “Personality disorders” and “PDs” mean the same thing. Moving from words to acronyms does nothing to address any underlying lexical/taxonomic issues at all.

            So, no, you’re not recanting. And I see you’ve gone from remotely diagnosing Caplan with something to remotely diagnosing, well, a large part of the commentariat here, it seems. I wonder what our resident practising psychiatrist thinks about these adventures in amateur psychiatry…

          • John Sidles says:

            It would be regrettable if wrangling over whether certain cognitive limitations are best described as “conditions” versus “syndromes” versus “disorders” obscured this broader point: effective economic analysis requires broad-ranging cognitive skills, in the literal sense that It all turns on affection (Berry, 2012)

            Berry’s point Incapacity in regard to empathy implies incapacity in regard to economic analysis.

          • Peter says:

            1) “Personality disorder” has a specific meaning in psychiatry – if you’re going to be talking about “PDs” as such, linking to personality disorder forums etc. then you should be aware of it. There are things which are called “disorders” which are distinct from “personality disorders”. If you’re going to go talking about personality disorders, then you should inform yourself as to what they are, and which ones exist.

            2) “ASD/ASPD”. I looked up ASPD to see what expansions people had of it, the only expansion I found relevant to mental health etc. issues is “antisocial personality disorder”, a concept closely related to psychopathy and sociopathy. Of all of the stigmatising things to slash ASD with, you had to go for that one.

            Now, being charitable here, it’s possible that you merely have no idea what you are talking about, and are just throwing terms you don’t understand around carelessly. In which case, you should stop, before you say something even more wrong and offensive.

          • John Sidles says:

            The Out of the FOG forum’s Personality Disorders Overview is a well-organized use-tested user-friendly pragmatic science-respecting resource for addressing the tough cognitive and interpersonal issues that Peter’s comment raises.

            And Wendell Berry’s 2012 Jefferson Lecture “It all turns on affection” (text and video) shows us, in-depth, what rational Caplan-style economics looks like after its empathic deficiencies have been remediated.

            Hopefully neither of these two statements are “even more wrong and offensive”, in the sense that, although they may be wrong or misguided, both of the above statements are embraced in practice by large numbers of thoughtful people of good will.

          • Peter says:

            Take your link.

            Search it for autism, autistic, Asperger’s and ASD. Nothing. Search it for ASPD. Antisocial Personality Disorder – and only – Antisocial Personality Disorder. The page is pretty clear on what personality disorders there are, and autism isn’t one of them.

            Yes, I believe it resolves those issues quite adequately. Autism and personality disorders are two different things and you shouldn’t treat them as the same thing, and furthermore you really shouldn’t equate autism and ASPD.

          • John Sidles says:

            The psychiatric literature relating to comorbid disorders with autism and Asperger’s explains why, in practice, it is exceedingly difficult to sustain sharp distinctions.

            Plenty of forums offer extensive and sympathetic discussions of these hard-to-discern boundaries.

            The economic literature is less satisfactory in this regard, definitely.

          • Peter says:

            @John Sidles

            Your link on common comorbid stuff a) I’m not seeing any personality disorders on that list, b) just because some other conditions often co-occur with autistic spectrum conditions, doesn’t mean you can just smoosh them together whenever it’s convenient for your argument. Indeed in one of the discussion forum threads people were pointing out some very important distinctions between autistic spectrum conditions and personality disorders.

            By “often co-occur”, you do often seem to get autistic spectrum conditions and anxiety disorders co-occuring fairly often – hardly a surprise when people like to attribute all sorts of strange pathologies to people with autistic spectrum conditions – but reading that PubMed Central article you linked to, things seem to be at the level of a small majority of people with autistic spectrum conditions having at least one anxiety disorder; “one study” gets a number as high as 84% but other studies seem to get smaller numbers. And guess what – no-one (except maybe you?) – conflates autistic spectrum conditions and anxiety disorders.

            Some people may indeed have “sympathetic” discussions of things. I fail to see how your attempts to pathologise some opinions about economics etc. counts as “sympathetic”.

            Look, if you were actually sympathetic, I’d hope you’d know that stigma management (hey, have a PubMed search, you seem to like that sort of thing) is kind of important to people with autistic spectrum conditions (such as myself), and that tarring people with broad brushes really does not help. Again, it’s just about possible that you’re clueless enough not to realise this. In which case, get a clue pronto.

            Anyway, this is the last from me on this thread, I’ve had enough.

          • John Sidles says:

            @Peter, those PUBMED articles on stigma management are really excellent; thank you for pointing SSC readers toward them.

            Query  To the degree that social stigmatizing is morally wrong, isn’t market stigmatizing (via higher health-care insurance rates) morally wrong too?

            Conclusion  These issues are tough socially, tough morally and tough economically.

            Which is all the more reason why (as noted above) incapacity in regard to empathy implies incapacity in regard to economic analysis.

          • injygo says:

            Surely you’d rather point out some actual flaws in an economic theory than argue that some (unproven) deficit in empathy might make economic theories worse in general? Even if Caplan is autistic, he is not necessarily lacking empathy, and even if he does lack empathy, he is not necessarily a bad economist, and even if he is a bad economist, his theory is not necessarily wrong.

            Whenever people in this thread point out some factual error you make, you say “the issues are complex!” but you have no problem making specific assertions about the relevance of modafinil use among rationalists (!) or Caplan’s (supposed) autism. Please provide some sort of justification for your assertions, or else admit that they were wrong.

        • Ghatanathoah says:

          For experienced care-providers, obsessively rational economic worldviews (like Caplan’s) read as high-IQ narratives that are devised in adulthood as coping mechanisms for attachment disorders that typically originate in childhood.

          It’s my experience that highly obsessive and rational people form unusually strong attachments in childhood. The notion that rational people are unloving and devoid of emotion comes primarily from confusing phlegmaticism with lack of emotion (and from pop culture). Highly emotional people who let their emotions carry them away often mistake emotional control for lack of emotion.

          Attachment-free economic ideologies, and the cognitive capacities of the individual creators and proponents of these ideologies, do not naturally accommodate attachment-centric human behaviors and moral values.

          This is the old canard about libertarianism not working because people aren’t selfish, given a thin coating of pop science. The fact is, most libertarians acknowledge that people aren’t selfish. They just believe that private charity and NGOs are a better outlet for altruism than the government.

          I’m not sure what it says about someone that they identify the government so strongly with pro-attachment, pro-social behavior that they equate opposition to the government with opposition to attachment and pro-social behavior. If we follow your logic, it is probably some kind of authoritarian personality disorder.

          • Marc Whipple says:

            Spock once observed to someone (who it was is a spoiler, old as the book is) that the common perception that Vulcans have no emotions is completely wrong. They have them. It’s just that they are taught to keep them so firmly in check that to a member of almost any other humanoid species the most emotionally-demonstrative Vulcan in the Galaxy appears to be a machine in a biosuit.

            I often think of this scene, as I am frequently accused of being unemotional. This is an absolute slander: I am very emotional. I choose not (or am unable) to display my emotions most of the time.

          • John Sidles says:

            Ghatanathoah deplores  “The old canard about libertarianism not working because people aren’t selfish.”

            This topic is hilariously debated among philosophers.

            Note: click “Didn’t Get the Joke” at the above Existential Comics link to read:

            Ayn Rand was a 20th century philosopher and author, and while she has been largely ignored in academic philosophy, she is still very well regarded in the train fanfic community, for her seminal work Atlas Shrugged. It has the distinction of being the longest, and arguably the best, train fanfic ever written.

            This plausibly is the world’s most cogent review of Atlas Shrugged.

            Kudos to the scholars at Existential Comics!

          • Vox Imperatoris says:

            Ayn Rand never claimed that everyone was selfish, or that one can’t help to be selfish. On the contrary, she believed that selfishness is a choice, one that most people do not make, but that it is a choice one should make. And by “be selfish”, she meant “consciously choose to pursue happiness as one’s highest purpose”.

            Moreover, no one here is denying the existence of personality disorders, so all the evidence you submit is beside the point. What they are objecting to is your assertion that your political opponents suffer from personally disorders, thus making their opinions invalid.

            Myself, I think you just might be suffering from sluggish schizophrenia.

          • John Sidles says:

            Alternate philosophical (and even comic) readings of Ayn Rand’s works are commonplace.

          • I’m reminded of an incident when our daughter was born. An hour or two before I had been discussing with the nurse some issues in the history of contraception, in particular what I viewed as her misunderstanding of a passage in Casanova’s _Memoirs_. When Becca was born I behaved in my usual fashion towards babies—I like babies—but more so this being my baby. The nurse later commented to my wife how surprised she was by the contrast between my rational and unemotional discussion earlier and my reaction to my new daughter.

        • Jon H says:

          “obsessively rational economic worldviews (like Caplan’s) read as high-IQ narratives that are devised in adulthood as coping mechanisms for attachment disorders that typically originate in childhood.”

          No wonder he wants to clone himself and raise the clone as his own child.

        • Sarah says:

          Nope, sorry, not a thing.
          https://en.wikipedia.org/wiki/Attachment_disorder
          According to the DSM, “reactive attachment disorder” requires a history of significant neglect and abuse. Most economists are not abuse victims. Reactive attachment disorder is also not a personality disorder and does not include “excessive rationality” as a symptom.

        • Andy says:

          Reported comment for excessive unkindness.

          As long as we’ve got a Reign Of Terror, why not use it to our benefit?

        • Paul Torek says:

          Thank you for coming right out and saying that. While attempts to psychologize opposing viewpoints are dangerous, your Conclusion stands on its own. And, well – sometimes the truth is dangerous.

    • AMac says:

      The discussion of the applicability of Caplan’s model to foster care is illuminating. Three words sometimes come to mind when reading about libertarian ideas: carpenter, hammer, and nail.

      • Cliff says:

        It’s really not a libertarian idea at all, is it?

        • It’s an economic idea, not a libertarian idea—not all economists are libertarians and not all libertarians think like economists, although many do. And while it’s true that if you have a hammer everything looks like a nail, it’s also true that looking at things from an odd angle sometimes tells you things you might miss.

          I am an economist. I will happily concede that the economic approach to understanding behavior does not always provide a full and correct explanation. On the other hand, I think it does provide some understanding of a considerably wider range of behavior than most non-economists assume.

          Possibly including insanity.

          There are quite a lot of different things for which a hammer is useful.

          • Andy says:

            There are quite a lot of different things for which a hammer is useful.

            Coping with/fixing insanity (whatever “fixed” insanity looks like with optimal kindness and agency”) is not one of them.

          • @Andy:

            An actual hammer is unlikely to be a kind way of coping with insanity, although one can imagine contexts in which it was a prudent way. But the economic approach to understanding behavior, my metaphorical hammer, might be of use in understanding behavior commonly classified as insane.

          • Andy says:

            An actual hammer is unlikely to be a kind way of coping with insanity, although one can imagine contexts in which it was a prudent way. But the economic approach to understanding behavior, my metaphorical hammer, might be of use in understanding behavior commonly classified as insane.

            Yeah, I got that. And as someone who’s struggled with a lot of mental illness and brain chemistry issues, many of which are hereditary, I feel that hallucinations are not one of them. I’ll grant, economics can be useful in figuring out patterns of urban violence (for example) that look like insanity if you don’t understand the local flows of money and goods and information that create incentives for control of territory. When it comes to brain chemistry, anyone who tells me that I or my family members are depressed because we choose to be, and not because we have weird stuff going on in our headmeats, is worthy of some contempt.

          • Bill Murdock says:

            @Andy

            “I or my family members are depressed because we choose to be, and not because we have weird stuff going on in our headmeats”

            If you were too short to reach something you’d have to make a choice: go through the effort of getting a step stool, or choose a course of action that doesn’t include the thing that was too high for you to reach.

            Economics doesn’t say that a certain brain chemistry was your choice anymore than a certain amount of hormones during your growth spurt was your choice; instead, it talks about your choices – given that state of affairs.

            If you have free will, then even if you are shorter, or feeling more tired, than another similarly situated person, you still have to choose – based on cost and benefit – which action to take. And your choice will be your preference, and thus rational.

            Economics doesn’t “say” that you are short by choice, it takes your physical condition as given and examines your actions *given* all the variables, and your physical condition is one of the variables.

    • Ghatanathoah says:

      In what respects (if any) is rational economic theory fundamentally inadequate to this explanatory challenge?

      It is not inadequate in any way. Following Caplan’s framework from the OP, all the individuals you discussed have a preference for nurturing children who would otherwise not be nurtured. Their preference for nurturing children appears to be much stronger than their preference for being loved by children, so they remain willing to nurture children even after being informed they will not be loved by them.

      As rational actors, they rationally acted to fulfill their desire by fostering children. It would have been fundamentally irrational of them to not foster children, since not fostering children would result in them not nurturing children who would otherwise not be nurtured; and they want to nurture children.

      Any contradiction you perceive comes from the fact that you seemed to have gained your understanding of “rationality” from Hollywood rather than from economic and philosophical literature. You also seem to confuse the colloquial definition of “self-interest” with the much more expansive definition encompassed by VNM utility functions.

      As a practical matter, can rational economists reasonably be entrusted, as individuals, with child-care responsibilities?

      Yes. If Bryan Caplan’s blog is anything to go by he’s a great dad. Rational economists in general are probably better than average parents because they are less likely to fall for stupid parenting fads.

      Can rational economists, as a profession, reasonably be trusted to recommend child-care policies?

      Definitely! Bryan Caplan’s book on childcare is one of the best in the field!

      • My sample of economist parents is pretty small, but I can at least report that I got along very well with my parents—I cannot think of anyone I have known by whom I would rather have been reared—and my children have gotten along well with me.

        I gather from what my children (now adult) tell me about their friends that quite a lot of people don’t get along with their parents, which strikes me as representing possibly the most serious risk in having children. But my sample size is too small to tell whether my parents and I did things right or were just lucky.

        • onyomi says:

          My parents are not economists, but I always got along with them pretty well, as I did with my siblings (though my parents do not get along with each other anymore). It always struck me as odd that so many people get along so badly with their parents and siblings, given that they are the people most likely to be similar to them in the world–both on genetic and environmental grounds. I find it easier to get along with people who are similar to me and find it hard to understand why it would be otherwise (though I’m familiar with the “magnet” theory of interpersonal relations, of course).

          • Nornagest says:

            That kind of similarity picks up both the things you like and the things you dislike about yourself — it’s not like making friends, where you can select for just the stuff you like and get a flattering mirror of yourself.

            Sometimes that’s not too big a deal. But a lot of times it is.

          • Marc Whipple says:

            Ah, but turn that on its head: if your children are likely to be like you, and you’re not the kind of person who gets along well with most people and/or is very likeable… Whoops. 🙁

          • onyomi says:

            “picks up both the things you like and the things you dislike about yourself”

            But I am more forgiving of faults which I can understand than of faults which are alien to me.

            Though I do understand many people are most bothered by those faults in others which most bother them about themselves. So… basically people who hate themselves are more likely to hate their close relatives. I (mostly) like myself.

        • Marc Whipple says:

          That is not an “or” question. You must do both.

          Or, at the very least, you will almost certainly not get along with your children if you do not do the right things. However, doing the right things improves the odds but does not get you anywhere close to certainty of getting along “well” with them. You need luck for that part.

  3. Epistemological issues aside, what do you think about the economic argument at the end, regarding how we as a society should treat the mentally ill?

    Some [psychiatrists] explain why their client should not have to pay the normal price for his behavior; others, why a person willing to pay the normal price for his behavior should be prevented from engaging in it nonetheless.

    I don’t know about psychiatrists, but an awful lot of rhetoric surrounding mental illness on places like Tumblr is like this. And I think Caplan’s approach is better; if somebody really wants to do lots of drugs, or play lots of video games instead of doing their schoolwork, or whatever, and is willing to accept the accompanying social sanction, then I don’t think it’s right to forcibly prevent them from doing so. At the same time, social sanctions generally exist for a reason, and if we declare people exempt from otherwise-beneficial social norms if they get the right diagnosis, then that warps the incentives.

    • Nita says:

      if somebody really wants to do lots of drugs, or play lots of video games instead of doing their schoolwork, or whatever, and is willing to accept the accompanying social sanction

      The purpose of sanctions is to modify behavior, so their intensity tends to increase if the behavior continues. Punishments and prices are different social widgets.

      • fubarobfusco says:

        If the purpose of sanctions is to modify behavior, then if the behavior continues, that may well indicate that the sanction being tried is ineffective. Increasing its severity would seem to rest on an unstated assumption about the nature of this ineffectiveness.

      • Marc Whipple says:

        Punishments are prices.

      • Jeffrey Soreff says:

        >Punishments and prices are different social widgets.

        Which one is a fine? Or is that different from both?

      • HeelBearCub says:

        It seems to me that for a price to be a price, and not a punishment, then, broadly speaking, whoever is setting the price should be happy to see a great deal of the activity, indeed they should desire even more of the activity than exists currently.

    • Deiseach says:

      At the same time, social sanctions generally exist for a reason, and if we declare people exempt from otherwise-beneficial social norms if they get the right diagnosis, then that warps the incentives.

      Sure, but that’s not really addressing Szasz (who is the guru from whom Caplan is deriving his principles). Szasz claims slapping a label of “psychiatric illness” on behaviour that society disapproves of or finds inconvenient is a moral/ethical, not medical, decision.

      Szasz seems to have a horror of involuntary committment, whether or not it’s because he thinks psychiatric hospitals are dreadful places and abuse rather than treat patients, I don’t know. Presumably, if such behaviours are preferences, we should not interfere with them. But Caplan is making the logical deduction from such: if they’re preferences (and not “a man with no legs can’t climb Everest” type physical inabilities to function), then the person should pay the social price of their preference. Don’t want to work, would rather stay at home and pretend the CIA is spying on you? Great, but don’t expect society to give you handouts to indulge yourself. Work or starve.

      So this is a compassion that turns out not to be compassionate. We shouldn’t involuntarily commit someone who is talking about seeing the Devil; we shouldn’t lock them up in a hospital or asylum. We should wait until they do kill their father and then lock them up in prison. How is prison so much better than a hospital? How did that forebearance help the person or anyone else? Is the person really happier being a patricide? Or now a convicted murderer?

      Maybe both Szasz and Caplan are tough-minded on this; if you have weird preferences then good for you, but instead of using psychiatry to say you’re ill and coddling/forcing you to change by involunatary commitment and medication, we’ll give you a choice: change your preferences voluntarily to be a productive member of society, or indulge them and suffer the consequences (you can die of a heroin overdose and nobody’s going to stop you, but you will go to prison if you break the law. You can pretend to be hearing voices conspiring against you and nobody will tell you to stop, but if you don’t want to hold down a 9-to-5 job and earn money to pay for your living expenses like the rest of us, then find some way of supporting yourself other than living on social welfare).

      Really their argument – or the argument Caplan derives from Szasz, who might or might not agree with it – is that mental illness is a dodge, a fakery, a way people who don’t want to do the work necessary to live use to avoid sanctions. The way Caplan talks about “regret and expressing a desire to change are a way of avoiding social and legal sanctions” sounds as if he thinks such expressions are insincere, are lies, are like a child saying “Sorry, I won’t do it again” when they’re caught with their hand in the cookie jar: meaningless and only trotted out to avoid punishment.

      So we’re still getting ethical judgements on the mentally ill, but this time it’s calling it criminality or venality instead of mental illness.

      • stillnotking says:

        The way Caplan talks about “regret and expressing a desire to change are a way of avoiding social and legal sanctions” sounds as if he thinks such expressions are insincere, are lies, are like a child saying “Sorry, I won’t do it again” when they’re caught with their hand in the cookie jar: meaningless and only trotted out to avoid punishment.

        There’s a difference between sincerity in the moment and “real” sincerity. When an abuser begs his estranged wife to come back and swears he’ll never hit her again, he’s probably sincere (in the sense that he’d pass a lie-detector test on the spot), but he’s also probably going to hit her again.

        Humans have evolved all kinds of tricky adaptations to exploit one another, many of which involve self-deception. I draw the opposite conclusion from Caplan, though: I think our unreliability is the very reason a degree of state paternalism is justified. The state is not a perfect arbiter, but it can at least be a disinterested one, which is often all it takes.

      • Max says:

        > Szasz seems to have a horror of involuntary committment, whether or not it’s because he thinks psychiatric hospitals are dreadful places and abuse rather than treat patients, I don’t know.

        Szasz started writing in the 1950s, and at the time psychiatric institutions were a much different place, and involuntary commitment was much more common. Indeed, Szasz is often credited with exposing much of the horror of involuntary commitment that was occurring at the time, and legal power to commit someone nowadays is much more restricted.

        > We shouldn’t involuntarily commit someone who is talking about seeing the Devil; we shouldn’t lock them up in a hospital or asylum. We should wait until they do kill their father and then lock them up in prison. How is prison so much better than a hospital? … Really their argument … is that mental illness is a dodge, a fakery, a way people who don’t want to do the work necessary to live use to avoid sanctions.

        A major portion of Szasz’s writing on this subject isn’t about mental illness itself, but rather about the nature of the criminal justice system. It expresses his views as a libertarian about personal responsibility and its relationship to crime. He writes that in every other part of the criminal justice system, there is never a justification for locking someone up *before* a crime has been committed. The way the justice system works is that someone commits a crime, and then they pay the appropriate penalty. But in the case that a psychiatrist has labeled someone mentally ill, now the state has the power to lock someone up, Minority Report-style, even if no crime has been committed. He has a few problems with this. One of these is that psychiatrists then become agents of the state, who functionally have the legal power to lock someone up merely by diagnosing someone a certain way. He argued that this was what caused the horrors of psych institutions at the time.

        I’d say the other major problem arises because he felt mental illness is a category description, and (at least at the time of his writing) not determinable other than through the diagnosis of psychiatrists (who often would reach conflicting results given the same apparent symptoms). This resulted in the insanity defense, among other things, meaning that you could become free from responsibility from crimes you have committed, and again only because a psychiatrist said so. To him this negated the concept of the criminal justice system, which required an individual to pay for the crimes against society they have committed.

        So when you ask whether the hospital was better or worse than the prison, you’re missing the point he made. What was better for the treatment of the individual was less important to him than the power that society was handing to mental health experts to functionally supersede the normal authority of the criminal justice system.

      • Mary says:

        “We shouldn’t involuntarily commit someone who is talking about seeing the Devil; we shouldn’t lock them up in a hospital or asylum. ”

        Of course, that’s THEIR preference. Why should we not indulge our preference of locking them up, if preferences are so sacred?

        • Virbie says:

          Are you being sarcastic, or are you truly unable to distinguish between preferences that meet the bar for harming others and those that don’t?

          • nyccine says:

            Are you seriously telling us that someone who talks about seeing the Devil cannot possibly harm others if left at large? Are you seriously telling us that there exist psychiatric disorders that can never result in the sufferer causing harm to others? Are you seriously arguing that denying someone their preference doesn’t harm them?

          • Mary says:

            Are you being sarcastic, or are you truly unable to see that in practice, preferences are not that easily sorted out?

            Suppose you had to prove that institutionalization was harm — why, it gives you free food, clothes, shelter.

            Also, I note you are positing something that was not in the original argument, namely that it is licit to discriminate between preferences, which was exactly what they were out to reject.

    • Desertopa says:

      Warps the incentives to favor feigning insanity? I believe Scott’s previously addressed how practical this is (contra the frequency of its use as a fictional device, not very.)

      In terms of modifying behavior, it’s not as if we exempt people with severe mental illness from social incentives. Rather, we’re applying a different lever. Going to prison is unlikely to modify the incentives that actually caused a schizophrenic person to commit a crime, and might cause them to commit crimes again, but inpatient treatment might.

  4. I think you’re about 95% right. Caplan is taking an often-useful first-order approximation to human behavior (rational choice) and trying to push it way beyond its regime of applicability. But can we steel-man Caplan’s argument? Is there a less extreme version of what he has to say that might be better founded? For example, oppositional defiant disorder strikes me as a good candidate for the kind of thing Caplan is talking about — at the very least, it’s a diagnosis that could easily be abused by authoritarians.

    • Wrong Species says:

      Psychopathy is an obvious candidate for being a different preference rather than a constraint. Multiple personalities and high functioning autism are more borderline. More controversially, pedophilia.*

      *Unnecessary disclaimer: just because I don’t think pedophilia is a mental disorder doesn’t mean I embrace it.

      • Vox Imperatoris says:

        I think the question of whether homosexuality or pedophilia is “objectively a disease” is just a confusion. See Scott’s article on LessWrong for one (though I have my own problems with it).

        The main point is: no one is disputing that with both homosexuality and pedophilia, people’s minds seem to be put together in an unusual way such that their sexual preferences are deviant from the average person. Moreover, they don’t seem to have any control over what their preferences are. Even though some homosexuals don’t want to be homosexuals and some pedophiles don’t want to be pedophiles, they can’t change it. These are the psychological facts.

        The difference between the two is the social consequences of the resulting behaviors. Homosexuality may be practiced among consenting adults, and if accepted, embraced, and practiced, homosexual behavior seems to give its practitioners great fulfillment. Moreover, despite what some neoreactionaries here might say, it doesn’t harm society in any significant way. So the therapy, if any, is to counsel people to discard their religious or other hangups about being homosexual and freely embrace the way their minds are constructed.

        Pedophilia, on the other hand, can not be practiced among consenting adults. If practiced by actually engaging in sex with children, it gives the pedophiles perhaps a fleeting sense of guilty pleasure and causes great harm to the children. Moreover, this violation of the child’s rights is bound to provoke righteous indignation in society at large and lead to the pedophile being severely punished. So the therapy tries to encourage sexual repression, celibacy, or attempts to have romantic relationships with adults, to whom they do not feel the most sexual attraction—the same kinds of things traditional religion encourages homosexuals to do. (Perhaps therapy might also encourage pedophiles to satisfy their urges with pornography that does not depict real children, although that is more controversial.)

        Pedophile “conversion therapy” is probably about as (un)successful as homosexual conversion therapy, but it is used because it is the only reasonable option.

        • nydwracu says:

          Isn’t there a bit in one of RAW’s books about how a homosexual was ‘cured’ with LSD therapy?

          • Muga Sofer says:

            I heard about an experiment where a gay guy was “cured” using wireheading once – by Robert Galbraith Heath, I believe.

            Heath was sufficiently unethical and sloppy that it’s fairly unclear even as a question of fact whether it really “worked”, though.

          • bbartlog says:

            As I recall, all Heath achieved was that the guy was able to have sex with a prostitute *while wireheading*, which does not sound to me like evidence of any kind of lasting or indeed even temporary preference change.

        • Deiseach says:

          Even though some homosexuals don’t want to be homosexuals and some pedophiles don’t want to be pedophiles, they can’t change it.

          This is controversial because gay rights activism is very opposed to reparative therapy; quite apart from whether such therapy works or not, or is abusive, the idea is that being LGBT is perfectly fine and normal so you shouldn’t want to change, and if you do, it’s internalised homophobia due to societal bigotry and the way to act is to embrace your true sexuality and change social attitudes.

          Therefore, even if someone seeks such therapy, and even if such therapy is effective, it should not be permitted or recommended because it is bad in itself for wanting to change someone to what is wrongly considered “normal” or “default”. The emphasis, therefore, on sexuality being immutable and “born this way” is a necessary and useful political tool to encourage acceptance of alternate sexualities amongst mainstream society (regardless of whether it’s true or not; admitting sexuality is fluid and can be changed is surrendering an outpost to the bigots who say that homosexuality is a lifestyle and a choice and is a behaviour amenable to change).

          It may well be that in fifty years time, whatever new edition of the DSM (if it’s still around) will remove paedophilia as an illness, and we’ll get articles about the horror stories of the past when paedophiles were forced to undergo chemical castration or coerced into therapies to change their orientation with the threat of prison if they didn’t (see the legendarium of Alan Turing, Gay Martyr driven to suicide, though it could possibly have been accidental rather than deliberate).

          • anodognosic says:

            While it seems clear that “born this way” tends to go way too far, it seems a lot of high profile anti-gay organizations have reversed course on reparative therapy because they can’t find any evidence of its effectiveness?

            Also, based on the bellwethers, the coming consensus on pedophiles will probably be “love the sinner, hate the sin.” Because child sexual abuse has a clear and definite victim (I’d call homosexuality victimless, but for argument’s sake let’s leave that aside), I don’t see it becoming accepted in a liberal/progressive society, but at the same time, the immutability of the condition of the pedophile will drive people to feel compassion for him or her.

            The right answer is to offer a few non-terrible life options for non-offending pedophiles who “come out” that don’t include total and permanent ostracism. The creation of childless communities, for instance, or, yes, chemical castration as an option. More controversially, simulated experiences like digital pornography that satisfies their urges.

          • This is why it is disingenous to call it a gay rights movement, when they want to reduce the rights of some gays, namely those who don’t want to be gays. They are about the right to be gay, not about the right of gays to be what they want. It is objectively illiberal, which is not a problem fpr me, but it just shows how liberal movements don’t stay so forever, it is not a stable balance. Everything reduces to tribes who are mainly about themselves, not universal rights. It should be called something more of a pro-gayness movement.

            Also, one could just ban gyms by the same logic. Being thin is normal. Why would anyone want to change that to buff? That is just internalized thinphobia.

            It is also normal not to be a scientist. Most people aren’t. Hence people should not learn science. It is just internalized laymanphobia.

            Hey! I like it! I could use it to ban anything! 🙂

            Joke aside, I yearn for the day when the first university dropout will say educating people is bad because it makes the uneducated looks worse in comparison.

          • Alex Z says:

            Slight detour: I always found the insistence that conversion therapy does not work weird and misguided. Presumably, some non-abusive therapy could be developed in the future. What then? Is homosexuality suddenly wrong?

          • Anthony says:

            The problem so far is that reparative therapy, as currently practiced, seems to have negative net benefits in the case of homosexuals. Many of those who want to change are unsuccessful, and many teenagers are forced into reparative therapy involuntarily. However, I think banning it goes too far. I would be ok with banning it for anyone not yet capable of being economically independent – minors, and those who are essentially in conservatorship. But plenty of people waste their money on ineffective psychotherapy; if they want to try becoming not-homosexual, that should be their choice.

            I suspect that to the extent reparative therapy works, it gets bisexual men who’ve found it easier to get sex from men to shift their preferences within their preference range towards women, and to make the effort to try to get sex from women. Everyone has *some* range of what they are sexually attracted to, and it’s not that hard to shift people’s preferences within that range.

            Lastly, anodognosic is wrong. Liberal/progressive society has a history of having accepted pedophilia, and I don’t think it’s at all impossible for it to go there again.

          • Luke Somers says:

            > This is why it is disingenous to call it a gay rights movement, when they want to reduce the rights of some gays, namely those who don’t want to be gays.

            Yes, there is a smudge on the edge of the relevant space that doesn’t fit. The far more central examples fit. This doesn’t make it disingenuous.

            Also, if heterosexual conversion therapy actually worked, that would change up a whole LOT of things. If that were the case, I can very easily see the movement splitting over it.

          • Anonymous says:

            it seems a lot of high profile anti-gay organizations have reversed course on reparative therapy because they can’t find any evidence of its effectiveness?

            Given the effectiveness of alcohol rehabilitation programs, we probably shouldn’t put much stock in any random group’s interpretation of effectiveness when it comes to a politicized topic.

          • James Vonder Haar says:

            @Anthony, re: the left and pedophilia:

            The amount of support amongst the left for pedophilia pales in comparison to the voluminous number of conservative and patriarchal societies that accepted and celebrated pederastry or child brides. The modern horror of pedophilia comes almost entirely from a post-sexual revolution ethic of respect for autonomy and consent. When women aren’t really given a choice of who or whether to marry, and given no chance to refuse sex once in marriage, it hardly matters whether they’re old enough to consent. Harm, not purity, is the only moral foundation that successfully protects children from predation.

          • Nornagest says:

            The amount of support amongst the left for pedophilia pales in comparison to the voluminous number of conservative and patriarchal societies that accepted and celebrated pederastry or child brides.

            Seems a little… asymmetrical to be holding up every “traditional” society in history up against one school of thought in one society and then acting like you’re surprised to find more and more varied norms excusing bad behavior (of whatever kind) among the former.

            I’ll bet I could count more abuses of religious authority among religions that are not Scientology than among Scientologists, too. Doesn’t mean I’m gonna run out and buy a copy of Dianetics.

          • anodognosic says:

            Yeah, I didn’t mean that liberals/progressives had never or could never support pedophilia, I just don’t see it going that way in the next several decades. The Sexual Revolution broke down all sorts of barriers, and it wasn’t clear where they’d be set up again, if at all. Which is why it doesn’t surprise me that people defended pedophilia in the 70s.

            But we’ve been in the process of rebuilding sexual norms kind of ever since, and pedophilia has landed pretty solidly on the NO side.

          • Anthony says:

            The Left’s morality can shift with sudden rapidity. Having seen at least a couple of different articles about “innocent” pedophiles – those who claim to have the attraction but not acted upon it – and the Left’s inability to maintain a “hate the sin, love the sinner” stance for any length of time, I would not be surprised to see a return of the attitudes of the 70s fairly soon. Or not – just because it can happen doesn’t mean it will.

            Christian societies have generally not accepted nor celebrated actual child sex, even when the powerful in those societies regularly got away with it. That’s still true for some post-Christian societies – powerful people in England and Belgium are reported to be involved in pedophile rings, but the response when these things are exposed does not indicate any level of societal acceptance of pedophilic acts. There’s a difference between allowing 14-year-olds (who are physically mature, and in many societies, considered capable of undertaking most adult responsibilities) to marry, and allowing marriages of 9-year-olds to be consummated. I don’t know as much about the history of Islamic or Indian or Chinese societies to argue that point, but the Christian abhorrence of pedophilia is pretty long-lasting for something based on a purity foundation rather than a harm foundation.

          • Luke Somers says:

            > The Left’s morality can shift with sudden rapidity. Having seen at least a couple of different articles about “innocent” pedophiles – those who claim to have the attraction but not acted upon it – and the Left’s inability to maintain a “hate the sin, love the sinner” stance for any length of time, I would not be surprised to see a return of the attitudes of the 70s fairly soon.

            That’s a wild misreading. The sin is not in feeling the attraction. Hence their being innocent. The SIN IS IN SCREWING WITH KIDS. Full stop. If a pedophile does not cross that line, best of luck to them. If they do,you don’t need ‘hate the sin, love the sinner’ – it’s okay to go straight to ‘die in a fire’.

          • Jaskologist says:

            @Luke,

            How is that any different from the standard Christian view of homosexual attraction/actions?

          • Vox Imperatoris says:

            @Jacksologist

            It’s not different at all. Who is arguing that it is different?

            The difference between homosexuality and pedophilia is at the object level, not the meta level.

            Neither homosexuals nor pedophiles are to blame for their desires. But pedophiles are to blame for acting upon their desires because that means harming children; whereas homosexuals are not to blame for acting upon their desires because they do so with other consenting adults.

            If homosexual acts were just as harmful as pedophilic acts, they ought to be prohibited. If pedophilic acts were just as harmless as homosexual acts, they ought to be allowed.

            But as things actually stand, one is harmful and the other isn’t, so one ought to be allowed and the other ought to be prohibited.

          • Jon H says:

            “Lastly, anodognosic is wrong. Liberal/progressive society has a history of having accepted pedophilia, and I don’t think it’s at all impossible for it to go there again.”

            My understanding is that, at least in England, this was aided by pedophiles taking advantage of an edge case which seemed reasonable to gain wider support. If I remember correctly, teen girls could have sex with boys at ages that were illegal for same-sex intercourse. This may have also included cases where the girl was significantly younger than the guy.

            I think there was leftwing support for removing that discrepancy, because of the obvious unfairness. That, I think, led to the left wing getting involved with groups that were proponents of pedophilia in general.

          • Brad (the other one) says:

            @Jaskologist

            >How is that any different from the standard Christian view of homosexual attraction/actions?

            >That’s a wild misreading. The sin is not in feeling the attraction. Hence their being innocent. The SIN IS IN SCREWING WITH KIDS. Full stop. If a pedophile does not cross that line, best of luck to them. If they do,you don’t need ‘hate the sin, love the sinner’ – it’s okay to go straight to ‘die in a fire’.

            In Christianity, the sin is in the attraction. C.F. Matthew 5:28, Matthew 15:17-20. (https://www.biblegateway.com/passage/?search=Matthew+5%3A28%2C+Matthew+15%3A17-20&version=ESV)

            That is, the problem in liberal circles is consequential in wrong-doing; the problem in Christianity is wrong-being (which both leads to and can be identified by wrong-doing.)

        • Deiseach says:

          Pedophilia, on the other hand, can not be practiced among consenting adults. If practiced by actually engaging in sex with children, it gives the pedophiles perhaps a fleeting sense of guilty pleasure and causes great harm to the children.

          I take it you did not live through the 70s? There was an attempt to argue that:

          (1) Children are inherently sexual beings. Adults are uncomfortable about this and attempt to repress and control burgeoning sexuality due to their own hang-ups and repressions. Open, healthy communication about sex, without judgement or declaring anything to be wrong or bad or taboo, was the way to overcome this and help us achieve a society free of the bad effects (rape, sexism, etc.) of such conventional, outmoded, repressiveness. Parents should let their kids see them in the nude in order to let them know the human body was a beautiful, natural thing and nothing to be ashamed of!

          (2) Children can give consent if they’re mature enough, and maturity is not a function of age. Indeed, age of consent laws are repressive and punitive, because it’s ridiculous to threaten a minor with prison for a mutually consenting romantic relationship with another minor.

          (3) The harm done by paedophilic relationships is not because of the paedophilia, it is because of the reaction of other adults and society. A child who has had a loving, safe opportunity to engage in sexual exploration and find out the ways it can experience pleasure and the ways in which its body functions is made to feel afraid, ashamed, and that something bad and wicked and dirty has happened. If people stopped freaking out and were calmly accepting, there would be no trauma, and hence no harm or damage.

          (4) Paedophiles are not rapists. They love and admire children. They only feel guilty because they are made to feel guilty. There is no reason they should be ashamed of a natural desire which they can’t control and didn’t choose anymore than you chose to be straight or gay.

          A lot of right-on trendy progressives – including people involved in gay rights activism, but not limited to them – got badly burned in later decades when their association with, stated support for, or other ways they got entangled, knowingly or unknowingly, with the Paedophile Information Exchange became public knowledge. Campaigns for lowering the age of consent were a favourite tactic and method of infiltration; people who were convinced it was bad archaic law or repression of youthful sexuality or sex-negative attitudes and had no intention of legalising paedophilia were convinced by plausible campaigners to come on board.

          It embarrassed a lot of people, from Peter Thatchell (gay rights activist, cajoled into contributing a chapter to a book ostensibly about the age of consent, and who wrote a letter to “The Guardian” newspaper in 1987 which he claims was edited for publication, but where he claims he has friends who had sex with adults when they were between the ages of 9-13 and it did them no harm), to members of both the Labour and Conservative parties.

          • Taradino C. says:

            The harm done by paedophilic relationships is not because of the paedophilia, it is because of the reaction of other adults and society. A child who has had a loving, safe opportunity to engage in sexual exploration and find out the ways it can experience pleasure and the ways in which its body functions is made to feel afraid, ashamed, and that something bad and wicked and dirty has happened.

            This is close to what Rind et al found in 1998, which was later replicated by other researchers: that the development of negative psychological outcomes in children who had sexual contact with adults is moderated by things like “willingness” (what we’d call “consent” in adults) and, more surprisingly, gender.

          • Nornagest says:

            moderated by […] gender.

            Interesting. Howso?

          • Vox Imperatoris says:

            No, Deiseach, I am well aware of that position. It is logical and consistent.

            I just think it is empirically wrong.

            If it were right, then I would take back what I said and fully embrace the free expression of pedophilia. If the evidence of pedophilia’s being harmless were clear and convincing enough, I would regard those who refused to hire or associate with pedophiles as bigots and condemn them morally.

            Although I would condemn their actions, I would support the right of “pedophobes” to refuse to hire or associate with pedophiles for the same reason that I support the right of racists to refuse to hire or associate with blacks.

            That’s the great thing about basing moral opinions on facts: if your understanding of the facts changes, you get to change your opinion.

          • gold-in-green says:

            Deiseach, would you mind filling in the history of ideas a little more? (to assuage the curiosity of someone born in the 90’s but trying to understand those crazy 70’s)
            How popular did these arguments get? Was there much real oppositional engagement with them, as opposed to just “ick”? When did the backlash start? Was it just the anglosphere?

          • Everyone in this discussion seems to assume that either sex with children is always wicked, harmful, and non-consensual or it never is. Neither strikes me as very likely. Humans, including young humans, vary a lot. Some are much more mature, better able to make decisions for themselves, than others.

            Suppose you were convinced that a particular act of pedophilia was done with real consent, at least as real as consent to sex by an adult, and saw no evidence that it had made the “victim” worse off. Would you still condemn it?

            For an SF version … . I discuss in _Future Imperfect_ the possibility of drugs to delay puberty, which I can imagine some parents choosing to give to their children. Suppose their use becomes common, and some people choose to never go through puberty–perhaps one effect is a considerably longer life expectancy, perhaps they merely want to avoid the emotional turbulence of adolescence.

            Would sex with a pre-pubertal twenty year old count as pedophilia? As wicked?

            At a further but not irrelevant tangent … . Aisha, whose marriage to Mohammed was said to have been consummated at nine (possibly what an earlier commenter referred to), was on all the evidence available to us a loving and committed wife until the death of her husband. And her behavior thereafter does not suggest that she was a weak willed and malleable sort.

          • Nornagest says:

            Aisha, whose marriage to Mohammed was said to have been consummated at nine […] was on all the evidence available to us a loving and committed wife until the death of her husband.

            While that’s what the evidence we’ve got says, and while I’m not totally unsympathetic to models where expectations of victimhood do a lot of the damage in situations like this, we are talking about the founder of a major religion here. A religion which is historically hostile to unflattering depictions of its roots, and in a place and time where there weren’t many non-Muslim observers left alive and unconverted. If Aisha had been unhappy in her early marriage to Mohammad, I’m not at all sure there’d be any evidence left by now.

            (Those 2200 hadith of hers don’t exactly point to a traumatized person, though.)

          • Jon H says:

            “Campaigns for lowering the age of consent were a favourite tactic and method of infiltration”

            I believe the “presentable” version of that was campaigns to lower the age of consent for same-sex intercourse, which was higher than that for male-female intercourse. Which, on its own, is not unreasonable. If a 16 year old boy and girl can 69, I can’t think of why two boys or two girls of the same age ought to risk jail.

            I’m sure pedophile groups tried to take advantage of support for that minor change in an attempt to lower age of consent in general.

          • Jiro says:

            Asking what if I were “convinced” that pedophilia was okay is like being asked if I was convinced of any other really unlikely proposition (flat earth, 2+2=5, Jewish conspiracy to take over the world). My belief that I have a good reason to believe X is likely to result from an undiscovered error so I would refuse to believe X, even if I have an airtight argument for it, unless I can get other people to review it for flaws, which I presumably cannot do here. (You can’t save this by postulating I was told by a 100% accurate Omega, because “this is an 100% accurate Omega is itself such an X.)

      • chaosmage says:

        Disagree on psychopathy. The only psychopath I ever talked to in depth convinced me that for her it was not a preference. She had worked out, after many years of thinking, that other people actually had complex emotions that she was missing out on. She has excitement and boredom, but nothing else. And she understands, on a purely cognitive level, that love at least appears to be something worth experiencing.

        She’s not too sorry about the particular mind she has. It obviously helps her being successful in her job, especially by giving her immense frustration tolerance. She’s a formidable liar. Her (seemingly untested) ability to kill a human and not regret it is, in her view, obviously an asset. But I believe her that she would prefer to be able to feel love, and she can’t.

        • >And she understands, on a purely cognitive level, that love at least appears to be something worth experiencing.

          Saddest sentence of the week so far.

          >It obviously helps her being successful in her job

          Lawyer?

          • Anonymous says:

            >>It obviously helps her being successful in her job
            >Lawyer?

            Politician? Banker? Street gang member?

          • Marc Whipple says:

            Insurance claims adjuster.

            (“Lawyer” was funny. But you know how normal people think about lawyers? That’s how most lawyers think about insurance claims adjusters/insurance company lawyers.)

        • Mary says:

          I’ve heard of a psychopath who went in for counselling.

          Though his was the much more pragmatic question of, twice people had tried to kill him, what techniques could he use to prevent this happening the future.

          Apparently he was able to grasp “You scratch my back, I scratch yours,” as an operating principle and liked it, because it was effective and safer.

  5. JHK says:

    So just getting through part I… hit a hiccup in your quote of Caplan — “Equally importantly, economists At the same time, economists also recognize not only that rentseeking is a ubiquitous force, but that most rent-seekers create and internalize public-interested justifications for their activities (Klein 1994).”

    Going through to the link, looks like this quote got jumbled in the copy and paste (or whatever) process. Just thought you should know. EDIT: It is from 7. Conclusion in the paper

    Stumbled upon this late night, but looking forward to finishing it in the morning!

  6. Ton says:

    You borked the first quote.

    • Andy says:

      Are you referring to the way it repeats halfway through? I’ve bolded the bit and added ***** to mark the point of repeat.

      At the same time, economists also recognize not only that rentseeking is a ubiquitous force, but that most rent-seekers create and internalize public-interested justifications for their activities. It is not overreaching for economists to criticize domestic auto makers’ arguments for protectionism. The auto makers know more about the details of their own industry, but economists are better at interpreting those details. Equally importantly, economists ***** At the same time, economists also recognize not only that rentseeking is a ubiquitous force, but that most rent-seekers create and internalize public-interested justifications for their activities (Klein 1994). It is not overreaching for economists to criticize domestic auto makers’ arguments for protectionism. The auto makers know more about the details of their own industry, but economists are better at interpreting those details. Equally importantly, economists are trained to consider the costs of a policy for everyone in society, not merely groups with the most political influence.

  7. Douglas Knight says:

    Zsazsaian

    No, that’s a follower of Zsa-Zsa Gabor, not Thomas Szasz.

  8. onyomi says:

    I feel like there is an analogy here between Caplan’s rather strange view of mental illness, and a (non-realist utilitarian?) ethic I’ve seen some express here on SSC (most recently in Popen Thread), and also read about elsewhere: that is, the idea that, because morality implies “ought” and one wouldn’t do what one knows one ought not to do, therefore people don’t really do anything that is immoral by their own lights: rather, people whom most of society judge to be acting unethically are actually just acting in accordance with an unusual morality.

    But as failures of will power seem to disprove this (it is possible for me to simultaneously think I ought not to cheat on my wife and yet do it), so, as Scott points out here, does the fact that someone may want to work really hard but struggle with crippling fatigue, anxiety, hallucinations, etc. that get in the way seem to disprove Caplan’s view.

    At the heart of it seems to be differing conceptions of the acting person: psychiatrists, maybe taking a cue from Freud’s super-ego and ego, or maybe just relying on their experience of what seems intuitively obvious to me, don’t view the psyche as a unitary acting unit; economists, on the other hand, do tend to do so, since they are more interested in the real-world impact of the choices people actually do make, and perhaps less so with how people arrived at them.

    The answer, to me, seems to be that, sometimes the human “actor” is united in his purpose, and sometimes divided. There are cases when “the spirit is willing but the flesh is weak,” and also the reverse.

    Yet I would also say there may be a kind of “mind-body dissonance” which works to bring the two into accord: it is commonly experienced that one “finds” the energy–even the physical strength–to do things which really interest him, whereas motivation mysteriously evaporates when engaged in a boring task. But there are limits, of course: no amount of wishing will enable the blind man to see. Perhaps Caplan’s mistake is more in drawing a hard line between mind and body, when, in fact, there are actually both “hard” and “soft” limitations of both body and mind (the person with IQ 70 is literally incapable of getting a PhD in theoretical physics as the person in a wheelchair is literally incapable of running a marathon unassisted; conversely, the person with mild-to-moderate anxiety may be able to accomplish as much as someone without, albeit with more difficulty, and the highly motivated athlete may sometimes surpass the naturally talented but less motivated athlete).

    • Anonymous says:

      There’s a lot of this. I think a lot of people should be aware of the concept of second-order will, which goes back at least to Aquinas.

      • Irenist says:

        Indeed. For anyone curious about Aquinas’ view, the ninth chapter of Eleonore Stump’s Aquinas (2003) describes it well. The upshot:

        Say I’m a sinner, so I will to do sinful stuff. But then I repent, and ask God to make me will virtuously. In that moment of repentance, my “first-order volition” is my desire for the sinful thing that tempts me, but my “second-order volition” (I think a rationalist would probably want to say “meta-volition” or something else more LW-sounding) is not to have that first-order volition anymore–to no longer desire to sin.

        This is exactly like Scott’s example I mention in my comment just below this one, of being tempted by a box of donuts. The dieter wills to eat yummy donuts, and meta-wills not to will to eat them.

        The Caplan tie-in is that, as Scott points out in the OP, the alcoholic often wills to drink, but meta-wills for paternalistic help from a Higher Power, a support group, and maybe an inpatient clinic NOT to will to drink (just as St. Augustine eventually willed for Heavenly-Fatherly [i.e, Paternalistic] help not to will to sin), and Caplan’s doctrinaire libertarian view of humans as rational preference maximizing homo economicus types totally ignores this akrasia aspect of human life.

        The LW tie in, OTOH, is that IIRC, the Coherent Extrapolated Volition (CEV) project involves some deep thinking about how to ensure a second-order volition that the volition not depart too much from what we programmed it to be: sort of like Moravec’s example of an AI having a Constitution in its mind that overrules impulses to change other parts of its volitional self-legislation.

        • HlynkaCG says:

          This (along with many other similar examples) is why I firmly believe that while times change people don’t.

        • onyomi says:

          The problem is that God is not available to force us to be good, and any human whom you imbue with such power is subject to all the same fallibility you yourself are.

          The reason I’m a libertarian is because I object to other adults, who are usually no smarter than me and who know less about my life than me, forcibly treating me as a child.

          Of course, if you want to be bossed around, the libertarian does not object to your hiring a life coach, personal trainer, dominatrix, etc. Just don’t force that preference on me.

          • Jaskologist says:

            I shall never tire of quoting Federalist 51:

            If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary. In framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next place oblige it to control itself.

        • HeelBearCub says:

          @Irenist:
          I think it’s incorrect to think of first and second order. I believe, and I think research shows, that the right model is that we have competing heuristics.

          “I want to avoid the grass where the lion may lie in wait for me.”
          “I want to travel efficiently so I do not waste energy.”

          Those aren’t first and second level intentions or desires. They are in competition.

          Now obviously this example is too simple to apply directly to the various behaviors such as alcoholism, as both the harm and the benefit of drinking are not so readily apparent. But it seems to me that instead of regarding things as first and second order, it is simpler to say that the heuristic for drinking is stronger than the heuristic for not drinking at certain times under certain conditions.

          Thus we can say that you desire to drink and you desire not to drink, both at the same time.

          • onyomi says:

            I agree that this is probably a better way to look at it, and that the privileging of one type of desire over another just because it better accords with morality, health, or what have you is probably an arbitrary distinction with religious roots. I want to be skinny. I also want to eat delicious food whenever I want. The former requires more willpower to pursue but may make me happier in the long run; the latter is the opposite. Yet those facts don’t necessarily make one option “primary” and the other “secondary.”

            I don’t think Caplan is discounting the power of akrasia, or the existence of competing desires; he is merely saying that, insofar as we may observe a person’s actual actions, we may tell which desire has, for the time being, won out.

          • HeelBearCub says:

            @onyomi:
            I don’t think that is correct. He is wrapping the two together and calling them one thing, “preference”. I won’t repeat my arguments about economists’ definition of preference which I have made elsewhere in the thread.

            But I don’t think it’s appropriate to say that Caplan views two things competing. If he did, that would blow up his entire argument. I don’t think it’s uncharitable to state the Caplan argument as “He drinks and is “miserable” and says he wants to quit. But clearly he doesn’t want to quit, and does want to be miserable, or he would stop drinking and start being “happy.”

            I’m putting quotes around “miserable” and “happy” because, in the economists view, I don’t think a person can do anything to make themselves unhappy. Not if having your preferences satisfied is the sort of thing that can be assumed to make you happy.

          • Anonymous says:

            “I want to avoid the grass where the lion may lie in wait for me.”
            “I want to travel efficiently so I do not waste energy.”

            Those aren’t first and second level intentions or desires. They are in competition.

            Sure, but saying that there can be conflicts between first order desires does not disprove the concept of second order desires. Neither of these examples is a will about a will… which is the kind of thing we call a second order will.

          • HeelBearCub says:

            @Anonymous:
            Isn’t the “meta” or “second order” will really just the recognition of conflict between first order wills?

            The example: I want to eat the donut, but I want to not want eat the donut.

            Well why do you want to not want to eat the donut? There is an unstated first order will that is doing all the work. (You are over the weight you consider ideal. You are diabetic. You desire to meet your Lent obligation.)

            If you can give me some second order will that does work on its own, I’m all ears.

          • Anonymous says:

            HBC, a second-order desire is a desire about a desire. A first-order desire is the object of a second-order desire.

            example: I want to eat the donut, but I want to not want eat the donut.

            These are two conflicting first-order desires, because they each have an action as their object. An example of a second-order desire would be, “I desire to have a desire for donuts.” This isn’t even necessarily to say that you desire the first-order desire to go all the way to action. IIRC, the classic example is a counselor for drug addition desiring to have a desire for drugs in the same way her patients do. She doesn’t necessarily want that first-order desire to go to action (i.e., she doesn’t necessarily want to take the drugs), but she wants to know what it’s like to have the first-order desire so that she can better understand her patients.

    • Irenist says:

      Agreed about Caplan’s views. But I think they make sense giving his other commitments: the problem with a Strict Harm Principle society, as Scott pointed out in his “Archipelago” post, is precisely akrasia. Scott’s examples were tobacco advertising and people leaving free donuts in the doctor’s lounge.

      This blind spot is among the worst problems libertarianism has. Caplan seems in this post to want to believe we are all homo economicus, and our actions reflect our preferences and our resources. Because if we’re not, if we struggle with akrasia then some form of paternalism (even just self-imposed, like how I block certain websites at work so I can get more done, and don’t keep junk food in the house) becomes desirable, even empowering, liberating.

      It’s a famous complaint that libertarianism struggles to deal with child-rearing, because children are the paradigmatic example of dependent people who need paternalistic care. The gravely mentally ill are another example: those who present a serious danger to themselves or others cannot properly be treated as we would some rational homo economicus. One of virtue ethicist Alasdair MacIntyre’s points in his book “Dependent Rational Animals” is that we are all dependent insofar as no man is an island with affective and physiological needs for love, community, and resources, so externalities like that box of donuts tempting us are a real problem that we wouldn’t have if we were just Vulcans or something.

      I think Caplan (and some of the rationalist community) are perhaps neuro-atypical such that modeling humans as Vulcans feels more plausible for them than it does for the rest of us schlubs. That’s fine (I love the LW and SSC commenter communities) but it’s not accurate because we’re not Vulcans.

      • onyomi says:

        “It’s a famous complaint that libertarianism struggles to deal with child-rearing, because children are the paradigmatic example of dependent people who need paternalistic care.”

        Is it? I’ve been a libertarian for some time and never heard it.

        Remember, it’s not dependency libertarians object to, it’s coercion. Sure, you may need to coerce your child by grabbing him before he steps in front of a bus, but you’d do that to an adult friend as well.

        And as someone who constantly resented being literally forced (rather than convinced) to do things throughout my childhood (and no, my parents weren’t unusually strict or authoritarian; just “normal” by our society’s standards), I can say that children prefer being convinced, rather than forced, to do the things their parents believe better, just as adults. Of course, my hatred of being forced to do things from an early age is probably also part of why I’m a libertarian.

        • Irenist says:

          Well, it’s a famous complaint in “traditionalist Catholics who sit around reading Chesterton all day and commenting on each other’s traditionalist blogs” circles, so it’s famous to me.

          As for the rest of it, sure: I’m not saying libertarians “object” to dependency–that’s Objectivists. I’m saying less nuanced libertarianisms struggle to account for dependency, for everything from classical notions of akrasia to modern notions in behavioral economics and cognitive biases indicate that left to their own devices in a minarchist night watchman state, a lot of us are going to make bad decisions that we desire but don’t meta-desire–like Scott and the donuts, or a guy in Bloomberg’s NYC who wanted to lose weight, but kept being tempted by humongous sodas until Bloomberg nanny-stated away the problem for him: he desired yummy cold soda, but meta-desired not to be fat anymore. It can be really hard to achieve our meta-desires in a minarchist setting, and that’s a real issue for libertarianism.

          • onyomi says:

            I mean, I don’t deny that there may be cases–maybe even many cases–in which others’ meta-desires, and maybe even some of my own meta-desires, would be more easily and/or efficiently achieved through use of force. The primary reason I’m a libertarian is not because I deny such cases exist, but because, basically, “keep your meta-preferences away from my preferences” seems a wholly defensible moral position. That, and deciding whose meta-preferences get to be the ones imposed on everyone else is inherently problematic.

          • Vox Imperatoris says:

            It’s a strawman of Objectivism, too. And as an Objectivist, I’ve heard this sort of argument advanced against it far more than against libertarianism in general.

            Objectivism doesn’t “object” to the metaphysical fact of dependency. It objects to people who choose to live parasitically, by demanding value from others without giving back value in return—whether they do it through force (“looters”) or guilt-tripping (“moochers”). Moreover, it says that there is no Kantian imperative to help people in need; you should do so only to the extent that it will bring you happiness in the context of a well-ordered life.

            Where people go off the rails is in interpreting “value” in a narrow, materialistic way. So they think children provide no value to their parents or something.

            Objectivism absolutely says you should have children if you think that will bring you happiness. And most parents seem actually to enjoy raising their children. So they are doing nothing wrong.

            Now, it is true that if children are going to be a net loss—a burden or a sacrifice—you should not have them. So if you find out your fetus has Down’s Syndrome or some kind of horrible disease, an abortion is quite reasonable in those circumstances. It is generally unpleasant to raise a retarded child—or even if it is tolerable, it’s better to raise a normal one.

            Ayn Rand also said that, once a child has been born, you do have an obligation to keep raising him until he is an adult, whether you like it or not (unless you find someone to adopt him). Otherwise, you’re just a parasite yourself, foisting your child upon unwilling others. It’s the same as your obligation to keep any regular contractual agreement.

          • Mary says:

            “Objectivism absolutely says you should have children if you think that will bring you happiness.”

            What happens when the parent decides that happiness is best achieved by kicking the six-year-old and three-year-old out of the house because they interfere with having a new lover?

            “So if you find out your fetus has Down’s Syndrome or some kind of horrible disease, an abortion is quite reasonable in those circumstances. It is generally unpleasant to raise a retarded child—or even if it is tolerable, it’s better to raise a normal one.”

            Do you have any evidence that raising a Downs Syndrome child is not as good — or better — than raising a normal one?

            Would not the rational decision be to smother the kid at birth, to be more certain of the diagnosis?

            Or even start to raise the kid to test whether it will contribute to happiness or not, and smother the kid according to results?

            “Ayn Rand also said that, once a child has been born, you do have an obligation to keep raising him until he is an adult, whether you like it or not”

            Thus demonstrating that she was not consistent. Leaving aside the magical significance that she imputes to birth, she is admitting that some duties are more important than happiness and selfishness. (Similarly, she thought it the duty of Hollywood to keep Communist propaganda out of movies, even if the effort to keep the Communists out or monitor their output did not contribute to their happiness.)

            If even she can’t be consistent, are the principles sound?

          • Vox Imperatoris says:

            @Mary:

            What happens when the parent decides that happiness is best achieved by kicking the six-year-old and three-year-old out of the house because they interfere with having a new lover?

            By all means, if that person had thought completely honestly and rationally about the issue and concluded that the best way to promote his own life and happiness was to kick his child out in order to shack up with a new lover, he ought to do it.

            The objection that I have (and that Ayn Rand certainly would have had) is that this sort of wild, chaotic, and irresponsible behavior is not conducive to long-range flourishing. But if you disagree and think it is in your interest to kick your children out of your home (because you don’t love them or enjoy interacting with them), I’m certainly not going to stand here and say you should continue to tolerate them out of self-sacrificial duty.

            I might hold you legally culpable for child neglect, but the way you ought to behave and the way society ought to respond are, in principle, two separate questions.

            Do you have any evidence that raising a Downs Syndrome child is not as good — or better — than raising a normal one?

            Would not the rational decision be to smother the kid at birth, to be more certain of the diagnosis?

            Or even start to raise the kid to test whether it will contribute to happiness or not, and smother the kid according to results?

            I don’t have any hard scientific studies, but I think it stands to reason that it would be more enjoyable to raise a healthy, high-functioning child with whom you can relate on an intellectual level than to raise an idiot who will never grasp any but the most basic concepts. I would say the same for raising a child with functioning limbs vs. raising a quadriplegic.

            That’s not to say that the mentally or physically impaired children would have zero or negative value; it’s just that, other things being equal, a fit child would be better.

            And all right, what about smothering the child at birth or when he’s ten years old and you feel tired of him (or whatever absurd example)? Again, if you really think this would be the most enlightened, welfare-promoting course of action for you, do it!

            But for my own part, I think that one virtue of a rational life is a decent respect for the rights and lives of other human beings. The inculcation of this habit of benevolence pays for itself many times over and is an essential part of a happy life as a psychologically normal human being. So I would not say that murdering children, much less one’s own children, is a good way of achieving a flourishing, happy, and successful life.

            And as for abortion, I think it is quite a different question when dealing with an undeveloped embryo or non-viable fetus. It is not a rational being capable of independent life. I don’t think the woman ought to be enslaved, in a legal or moral sense, to the mere potentiality that is the fetus before it develops the capability for independent existence. Certainly, I would morally condemn a woman who wantonly and irresponsibly got herself pregnant by not thinking of the consequences of her actions—for the same reason I would condemn any similar irresponsibility. However, she needn’t compound that irresponsibility by having a child she is not prepared to care for.

            (Incidentally, Ayn Rand never took a firm position on whether the line for abortion ought to be drawn at birth or viability. She only mentioned the question in passing and dismissed it as a distraction from the main question of whether abortion ought to be allowed even in the first trimester. For my own part, I do see the merits of viability being the dividing line, since the capabilities of the fetus seem to have much more importance than its physical location.)

            Now, your line of argument does suggest the following scenario: what about a woman who is too irresponsible to have gotten an abortion before the fetus is viable? And suppose she never developed any feelings of benevolence and sympathy that would lead her to hesitate to kill an innocent child at birth? Objectivism may (possibly) have no good advice for her. She has the choice to murder the baby, as (I suppose) is consistent with her established values; or she completely overturn her character and values, and take responsibility for her mistakes. Yet some people’s vices are too firmly set, by a certain age, to be realistically changed. Objectivism is not a philosophy of universal redemption.

            (And again, this says nothing about what the legal response should be to her actions. Irredeemable people might just be what the guillotine was made for.)

            Thus demonstrating that she was not consistent. Leaving aside the magical significance that she imputes to birth, she is admitting that some duties are more important than happiness and selfishness. (Similarly, she thought it the duty of Hollywood to keep Communist propaganda out of movies, even if the effort to keep the Communists out or monitor their output did not contribute to their happiness.)

            No, she did not think any such thing. She never, at any time, conceded or implied that there are any duties more important than the pursuit of one’s own happy and successful life.

            She did not suppose that movie producers would have maximally happy lives funding Communist propaganda, but that they had to sacrifice some of that happiness to the “duty” of fighting Communism. On the contrary, she believed that fighting Communism was its own reward. A rational, independent thinker would judge Communism to be evil. And he would find it preferable to live a life where he can proclaim his judgements honestly and produce work that reflects his true opinions than to censor himself to conform to the views of others. Having intellectual and creative independence makes up for having perhaps little less money.

            You should read The Fountainhead because it is actually about this precise issue. Not fighting Communism, but the value of intellectual independence.

            Most relevant is the character Gail Wynand. Wynand stands in contrast to the pathetic Peter Keating, who doesn’t think for himself at all and purely conforms to others’ judgments. But Wynand is also a flawed character. He builds a newspaper empire on the basis of “yellow journalism”, managing to rise from Hell’s Kitchen to wealth and power. And he supposes that he can privately think whatever he likes, enjoy his own beautiful art collections, etc. while pandering the lowbrow public, giving them any kind of trash they want to have.

            Yet he finds that all his “power” is useless when he at last tries to fight for something he truly believes in: to save the career of his friend Howard Roark. The power he thought he had to shape public opinion is revealed as an illusion: when he tries to turn around the editorial line of his newspapers, most of the public is indifferent and any who would care have no respect for whatever one of Wynand’s papers might say. The price of building a career off of pandering to the public is that his wealth and power are the slave of their whims. At the end of the novel, he commits suicide (as I said, Objectivism does not emphasize the infinite malleability of the human psyche in pursuit of universal redemption).

            Whereas the hero, Howard Roark, faces many setbacks and never becomes some kind of leading power-broker—but he doesn’t abandon his creative independence, making him the happier for it.

            The problem with your outlook is that you seem to have the idea that you arbitrarily come up with what you want to do, then Morality comes in and tells you why you’re not allowed to do it. Objectivism has a completely opposite picture of things: you’re “allowed” to do anything you want. The purpose of ethics is to tell you how to get what you want, given the constraints of reality. And happiness—by definition, really—is the most personally satisfying thing to have. So the purpose of an egoistic ethics, more specifically, is to tell you how to get it.

            So it is an absurdity to say: “Okay, so you’re living this maximally selfish lifestyle, but what if you’re still unhappy? Like, you have all these hookers and cocaine and the penthouse apartment, but you feel something is missing.” But if you’re unhappy and unfulfilled; you must be doing something wrong! You must not actually be living in the most selfish way. (Or else, you are living in material conditions that preclude the achievement of happiness.) Because you’re not getting what you really want: happiness.

            Indeed, if there is one Christian aphorism which Objectivism very much sympathizes with, it is: “For what is a man profited, if he shall gain the whole world, and lose his own soul?” As an Objectivist would say: “What good is it to have the hookers and cocaine and penthouse apartment, if you aren’t happy?” Perhaps those kinds of things are not what’s really essential to happiness.

            There are a lot of bad things about Christianity, but it at least seems to say that ethical action is, in the long run, in one’s enlightened self-interest.

            Of course, if you take the deontological element of Christianity seriously, the prospect of heavenly reward and hellish punishment should be irrelevant to one’s reasons for acting morally. Some sects, indeed, teach that heaven is not the reward of “good works” but is a gift granted by God more or less arbitrarily (or rather: all of them teach this, some much more consistently than others).

            Nevertheless, Actually Existing Christianity, as practiced by normal people and not theologians, relies heavily on the idea that decent people basically earn their way into heaven and deserve to go there. Whereas evil people earn their way into hell and deserve to go there. And they follow religious commandments because they hope to earn entry into heaven. If the “reward” for following the Law were hell, I daresay Christianity wouldn’t have many adherents.

          • HlynkaCG says:

            Mary says: What happens when the parent decides that happiness is best achieved by kicking the six-year-old and three-year-old out of the house because they interfere with having a new lover?

            I believe that question has already been answered…

            once a child has been born, you do have an obligation to keep raising them until they are an adult, (unless you find someone to adopt him). Otherwise, you’re just a parasite yourself, foisting your child upon unwilling others. It’s the same as your obligation to keep any regular contractual agreement.

            As for the bit about Down Syndrome, would you expect someone to argue that having a congenital heart disease is somehow better than (or at least of equal value to) not having a congenital heart disease?

          • Nita says:

            Otherwise, you’re just a parasite yourself, foisting your child upon unwilling others.

            I don’t understand how this is consistent with Objectivism. If these unwilling others are proper Objectivists, they can just let the child die — no one can foist anyone on them against their will. And if they’re not — well, that’s their own fault, isn’t it?

          • Marc Whipple says:

            I don’t know that Objectivism necessarily implies anarchy.

            If we’re not going to have anarchy, then feral children (and/or their corpses) are a health and safety hazard, which has to be dealt with by whatever minarchist form of government we’re going to have. By consciously creating children and then forcing the MFG to deal with them, you are in fact foisting your problems off on others.

            In fact, even if we do have anarchy, this problem stands – I don’t know anyone no matter how Objectivist who’d claim that if you raise a dangerous animal and then release it into the world, you shouldn’t be liable for the harm it causes. I see no reason this is any less true for featherless bipeds than for pit bulls.

          • onyomi says:

            The plumb line Objectivist stance (as defined by what Ayn Rand herself believed) is not anarchy, but a minimal state. She believed that competition was good when it came to producing things we want, but not in the realm of violence, which we hope to minimize. The state is a monopoly on violence necessary, on her view, to suppress competing sources of violence which would destabilize the world of property rights necessary for capitalism to flourish.

          • Mary says:

            “I don’t have any hard scientific studies, but I think it stands to reason that it would be more enjoyable to raise a healthy, high-functioning child with whom you can relate on an intellectual level than to raise an idiot who will never grasp any but the most basic concepts.”

            What a profoundly ignorant view of Downs Syndrome.

            “It stands to reason” is not the right term for what you are doing here.

          • Mary says:

            “But for my own part, I think that one virtue of a rational life is a decent respect for the rights and lives of other human beings.”

            This would necessarily entail an unwillingness to stand aside when they are violated, which means you have contradicted yourself.

          • Vox Imperatoris says:

            @Mary:

            “I don’t have any hard scientific studies, but I think it stands to reason that it would be more enjoyable to raise a healthy, high-functioning child with whom you can relate on an intellectual level than to raise an idiot who will never grasp any but the most basic concepts.”

            What a profoundly ignorant view of Downs Syndrome.

            I’m aware that Down’s Syndrome does not always produce extremely severe impairment. So I admit that I should have been more clear there.

            I think the essential point stands, however. If extreme impairment is very undesirable, more limited impairment is undesirable to a lesser degree. How can you seriously argue that it’s just as good to have a mentally retarded child as to have a normal one?

            “But for my own part, I think that one virtue of a rational life is a decent respect for the rights and lives of other human beings.”

            This would necessarily entail an unwillingness to stand aside when they are violated, which means you have contradicted yourself.

            I am at a total loss to identify where I have supposedly contradicted myself. Could you specify it more clearly?

            If I saw a man attempted to rape a woman in an alley, and I had a gun, I would almost certainly come to her aid. Why would I not? I would get great satisfaction from having defended an innocent woman from a criminal, and if I had the element of surprise, I would not be in extreme danger.

            On the other hand, if there were 15 men with AK-47s, I would almost certainly run away if the woman were just some stranger. It would not be worth risking almost certain death.

            But if the woman were my wife, for example, then I might still attempt it, even if it were almost suicidal. Because she would be of such great value to me that I would not be able to go on, knowing that I had a chance to save her and didn’t. (If I wouldn’t do anything in that situation, what would that say about my claim to value her?)

          • HlynkaCG says:

            @ Nita:
            The concepts of liability and damages are both well within the bounds of objectivism. Rand herself argued that injuring someone or destroying their property was a direct violation of that person’s own property rights and as such you are obliged to make amends, and if not they are within their rights to take action against you.

            To that end I think that Marc Whipple’s example is apt.

            If you let your dog run amok, people may reasonably hold you responsible for any harm that it causes.

        • Mary says:

          Complain, complain, complain. I think libertarianism is an excellent philosophy for sterile immortals.

          There are things that it is the parents’ duty to compel the child to do, if the child refuses to be convinced. Especially extremely immature ones. A parent who lets the kid torture the cat because the kid can not convinced otherwise is a bad parent.

          Though actually I think the big problem is that you would need strong social pressure to compel parents to be good parents, or your libertarian society will not last two generations.

          • onyomi says:

            What is wrong with needing strong social pressure? Libertarians are not against social pressure. If anything, I think statists are the ones who end up breaking down traditional social pressures because they want everything “guaranteed” by the state. This tends to break down the need to rely on family and friends. Without the need to rely on family and friends there is less pressure to conform to group norms, which, one would hope, would exclude child abuse.

            The stigma against being a deadbeat dad, for example, has weakened significantly post great society. I would expect this stigma to be *stronger* in a libertarian society, not weaker.

          • Jaskologist says:

            I think you’re right in theory, but in practice, a lot of so-called libertarians are really just libertines in disguise. I agree that a libertarian state requires a whole slew of socially conservative cultural institutions to function (and conversely, that expanding government works to destroy those institutions). I think a lot of self-described libertarians are in denial about that, though.

          • Mary says:

            I don’t think there’s anything wrong with it. The problem is that I do not think a libertarian philosophy is conducive to producing it.

          • onyomi says:

            @Jaskologist

            You may be right–a subset of libertarians probably think “libertarianism means I get to do whatever the hell I want all the time,” but I think an equally large, if not much larger proportion of those advocating liberal/progressive policies are in denial about the destructive effects their policies have on family structure, community, etc.

            Some more radical leftists, of course, are okay with tearing down traditional institutions like family, etc., but I think many more moderate liberal/progressives erroneously believe that a strong set of supposedly agreed upon laws and regulations bring a community together, whereas I think the opposite is the case.

            Confucius: “If the people be led by laws, and uniformity sought to be given them by punishments, they will try to avoid the punishment, but have no sense of shame. If they be led by virtue, and uniformity sought to be given them by the rules of propriety, they will have the sense of shame, and moreover will become good.”

          • Mary says:

            Confucius: “If the people be led by laws, and uniformity sought to be given them by punishments, they will try to avoid the punishment, but have no sense of shame. If they be led by virtue, and uniformity sought to be given them by the rules of propriety, they will have the sense of shame, and moreover will become good.”

            all very nice, but it were that easy to make people good, someone would have done it by now.

          • Marc Whipple says:

            @Mary:

            “Good” is a relative term in this context. I don’t think Confucius would have argued that you could make EVERYBODY good, all the time, under any circumstances. But if a society’s main social pressure is shame, people will at least have some subconscious inclination to avoid “bad” behavior because it is shameful.

            If a society’s main social pressure is fear of punishment, people’s inclination will be to avoid punishment, which means that if they do not fear being punished, or can work out some means of avoiding punishment, they have no incentive to avoid “bad” behavior.

          • onyomi says:

            It has been done–just not completely. People in modern, Western, liberal democracies are WAY nicer than people of the past: it wasn’t that long that bear baiting and even gladiatorial games were considered great fun, as were public executions.

            Also, since when was it easy to lead by great moral example and without relying heavily on coercive laws, threats, and intimidation?

          • Nita says:

            @ onyomi

            pressure to conform to group norms, which, one would hope, would exclude child abuse

            Unfortunately, some of the communities where this pressure is the strongest have rather unorthodox definitions of child abuse. E.g., if you’re not sexually molesting your children or breaking their bones, it’s not abuse.

            Furthermore, a prominent political representative of such communities has argued that children are the property of their parents. And we all know how libertarians feel about people being told what to do with their own property…

          • FacelessCraven says:

            @Nita – “Unfortunately, some of the communities where this pressure is the strongest have rather unorthodox definitions of child abuse. E.g., if you’re not sexually molesting your children or breaking their bones, it’s not abuse.”

            …That… sounds pretty close to the standard definition of child abuse? Are you sure your definition isn’t the unorthodox one? We don’t let parents do lasting, acute physical harm to their kids, but they can still let them pig out on icecream and get fat if they want. We don’t let them acute mental or emotional abuse, but “acute” in that context is a pretty limited range.

            “Furthermore, a prominent political representative of such communities has argued that children are the property of their parents. And we all know how libertarians feel about people being told what to do with their own property…”

            Would you care to elaborate on a better legal/social model for the parent/child relationship? I’m pretty sure that, excepting the common definition of child abuse that you appear to disapprove of, parents have discretion over how they raise their children. We seem to grant that parents are dictators, and hope they are benevolent ones. If you disagree with this policy, maybe explain why or outline a better one?

          • Nita says:

            @ FacelessCraven

            …That… sounds pretty close to the standard definition of child abuse? Are you sure your definition isn’t the unorthodox one?

            So, if someone beats their kid every day, regularly leaving bruises and cuts, you don’t consider that child abuse?

            Would you care to elaborate on a better legal/social model for the parent/child relationship?

            The common view is that children are people who have their own rights, and parents or other guardians have a duty to act in the child’s best interests. All principal-agent problems are thorny, and “let’s just have the agent own the principal” is usually not considered an ethical solution.

          • FacelessCraven says:

            @Nita – “So, if someone beats their kid every day, regularly leaving bruises and cuts, you don’t consider that child abuse?”

            I suppose that would depend on the bruises, cuts, and how much of an exaggeration “every day” is. My concern is that you are conflating corporal punishment with child abuse. I am pretty sure that communities that advocate a social norm of beating their children to the point of serious injury daily are very small and very rare. You seem to be implying otherwise.

            “The common view is that children are people who have their own rights, and parents or other guardians have a duty to act in the child’s best interests. All principal-agent problems are thorny, and “let’s just have the agent own the principal” is usually not considered an ethical solution.”

            …By you, you mean. Parents have the right to determine “best interests” for the child within extremely broad bounds, and children have no grounds for appeal. The state only steps in when those broad bounds are crossed. From a legal framework standpoint, it’s not actually that different from pet ownership, though the responsabilities, standards, and punishments are obviously orders of magnitude higher. I mean, I entirely agree that parents have the responsability and legal obligation to act in their child’s best interest, and they’re fools if they act like tyrants. But that relationship seems to work out a hell of a lot more like “ownership” than you seem to prefer. If they decide to act like tyrants, neither you nor I can stop them.

          • keranih says:

            @ FacelessCraven

            Parents have the right to determine “best interests” for the child within extremely broad bounds, and children have no grounds for appeal.

            So long as you’re limiting your appeal to the state, then no. But most traditional societies are not built around the state, nor the nuclear family, and in my youth, the standard authority to which children appealed was the grandparents. Likewise, a broader family group was responsible for other behavioral pressures and support mechanisms that we have now transferred to the state.

          • Nita says:

            @ FacelessCraven

            communities that advocate a social norm of beating their children to the point of serious injury daily

            Sure, they don’t say “beat your children daily to the point of serious injury”. They say “spank your children with [implement of choice] whenever they fail to obey you instantly and cheerfully until their rebellious spirit is crushed”. And some kids’ bodies manage take a lot of damage before their spirit is crushed to their parents’ satisfaction.

            I entirely agree that parents have the responsability and legal obligation to act in their child’s best interest, and they’re fools if they act like tyrants. But that relationship seems to work out a hell of a lot more like “ownership” than you seem to prefer. If they decide to act like tyrants, neither you nor I can stop them.

            This is a very odd argument. The current framework fails to guarantee justice for all, so let’s redefine justice?

          • FacelessCraven says:

            @Nita – “Sure, they don’t say “beat your children daily to the point of serious injury”. They say “spank your children with [implement of choice] whenever they fail to obey you instantly and cheerfully until their rebellious spirit is crushed”.

            I’m pretty sure I’ve seen excerpts from the book you’re quoting. I’m also pretty sure it is followed by a vanishing fringe of the general conservative/traditionalist population. On the other hand, I knew as a child that adopting a “rebelious spirit” toward my parents’ authority would get me spanked if I pushed it. And in point of fact, those spankings did a damn good job of “crushing my rebelious spirit”. It established a hard limit to how far I could push my parents, and I find the overall effect on me was a highly positive one. I knew families growing up that allowed far less disobediance than mine did. The ones I can remember were unusually stable, polite, and diligent, without any apparent harmful effects to their intelligence or personality. They were, in a word, *disciplined*. In many senses of the word, I suspect.

            You may disagree whether raising children that way is a good thing, but the law and social norms both allow it, and if you want to change that you’re going to need to prove harm, not merely imply it.

            “And some kids’ bodies manage take a lot of damage before their spirit is crushed to their parents’ satisfaction.”

            Then their parents go to jail for child abuse. Meanwhile, I appear to have suffered no lasting harm from having a wooden cooking spoon broken on my butt.

            “This is a very odd argument. The current framework fails to guarantee justice for all, so let’s redefine justice?”

            Say rather, the fact that the current system isn’t perfect in no way proves that a radically new system would be better. I see a great deal of evidence that parents do a better job securing the happiness and well-being of their children than the state does. You came into this by suggesting that traditional communities have “rather unorthodox” views on child abuse, and have consistently offered the least charitable interpretation of their views possible. In fact it appears to be your views that are unorthodox, and the law and society are on the side of the traditionalists. You could probably make an argument against that state of affairs, but at the moment you’re mostly sneering, and I don’t think that’s useful.

          • Douglas Knight says:

            No, Craven, implication is much more effective than proof for changing laws and norms. Indeed, take the example at hand: the laws and norms about corporal punishment have changed in many places.

          • ” I think libertarianism is an excellent philosophy for sterile immortals.”

            I’m not certain, but I think that was originally my line. While a world of sterile immortals provides fewer problems for libertarian moral philosophy than the world we live in, it doesn’t follow that some alternative philosophy works better for our world.

            “Though actually I think the big problem is that you would need strong social pressure to compel parents to be good parents”

            You don’t think it is in the rational self interest of people to be good parents? The scariest outcome of being a parent I can think of that is at all likely is ending up with children who didn’t like me. Ending up with children who were not the sort of people I like and admire would also be somewhat grim. Being a good parent, as best I can tell, makes both outcomes considerably less likely.

            And, of course, social pressure is not inconsistent with a libertarian society.

        • nydwracu says:

          It’s also a famous complaint that libertarianism struggles to deal with tragedy-of-the-commons problems — but what’s often not noticed there is that problems of that nature (everyone is incentivized to do X, but everyone would be better off if no one did X / the incentive to do X could be removed) exist outside the realm of classic tragedies of the commons.

          For example: everyone has to watch TV in order to have something to talk to other people about, because everyone else watches TV, but watching TV involves making significant time sacrifices for an unproductive activity, and you have to watch these shows even if you don’t like them. And everyone has to be on Facebook because everyone else has a Facebook, so if you don’t have a Facebook, people will forget to invite you to events (because event invitations are carried out through Facebook) — but no one likes Facebook.

          It used to be possible to solve these problems by making the thing everyone has to do uncool — this helped along the demise of dueling, and worked on TV and smoking for a time — but these days, that requires going up against massive institutions designed for large-scale coolness judgment manipulation, by which I mean marketing agencies. At least on the East Coast, TV and smoking are cool again.

          Also: college.

          So what do you do with that?

          • onyomi says:

            I think the people who claim not to like Facebook yet continue to use it regularly are mostly lying, even if they themselves don’t know it. And this lends support, I think, to Caplan’s claim that many (though I think, obviously not all) people who say they want one thing and yet do another are actually social signalling, if sometimes even they themselves aren’t aware of it.

            Imagine how socially unacceptable it sounds to actually say out loud “you know, I know drinking is bad for me and is hurting my career and family life, but honestly, I don’t think it’s hurting my career and family life enough for me to stop, because seriously, I *really* like drinking.” And I think in many cases it’s not that people are consciously refraining from saying that; rather, they have been socialized well enough that the thought of putting it so bluntly never crosses their minds.

          • Nornagest says:

            I like Facebook for event planning and reminding me of people’s birthdays. I dislike almost everything else about it. And I don’t think this is rationalization; left to my own devices, I’d never use the damn thing. I do force myself to post something to it every couple of days, though, because that’s something like a social obligation nowadays.

            The most joy I get out of using it day-to-day comes from the “plonk” sound that clickbait domains make as they hit the bottom of my killfile.

        • Jon H says:

          “Remember, it’s not dependency libertarians object to, it’s coercion. Sure, you may need to coerce your child by grabbing him before he steps in front of a bus, but you’d do that to an adult friend as well.”

          The coercion is of the parent, for the benefit of the child.

  9. Shmi Nux says:

    Is there a medication, with manageable side effects, that cures a certain unhealthy preference for puns and swifties?

  10. creative username #1138 says:

    So comically misspelling someone’s name is Scott’s version of telling that person to die in a fire.

    • Anon says:

      Be reasonable here, his name is Szasz. How can you NOT find that funny?

    • RCF says:

      I wouldn’t classify it as “comical”. Comedy involves provoking a response of amusement, rather than confusion.

      • Vox Imperatoris says:

        Typical mind fallacy?

        In other people who read this thread (including myself), it provoked a response of amusement. It is likely that these people already knew who Szasz is, knew he had a difficult-to-spell name, and found it amusing for the same reason that they find absurdity in humor amusing.

        • keranih says:

          I had no idea who Szasz was. To me, an outsider, it was (a little bit) funny the first time.

          (Perhaps it is the custom ‘mongst psychologist types to mock each other’s names (and the names of their mentors) as a group bonding exercise. Perhaps when our gentle host goes to a psych conference, he is greeted by his peers with cries of “Oy, Scott the Great! Where’s your black pony, Great, you leave him at home?” And if Scott was not greeted thus, he would feel sad and left out. And so perhaps if Szasz reads a published paper where they cite his work, and don’t misspell his name at least once, Szasz goes home and weeps a little.

          Or perhaps Scott’s mocking someone he disagrees with because he can, and is indulging in a (rare) bit of childish nastiness.

        • Vox Imperatoris says:

          If you want me to engage full art-critic mode, another reason why it is funny is that Scott, in making this silly joke, provides us with a subtle window into the writing process.

          In general, blog posts are presented to us as something that just appears, fully formed, for our consumption. But when we see Scott comically misspell Szasz’s name over and over, we are reminded of the fact that each word had to be consciously selected and spelled. We think, for a moment, “I, too, would have trouble spelling this name” and feel a little more kinship with the author as a human being.

          Moreover, it subverts our social expectations: normally, accidentally misspelling the name of the person you are criticizing is a grave embarrassment. It is a signal that you have not done much research and have no idea what you are talking about. But by misspelling it so badly that it is obviously intentional, we get to laugh at the social script being flipped around. (This sort of thing is the whole essence of Seinfeld and similar comedy.)

          Putting those together, we imagine ourselves in the author’s shoes, having to spell a difficult name correctly. We imagine the embarrassment we would feel if we spelled the name wrong. But then the intentional misspelling “flips the script” and removes the tension.

          I am being intentionally silly myself in applying this much analysis to a throwaway joke, but these elements are real and are there.

      • Anonymous says:

        I agree with you that the material is weak, but I wasn’t confused – only upset, at the blatant racism of mocking a slavic name.

        • Anonymous says:

          It’s not Slavic, it’s Hungarian. Stop misethnying the poor man, you abominable ungrophobe!

        • Earthly Knight says:

          Scott and Szasz are both Askhenazi, so by the standard rules he’s entitled to make jokes about his kinsman’s name all he likes without being called a racist.

        • anodognosic says:

          ughhh can we not elevate making fun of sound and spelling in foreign languages to racism please?

          Like, sometimes we think something unfamiliar is funny, and that doesn’t always carry the weight of structural oppression, you know?

          • RCF says:

            I don’t think that it’s unreasonable to think that constantly being made to feel that one’s name marks one as an outsider might have significant psychological effects.

          • anodognosic says:

            I mean, sometimes? But maybe sometimes getting ribbed also marks one as an insider? And maybe sometimes it’s just a matter of setting a tone where people can give as much as they get? And maybe when the setting has a more jocular tone, people don’t have to be so careful about pussyfooting around each others’ feelings? And maybe there’s some value in that too?

            Just maybe?

          • 27chaos says:

            +100

          • HlynkaCG says:

            In the old country my family was very poor, they could only afford 4 consonants and 2 vowels.

        • Cauê says:

          This is “blatant racism” now, what have we come to.

          Do you think that finding the name funny is mediated by knowledge that it’s a slavic name, and the humor comes from that? I liked the joke, and though I knew of Szasz I had no idea where he was from.

          I have a funny middle name, but the only people who find it funny are those who understand my native language. Blatant self-racism.

        • anonymous says:

          upset, at the blatant racism of mocking a slavic name.

          As other replies imply (but don’t state explicitly, so I will), this mistake outs you as being motivated by something other than having taken authentic offense as a Hungarian (or, for that matter, Slav) yourself, which you obviously aren’t.

          Additionally, someone who aspires to political correctness really ought to know that race is not the same as language (is not the same as religion, etc.).

    • David Simon says:

      Yeah, I found this off-putting too.

      Scott, making fun of peoples’ names is the textbook example of needless bullying. Please don’t do it, especially when it detracts from an otherwise good and important point you’re trying to make.

    • The original Mr. X says:

      Nah he’s just bein Szaszy.

    • NZ says:

      I think Scott was channeling Steve Sailer there, specifically the way Sailer plays on all the various spellings of Qaddafi.

      As someone with a weird name, I don’t really mind. I think it’s funny and adds a bit of humor and lightness to an otherwise gloomy topic.

      • Randy M says:

        Arabic names and words are transliterated into English, and the different spellings can often be phonetically accurate (or equally close). I think what Sailer implies with that schtick is that journalists and/or interest groups change the approved spelling periodically in order to embarrass those not up with the latest trends and imply some malice in supposedly intentional misspelling of Koran or Qu’ran or whatever, or at least demonstrate heightened cultural sensitivity by using a novel spelling with apostrophies and such.

        • NZ says:

          Yes, I think that’s exactly right. But the end result is still funny independently of that understanding, and that’s the style of humor that I think Scott was channeling.

    • Siah Sargus says:

      Personally, I don’t think it was an insult. I read it as less serious and more szaszy.

    • John Sidles says:

      Filtering “comedy” to remove “cruelty” (including non-empathic cruelty) leaves mighty little behind.

      E.g., a book The Enlightened Comedy of Fred Rogers would be mighty short.

      He [Rogers] was a vegetarian on ethical grounds, stating “I don’t want to eat anything that has a mother.”

      As for the Friends, they (seemingly) have only one joke:

      Q  What do you get when you cross a Jehovah’s Witness with a Friend?

      A  Someone who rings your doorbell, then stands there without saying anything.

      Fortunately, it’s a funny one.

      Conclusion  Eliminating all cruelty would eliminate most humor … but the remnant would be precious.

  11. Sylocat says:

    Gotta love how he invokes that classic specter of electroshock therapy being administered to unwilling and frightened patients until they pretend to be normal.

    I’m surprised he didn’t namedrop Nurse Ratched while he was at it.

    • Marc Whipple says:

      Ever heard the story of Freeman doing two simultaneous transorbital lobotomies – one with either hand? Eat your heart out, Michael Carbonaro! I think there’s even a film of it somewhere.

      Electroshock and arbitrary commitment and more or less random lobotomizing were common in the memory of those now living. I understand you’d like to move on, but it simply hasn’t been long enough for that spectre to have dissipated. It doesn’t need to be “invoked:” it’s still hanging over things. The mental health profession has made great strides, but it has earned neither forgiveness nor forgetfulness as of yet.

      • Gbdub says:

        Except that ECT in particular and mental hospitals in general still exist, and are still effective / necessary for a lot of people, and bear very little resemblance to the old stereotypes. Perpetuating the no longer accurate Hollywood version of mental health care stigmatizes those who seek it and scares off many that should, and thus does real harm.

        • Marc Whipple says:

          That’s true.

          That does not affect my argument, which is that being oversensitive to “invoking spectres” regarding mental health, when those spectres are hanging over it all the time anyway, is a waste of mental resources. 🙂

      • Jon H says:

        Seems a bit like someone in 1950 ranting about surgical medicine based on experiences from 1900, ignoring advances in anesthesia, antibiotics, etc.

  12. NL says:

    Isn’t this sort of social model vs medical model?

  13. nydwracu says:

    It still seems like it would be possible to dispense with the category of ‘psychiatric illness’ as A Real Thing, and call it a ~socially constructed~ demarcation of [mostly the more severe] parts of the category “preference conflicts”, though that could be clarified by taking note of metapreferences, metametapreferences, etc.

    Say I’m thirsty and I want a glass of water [preference A], but I don’t want to get up and get one [preference B]. That’s a preference conflict. I don’t want to not want a glass of water [absence of countervailing metapreference against A], because I know I need water to survive and thirst tends to be a good sign that I should drink water, but I do want not to not want to get up and get a glass of water [countervailing metapreference against B], because being thirsty is annoying. I want A and I want B, I want to want A, and I want to not want B. Or, call metapreferences mA or ~mA: I want A, B, mA, and ~mB. (And mmA, m~mB, mmmA, mm~mB, and so on: I want a glass of water when I’m thirsty, I want to want a glass of water when I’m thirsty, I want to want to want a glass of water when I’m thirsty, etc.; I don’t want to get up, I don’t want to not want to get up, I want to not want to not want to get up, etc.) Of course, wanting comes in degrees — if I want a glass of water more than I want not to get up, I’ll get a glass of water, and if not, I won’t — and if I wait long enough, my desire for a glass of water will increase more quickly than my desire not to get up, but I also want to minimize the time I’m thirsty but too lazy to get up, so I want to decrease preference B to the point where A > B, as soon as I can. (I’m not sure whether “I want to minimize the time I’m thirsty” counts as a preference or a metapreference or what, or even if it matters.)

    Similarly, let’s say I feel like shit and I don’t want to talk to anyone. We don’t need to posit any conflicting preference here — I still have a metapreference not to feel like shit, because it’s unpleasant by definition, because it erodes social ties if it carries on for too long, and so on. So I have A without a conflicting B, but I have ~mA.

    This makes psychiatry into a set of tools for shaping preferences so as to resolve conflicts in accordance with metapreferences.

    • Anon says:

      How are hallucinations and having a train of thought dictated by the sound of words preferences? Surely these psychiatric diseases can’t be described as “Personality conflicts”.

      • nydwracu says:

        Point.

        Come to think of it, that’s also applicable to things like depression: on the one hand, you have preferences that contradict with metapreferences, but on the other hand, you have cognitive distortions — “I’m objectively worthless and everyone hates me” and so on — and, while you can reduce that to preferences (“I would prefer to have an active social life, therefore I would prefer not to believe that everyone hates me”), you still have the element of distortion.

        Then again, consider conflicts between epistemic and instrumental rationality: if you have an atheist who’s constantly haunted by thoughts of eternal nonexistence after death, he’d be better off if he converted to a religion that includes an afterlife and seriously believed it, even if that religion isn’t true. Or consider a hypothetical brilliant and well-respected composer who writes music by transcribing his musical hallucinations — he’s perceiving things that don’t exist, but he’s better off (let’s say these musical hallucinations have no downsides) with them than without them, because without them, his successful career would be over, and his preference for having a successful career (let’s say he’s not terribly talented at anything else and his other option is a boring cubicle job) and being respected and productive would be unfulfilled.

        • FacelessCraven says:

          @Nydwracu – “. Or consider a hypothetical brilliant and well-respected composer who writes music by transcribing his musical hallucinations”

          Generally speaking, Tulpas seem like a good concrete example of this as well.

          • Anon says:

            I would *love* to see some sort of scientific study on Tulpas (maybe with MRIs? Would we expect to see anything interesting there?)

            It’s pretty much the most fringe thing I’m interested in, but the community is both small and… eccentric? enough I have no idea whether there’s any substance in the concept.

          • FacelessCraven says:

            My Ex had several. It was by far the most mindbending thing I’ve ever experienced. Very very strange, but also apparently fairly useful and didn’t seem to cause them much harm. They had fairly serious mental health issues as well, but the tulpas seemed like an upside.

  14. jjbees says:

    Homosexuality has been depathologized and racism is being pathologized.

    People used to believe that racism was a positive and pro-social outlook/behavior, and now racism is viewed similar to how homosexuality used to be viewed.

    Psychology has lots of areas that are completely arbitrary, and many that aren’t. Schizophrenia, where you can actually see the damage to the brain and enlarged ventricles on CT, isn’t arbitrary. Other things like homosexuality or racism are much more arbitrary. Psychiatrists are extremely politically leftist as a whole, and this seeps into their everyday work.

    If I see a psychiatrist and tell him about my overtly racist thoughts/behaviors, am I more or less likely to be committed with some kind of diagnosis of psychosis? The obvious answer is more likely, because I’m pissing off the psychiatrist with views that are against his politics, exactly the same way homosexuality used to piss off psychiatrists.

    I am deeply sympathetic for people who are mentally ill, and I understand they need people to treat them. I have family who’ve felt that their psychiatrist saved their life. But I am also deeply worried for all the McMurphy’s out there, just waiting to fall on a psychiatrist’s bad side.

    • RCF says:

      “Schizophrenia, where you can actually see the damage to the brain and enlarged ventricles on CT, isn’t arbitrary.”

      It seems to me that by referring to nontypical brain architecture as “damage”, you’re begging the question.

      • Fibs says:

        Maye, but that seems a bit like a strange argument as well – what else are you going to call it? Provably it’s a damaged structure causing an actual impairment in some respect.

        If you puncture your kidney and require dialysis, am I being mean if I suggest you get it and suppressing your non-typical inner organ set up? Well, maybe? It’s just that refering to it as “damaged kidney” is sort of a medical neccessity in conveying the fact that you have severely impaired function, and we can attempt to mitigate that.

        Some things do actually cause damaging changes in the biological make up of a person, and Schizophrenia just happens to be one of those things. I’m all for precision in language and avoiding implications, sure, yet I think I think perhaps if demonstrably different architecture leads to impaired functioning on several metrics it’s quite right to refer to the change as “damaging”. Else we’re going to end up having to use very, very strange sentence constructs to communicate our ideas.

        (The removal of several supporting pillars radically changed the airflow of the building)

        • RCF says:

          “If you puncture your kidney and require dialysis, am I being mean if I suggest you get it and suppressing your non-typical inner organ set up?”

          I didn’t say you’re being mean, I’m saying you’re begging the question. You’re saying that it’s a damaged structure because it causes an actual impairment, and you’re saying that it’s an actual impairment because it can be traced back to a damaged structure.

          • Vox Imperatoris says:

            Exactly.

            We call it a “damaged” structure because it produces impairment.

            If it produced superior functioning, we would call it an improved structure.

        • DavidS says:

          It is difficult, though. I recently realised that in a conversation with someone with a child with Downs syndrome I’d asked about how in some regard her child differed from a ‘normal’ child. Only after the conversation ended did I realise I might just have been a massive dick.

          But on the case in point, you can relatively easily identify that some condition has a radical, noticeable effect on what the brain looks like. You can also notice a condition is socially immensely (self) destructive. But you can’t rely on the two being the same. Observing that a condition is related to a big brain difference at some level just shows that it must be ‘real’. Calling it damage is basically a judgement call. I don’t know if you can reliably guess by a scan of someone’s brain if they’re gay – but if so, I’d take that as evidence that being gay was strongly inbuilt, genetic or otherwise, rather than describing it as ‘damage’ because it was unusual.

          • Marc Whipple says:

            Tip: Replacing the word “normal” with the word “typical” is often very helpful in such conversations.

            I personally don’t get that worked up when someone uses the word “normal” to describe what my severely autistic daughter is not. However, I refer to what she is not as “typical.” For her, what she is is normal. However, what she is is not typical.

          • HlynkaCG says:

            That strikes me as dancing the euphemism tango, in 5 years “typical” will be the new “normal” and we’ll need a new adjective.

          • Marc Whipple says:

            Granted.

            I didn’t make the world: I only try to live in it. As I said, it doesn’t bother me.

    • SpaghettiLee says:

      Can you provide examples of people being involuntary committed for racist thoughts or behaviors?

    • PSJ says:

      I’ve never heard of someone in psychology or psychiatry even motion towards classifying racism as a mental disorder. Do you have a source for this claim? Maybe non-expert people who dislike racism, but I can’t imagine the field in any significant way ending up with that doctrine on a reasonable time horizon (20-30 years–past that the world is too unpredictable).

      Edit: ninja’dish

    • Anonymous says:

      I think you’re overstating the progress on issue of racism. It’s not a mental illness, even though some would like it to be considered such. If racism were considered an illness, you could not regard racists as evil.

    • tailcalled says:

      Arguably, if you decide to start talking about racist politics with your psychiatrist, you are showing lack of social awareness, which is probably an indicator of mental illness.

      • Brian says:

        Or you take a psychologist’s duty of confidentiality seriously in the same way that my client (I’m a lawyer) might freely tell me he was smoking marijuana.

        • DavidS says:

          Confidentiality is different to judgement, though. The client isn’t interested in your professional opinion of if they’re a good guy, they’re interested in your legal defence. Your defence of them isn’t relevant to them smoking pot (unless it is, in which case you can’t represent them if they confess to you, at least in the UK)

          Whereas if you were a psychiatrist, what someone chooses to talk to you about is in itself a certain level of evidence about their issues.

    • chaosmage says:

      I believe it’d be much easier to find a psychiatrist who thinks of sincere religious belief as subclinical psychosis, than it’d be to find one who thinks the same of sincere racism. And strong religious beliefs are kind of a textbook example for what is not reason enough to be involuntarily committed.

      So unless you describe other distress (like a phobia towards members of other races) or clear delusions (certainty of a coming race war), describing racist beliefs shouldn’t affect you probability of being committed at all – not even in practice.

    • Saint_Fiasco says:

      >If I see a psychiatrist and tell him about my overtly racist thoughts/behaviors, am I more or less likely to be committed with some kind of diagnosis of psychosis? The obvious answer is more likely, because I’m pissing off the psychiatrist with views that are against his politics.

      I disagree. If you tell your psychiatrist that you are afraid that black people will hurt you and always try to stay away from them, you are less likely to be diagnosed with something than if you tell them you are afraid red-haired people will hurt you and always try to stay away from them.

      Being afraid of red-haired people is just weird, while being racist is seen as evil, and you are more likely to be labeled as sick if you have weird beliefs than if you have evil ones.

      • anodognosic says:

        Meh. There are pretty explicit exceptions re: delusions for weird but commonly held beliefs. There’s no need to bring ideological persecution into this.

        • DavidS says:

          Agreed. E.g. believing weird miracles etc. from a mainstream religion is (correctly IMO) seen as basically normal, whereas believing them in a private religion you just made up? Less so.

        • Saint_Fiasco says:

          I think it’s a horse-zebra thing.

          Religious people and racist people are more common than crazy people, so if you have weird beliefs about race or god, a reasonable person will think you are racist or religious before considering the more uncommon possibilities like being crazy.

      • Jon H says:

        I think as long as your weird beliefs (or racism, for that matter) don’t cause problems in your life, it won’t be treated as an illness.

        If your belief in UFOs causes you to never leave the house out of fear of capture, perhaps that would be diagnosed as agoraphobia that simply manifests as fear of aliens. Treatment might cure the fear but without removing the belief in UFOs.

    • baconbacon says:

      To be fair McMurphy was asking for it.

    • PGD says:

      Schizophrenia is not really an organic brain disorder, at least it is not best understood as such today. Things might well change in the future, but as of now it appears that schizophrenia is just another big loose list of symptoms that psychiatry treats with drugs but has not determined a clear set of organic causes for.

      See here for more:

      http://brainblogger.com/2012/06/23/is-schizophrenia-really-a-brain-disease/

    • James Vonder Haar says:

      If we’re thoroughgoing materialists, aren’t all brain differences down to chemistry or morphology? Something physical, anyway. If we can’t peer into a racists’ brain and see the differences (or “deformities,” depending on what normative stance you want to take), that says something about the state of our medical knowledge, not the etiology of the difference/disease.

      (Unnecessary disclaimer: Am not actually endorsing treating racism as a mental illness).

      • I think there’s a fairly clear distinction, unaffected by materialism, between things like racism and religion and things like schizophrenia. Roughly speaking, racism and religion are both caused by limitations in the design of the human brain, whereas schizophrenia is a malfunction found in some specific human brains.

        By way of analogy, if I can’t drive to work because my car has a radiator leak, that’s a malfunction, and I need to get a mechanic to fix or replace the radiator. If I can’t drive to work because I live on an island, that’s a design limitation, and taking the car to a mechanic is not going to help.

        … the mechanic will, of course, be able to explain exactly why I can’t drive the car across the ocean, just as a psychiatrist might in principle be able to explain exactly why a particular person is racist, and in both cases the causes can be described (again in principle) in terms of “something physical”.

        The psychiatrist might even be able to solve the problem, just as, well … perhaps a sufficiently ingenious mechanic could take a normal car and make it seaworthy, I dunno, whatever. The point is that repairing a malfunction and working around a design limitation are two different things, and you really need to know which you’re dealing with in order to do a good job.

  15. An Austrian view:

    Economics presumes that the agent it is dealing with agents; that is its base level of abstraction, and it does not presume to speak of anything below that level. In fact, economics as such deals only with the action of those whose agency suffices for them to be treated as agents in the first place.

    The construction of agency, its constituents, and the maladies that affect does not fall within the domain of economics proper. That is the job of psychology, psychiatry, and perhaps the physiological sciences to the extent that they shed light on these processes.

    The logical hierarchy is as follows: psychology/psychiatry/physiology explain the construction of human agency. Economics takes as one of its axioms that it deals with the actions of those who agents; the actions of animals, natural phenomenon, or those whose agency is suspect or non-existent is not within its purview. This restriction is built into the foundations of the discipline, and restricts its scope. The logical and analytical methods of the discipline assume this to be the case. The entire edifice of economic thought is built upon this premise, and cannot be applied where this premise does not hold unless the implications of the lack of the premise are worked out in detail.

    This makes clear Caplan’s error: he treats economic categories as if they had no precursors, and applied universally; he behaves as if economics were an axiom-independent system. He applies the result of a discipline built on a premise (that of unified/integrated agency) to what is logically prior to – and in this case, at odds with – the premise itself.

    • PGD says:

      Great post. One thing I would add here though is that there are a lot of problems in terms of actually understanding economic behavior that come from totally abstracting away from how rational agents form preferences. If economics is supposed to be based at its core on an understanding of incentives, obviously the internal mechanics of preference formation and agency are going to come into play. Economists abstract away from this, but too many economists (like Caplan) mistake abstracting away for ‘having a really simple theory of it that is actually true’.

    • Basically what you are saying that if I have an internal dilemma because part of me wants to eat a cake and part of me wants to rather lose weight, it is for the praxeologist uninteresting. Only after the decision is made, and some actual exchange is taking place, does it become interesting.

      This is actually an acceptable approach as long as everbody understands and accepts that economics is a clearly defined, narrowed, limited discipline is, basically only catallactics (study of exchanges). The same way I don’t expect an eye surgeon to be able to do something with my knee pain, one should not expect economics to be the all to social sciences.

      However. Houston, we have a problem. This also means economics should have only a very, very limited influence on politics. The problem is that, Hayek, Mises and most importantly Rorthbard took their econ into generating a very firm, very… how to put it? very unyielding and inflexible kind of political theory.

      I mean, for example, if economics is strictly about exchanges, one thing you surely noticed that people who have any sort of problem with capitalism (and not just from the left but also from the right) they don’t have a problem with exchanges: they have a problem with the property structure that the exchanges are based on. Given that the real world is not homesteading based, especially for Europeans where every piece land was fought over for thousands of years, it seems that economics in this very narrow sense can say about nothing about the structure of property, of who should own what and how much. It can only talk about exchanges happening based upon pre-existing property conditions. And that merely sidesteps most reasons why people on the left or right want to regulate exchanges: usually, they don’t find the exchange inherently wrong but they have a problem with the underlying property structure. On the left, it is usually when they find it too inequal, on the right, it is usually when they find e.g. it is owned by foreign, lest trustable nationals.

      A while ago I was walking in Mises’s Vienna. In the Grinzing area, where the wineyards are. There was a sign proudly stating that the owner of this wineyard was given permission to serve his own wine to customers hundreds of years ago by the Emperor. I was wondering why does one need permission for that. His wine. His customers. A while later I saw another sign saying the Ottoman army besieging Vienna was camping around here. And then I understood. His wineyard? Was never really his. It always belonged to the strongest army who came around. And this it is entirely normal that they could also make rules about who to sell wine to.

      • sourcreamus says:

        The Coase theory has refuted this criticism. It does not matter who has resources initially, in the absence of transactions costs, resources will go to there highest value purpose.

        • PGD says:

          Coase says nothing about the distribution that will result from this, which is where most of the moral/ethical problem is. Also, the informational and incentive requirements for Coase to actually happen are rarely satisfied — another reason why economics cannot simply ignore how incentives work in the real world.

          • sourcreamus says:

            The lesson of Coase is that the distribution does not matter, whoever has the most efficient use of the resource will end up with it. Efficient use of resources is what makes a society rich and that is more morally important than who is rich within the society.
            If resources are not being used for the optimal use then the Coase theorem states that the reason is transaction costs which need to be identified. That is the point of the Coase theorem, not to describe a mythical world where there are no transaction cost, but to explain the real world where resources do not go to the most efficient use.

          • Nathan says:

            I think you’re slightly misinterpreting Coase. He argues that in the absence of transaction costs the efficient outcome will occur but the distribution of the resulting resources can be quite different depending on who is endowed what.

            Eg a cattle farmer whose stock stray onto his neighbours property, but the damage they do is less than the cost of stopping them. If the cattle owner does not have the right to let them stray, he will prefer to compensate his neighbour rather than stop the cattle. Or if he does, his neighbour will prefer to endure the damage rather than pay the cattle owner to not let it happen.

            Either way the cattle will stray, but the endowment still affects how well off each party is.

          • I think both of you are misreading Coase, as I did before rereading his books in the process of writing an article on the final one.

            As best I can tell, Coase viewed both “The Nature of the Firm” and “The Problem of Social Cost” as reductio ad absurdums of the standard economic model, which implicitly takes transaction costs to be zero. He said that references to a “Coaseian world” were backwards–the world of zero transaction cost was what he was trying to get economics out of.

        • No, Coase explicitly proved that it only leads to an efficient outcome, not a _just_ one.

          For example in the example of steam train engines burning down crops the farmer having to pay the railroad company not to do it is an efficient but unjust outcome.

          That sort of outcomes tend to make the Left pick up pitchforks, and if the farmer is domestic and the railroad is owned by foreigners it tends to make the Right pick up pitchforks too. (Right in the Euro sense, nationalists.)

          The fact that in your moral scale that does not matter is kind of irrelevant, it is the kind of morality that emotionally matters to a lot of people. And that is how morality actually matters at all. I personally can’t give half a shit about ethical philosophy, but in my calculations the emotions that move people are absolutely a crucial element in predicting political outcomes.

          Basically, when people feel something is unjust, it leads to disorder. I want order. Hence I need to pay attention when some folks feel something is unjust, and decide what is more efficient: kick the disorderly in the butt, or kick whoever caused the felt injustice in the butt. (As I am from a small country, I tend to go the nationalist way. If the railroad is foreign own, they get the butt kick. If domestic, split the difference.)

          Furthermore, whether a society is rich or not has surprisingly little do with emotional happiness. See Bhutan. Not violating social rules has a lot more to do with it…

          I would even go out on a limb and claim what Roman poets claimed: too much riches leads to decadence…

          • sourcreamus says:

            Bhutan is a great example. One ethnic group of the country was getting rich through business and rather than celebrating that the country was getting rich and copying them, the majority thought it was wrong that they were not prospering and started an ethnic cleansing campaign. This predictably impoverished the nation and so the dictator started pushing the Gross National Happiness BS to try to obscure the fact that because they were too concerned with how the wealth was distributed instead of how more could be created they made everyone worse off.

        • Jon Gunnarsson says:

          In the real world, transaction costs are never absent. In some cases they may be low enough that we can safely ignore them, but in the far greater number of cases transaction costs play an important role.

      • baconbacon says:

        You dramatically undercut the strength of the Austrian (and really just classical economic tradition) position by ignoring half of their philosophy. They did not simply start and stop with the assumptions that the current distribution of resources is moral, but they note (well more than note) that any political structure will be limited by these same factors. Would it have been a more moral outcome for the US government to grant reparations to freed slaves shortly after the civil war (preferably directly from their former owners)? Probably to almost certainly, but politically? In a country where many of the anti slavery faction were openly and proudly racist it is a practical impossibility. By the time that the country as a political union was ready to get past enough of that racism it was a century later -and during that century the market had chipped away at the inequality of pay between black and white men, a process that appears to have stopped right around the time of the great society. The minority only gained a political voice after decades of earning a political voice.

        There is no way to minimize economics the way you attempt to without minimizing politics. It is extremely difficult to propose a situation in which at individual levels citizens are willing to oppress group X but which when under their representative government they will suddenly become protected.

        • To expand on that point a little, it requires a much stronger consensus against a group to seriously oppress them privately than through government. If sixty percent of employers or renters are unwilling to deal with members of a minority group such as blacks or Jews, that’s only a minor annoyance for members of that group, since it still leaves forty percent of jobs or apartments available to a group of much less than forty percent of the population. But sixty percent might be enough to get the government to enact and enforce laws against the minority that make it harder for anyone to employ them or rent to them.

          • HlynkaCG says:

            Exactly.

          • I’m not sure that’s necessarily true in practice, because employers and landlords are not necessarily typical of society as a whole. It’s easy to imagine a society in which 90%+ of employers and landlords but far less than 50% of voters are prejudiced against a particular minority – even more so if you’re talking about prejudice against a majority. (Whether you can actually find a real-world example is another matter, of course.)

            Also, it seems common for particular regions to be far more prejudiced than the nation as a whole is. (That’s perhaps the more common scenario in the US, historically speaking?)

            Obviously, there are other factors – for example, plenty of people seem willing to argue that prejudice is entirely justifiable in private affairs, such as choosing a tenant or an employee, but not in public matters. Even more seem willing to behave in such a manner without admitting to it. That seems closer to the historical scenario in New Zealand – little open prejudice, but plenty of the more surreptitious kind.

          • nyccine says:

            …If sixty percent of employers or renters are unwilling to deal with members of a minority group such as blacks or Jews, that’s only a minor annoyance for members of that group…

            Did 60% of all Americans demand Brendan Eich be forced out of Mozilla? What you’re describing is practically the exact opposite of how it works today; increasing social atomization plus the extended reach provided by social media make it insanely easy for tiny groups of people to engage in witch-hunts. In the past, the target had to be someone universally reviled because otherwise you were at risk; if they had status and trust in the community, they could always turn the mob back on you.

            These days, the mob can be unleashed at virtually no risk to the person setting them off, the target won’t know the person stirring up the trouble, and cannot expect that the community’s opinion of him will be enough to protect him because there isn’t actually a community worth the name.

      • Jon Gunnarsson says:

        In Mises’s view, catallactics is the most important branch of economics, but definitely not the only one. After all, it takes him hundreds of pages until he actually starts to talk about market exchange in Human Action. For example, economics is a useful tool in analysing whether the distribution of property in society is sensible. It cannot make this ultimate determination on its own, since economics in Mises’s view is a value-free science, but it can help in a similar way to how mathematics can help you determine whether your accountant is cheating you.

        Austrian economists are generally quite good at clarifying the difference between value-free economic analysis and ideological statements and positions, which might be based on economic analysis, but are not part of economics itself.

  16. Bugmaster says:

    Look, I get that you hate this Thomas Szasz guy, but making fun of the man’s name is still pretty juvenile.

    • PSJ says:

      Did you read the post right before this one (besides open thread)? I don’t think juvenile is nearly as much of an insult in this setting as you may think it is. 🙂

      • RCF says:

        There’s a difference between childlike and childish.

        • PSJ says:

          Only in connotation. Some people who fancy themselves serious would be offended by either, but I was suggesting that Scott (not to speak for him) would not.

          Often accusations of childishness stem from a perception that it is inappropriate in the current setting, but not necessarily in an absolute sense. So, I was claiming that this space is perhaps not so serious and formal as to warrant offense at the occasional puerile joke.

          • RCF says:

            But if the objection is not merely lack of seriousness, but another objection such as confusing the reader or being offensive, then your response fails.

          • Bugmaster says:

            I just think that schoolyard name-calling belongs in its own separate post, and not in an article containing cogent analysis and rebuttal of one’s intellectual opponents.

          • DavidS says:

            I can totally see the argument here. Personally I read it as enjoying the pun and that sort of joke rather than being a way of demeaning the person. Based on half-remembered similar cases elsewhere on SSC I model Scott as just enjoying that sort of pun without malice.

          • houseboatonstyx says:

            I thought Scott was making fun of himself for not being able to spell it.

  17. Toggle says:

    Caplan’s model depends on a few clear assumptions about rational preferences are, such as completeness and transitivity; if a person’s preferences aren’t ordered in this way, then they’re outside his domain of study entirely.

    Are there any studies comparing rates of, for example, intransitive preference orderings in alcoholic behavior?

    • Corwin says:

      i find it completely, blindingly obvious that human preferences are none of : transitive, stable, ordered.

  18. RCF says:

    The post contains* eight references to Szasz, and every single one of them spell his name differently. And most of them aren’t even close to the correct spelling. What’s up with that?

    *by “contains”, I mean at the time of the writing of this comment; it may be edited later.

  19. Wrong Species says:

    You guys are taking Scott’s intentional spelling mistake way too seriously.

    • Hemid says:

      If there were any other substance in the text, we might talk about that instead.

      It’s a “lolbertarianz” thread. The best argument is the one with the most -steins added to an economist’s name.

      • anodognosic says:

        I… what? I literally cannot believe we read the same article. I cannot conceive of the mind that would say this article has no substance. Wrong? Sure, I could imagine that. But no substance? The inferential distance is a yawning abyss. Like, I would have to construct a whole new epistemology from scratch to come to that conclusion, where, for instance, counterexamples mean nothing. I… what?

        Could you expand on your criticism a little, as a sort of anthropological exercise?

        • Zorgon says:

          “No substance” in this context is being given its non-standard but surprisingly common secondary meaning “disagrees with my in-group”.

  20. Vox Imperatoris says:

    I think that this is an extended stating of the obvious, but sometimes the obvious needs to be stated. I agree completely!

    Even as a (political) libertarian myself, I can’t stand talking to libertarians who subscribe to this sort of belief. It’s like arguing with a conspiracy theorist: how can you refute someone who is willing to entertain any convoluted hypothesis in order to salvage the belief?

    However, I suppose I’m surprised that I agree with you so much here because I could not disagree more with your LessWrong article about whether something is a “real disease”. Of course, everything you say there follows quite naturally from determinist premises, but I am a (metaphysical) libertarian. And above all, there’s one thing I absolutely cannot concede, which really fires me up and bothers me even to hear it said: the idea that no one is ever truly morally responsible for his achievements or for his crimes, and the consequent implication that everyone, “deep down” deserves happiness.

    It is true that people are often too quick to dehumanize, to judge others as “innately evil” and ignore their real motivations. Yudkowsky’s writings on this subject are valuable. But at the same time, I think that people can choose to be evil. And not only am I not concerned with the welfare of evil people; I have an active desire that they suffer. Even if it did nothing to reform them or to protect society!

    I’m not even a deontologist! I’m an egoist and therefore a consequentialist. But I take it to be a fundamental psychological need to see the righteous rewarded and the guilty punished.

    • Leif says:

      What if that fundamental psychological need weren’t so fundamental? If someone gave you a pill that would make you permanently stop feeling a need for punishment, and showed you irrefutable proof that rehabilitation led to a happier world than punishment, would you take the pill?

    • Nita says:

      And not only am I not concerned with the welfare of evil people; I have an active desire that they suffer. Even if it did nothing to reform them or to protect society!

      Friend, some of your circuits seem to be overactive, causing your morality module to malfunction. But don’t worry — I’m sure Scott and his colleagues will find a way to help you soon enough 🙂

    • Sam says:

      And not only am I not concerned with the welfare of evil people; I have an active desire that they suffer. Even if it did nothing to reform them or to protect society!

      I completely agree. But it should not be forgotten here that the rent-seekers in medicine and politics themselves are evil and deserve to suffer accordingly.

    • Anonymous says:

      It is true that people are often too quick to dehumanize, to judge others as “innately evil” and ignore their real motivations. Yudkowsky’s writings on this subject are valuable. But at the same time, I think that people can choose to be evil. And not only am I not concerned with the welfare of evil people; I have an active desire that they suffer. Even if it did nothing to reform them or to protect society!

      Of course people can choose to be evil. If their evil is involuntary, they are not evil.

    • Corwin says:

      Your preference for people to suffer does not pass the reversal test. Thus, it’s evil.

      Isn’t universalizability useful

      • Orphan Wilde says:

        Which is better: The universe in which a dark-meat preference is universal, or the universe in which a light-meat preference is universal?

        Or maybe our world of diverse preferences, in which a greater number of preferences can be satisfied with the same amount of resources, is better?

        (Short of it: Every preference, made universal, results in a worse universe than a diversity of preferences.)

    • “And not only am I not concerned with the welfare of evil people; I have an active desire that they suffer. Even if it did nothing to reform them or to protect society!”

      This unfortunately common attitude is a recipe for endless conflict.

      • Orphan Wilde says:

        Life results in endless conflict. Tit-For-Tat is close to an ideal strategy, as simple strategies go.

      • DavidS says:

        Agreed. Admitting you feel like that is often an excellent sign of being aware of your own emotions+humanity*. But morally supporting that element of yourself? To me it’s like the uglier equivalent of the fact most people would let several strangers die to save a friend, despite how obviously opposed that is to universalisability of any stripe.

        *See, for instance, Alyosha in the Brothers Karamzov, specifically the chapter ‘Rebellion’, which is about 675 times better than the following, more well-known chapter, ‘The Grand Inquisitor’
        _____
        Ivan (speaking of a brutal aristocrat who hunted a child with dogs, who Alyosha, the novice monks, hopes will ultimately be forgiven): “Well—what did he deserve? To be shot? To be shot for the satisfaction of our moral feelings? Speak, Alyosha!”

        “To be shot,” murmured Alyosha, lifting his eyes to Ivan with a pale, twisted smile.
        _____

        Wanting people to be shot for the satisfaction of your moral feelings is massively natural. I’m just not sure it’s ethical.

        • Randy M says:

          Saying what someone deserves does not imply either it is what you want or what would ethically be best to happen to them. Justice, mercy, and vengence are difference concepts.

    • birdboy2000 says:

      I would consider having an active desire that other people suffer to itself be evil – indeed, it serves quite well as a definition thereof!

    • Mary says:

      One notes that if they really were determinists, they would think your punishing the criminals was as determined as their crimes.

      I’ve yet to read one that does.

      • Protagoras says:

        I’m a little vague on who “they” are, or “one” of who, but determinists who think the punishers of criminals are as determined as the criminals themselves are hardly difficult to find. A substantial number of philosophers have been determinists, the vast majority of whom realize that that is a consequence of their position.

      • Sylocat says:

        Well, they’d think his desire to punish the criminals was as determined as their crimes. I have that same desire at times, but I recognize that that acting on that desire is neither conducive to societal improvement nor particularly helpful to my long-term mental well-being.

        And that’s assuming that determinism means that the crimes themselves are inevitable anyway, rather than products of circumstances interacting with biology.

        • Mary says:

          You are not a determinist. A person who thinks that you can act or not act on desire is pretty much the definition of “not being a determinist.”

          “And that’s assuming that determinism means that the crimes themselves are inevitable anyway, rather than products of circumstances interacting with biology.”

          False dichotomy. A determinist thinks they are determinent — inevitable — precisely as products of circumstances interacting with biology.

          • Sylocat says:

            Ah, so we’re just arguing about the definition of “determinist” and the degree to which people fit the definition we’re assigning to it, then?

          • Mary says:

            Under what conceivable definition of “determinist” can you find “someone who thinks that people can voluntarily choose to not act on desires”?

          • Psmith says:

            “Voluntary choice” is not necessarily the same thing as “choice without a physical cause.” Peter Strawson’s “Freedom and Resentment” is a good read on this subject.

          • HeelBearCub says:

            @Psmith:
            I am not familiar with that book. Can you tell me if it addresses the following musing?

            One of the objections to physical determinism is (clearly) the idea that it “eliminates” free will. Given some physical state X, the next physical state Y is pre-determined, and presumably if you were able to know everything about state X and the rules that governed it, you would know state Y.

            But it strikes me that this problem does not go away for dualism! Let’s posit some rational mental entity (E) that “governs” the physical body. If you know all of the information available to E, and all of the logical rules that govern (E), you should be able to predict with absolute accuracy what (E) will do.

            It’s only if we assume that (E) is not governed by logic, which means that their actions are essentially random (or perhaps arbitrarily interrupted/changed by some outside agency), that we can’t predict what (E) will do.

          • Vox Imperatoris says:

            @ HeelBearCub:

            But it strikes me that this problem does not go away for dualism! Let’s posit some rational mental entity (E) that “governs” the physical body. If you know all of the information available to E, and all of the logical rules that govern (E), you should be able to predict with absolute accuracy what (E) will do.

            It’s only if we assume that (E) is not governed by logic, which means that their actions are essentially random (or perhaps arbitrarily interrupted/changed by some outside agency), that we can’t predict what (E) will do.

            No, you are not understanding the libertarian picture of free will correctly.

            One of the most basic assumptions of that position is than an entity can have sufficient potentiality at a given time to undertake more than one action. That is, for at least some entities at some times, the facts about the nature of the entity and its circumstances do not determine a single course of action for it.

            This does not mean that the entity is “not governed by logic”. Logic does not say that a single entity can only have one possible course of action to it at any given instant.

            It also does not necessarily mean that the entity’s behavior is “random”. It could mean this in the case of a non-conscious entity such as an electron: whether it “zigs” left or “zags” right could theoretically be random.

            But in the case of a conscious agent such as a human being, the action it takes can be determined by its free choice. An agent can certainly have reasons for its choice, but insofar as it is a truly free choice, they must not be sufficiently determinative reasons. So in every free choice, in addition to the reasons supplied by the intellect, there is an element (the expression of the agent’s free will), which is an uncaused cause, the beginning of a new chain of causality.

            To an outside observer, the expression of the agent’s will may seem random, since insofar as it is free, it cannot be sufficiently explained by reference to any reasons the agent had or to the agent’s physical nature. Yet to the agent itself, the determinations of its will are experienced as under its control. The agent simply observes that it has multiple potential actions and selects among them; it is the direct cause of what it wills.

            As Aristotle put it, the causes of actions in the world are not only a) necessity and b) chance, but also a c) tertium quid (“third thing”): autonomous agents.

            Note: it is not a requirement of metaphysical libertarianism that any choice be completely free, nor even that all choices be somewhat free. No choice is completely undetermined by previously existing circumstances, and the vast majority of people’s choices are not at all free (or perhaps only have a minuscule element of freedom), being completely determined by the agent’s prior character, circumstances, and reasons. That is why people’s behavior is largely predictable.

            I don’t agree with everything he says, but the “Information Philosopher” website has a great overview of just about every element of the free will question and describes every major thinker’s position. Here’s the article on agent causality.

          • @Vox: that strikes me as extremely improbable, given our understanding both of the laws of physics and of the way the human brain functions. Neither understanding is complete, of course, so I’m not claiming that we can definitively rule out agent causality on scientific grounds – but it really, really sounds dreadfully implausible to me.

          • HeelBearCub says:

            @Vox:
            I think that argument essentially resolves down to merely question begging.

            Why did the agent make the choice it did from among the choices it had available to it? Did they have a reason to do so? Or did they choose randomly?

            When they actually make a choice you don’t get to say it was not determined because they had other choices available to them. This out is available for the determinist as well.

            Dan Harrington (professional poker player) uses the second hand on his watch to randomize some of his decisions. That is a reasoned strategy born of free will that is inscrutable from the outside and still could be completely deterministic.

          • Vox Imperatoris says:

            @ Harry Johnston:

            It may sound implausible to you. However, I think such a theory (or a very similar theory) is necessary for explaining a great many things about human experience. Not least: how human beings are ever able to have objective knowledge of any sort. And when one adopts a proper view of the metaphysical requirements necessary to explain other phenomena like qualia / subjective experience, it is not that implausible.

            The materialist-determinist theory sounds superficially plausible to a certain type of person (it certainly is not plausible to most people) because it promises that we can explain human consciousness in essentially the same way that we explain occurrences in the external, physical world. The materialist, event-causal, determinist approach has had great success explaining the behavior of inanimate nature. But it just doesn’t work when applied to human experience, for a number of reasons. (Namely, it undermines the possibility of knowledge, of a coherent account of personal identity, of moral responsibility, and of a coherent account of inner subjective experience. If you trace out the implications of those, it takes out everything else, too—but those are just the direct consequences.)

            If the theory doesn’t fit the facts or, worse, ends up refuting itself, we have to reject it, no matter how “plausible” it may seem.

            @ HeelBearCub:

            I think that argument essentially resolves down to merely question begging.

            Please specify more precisely why you think it is “question begging”. I’m not sure how to respond to that. I didn’t really even argue for agent causation. I just explained what it is. So what aspect of the conclusion of my non-argument could be assumed in the premises?

            Why did the agent make the choice it did from among the choices it had available to it? Did they have a reason to do so? Or did they choose randomly?

            The agent may have made the choice for a reason, but the reason, while a sufficient explanation, is not a contrastive explanation. That is, the agent may have had reasons for making the choice it did, but insofar as the choice was free, the agent also had sufficient reasons to refrain from making that decision.

            A contrastive explanation explains why an agent did A and not B. A non-contrastive explanation says why an agent did A but allows that B was also a possibility.

            (In my last post, I phrased this a little bit differently. I said that the agent had reasons, but that they were not “sufficiently determinative” reasons. This was a mistake of terminology: I haven’t written on this rigorously in a while! “Sufficient reason” is often but mistakenly used to mean “contrastive reason”, and this tripped me up until I thought about it more!

            I also used the term “uncaused cause” for the expression of a free agent’s will. Strictly speaking, this should have been “self-caused cause”: a free agent’s will does not come into being uncaused. Rather, the agent is the cause of its own will.)

            An example will probably make this clearer. Suppose, with Thomas Reid’s example, that “Cato was good because he could not otherwise.” That is, Cato’s character was such that the reasons for doing good determined him to do good and not evil. If that were the case, then Cato’s actions were not free. (However, Cato could still be responsible for them to the extent that, in the past, he determined his character.)

            Cato’s actions would only be free if the reasons for doing good were not strong enough to serve as a contrastive explanation of his behavior. He could still have the reasons and act on them; but he could also not act because of some other reasons. Therefore, you could explain Cato’s choice after the fact in both cases. If he chose to do good, you could say “He did good for reason X.” If he chose not to do good, you could say “He did not do good for reason Y.” But you do not know ahead of time which one it will be.

            Anyway, you can (for the purposes of logical analysis, at least) separate all choices into the free element and the determined element. For the determined element, you can ask “Why?” But for the free element, you cannot ask “Why?” You cannot ask “Why? because it is the start of a new causal chain; it is for the same reason that, supposing you can trace all motion in the universe back to a single first cause, you can’t ask why this cause existed. The question “Why? is a request for a previous cause to explain an effect; for a causa sui there is no such previous cause. The free agent itself is the cause of its own action.

            As long as you don’t believe that all causal chains go infinitely far backwards into the past, you have to accept the existence of a causa sui of some sort.

            But as I said above, the fact that you cannot ask “Why? the agent acted in a certain way does not mean the action was “random”. “Random” implies that the action is not “up to” the agent, that it is out of the agent’s control. But a free action is “up to” the agent and in its control; it is caused by the agent. Free action is the “third thing” which is neither necessity nor chance.

            Dan Harrington (professional poker player) uses the second hand on his watch to randomize some of his decisions. That is a reasoned strategy born of free will that is inscrutable from the outside and still could be completely deterministic.

            I’m not sure what role this is playing in your argument. Actions are not free because they happen for “random” external factors, like the position of the second hand on a watch. I also don’t see how this strategy is “inscrutable from the outside”.

            A paradigmatically free action consists of an agent observing that it has the potential both to act or to refrain from acting, and then exercising a basic causal power to actualize one of those two possibilities. The resulting action or inaction comes directly from the agent’s choice. There is no contrastive explanation for the agent’s choice; the agent has sufficient reason both to act and to refrain from acting. But neither is the choice “random”. The choice doesn’t “just happen”; it happens because the agent chooses it.

            I know that all of this can be very confusing. I wrote a paper on it a couple of years ago in undergrad which may be helpful. Link here. Note that while the paper discusses it in the context of the writings of medieval philosopher and theologian Peter John Olivi, I am not a theist and the theory has no special relation to theism.

          • HeelBearCub says:

            @Vox:
            After the choice has been made, does the agent belive that they decided as they did due to reason? Or was it whimsical?

          • Vox Imperatoris says:

            @ HeelBearCub:

            Yes, the agent senses that he took the action for a reason. But he also senses that he could have chosen not to act on that reason.

            As Peter John Olivi writes, in his confusingly medieval way:

            The will is also extremely undetermined in respect of acts. For if at the time of acting and when it is acting it were inclined to those acts in the way other agents are inclined to their acts, then when we are acting or at the beginning of our acts we would not sense within ourselves a certain power and capacity readily able not to do what it does. But we all do most certainly sense this within ourselves. Moreover, [we sense this] in the case of things in response to which we are greatly affected and drawn with much feeling. So there is no doubt that we sense that we have within ourselves a certain power that is not so determined to act, when it is acting, and not to act, when it is not acting, that when it is acting it is not able not to do that, and when it is not acting it is not able to do that. And we like and value the sense of this power so much that it above all moves us to love dominion, freedom and full power. And because in some amazing way we sense this [sense]
            to be present to other human beings as it is to ourselves, we find ourselves able, in the combinations of attitudes set out above, to be conjoined with other human beings and not with beasts or non-rational things. This also is why we prefer every human being to beasts, not just intellectually, but also by a kind of internal and natural sense.

          • HeelBearCub says:

            @Vox:
            This is no different than the deterministic view.

            Having a sense that you could have chosen differently doesn’t change the logic. Either you choose because reason caused a certain decision, or you chose between possible decisions essentially randomly, whatever story you tell yourself.

          • Psmith says:

            “Freedom and Resentment” argues for a form of compatibilism. Essentially, its thesis is that the following claim is false:
            “One of the objections to physical determinism is (clearly) the idea that it “eliminates” free will.”

            A brief and reasonably accurate summary from Stanford Encyclopedia of Philosophy: “His argument is that our ‘reactive attitudes’ towards others and ourselves, such attitudes as gratitude, anger, sympathy and resentment, are natural and irrevocable. Their presence, therefore, needs no abstract entitlement from philosophy, which is simply irrelevant to their existence or justification. There cannot be abstract a priori principles locating general metaphysical conditions for such attitudes. His claim is that our practice of holding ourselves and each other responsible for actions is similarly natural and not dependent on general metaphysical requirements. Between determinism and responsibility there can be no conflict.”

            By way of clarification: a robust characterization of “free will” is roughly “that which is required to be morally responsible.” Likewise, a voluntary act would be an act for which the agent could be held morally responsible. Philosophy, in general, cashes out free will in terms of moral responsibility; when we’re interested in whether free will exists, we’re interested in whether people can be held morally responsible for their actions. If people can be held morally responsible for their actions, they have free will (or their actions are voluntary)–and Strawson argues that they can.

          • @Vox:

            The materialist-determinist theory sounds superficially plausible to a certain type of person (it certainly is not plausible to most people) because it promises that we can explain human consciousness in essentially the same way that we explain occurrences in the external, physical world.

            Well, quite. It seems presumptuous, to say the least, to assert that humans have some kind of magical exemption from the laws of physics.

            I would assume (perhaps naively!) that my position, or variations thereof, is common – or at least plausible – to most atheists. Obviously the religious and the superstitious can’t accept it, because it directly contradicts any belief in soul and/or spirit.

            The materialist, event-causal, determinist approach has had great success explaining the behavior of inanimate nature. But it just doesn’t work when applied to human experience, for a number of reasons. (Namely, it undermines the possibility of knowledge, of a coherent account of personal identity, of moral responsibility, and of a coherent account of inner subjective experience. If you trace out the implications of those, it takes out everything else, too—but those are just the direct consequences.)

            I disagree that it undermines any of those things. At most, it makes them harder to understand … but that’s directly analogous to the way that evolution is harder to understand than creationism. The fact that there are gaps in our understanding does not mean we should automatically throw out the parts we can understand.

            Now that I think of it, though, libertarianism being predominantly a US belief, I suppose most libertarians are in fact Christian? That seems weird in other ways (not worth going into, if only because it is almost certainly due to my failing to fully understand either Christianity or libertarianism) but would certainly explain why many/most libertarians take a religious view of free will. So, please excuse my interruption. 🙂

    • Winter Shaker says:

      Just to pile on, here, I’d add that it’s perfectly understandable that we would have evolved a preference for seeing suffering inflicted on wrongdoers: if people have good reason to fear that you will punish them if they harm you or other members of your group, then they are less likely to do that, and for that to be a credible threat, you will actually need to seek revenge on those who cross you every so often. And it is computationally much simpler to sculpt a brain towards punishing behaviour by instilling a deep-rooted thirst for revenge than it is to instill a painstaking cost/benefit analysis of whether punishment in each specific case will actually be a net good for you and yours.

      This means that people are afraid to cross you, but it also means that if the blind, mad idiot god that shaped our bodies and minds happens to have got things miscalibrated, then we can very easily get into escalating spirals of mutual punishment, each side perceiving the other side’s reasonable-to-them act of revenge as an unreasonable over-reaction, and over-reacting accordingly in turn. See for instance every culture’s literature on dynastic feuds, or every centuries-long ethnic tension fuelled border conflict.

      The thirst for revenge is to some extent useful as a deterrent, but it is a kludge which can lead to real unnecessary suffering, and wherever it actually is possible to do the maths and conclude that a reconciliatory/rehabilitationist approach would have better outcomes than a retributive approach, we should be willing to entertain the possibility.

      Of course, it is conceivable that the thirst for revenge is so strong that, under a conciliatory/rehabilitationist system, even if the conciliatory approach is more effective at reducing future crimes, the psychological anguish inflicted on those whose desire for revenge is thwarted causes them to suffer so badly as to outweigh the gains in reduction-of-suffering by those wrongdoers who would have faced a painful vengeance and now merely face an (effective) rehabilitation plus the marginal would-be victims of future crimes who now never become victims because those crimes now don’t happen in the first place. But if so, that would be a sad fact about human nature, and one that we should want to change.

      • jaimeastorga2000 says:

        You are thinking like a utilitarian, thinking that revenge and punishment only has instrumental value insofar as it reduces the net amount of pain/suffering/anguish/harm in the world, and that when it does otherwise it is to be regarded as a design flaw created by evolution. But other people value revenge and punishment terminally, for their own sake.

        • Sylocat says:

          I don’t wish to speak for Winter Shaker, but I think that was his/her point.

        • Winter Shaker says:

          As Sylocat points out, that was indeed my point. The fact that people desire revenge and punishment as terminal goals is a design flaw created by evolution, in any circumstance where a well-crafted less-vengeful response would lead to less future crime than a vengeful one.

          I don’t know how often that applies – there are a myriad possible responses to any crime, varying in their punitiveness and along many other axes – but I don’t think it’s controversial to say that in any case where the thirst for revenge would lead you to actions that would cause more harm than they would prevent, then we ought to be suspicious of it, and not simply accept it as a valid terminal goal.

          • Sam says:

            We’re adaptation executors, not fitness maximizers. You seem to think we want to optimize some output metric, e.g. future crime rate, when we really want to harm our enemies.

          • Winter Shaker says:

            We’re adaptation executors, not fitness maximizers

            I know, I know, I’ve been hanging out here long enough to have memorised the mantras 🙂

            But I’m just trying to say that having a thirst for revenge as a terminal goal, uncoupled from whether that revenge will actually produce less future suffering, is not optimal, and that if you find yourself, like Vox Imperatoris said, desiring to hurt your enemies purely for the sake of hurting them, then that should be something we try to train ourselves out of, rather than passively accept as a reasonable way to react.

          • jaimeastorga2000 says:

            optimal

            should

            reasonable

            This is the sticking point. You keep speaking as if your terminal preference for less suffering is the obviously correct one, while other people’s terminal preference for revenge is an obvious design error. Who knows but that those other people should say analogous things about your preferences?

          • Winter Shaker says:

            You keep speaking as if your terminal preference for less suffering is the obviously correct one, while other people’s terminal preference for revenge is an obvious design error.

            Okay, I’m … a little surprised that a preference for a world with less suffering is so controversial, but so be it. Accuse me of typical mind fallacy if you will, but I can’t imagine why someone would prefer the world with more suffering. And I’m not trying to claim that the thirst for revenge is an obvious error – like I said, up to a point it is a reasonably workable kludge (and before you’ve exceeded that point, where the thirst for revenge is actually serving as a useful deterrent, I wouldn’t call it an error at all); just that it is apt to overshoot in some circumstances environments and cause more harm than it deters.

            Well let’s try to justify it. I prefer a world with less suffering because suffering is painful, and I have a preference for avoiding pain that I am confident extrapolates in most circumstances to most people. Suffering that does not come with the prospect of greater gains is bad by what I am confident is most people’s understanding of bad, therefore all else being equal, a world with less suffering is a better world. I’m afraid that’s the best I can do for now.

            Are you actually yourself defending vengeance as a terminal goal, by the way, or just noting the existence of terminal revenge preferrers? Because if the former, I’d be curious to hear your justification for why someone should prefer revenge to rehabilitation even where it would cause more suffering.

            Edited to add: I have a strong suspicion that Vox Imperatoris’ belief in free will is doing a lot of work in underpinning their preference for vengeance even when it will lead to more suffering. I am very much in agreement with the determinist position – you can change the incentive structure and thus change people’s behaviour relative to what they would do under different incentive structures, but you can’t step outside of the chain of cause and effect. Thus free will is not merely an illusion, but a confusion – an incoherent concept that we believe in only by partitioning our minds. I.e. it is not a morally relevant fact about reality; it is simply the name we apply to the fact that we can’t always predict in advance how we or others will react to any given situation. And with that in place, the idea of deserving anything at all on a deep level also melts away. We can set up incentive structures to bring out the best in people by making better things come to those who do better, but that is the limit of it; those who are destined to not do better did not choose to have the brain of someone who couldn’t do any better.

            So when people say that everyone ‘deserves to be happy’, yes, that is a little incoherent, but can easily be steelmanned to ‘it is a better world, overall, if we maximise wellbeing’.

            Does that make sense?

          • Vox Imperatoris says:

            @Winter Shaker

            Well let’s try to justify it. I prefer a world with less suffering because suffering is painful, and I have a preference for avoiding pain that I am confident extrapolates in most circumstances to most people. Suffering that does not come with the prospect of greater gains is bad by what I am confident is most people’s understanding of bad, therefore all else being equal, a world with less suffering is a better world. I’m afraid that’s the best I can do for now.

            […]

            So when people say that everyone ‘deserves to be happy’, yes, that is a little incoherent, but can easily be steelmanned to ‘it is a better world, overall, if we maximise wellbeing’.

            The first part of my objection to you is my objection to any form of utilitarian or, more broadly, impartialist ethics. The first error of impartialist ethics is its failure to comprehend the agent-relativity of “good/evil”/”better/worse”.

            There is no such thing as a “better world” in an absolute sense. “Better” is simply meaningless when not specified (implicitly or explicitly) as “better for whom or for what”.

            So is a world with more suffering better or worse than a world with less suffering? This is completely impossible to determine unless we know who is suffering.

            The second error of impartialist ethics usually but not necessarily stems from the first. It consists of making the amazing logical leap from “I experience my suffering as intrinsically bad, so I ought to minimize my suffering,” to “Everyone else experiences suffering as bad, so I ought to place equal weight on minimizing their suffering.” This just doesn’t follow.

            The appropriate inference is: “Everyone else experiences his own suffering as bad, so each individual person ought to minimize his own suffering.” The fact that everyone views his own suffering as bad is a reason for everyone to minimize his own suffering, not a reason to minimize suffering-in-general. Everyone does not experience everyone’s suffering directly: that is the very meaning of the distinction between one’s own and others’ suffering. People only experience others’ suffering to the degree that it causes themselves to suffer, as well (this is the literal meaning of empathy).

            So there is, in fact, no reason whatever for people to act to minimize suffering-in-general. They ought to minimize their own suffering—minimizing suffering-in-general only as it furthers that end.

            Moving on, imagine (at least for the sake of argument) that there are two groups of people: those who are more or less ethically decent (rational, productive, peaceful, etc.), and those who are not. There is no reason for the decent people to desire a world which maximizes the aggregate welfare of the decent and the indecent. Rather, they only need a world that maximizes the welfare of the decent people. (Insofar as they make collective decisions; insofar as they make individual decisions, they should maximize their own welfare.)

            So it is possible that a policy that inflicts a large welfare loss on the indecent people and only moderately contributes to the welfare of the decent people might nevertheless be more desirable (from the perspective of the decent people) than a policy that produces a welfare gain for the indecent people and is neutral with regard to the decent people. Of course, the indecent people would not like such a policy: too bad for them.

            I have a strong suspicion that Vox Imperatoris’ belief in free will is doing a lot of work in underpinning their preference for vengeance even when it will lead to more suffering.

            Indeed, I explicitly stated this and think it is of crucial importance.

            Now, it’s possible for everything I just said to apply just as well to a determinist view of the world as to a libertarian view. Calvinism is essentially such a view: it’s perfectly alright for God to damn the reprobate and save the elect, even though neither of them had a real choice about their behavior.

            So you could say, “Though I have really done nothing to deserve it, I seem to be one of the decent people. Therefore, I will support a policy that maximizes the welfare of the decent people at the expense of the indecent people, even though the latter did nothing either to deserve it.”

            But, especially in our modern age, that seems a very cold and brutal position. One is faced with the nagging thought that “There but for the grace of biochemistry go I.” This thought encourages one to empathize with the indecent people, making it very hard to bear watching them undergo harsh retributory punishments.

            But if one believes in free will, one need not say “There but for the grace of biochemistry go I”; rather, one can attribute the fact that one is an essentially decent person to one’s own freely exercised moral effort. And thus, instead of empathizing with the indecent people being punished, one will say “The bastards had it coming!”

            (Of course, one will be more or less empathetic toward people whose external circumstances forced them or greatly tempted them to commit wrongs. If they were forced, we consider it a complete excuse. If they were greatly tempted, we consider it a mitigating factor.)

            I am very much in agreement with the determinist position – you can change the incentive structure and thus change people’s behaviour relative to what they would do under different incentive structures, but you can’t step outside of the chain of cause and effect. Thus free will is not merely an illusion, but a confusion – an incoherent concept that we believe in only by partitioning our minds. I.e. it is not a morally relevant fact about reality; it is simply the name we apply to the fact that we can’t always predict in advance how we or others will react to any given situation.

            I’m not going to argue the merits of the free will question. I am, however, going to take issue with the idea that it is an “incoherent concept”, because that is just wrong.

            Believers in free will (at least, the rational ones with whom I agree) do not deny causality. They believe you can step outside the “chain” of causality only insofar as they do not believe it is a single chain. They reject the theory of “event causation”, which makes causality a property of events, such that each event is an effect which must be attributed to a previous cause. Instead, they subscribe to the theory of “agent causation” and/or “substance causation”, which make causality a property of agents and/or substances, such that agents and/or substances must act in accordance with their nature.

            But if a substance is of such a kind as to give it sufficient potentiality for more than one action at a given moment, there is no contradiction or violation of causality in saying that it did one thing but just as well could have done the other. And if it is a conscious agent, there is no contradiction or violation of causality in saying that it did one thing rather than the other because it chose to do so—a choice that is an explanatory primary, the beginning of a new causal chain.

            You may think this is implausible (I think it is a good deal more plausible than determinism), but it is not incoherent.

          • @Vox: seems to me that you’re missing the point. An overactive revenge instinct causes (or potentially causes) more suffering for the decent people, not just more suffering overall.

            As, for example, people insisting on mistreating criminals, even if the predictable result is that said criminals will commit more and worse crimes when finally released. Or when the families or nations of those you’ve sought revenge on seek revenge upon your family or nation in turn.

          • Vox Imperatoris says:

            @ Harry Johnston:

            @Vox: seems to me that you’re missing the point. An overactive revenge instinct causes (or potentially causes) more suffering for the decent people, not just more suffering overall.

            Well, those are two separate questions. I grant that if a certain policy, taking all factors into account, is a net negative for the decent people, they shouldn’t do it. I’m not arguing for “let revenge be done though the heavens fall.”

            In many cases, it’s not practical. For example, imagine a slave on a plantation whose cruel master whips him every day. One day, the slave gets a chance to escape. Now, he’s almost certainly better off just running than trying to track down his old master and kill him. But it sure would be nice if that sadist got what was coming to him.

            I’m also not arguing for “collective responsibility” or “collective revenge”. There’s no such thing as collective guilt. So in the Civil War, it was not the case that every Confederate soldier deserved to die for fighting a treasonous war to defend slavery. It would have been monstrous to bring them all to the guillotine afterwards. The reason is that, given the circumstances of the social pressure and often physical coercion to join, anyone would be excused for doing the same. (One can, of course, kill soldiers who don’t deserve to die insofar as it is required for achieving victory. But it’s not really different in principle from killing civilians when necessary to achieve victory.)

            Nevertheless, you can make a good case for the justice of killing the ringleaders, for “hang[ing] Jeff Davis to a sour apple tree.” (The same goes for killing Hirohito after WWII.) But even there, you can also make the case that in such situations, “national healing” is more important than seeing justice done. (It was, after all, the ostensible reason for pardoning Nixon.) The point is that if you could have both, it would be better.

            However, Winter Shaker seems to be arguing for regular old utilitarianism and that everybody’s suffering matters equally. That was the main point I wanted to address, even though you yourself are not making it.

          • Sam says:

            Winter Shaker, I agree with you that a world with less suffering is better in a utilitarian sense, but I still want my enemies to suffer more than I want to make the world better.

          • Sylocat says:

            So is a world with more suffering better or worse than a world with less suffering? This is completely impossible to determine unless we know who is suffering.

            If it’s impossible to determine without knowing who is suffering, why does knowing who is suffering help us determine it? Is it really as simple as “A world with more suffering is better so long as the suffering is inflicted upon the deserving?”

            Winter Shaker, I agree with you that a world with less suffering is better in a utilitarian sense, but I still want my enemies to suffer more than I want to make the world better.

            Assuming you’re not being sarcastic nor speaking in some hypothetical character-voice version of “I,” well, you have my pity.

          • Jiro says:

            Why does he have your pity? Did he claim to be a utilitarian? If not, that statement is no different from “I agree that a world with a lot of paperclips is better in a paperclipper sense, but I want something other than paperclips”.

          • Vox Imperatoris says:

            @ Sylocat:

            If it’s impossible to determine without knowing who is suffering, why does knowing who is suffering help us determine it? Is it really as simple as “A world with more suffering is better so long as the suffering is inflicted upon the deserving?”

            When I say that it is impossible to determine whether more or less suffering is better without knowing who is suffering, I do not mean that knowing who is suffering is the only thing you need to know to determine whether the world is “better”.

            But it is necessary to know it.

            For example, (as Jiro reminds me) imagine a paperclip maximizer who wants to maximize the number of paperclips in its particular “stash”. It is not then enough to know whether an action is “good” that it produces more paperclips. If an action produces more paperclip but puts them in another maximizer’s “stash”, the action is not good at all. The maximizer needs to know in whose “stash” the paperclips will be put.

            Now, if the paperclip maximizer only wanted to maximize the number of paperclips in the world, regardless of whose “stash” they’re in, then it would not need to know anything about where the paperclips will be put.

            But as I argued above, we have much more reason to act as maximizers of our own utility (the paperclips in our “stash”) than to act maximizers of aggregate utility (paperclips in the world). (What is the alleged reason we are supposed to maximize aggregate utility? I have never been able to get that out of anyone.)

            So if we want to maximize our own utility and/or minimize our own suffering, it is necessary to know whose suffering will be lessened by our actions—not only that suffering will be lessened.

          • Age of Utilitron says:

            What is the alleged reason we are supposed to maximize aggregate utility?

            Well, we’re not supposed to do anything. The universe doesn’t come with a normative rulebook. But there are some intuitions about universalizability and simplicity here.

            Thought experiment: Alice can inflict a suffering on Bobby to gain a net advantage that is smaller than Bobby’s suffering. If she cares only about her own utility, it is rational to do so.

            But then she learns a new piece of information: Bobby is in fact future Alice travelled back in time after an event that gave her amnesia and a new face (insert many scifi references of your choice here).

            Is it still rational to make the same choice? If not, why not? The situation remains the same, just with different context information.

            In the multiverse, there are many versions of us that have many transformation pathways and partial identity overlaps. Personal identities bleed over into each other, just like species do when you look at all the ancestors.

      • Mary says:

        One notes that there is signalling value in punishing with an even hand.

        • Winter Shaker says:

          Sure – I’m not advocating capriciousness, just saying that valuing retribution for its own sake, beyond its usefulness at preventing future crimes, is more likely to be a workable-but-suboptimal trait that came about as an evolutionary kludge than one which consistently reflects the best way to deal with wrongdoers in the present environment.

    • FacelessCraven says:

      @Vox Imperatoris – “ut at the same time, I think that people can choose to be evil. And not only am I not concerned with the welfare of evil people; I have an active desire that they suffer. Even if it did nothing to reform them or to protect society!”

      “For children are innocent and love justice, while most of us are wicked and naturally prefer mercy.”

  21. Banananon says:

    Minor typo:

    > […] indeed when a schizophrenic person has a formal thought disorder *is* is there to stay until they are treated.

    Presumably should read “*it* is there to stay”.

    Feel free to delete this comment after fixing.

  22. RCF says:

    It’s a bit problematic to critique an argument without the author of the argument being available to clarify the claims made, but it does seem to me that alcoholism can be modeled as an inward shift of constraints. An alcoholic can either drink alcohol and experience the negative consequences of that, or not drink alcohol and experience the distress that that causes. An alcoholic who does not drink experiences distress that a nondrinking nonalcoholic doesn’t experience. This is a decrease in the nondistress budget.

    • Mary says:

      Yeah, if failure to drink caused terrifying hallucinations — such that patients have been known to throw themselves out windows to escape — and epileptic fits, and carried a serious risk of dying, I might drink too.

  23. Tracy W says:

    My own objection is simpler. The brain is a physical organ and every other organ is known to go wonky from time to time, it would be awfully implausible if the brain was somehow exempt.

    • Max says:

      Certainly Szasz would have no objection to that: if a particular behavior could be clearly pointed to as a result of some “lesion” (his terminology) to the brain, then it would grouped in the same category as all other physical illnesses, many of which cause functional behavioral shifts in the way Scott argues. And in principle it could then be treated appropriately. But Szasz was critiquing illnesses of the *mind*, which could *only* be diagnosed as a behavioral pattern rather than as the result of some biological malady. He didn’t deny that some of these might be the result of neurobiological problems, but at the time of his writing (and still today, in many cases) the diagnosis always came from an examination of the patient’s behavior, and not because the person making the diagnosis could actually point to the specific neurobiological problem.

      • Mary says:

        The problem being is that diseases of the mind have time and time proven themselves to be real diseases.

        Epilepsy.

        Catanoia, when caused by hypnothyroidism.

        and more.

        • Max says:

          And the Szaszian answer to this would be that these real diseases should be treated by real doctors.

          • Mary says:

            did they become real when we found the physical causes? Or were they always real?

            If the latter, then all “mental diseases” COULD be “real diseases.”

      • Tracy W says:

        Maybe this is the result of me being not an American, but I’m accustomed to medical staff mostly diagnosing any illness by symptoms, not by finding a leison or any other attempt to find an underlying physical cause. I don’t really see much difference in technique between “huh, probably measles” and “huh, probably schizophrenia”.

        • Nornagest says:

          Nah, American doctors do that too. Tests are common when diseases get rarer or more severe, or when there’s a tricky differential diagnosis, but for something as common as measles you’ll probably get a prescription without the doctor checking anything more complicated than your blood pressure.

        • Earthly Knight says:

          Uh, measles is a highly contagious and potentially fatal disease which has been nearly eradicated from the developed world. If your doctor suspects you have measles she will not only run a flurry of additional tests but very likely summon the Health Ministry to bring the hammer of God down on you. The common cold might be a better example.

        • Max says:

          The main difference, in Szasz’s perspective, is that schizophrenia is *defined* as the pattern of behavior used to “diagnose” schizophrenia, whereas a collection of symptoms commonly attributed to measles is not the measles itself, but rather a manifestation of the underlying physical lesion. The argument is then that while many of these mental illnesses might be the result of underlying physical lesions, that’s never the concern of the psychiatrist, who is interested in categorizing the behavior of the patient. And that’s why you can have things like people faking their way into being committed.

          • Tracy W says:

            Wouldn’t measles at one point have been defined as a set of symptoms without any particular underlying physical cause? And diabetes too?

          • Mary says:

            That’s the difference between a syndrome — a constellation of symptoms, not from a cause — and a disease, which has a cause. They exist in the physical arena, too. I read The White Death on TB, and one of the elements of the chapter on the limits of TB treatment was reeling off a long list of diseases that were not TB, and then explaining the relevance, namely, that as long as consumption was a syndrome (or even a de facto syndrome since you didn’t check though you knew about the causes), they were hidden under the umbrella “consumption” and cures for TB brought out their existence.

            Diabetes is still a syndrome. Type I and Type II are diseases, but since their causes are entirely distinct, the common ground is still a syndrome.

            AIDS is no longer a syndrome, but for a long time, it was. Oddly enough, it was treated as a disease.

          • Arthur B. says:

            I’m going to be a bit cheeky, but the same could be said of a bear. There’s no such thing as a bear, only a pattern of observations: a large brown mass crossing the field of view of hitchhikers, air vibrations transmitting rawring sounds, picnic baskets disappearing, etc.

            This pattern have been widely and consistently observed across the world. It is conveniently referred to as “a bear”.

          • Max says:

            @Tracy and Mary: that’s tangential to the point Szasz makes, which is that psychiatry is by construction never about trying to figure out the underlying physical cause.

          • Jon H says:

            “psychiatry is by construction never about trying to figure out the underlying physical cause.”

            Since certain physical diagnosis would often involve cutting up the brain, this isn’t really a very good argument. Psychiatry is limited by the problem of keeping the patient alive.

            It’d be nice if dementia could be diagnosed with a throat swab, or even a spinal tap, but that’s life.

  24. mtraven says:

    I was going to suggest Ainslie’s theory of inconsistent time-discounting of preferences as a theory of addiction that might satisfy an economist like Caplan, but I see his paper mentions and dismisses it, probably because it undermines his rational-agent fundamentalism that Freedom and Compassion mentioned above. But, it’s an excuse for me to recommend it and ask Scott what he thinks of it; I understand it is known in the rationalist community.

  25. Sam says:

    I agree with Caplan on this. As a patient, I have been harmed far more than helped by the medical system, specifically psychiatry. It’s mostly an extraction scheme based on totalitarian mechanisms.

    • Anonymous says:

      Isn’t that sentiment – that you’ve been harmed more than helped – just as easily, if not more so, explained by the incompetence?

      • Sam says:

        Well, if incompetent doctors earn money (from forced insurance) by harming people, while knowing this, they might just as well be frauds.

        • Anonymous says:

          This is different from the underlying problem – illness – being fictional. The snake oil salesman doesn’t have to make up a disease to pretend to cure it and reap benefits.

  26. Deiseach says:

    Delusions may be a preference to have a weird belief – for example, somebody might feel trivial and neglected, so in order to make themselves feel important they cook up a paranoid conspiracy theory where the FBI, CIA, and Freemasons are all after them because of how important they are. Wanting to believe that the government is after you is a weird preference but, Caplan insists, nevertheless still a preference.

    All I can say to that is that they must never have met or had any interaction with people suffering from schizophrenia. That this is based on the work of a psychiatrist I find baffling.

    So our client, who is a paranoid schizophrenic and who had to be barred from our city offices, merely prefers to act and think the way they do? Their activities can be explained away by “making themselves feel important”, so that’s why they believe their neighbours routinely break into their house and that we, acting as agents of the government, are putting cameras down the plumbing to spy on them?

    All they have to do is speak sternly to themselves and say “Now cut this out, you’re only attention seeking!” and all will be well? Their wretched misery, where they don’t have a moment’s peace nor ease in their life because of their constant anxiety and paranoia; the way you can tell when they’re having an episode by the rapidity and disconnectedness of their speech and how their thoughts, put into words, spiral off into coherent but unreal imaginings – all this is not a genuine organic illness but merely an arrangement of preferences and misinterpretation or exaggeration of normal everyday experience?

    If that is what he genuinely thinks, he’s an idiot. But please don’t take that as stigmatisation; hey, if he prefers to be an idiot, that’s his choice, right?

    Szasz faults the common sense view for refusing to take human heterogeneity seriously. What makes you think that no human being would prefer a life of day-dreaming, play-acting, daily heroin use or sadism

    Because, in the case of our client, they are suffering. They do not enjoy their “preference”; they come to us for relief, to change the locks so the neighbours can’t break in with stolen keys, to demand we take the cameras out of the plumbing. Their life is not happy and very barely functional; they had a job and lost it because their illness made them unable to hold it down (I suppose Mr or Dr Szasz would say that they didn’t want to work so they acted in a way that would get them fired?)

    This is the Hollywood movie model of mental illness, where free-spirited creative types are forcibly locked up and dosed and otherwise abused by medical treatment aimed at making them socially acceptable by “normal” society; the Manic Pixie Dream Girl where the mundanes don’t like the challenge to the status quo posed by the bold free life and so they have to be called “mentally ill” and punished for their oblique view of life.

    This is the kind of theoretical crap that I argue has poisoned the brains of social work graduates so that when they first start working with clients, they are tripping over themselves to be non-judgemental and supportive (not bad requirements in themselves) and so they get taken for a ride by the hard cases who know how to work the system, but even worse, they don’t intervene in genuinely bad and abusive situations (because a mother of a young child shooting up heroin in front of the kid, well, that doesn’t mean she’s a bad mother, does it?)

    By Szasz and Caplan’s view, such a person is only exhibiting a preference. Fine. But what about the child’s preference not to be neglected, malnourished, and to have parental attention and care instead of someone out of it on smack?

    • Mary says:

      At this point I will be a killjoy, even though I think there are mental illnesses.

      Because treating paranoia can cause depression. Apparently discovering that you aren’t so fascinating and the center of the universe to so many people is a depressing thought. The human desire for attention in its purest form.

      • Sylocat says:

        To be fair, this could also be attributed to the simple fact that finding out that your own brain has been lying to you, that you can’t even trust your ability to interpret your own grip on reality, can be disheartening for a far more sympathetic reason.

  27. drethelin says:

    I’m not sure that there’s such a strong conflict here. Even under the assumption that all mental illnesses are simply strong and weird preferences, why does that change how we should treat them? If someone has a strong preference for murdering, we don’t respond to that by saying “well I guess that’s your preference!”

    I think the answer to my semi-rhetorical question is that there is something of a taboo right now of the notion that you can have preferences that are bad. Especially in America, fulfillment of your preferences is glorified in all sorts of television, books, and even the cultural tropes we share about marriage, careers, and family. There are many dystopian works of fiction where the most terrible part of the dictatorship is that people are not allowed to choose their own preferences (itself something of a contradiction), like We, The Giver, and Brave New World. If all preferences are (by vague definition or assertion) Valid, then the framework of mental illnesses as preferences is extremely hard to deal with. But if preferences are allowed to be inappropriate or evil or simply impractical, then the issue becomes one of haggling over the price.

    If you can admit that preferences can conflict with each other within a person and between people within society, and that it’s ok to change them rather than to change society or a person’s place within it, you can avail yourself of chemical and methodological solutions. In which case, the practical distinction between “I want a cure for my ADHD” and “I wish I had a stronger preference for focusing on schoolwork than on looking at that squirrel outside the window” is largely moot.

    • Mary says:

      the problem is that it gives us no rule for determining which preferences should win. Might makes right gets ugly.

      And psychology can give us no guidance in the arena.

    • Sylocat says:

      I think the answer to my semi-rhetorical question is that there is something of a taboo right now of the notion that you can have preferences that are bad. Especially in America, fulfillment of your preferences is glorified in all sorts of television, books, and even the cultural tropes we share about marriage, careers, and family. There are many dystopian works of fiction where the most terrible part of the dictatorship is that people are not allowed to choose their own preferences (itself something of a contradiction)

      Slightly OT, but I’ve noticed that American culture pays a whole lot of lip service to the idea of forging your own destiny/making your own choices/radical individualism/freedom &c., then turns right around and shouts down people who don’t value the correct things. If a female character in a mainstream Hollywood movie doesn’t want to get married and have kids, odds are that this trait will be treated as a problem that needs to be solved, and it usually will be “solved” by the end (note that I said “odds are,” so please save your list of a half-dozen exceptions, and no I’m not saying that this is an inferior preference nor that it’s inherently a bad narrative choice for every story). Marijuana is evil, and one puff will get you hooked for life. Scientific progress is chastised for hubris, because We Must Not Tamper In God’s Domain. The list goes on, and on, and on.

      I think the reason mental illness is so hard for people to “process” is because we just don’t want to admit that we’ve been socialized to believe that every preference that seems weird to us is a mental illness, a problem that must be fixed.

      • Mary says:

        But if we supported their choices, what would the need be to FORGE your destiny?

        • Sylocat says:

          That’s why I said “pays lip service to the idea of,” rather than, “actually promotes.”

          It’s the difference between having a character make a rousing speech towards the end about how We Make Our Own Decisions, versus actually rewarding or punishing a character for making decisions outside the bounds of mainstream acceptability.

          • Mary says:

            People who are intimidated away from choices by such extrinsic considerations would not be forging their destiny under any circumstances whatsoever.

            It is the essence of doing so that you do not need other people to actually promote your doing so.

          • Sylocat says:

            I don’t think anyone’s claiming that you can’t reject extrinsic considerations and blaze your own trail anyway. I was responding to something drethelin said about whether pop culture (American pop culture in particular) venerates doing so, and I argued that, with the odd exception here and there, it does not.

  28. krpr says:

    I remember a fair amount of annoyance among economists when physicists started publishing economics papers. One of the economists’ criticisms was that the physicists were applying mathematical analyses common in physics to economic data, then announcing the results with much fanfare while ignoring what actual economists thought. There were many articles published decrying arrogant physicists trying to save economics from the economists, without knowing much actual economics.

    I am not so much pointing out an amusing parallel between economics and physics, as I am saying that psychiatry will become even more annoying when physicists decide they have found a way to model mental illness with partial differential equations.

  29. Doug says:

    Are there any psychiatric disorders which you feel ought to be treated as unusual preferences? What is a way we could go about preventing such category mistakes in the future? Or is there something fundamentally different about homosexuality from all things currently classed as disorders?

    • Anonymous says:

      Tangentially, I wonder what would happen if homosexuality was found to be caused by the structure of certain parts of the brain, and a method for altering those places to “heterosexualize” the patient was practical? What would be its medical status then?

      • Leif says:

        Cosmetic surgery exists, and is considered medical, but we don’t consider being ugly a medical disorder. Couldn’t it be like that? (That’s not to say that being homosexual is ugly).

        • Wrong Species says:

          I think making “ugly” a medical disorder would not be the worst thing that could happen. It would certainly pass the utilitarian test with flying colors.

    • Muga Sofer says:

      Bodily integrity disorder, I think – that one where you want to have body parts amputated. Scott’s said he thinks it’s pretty obviously the same sort of phenomenon as trans people. (Although you could argue that’s merely a different KIND mental illness.)

    • anodognosic says:

      There are many autistic people who embrace the condition and prefer it not to be medicalized. Also, Ozy of Thing of Things has Borderline and is pretty outspoken about how they would not cure it given the chance.

    • Jon H says:

      In the case of ADHD, you have people who think the world would be a better place if it reconfigured itself to suit people with ADHD. More engaging schools, more flexibility at work, etc. These people, I think, would consider ADHD-related behaviors to be akin to preferences, rather than a disorder to be treated.

      Yet, even in such a world, people with ADHD might have ambitions in areas that are not amenable to being made ADHD-friendly. They would likely prefer *not* to have problems with attention.

  30. Muga Sofer says:

    >I discharged him and as far as I know he’s still taking those medications. If schizophrenia was a preference, this would be strange: he prefers to be schizophrenic, he knows that taking medications will make him less schizophrenic, but he keeps taking them anyway! Since many people like him become schizophrenic, keep taking their antipsychotic medication, and then become better – leaving them much as they were before they became schizophrenic – Caplan’s theory can only theorize that they have a base-level preference for being on antipsychotic drugs.

    Not exactly?

    It’s generally agreed that drugs can *change* a person’s preferences; the obvious example being, well, alcohol. Silly though Caplan’s theory is, it would be perfectly consistent with it for antipsychotics to remove “schizophrenia” – that is, the personal preference to LARP all day about government agents.

    (Heck, you even mention above that Caplan explicitly dismisses all neurological evidence at he beginning on the grounds that *all* preferences are a result of, well, neuranotomy.)

    Here’s how I imagine he might respond:

    Imagine for a second that not quitting your job was considered a serious psychological condition.

    This could be easily treated by giving people cocaine whenever they completed a work goal. Right? Of course, there would be side-effects, like with any medication. But it sure would “cure” people of their tendency not to go to work.

    But does the fact that the person now wants to keep earning their cocaine hits prove that they always really *liked* working, deep down, all along, and they just couldn’t work up the willpower to do it? Have we done them a favour by curing this willpower deficiency? After all, they could always secretly not take their medication if they didn’t want to be cured, right?

    Of course not! They might well hate their job; heck, the prostitute who hates working but has no choice to feed their drug habit is a well-worn stereotype. The drug has simply modified their preferences so they prefer work-plus-cocaine to work-plus-no-cocaine. Before, when you offered them the choice, they would never have taken it.

    • Aegeus says:

      If you accept that preferences can be altered by external forces, then the preference/ability distinction seems meaningless. If you can’t go to work because of the flu (but you would if you were cured of that), how is that different from not going to work because of depression (but you would if you were cured of that)? Both of them prefer (on the object level) not to go to work, but prefer (on the meta-level) that they be cured of the thing that makes them prefer not to go to work.

      The argument is not just “you can in theory model any behavior as a preference,” but “You can model any behavior as a preference, which makes it clear that psychiatry is just trying to provide a political shield to weird preferences, which is a bad thing they shouldn’t do.”

      If you accept that preferences are easily mutable, then that extension of the argument doesn’t hold up, because you can instead conclude “…which makes it clear that psychiatry is just trying to help people with weird preferences change what they prefer, which is a good thing.”

    • Loquat says:

      How does that hypothetical response account for people who freely choose to start taking preference-altering medication in the first place, though? Example: the Sinclair method for treating alcoholism, which uses naltrexone to reduce and eventually eliminate the craving for massive amounts of alcohol. I have an alcoholic in the family who’s recently been using it, with some success – on one level, he did indeed have a preference to drink a fifth of vodka after work every day, but on another level he had a preference to stop doing that which wasn’t strong enough to overcome attacks of the first preference without pharmaceutical help.

  31. Eliezer Yudkowsky says:

    That part about Caplan saying this in 2006 really needed to be more prominent. You can’t go assuming people agree with stuff they said nine years ago!

    That said, while I don’t ordinarily advise people to do drugs, if Caplan is still of this opinion I advise him to try a substantial dose of shrooms. It’s one of the safest psychedelics and should rapidly convince him that there are ways to disable a brain that are not like having different preferences.

    • chaosmage says:

      True, but Salvia Divinorum, while similarly debilitating for a few minutes, is probably even safer and unlike shrooms remains legal in some states of the USA.

    • Jared says:

      However, we can (in good fun!) judge Bryan Caplan for what his home page looked like in 2011.

    • Phil says:

      seems like a response to this:

      http://econlog.econlib.org/archives/2015/09/scott_alexander_2.html

      http://econlog.econlib.org/archives/2015/09/scott_alexander_3.html

      not sure what the date on Scotts original anti-Libertarian FAQs were, but they seem to date pretty far back in the past

      I suspect Scott found Bryan Caplan’s positioning of his original essays as work of a wayward potential student grating (I found it grating reading it originally too)

      ——————–

      if that’s what this was, I don’t love it, one of the things that make blog level debate interesting is that people try to argue across professional silos, I don’t love the tit for tat ‘stay in your silo’ exchange that happened here

      • Scott Alexander says:

        No, it had nothing to do with that. I genuinely disagreed with his paper, and have been meaning to write about it for a long time. I thought Caplan’s criticism of me was well-done and informative, though I don’t agree with all of it.

        • Phil says:

          ok, fair enough

          I read and like both your blogs

          ————-

          I think sometimes he has a tendency to slip into a tone that I think he’s kind of oblivious to how condescending it comes off (maybe I’m reading too much into that)

          (and tbf I wonder if that’s not an oblivious habit of my own writing, one limitation of writing as a medium is that it lends itself to unintended condescension, you try to write w/ some degree of authority …. its hard to know exactly how authoritative your tone should be)

          I do think his blog brings up a lot of interesting points that I hadn’t considered before, which (for me at least) is test of what makes a blog worth reading

          • Nathan says:

            I think Caplan goes out of his way to be polite to those he disagrees with. Sure, he tends to think he’s right and everyone who disagrees with him is wrong – don’t we all – but he makes sure to sprinkle compliments in amongst his critiques. From a certain point of view I can see that could appear to be condescending but I think he’s just trying to be nice.

    • RPLong says:

      Why, in this one case, is it appropriate to advise someone to do drugs? Shouldn’t your comment alone cast enough doubt on his opinion that he’d go do some more research?

  32. dahl says:

    Caplan is clearly wrong and over-reaching. One wonders why he would write such inflammatory material.

    But, there is a kernel of truth in the view from my perspective.

    I think there is an argument about when/where the margin is between poor behaviour and mental illnesses that we haven’t got quite right at present. The expansion of the DSM to cover what seems to be just ‘benign ass-hattery’ in all its forms has been a mistake of the profession.

    I’m not sure what test could/should be applied – but surely it would have to be a combination of the ‘compellyness’ of a behavioural problem (ie how much can a person control the behaviour), and the effects on themselves and society (who and how much harm is caused).

  33. Hi Alexander

    Congrats for your great blog.

    > There’s nothing obvious stopping an alcoholic from quitting booze and there’s nothing obvious preventing someone with ADHD from sitting still and paying attention. Therefore they are best modeled as people with unusual preferences – the one with a preference for booze over normal activities like holding down a job, the other with a high dispreference for sitting still and attending classes.

    This is absolutely fucked up, but it is not a psychiatrical problem, not an economical problem, but a problem with the underlying philosophy of both. This is actually the very same philosophical problem I based my Dividualist blog on: preference implies an undivided, individual will. There is NO such thing. Part of the alcoholic wants to drink and part doesn’t.

    You are roughly right in IV but you should really see the deeper implications i.e. dividualism, lack of unified will and thus lack of unified preference, and basically that kills the whole liberalism project, be that left-liberalism or right-liberalism (libertarianism). The basic unit of liberal thinking is the decision making person with will and preferences. Such a thing does not exist: there are only subagents inside us.

    It is important to see – even if you don’t accept dividualism – that preferences or desires are PREDICTIONS. They are a tantamount to saying “this is going to make me happy”. Then they come true or don’t.

    If we accept dividualism, the whole being of a human has only really broad meta-preferences like “I want to be happy”.

    Different parts of us make competing predictions. “We will be happy if we lose weight!” “No, we will be happy if we eat that cake!” and the strongest one wins and becomes the “individual” preference.

    • suntzuanime says:

      I think it’s a mistake to assume that the whole being of a human has broad meta-preferences like “I want to be happy”.

      • Heh, I get out-dividualisted in my first comment 🙂 Must love rationalists.

        Sure, but let’s just be optimistic and say individualism is only 99% wrong not 100% because people couldn’t have been _so_ stupid to believe something _so_ wrong for such a long time. So at there is at least some thin thread connecting out subagents, a certain sense of shared interest or future – if the body hurts, all of them will hurt. So they at some level still try to optimize for the welfare of the body they inhabit.

    • Tim Martin says:

      “This is actually the very same philosophical problem I based my Dividualist blog on: preference implies an undivided, individual will. There is NO such thing. Part of the alcoholic wants to drink and part doesn’t.”

      Yep, that’s exactly what I was thinking when reading this (well, the part about a divided will – not the part about your blog).

      The problem of akrasia is super relevant to this. You want to get things done, but you don’t want to do them? You’ve got competing preferences.

      • I did an experiment. Not with akrasia.. We wanted out flat to feel larger. It felt cramped but did not want to get an actually bigger one so we just figured it could be rearranged to feel better. We hired an interior designer, actually just a student couple (cheaper) and ask them to tell us what we should want. They were surprised they thought it is like clients tell them what they want and they design how. I said no, you are the experts, figure out whatever arrangement makes typical human beings feel a space is roomier. They gave us some pretty good ideas. But they found it weird people ask them what they should want as they were used to the idea that clients know what they want just not how.

        Anyway, this worked out well.

        The result of the experiment is that if you trust an expert, you can get good outcomes from swallowing your pride and basically subordinating your will to him / her, handing over basically all your decision making in a domain and making him / her boss.

        Thus, I would solve akrasia through something like a personal trainer who is paid to ORDER you to do your work. Like a football coach. Consider it in the broad sense, I am not actually saying college students somehow afford to hire actual trainers or coaches. Maybe an app?

        • Winter Shaker says:

          Maybe an app?

          Beeminder (which sponsors this very blog) is quite useful for some people, myself included.

        • Tim Martin says:

          It’s funny you should say that. For the past year I’ve been kicking around the idea of starting a business. One of the reasons that I haven’t attempted it is because I often don’t have the motivation for self-direction. A business involves making lots of open-ended choices in pursuit of far-off rewards… and I know I do poorly with those.

          I have realized, however, how good my work is when someone else tells me to do it. Having a boss who assigns me tasks means I generally kick ass at those tasks. This only works if I’ve “bought into” the reward scheme- if I feel that doing my job is rewarding or getting good grades is rewarding. I won’t just do what anybody says. For that reason I don’t know if the app would work (I’ve had mixed results with beeminder). A life coach, maybe. In any case it’s an interesting idea.

  34. YmcY says:

    Thanks for writing a post I wanted to a long time ago, Scott.

  35. suntzuanime says:

    I think the way to steelman Caplan’s position is that it’s not so much that he’s ascribing more agency to the mentally ill than society does, it’s that he’s ascribing less agency to the mentally healthy. Ordinary people do the dumbest bullshit all the time for no good reason; the polite term for this phenomenon is idiosyncratic preferences. Ordinary people’s perception of the world is no more than a hallucination, as you can see if you check out some optical illusions or read some Moldbug. Ordinary people’s explicit intentions often fail to cash out in actions predictably leading to the fulfillment of those intentions when the fulfillment would conflict with some base desire of theirs, so why should we expect that someone with alcoholism or ADD would be any better at it?

  36. Richard Gadsden says:

    I have obstructive sleep apnoea, and before it was properly treated, I used to get very seriously sleep-deprived from time to time.

    When very sleep-deprived, I would hear voices – usually one of my parents – that were not there. And I’d look around to see where they are, and then realise they aren’t there and put it aside.

    So yes, hearing voices is a real phenomenon.

  37. keranih says:

    The mental health of humans is not my field, except so much as I am a human. (And pay taxes which are used to pay practitioners in mental health fields, and that I have a strong desire to live life without excessive contact with people who have disruptive mental disorders.) Nor is my area economics, except so much as I participate in an economy and vote for government officials who have (so they tell me) the ability to adjust the economy to my best preferences.

    One might see this as sufficient reason to form an opinion on the influence of economic theory on the practice of psychiatry. Instead, I’m fighting the urge to invest in popcorn futures.

    I think there is something to the idea of preferences in human behavior, and I also think that choice is overstated in normal behavior. We don’t choose to fall in love, we don’t choose to be hungry, or cold at a certain temperature, or think thunder is loud and startling – these mental/emotional reactions are fairly well hardwired into the basic model. We operate within the constraints of these typical ‘preferences’ day-to-day.

    Suppose that communities have developed around the basic preferences of people, and so tend to support ‘normal operation’ in the physical and cultural environment of that culture. So a society would allow a broader range of preferences where lots of deviation didn’t hurt the community, and required stricter adherence to ‘normal’ (or to some variation just off ‘normal’) where it was important for that society. Different societies could allow deviation in different places.

    And it’s possible that a society could allow (or encourage) unhelpful deviation for that community, in that situation, and not realize it until damage started appearing. – as one doesn’t realize that a hat and a shirt would have been a good idea until after the sunburn set in.

    …like I said, not my field(s).

  38. My two cents (still have not read Caplan’s piece, which I intend to do, but I trust you enough to believe you’ve presented it fairly) is that he’s taking what would be reasonable arguments against most clinical psychology, and just barking at the wrong tree. Anyway, I give psychiatry much more credence than economy, and I’d say it treats “real” conditions (causes of human suffering and non-voluntary in any sense limitations to the amount of flourishing the people afflicted by them may aspire to achieve) in a thoroughly more scientific way than any “social” science. The result of a (properly powered) double blind experiment seem to me a valid epistemic criterion to separate right from wrong statements. Half assed experiments with a handful of students in exchange for beer money and a lot of data mining over historical events once they are over do not seem so reliable…

  39. Anonymous says:

    I actually think my preferences when severely depressed were rational, taking my distorted perception of reality into account.

    Things I believed when depressed included “I am a weird freak that no one could ever relate to and the only way I ever find companionship is by faking my personality” and “I do not deserve kindness, gentleness or consideration and I need to toughen up and learn to deal with inconsiderate behaviour better.”

    Those beliefs bore enough superficial resemblance to healthy ideas like “Fake it till you make it” or “Don’t get upset about trivial things” that without a lot of help I couldn’t detect them as irrational. But they made the world a miserable enough place that staying in bed all day WAS my best option, even though out of guilt or shame I often tried to fight with myself to get stuff done.

    I suspect that “rational preferences given false information about the world” also covers a lot of undesirable behaviours associated with schizophrenia. But of course the false information is the actual problem.

    Goddamn, that Caplan article was ridiculous though. I was going to say “stupid,” but it reads more like “smart person following through on a drunken bet.”

    • Deiseach says:

      I suspect that “rational preferences given false information about the world” also covers a lot of undesirable behaviours associated with schizophrenia.

      Of course! If you genuinely, absolutely believe that your neighbours are stealing your keys to break into your house, then calling the cops, setting alarms, and even sitting in the back garden with a shotgun all night are rational preferences. But it still doesn’t mean you’re making a choice about what to believe about your neighbours; the distorted thinking of the illness puts 2 + 2 together and gets 93 and 2/5ths, where noticing Jane is wearing a pair of shoes that are like a pair you own makes you jump to the conclusion that Jane has stolen your shoes, rather than that these are not unique shoes and she bought one of the many similar pairs on sale in the shops.

      It’s possible to say “people who prefer to drink all day and not waste their drinking time having to go to work” are simply acting out of a preference rather than suffering from a disease, but it doesn’t help bolster Szasz and his idea that labelling people as mentally ill or troubled is ethical not medical judgement, and it certainly permits judgementalism (“he’s not an alcoholic, he’s a lazy free-loading bum!”)

      I do not see how it is possible to say, other than using technical terms that do not have the same tenor as the words in common parlance, that someone has a “preference” to be depressed or schizophrenic.

  40. I don’t know how much you ultimately disagree with Caplan, other than in regard to terminology.

    But I’m pretty sure you are mistaken about whether beliefs are voluntary. I’m quite sure that direct doxastic voluntarism is completely true, based on my own experience and everybody else’s.

    You say, “If someone offered me $1 million to believe that Greenland is in the southern hemisphere, could I do it?”

    I say, “If someone offered you $1 million to go kill yourself right now, could you do it?”

    No for both, because you don’t want to. It’s that simple.

    • Anonymous says:

      Forcing yourself to physical action is a different thing from forcing yourself to a mental state.

    • Anonymous says:

      I do want to! I am quite happy to believe something false about Greenland for $1million. But I don’t know how to. If you know how to change your beliefs about where Greenland is, you should share. That sounds like very useful brain hacking technology.

      That’s entirely different from not wanting to commit suicide.

      I think the experience you are basing your model on probably doesn’t generalise to other humans (exception: Bryan Caplan?) I’d like to hear more about it.

      • You don’t want to commit suicide because it will have bad consequences, namely because you will be dead.

        You say you are happy to believe that Greenland is in the southern hemisphere for money, but in fact you do not want to, because it would have very bad consequences, even if you haven’t thought about them clearly.

        For example, if you go around saying that Greenland is in the southern hemisphere, people will point to maps and say, “Why does everyone say it is in the north?” You could simply respond that you decided to say it is in the south for money, but then people will say, “so you don’t really think it is in the south?” If you say that you do, as you must if you want to keep the money, then they will insist, “So why do the maps all say it is in the north?” You cannot admit that the reason is because it is in the north, since then you will have to give back the money. So you will have to make up some reason to say it is really in the south, and all the maps are a fraud.

        That is only a start of the bad consequences, and they will continue to build up. Those are the reasons that you do not want to believe that, even for $1 million.

        I will make another comment indicating some of the obvious experiences that indicate that all beliefs are completely voluntary.

        • Anonymous says:

          Have you ever seen someone hypnotised by a stage hypnotist?

          They will come up with (highly entertaining) rationalisations at the drop of a hat to justify the beliefs just implanted into them.
          It doesn’t look that terrible. Certainly not something I’d be unwilling to undergo for $1million.

          What do you think Flat Earthers claim about the map problem? I bet they’ve got explanations.
          Many people believe elaborate conspiracy theories and have perfectly normal lives otherwise. As said above, I’m entirely happy to have false beliefs about Greenland.

          Your reasons that I don’t want that $1million (how very presumptuous of you to tell me what I want, by the way) are not valid or convincing.

          Please to share your belief changing technology? I want that.

          • “How very presumptuous of you to tell me what I want, by the way.”

            Exactly. If beliefs are voluntary, they can be presumptuous. If they are not voluntary, they cannot be presumptuous. You are making my point.

          • Anonymous says:

            That’s absurd. You’re not presumptuous for having one wrong belief. The other false beliefs that you’re revealing (primarily beliefs about yourself and your relative level of insight and acuity) which allow you to both believe and express stuff like that are the reason I’m calling you presumptuous. I’m pretty sure that those beliefs are mostly involuntary and aren’t impacting your life in a good way.

            I’m going to disengage now since that was a lot more personally insulting than I wanted to be but I didn’t see any other way to communicate meaning in this case, and I don’t want the conversation to continue to deteriorate in this way.

            Edit: there seems to be a loop thing happening here. This comment doesn’t concede your absurd point, maybe just keep reading the above few paragraphs over again until the actual meaning sinks in?

          • It’s not absurd at all. I think you don’t want to believe that Greenland is in the south. If this thought is not a voluntary act, it cannot be presumptuous for me to think it, and you concede this in your most recent response.

            In reality, people can have presumptuous thoughts. Those thoughts are voluntary.

        • Soumynona says:

          Your are equating the belief in something (Greenland is in the south) with talking about it all the time. There’s an option to believe that Greenland is in the southern hemisphere and shut up about it, to avoid arguments with all the crazy people who believe otherwise. It’d almost certainly never come up on its own and if it did, you could change the subject because no one cares about Greenland that much. Most people go through their lives without ever debating the location of Greenland.

          • The problem with this is that it will come up in your own mind when you consider the consequences in relation to other things you believe, even if you don’t talk about it.

        • Earthly Knight says:

          You say you are happy to believe that Greenland is in the southern hemisphere for money, but in fact you do not want to, because it would have very bad consequences, even if you haven’t thought about them clearly.

          Suppose someone offers me $1 million if I can will myself to believe that Greenland is in the back room of a convenience store located in Truth or Consequences, NM. If unrestricted voluntarism is true, it doesn’t seem like anything is stopping me from adopting the following pair of beliefs:

          1. Greenland is in the back room of a convenience store in Truth or Consequences, NM.
          2. Neither (1) nor (2) conflicts with any of my other beliefs or should affect my future behavior in any way except by allowing me to collect the reward.

          If I adopted this pair of beliefs, I would get a cool million with no downside, so there does not seem to be any way for you to explain away my failing to do so as a matter of choice or desire. But I’m extremely confident that I still could not will myself to believe that the island of Greenland is entirely contained within the back room of a convenience store in Truth or Consequences, NM, not for a million dollars, not for any amount of money.

          Ergo, unrestricted voluntarism is false.

      • See Robin Hanson here (http://www.overcomingbias.com/2015/08/why-have-opinions.html) for some examples of general experience that suggest that opinions are voluntary. Hanson does not say it explicitly, but it is implied by all of that (which are very common reasons, not just reasons he has personally) that we adopt our opinions voluntarily.

        Religious conversion is an obvious example of voluntary belief, whether from one religion to another, from religion to atheism, from atheism to religion, or in any other way. People will often explicitly admit that there was a moment when they decided their previous beliefs were false. You might suppose that the moment was just like a moment when someone hit you (i.e. something involuntary) but in fact if you think about it, those cases are perfectly obvious cases of “decisions,” namely decisions much like the decision to get married. Someone might feel himself at a crisis point, lay out all the evidence for himself, and finally decide to change his position, or to keep his position. Either way he is making a choice, not having something happen to him.

        When you have a discussion with someone, and someone is presenting very convincing arguments for his position which is contrary to yours, it is very unusual to change your mind immediately. Instead you go home to think about it. This doesn’t mean you go home to wait until you get hit on the head by the truth. It means you go home to think about whether or not it would be good to allow yourself to be convinced or not. You are making a choice.

        Rationalists are always talking about the importance of updating on evidence. They talk about it in very moral terms, that is, you are doing wrong and behaving viciously if you don’t update, and behaving virtuously if you do. They are right. Updating is a moral act. It is a choice: you decide whether or not you want to ignore the evidence, or modify your belief based on that evidence.

        We can assert, defend, and act upon in the real world, any belief we want to, and we are doing that constantly. We are choosing our beliefs.

        • Anonymous says:

          Opinions should be distinguished from beliefs. Personally I have a habit of adopting opinions based on what I think will most annoy the person I’m talking to. I suspect the same may be true of Robin Hanson. And Bryan Caplan. A lot of economists are just contrarian dicks tbh.

          Actual beliefs about the nature of concrete reality are a lot harder to change and it is pretty rare that people experience a change in said beliefs as voluntary.

          • You are largely right about “actual beliefs about the nature of concrete reality.”

            That is because if you are wrong about e.g. whether God exists, or whether gun control is good or bad, it will be unlikely to affect your life in the slightest. So it is easier to decide to believe or disbelieve those things, since it won’t hurt you.

            But it’s very difficult to decide to believe that you will be ok jumping from a third story window, because that belief is probably going to hurt you. It’s hard to decide to believe that, because you know that believing it is a bad idea.

          • Anonymous says:

            Yet people sometimes do arrive at beliefs like that. Involuntarily. Under the influence of certain substances. Or indeed schizophrenia.

          • Psmith says:

            “A lot of economists are just contrarian dicks tbh.”

            I resemble that remark!

        • Jaskologist says:

          Religious conversion is an obvious example of voluntary belief, whether from one religion to another, from religion to atheism, from atheism to religion, or in any other way. People will often explicitly admit that there was a moment when they decided their previous beliefs were false.

          Disagree. Just because it can change doesn’t mean I can change it. I could not simply decide to be a truly devout, believing Hindu for the next three days. It is nevertheless possible that at some point in the future I could be convinced to become a devout believing Hindu (and note that even there we would the language of convincing as something being done to me).

          Not to mention, the bulk of Christian theology comes down pretty strongly on the side that says that conversion is not a choice we can make. No doubt this is heavily influenced by the biographies of its major influences (St. Paul and St. Augustine), neither of whom found they had much say in their own conversions.

          • FacelessCraven says:

            @Jaskologist – “It is nevertheless possible that at some point in the future I could be convinced to become a devout believing Hindu (and note that even there we would the language of convincing as something being done to me).”

            What’s the difference between chosing and convincing?

            I’ve been convinced to change my fundamental views about bedrock reality several times in my life. At least one of those came down to something that felt an awful lot like raw choice; I was faced with two contradictory worldviews, I picked the one that seemed to have the less awful consequences, and observed my evaluation of evidence changing like magic. Sure, it was pretty obviously irrational, motivated cognition, but the experience left me pretty doubtful of whether anyone else is doing much better. We choose what we want to believe, and our evaluation of evidence shapes accordingly. That doesn’t mean that our choices are arbitrary, it just means that worldview is a fundamental choice we make, one way or the other.

            “Not to mention, the bulk of Christian theology comes down pretty strongly on the side that says that conversion is not a choice we can make.”

            Really? As a Christian, I find that claim pretty surprising. I know this isn’t really the forum for it, but could you elaborate a bit? Is this a catholic/calvanist thing?

          • Jaskologist says:

            Calvin is best known for it, but he pretty much lifted predestination straight from Augustine, and it’s not like there isn’t ample backing in Paul. I tend towards Arminianism myself, but I have to acknowledge that this has not been the dominant view historically.

            Augustine, On Grace:

            For not only has God given us our ability and helps it, but He even works [brings about] willing and acting in us; not that we do not will or that we do not act, but that without His help we neither will anything good nor do it.

        • RCF says:

          You seem to be basing your argument for the proposition that deciding to perform an action and deciding that a proposition is true are identical action on the fact that the English language happens to use the same word (“decide”) to refer to both. This is a highly fallacious argument.

    • Deiseach says:

      Unless I had an impoverished family to support, or a particular cause I wished to donate to, then killing myself for $1 million, or $10 million, or $100 million makes no sense – how can I enjoy my riches if I have to kill myself right now?

      It might be different if it was the classic pact with the Devil – ten years’ worth of fame, wealth, health, good looks and as many attractive persons of your preferred gender/orientation as you could wish, then the reckoning comes due.

      • Yes, you’re giving reasons not to want to kill yourself for money. But there also are reasons not to believe that Greenland is in the south as well, very strong reasons even if you will be able to use the money.

        • Jon H says:

          “But there also are reasons not to believe that Greenland is in the south as well, very strong reasons even if you will be able to use the money.”

          As long as the option exists to outwardly pretend you believe it is in the North, there are very few people who would actually face significant problems due to believing that Greenland is in the south. Maybe pilots who need to be find a place to land in an emergency.

    • Scott Alexander says:

      When you say “Don’t want to,” of course I don’t – $1 million isn’t nearly enough to make me want to kill myself, and depending on how altruistic I am maybe no amount is, since I can’t enjoy the money.

      Make me a decent offer, and maybe I’ll take it.

      On the other hand, I really have no reason to care which hemisphere Greenland is in. The worst that happens is I look dumb on a geography quiz. How is that not worth $1 million?

      • Looking dumb on a geography quiz isn’t the only thing that will happen. It might be the only thing that will happen if you simply say “Greenland is in the south,” without really believing it. But we’re talking about what will happen if you actually believe it. I am saying that you don’t want to because (at least at some level) you expect that extremely bad things will happen if you actually believe it.

        Starting with being forced to accept that everything in the world is explained by conspiracy theories. And what will happen when you act on those theories?

        • Captainbooshi says:

          There are a ton of otherwise perfectly normal people who believe that life is run by conspiracy theories. I see no reason why it wouldn’t be worth a million dollars to join their ranks, especially if it’s to believe in a conspiracy as harmless as that the maps are all wrong. I just couldn’t force myself to believe something I thought wasn’t true, no matter how incentivized I might be. It would always be an act.

          On a more personal note, I’ve had beliefs directly changed by pharmaceuticals. At one time in college, I was so depressed, I often couldn’t even bring myself to leave my room to eat. After only a short time on anti-depressants, quite a few of my beliefs changed, through no decision on my part. This would seem to pretty conclusively show that not all beliefs are completely under your direct control.

          • Three things about this:

            1) It occurred to me just now that if someone says, “I’ll give you money to believe that Greenland is in the south,” it may actually be the case that you can’t do it, not only because you don’t want to, and not because belief is not a voluntary act, but because you may not know how to do it in that context, just like if someone offers you money for making a certain facial expression, you may not be able to do it, despite the fact that in other contexts you make that expression on purpose, making a face at something someone is saying. That expression is voluntary whenever you make it, but you might not be sure how to make it in an arbitrary context where someone asks you to do it. This can happen with belief as well. However, if that is the case I can explain how you can do it in any context, given that you actually want to, and are willing to accept all of the consequences.

            2) I think your point about conspiracy theorists is that they don’t feel like it is an act, while it would feel that way for you. And that is probably because it would be an act for you, that is, you would not believe it. But not because you can’t, but for a different reason.

            Namely this: if you believe something, then you act in the way that would be appropriate if that were the case. You can’t just say, “The FBI is after me.” You have to actually lock the door to keep them out. Otherwise you are implying that you don’t really believe it. I don’t think you would be willing to do everything that is implied by the conspiracy theory being true, no matter what comes up. You mean precisely that you would be willing to put on an act for the sake of the million and seem to be a conspiracy theorist. But to be a real one and to do everything, that is different.

            If the point is that you would simply have a feeling that “this feels like an act,” many people who believe things have a feeling like that. It doesn’t stop them from believing it anyway, but it can be one of the bad consequences of believing something that is not supported by evidence.

            3) I would suspect that you simply didn’t notice the decisions, since we are constantly doing things on purpose all day long without noticing the fact.

          • Simon says:

            It would be interesting to see how forced religious conversions play into this.

            I’m a secular liberal Western European guy with enough money, and the idea of starting to believe in a God just strikes me as impossible. I simply can’t, just like Scott just would not be able to sincerely believe Greenland is in the Southern hemisphere.

            I suspect that the same is true for people who are religious. New Atheists sometimes say that religion is a choice, but in this way it’s clearly not. They could fake it, like how I could vote for Trump, but I simply cannot believe that he would be a good president.

            Yet all throughout history people have been forced to start practicing certain religions and for the most part kept with it. There are of course a lot of stories about martyrs who kept their original faith under extreme duress, but there are many more people who just made the switch, and presumably actually started believing something else. Even though the consequences of not believing the right thing were very high (eternal suffering and such).

            It would be interesting to see data on how big retainer rates are for these kinds of events, but I would assume in a decade or so the new religion has been normalized and internalized.

            That would suggest that if someone offers you a million for believing Greenland is Argentina’s Madagascar, you should just keep trying really hard for a couple of years to believe it. Try to sink some cost into it if you can, by writing a blog about it or arguing with your friends over it. And maybe after fifteen years or so you can get that sweet million dollars.

          • Psmith says:

            “there are many more people who just made the switch, and presumably actually started believing something else.” This is not at all obvious to me. Particularly considering how often people either kept doing what they were doing before but added in some boilerplate about how this was actually a commemoration of their conquerors’ religion or were suspected by the conquerors of continuing to practice the ancestral faith in secret. I think you’d have to wait a generation at least to get a population that actually believed and didn’t just profess to believe as necessary in order to stay out of trouble.

          • Simon says:

            I don’t know many examples, but the few mass forced conversions I can name have kept their new religion, which suggests that they didn’t offer all that much resistance.

            But it’s an interesting point about reforming your old beliefs to adhere to the new ones. Say I get offered the million bucks re: Greenland, and instead of saying it’s next to Argentina, I start saying the Northern hemisphere is actually the Southern hemisphere. Why do you people even call it that? It’s an arbitrary colonialist construction to put Europe ‘on top’ of the planet that’s just floating through space. It’s a construct, so we should call the Southern hemisphere northern etc. etc.

            That way I don’t have to accept the obviously false belief that Greenland is next to Argentina, but I can construct a narrative in which facts I don’t think are true can be true. Maybe forced conversions also go like this, with newly ‘necessary’ beliefs not just accepted but forced into the original subset of ideas.

            It would be interesting if on the border of Islamic Africa and Christian African there are Islamic sects that accept Muhammed as the final and most important Prophet, but still focus on Isa/Jesus in the way they practice their beliefs.

          • Psmith says:

            I was thinking of something like Interpretatio Christiana (see https://en.wikipedia.org/wiki/Interpretatio_Christiana), although I couldn’t think of any real examples at the time.

          • Deiseach says:

            I start saying the Northern hemisphere is actually the Southern hemisphere. Why do you people even call it that? It’s an arbitrary colonialist construction to put Europe ‘on top’ of the planet that’s just floating through space

            You mean Northern Hemisphere Bias? Indeed, it is true to say that:

            Because orienting north toward the top is a matter of convention rather than correctness, a south-up map is technically just as correct as north-up

            So if you wish to overcome irrational hemispheric bias, and read from a south-up map, it is perfectly true and easily believable that Greenland is indeed in the ‘southern’ hemisphere 🙂

        • Aegeus says:

          Well, /r/conspiracy indicates that there are over 300,000 people who believe in conspiracy theories, and yet are content to post on Reddit instead of going out to smash the evil government surveillance state. And don’t tell me that they don’t “really” believe it because they don’t act on their theories – if you read any arguments on that site, you’ll see their beliefs are as fervent and unshakeable as any religion.

          Actually, religion is probably an even stronger counterargument. How many people believe that the Earth is 6,000 years old, and yet still manage to live normal, happy lives outside of a biology classroom?

          • People are different. If you believe something, that is going to have some consequences for their other beliefs. Some people are comfortable with believing that the earth is 6,000 years old, but that is because they don’t notice the inconsistencies with other beliefs. So anyone can choose to believe that the earth is is 6,000 years old, but not everyone is going to be happy with the consequences of that.

          • Marc Whipple says:

            Saying that young-Earthers don’t “notice” the inconsistencies is giving them far too much credit and, ironically, also giving some of their opponents far too much credit.

            The latter because their more outspoken opponents never miss an opportunity to actively ridicule them, to the point of being obnoxious jerks. The idea that young-Earthers could fail to notice their actions downplays this obnoxious jerkitude to a significant degree. 🙂

            The former because even absent obnoxious jerketizing, there are few adult young-Earthers who by now have not been extensively exposed to modern science through education and mass communications. They noticed. They just don’t care. This is for many reasons (they may think it’s a trick of the Adversary, they may think it’s God testing our faith with plausible alternative explanations, they may think it’s all a huge Science conspiracy, et cetera.) But they are well aware of the contradictions.

          • Aegeus says:

            So what’s stopping Scott from also choosing to ignore the inconsistencies with other beliefs? If millions of YECs can learn the art of “not giving a crap about a false belief that almost never impacts daily life,” why can’t Scott learn it? He’s not some sort of Avatar of Consistent Knowledge who will be shattered to the core if he ever notices a contradiction. He’s human like all the rest of us.

            Actually, even if Scott is somehow different, you’re still making the claim that a creationist, since he’s learned to ignore inconsistencies with his beliefs, should be able to will himself into believing that Greenland is in the southern hemisphere. That still sounds implausible.

        • Hhmmmm… this is an area I’ve been very interested in lately, as I share with you the impression that certain beliefs are indeed voluntary, but preceive that as a very minoritary opinion nowadays, when most people seem to assume, as some previous poster has already noted, that “mental states” (belief being one of them) are just a product of the circumstances that surround us and over which we have no control.

          There is a quite rich literature about what makes a belief “warranted” (Alvin Plantinga has a quite subtle and astute trilogy on the subject) but in the end intelligent and sensible people come to opposing conclusions (not just on this particular point i.e. to what extent belief is voluntary, but about what content of such beliefs is warranted or not), and I have the impression that the latter point (what is it reasonable to believe) much influences one’s position towards the former (if one has some choice in holding them).

          I would argue that as there are meta-volitions that can influence the first level content of our volitions, there can be meta-beliefs that can similarly influence the content of our first order beliefs, and of course it is well known that people are more ready to believe what is in accord with their desires (so what we want has a marked influence, not necessarily conscious, on what we end up believing). Now I would also say that some beliefs are more amenable to being influenced by volition than others. Things like the existence of God, the correct moral framework for deciding how to act or the reasonableness of certain political positions are highly “influenciable”, whilst what hemisphere Greenland is on or the number of fingers I’m holding in front of my face right now seem less so, and more apt to be changed or reviewed by changes in the information presented by our senses, regardless of what we want.

          • Yes, I agree with pretty much all of this, including the last point, that some beliefs seem much more voluntary than others. But I would interpret that mostly as implying that we have different kinds of desires and sometimes one wins out over another.

            So one example would be the case where you can’t hold your hand in a fire. Some comments said it may be physically impossible for someone to do this. That may be true, but even in that case I would still call it a kind of desire, just a very low level one that you can’t overrule. Obviously that is different from a conscious desire. But this could apply to some beliefs as well.

            Another example on the physical level: once I saw someone standing on the edge of a low cliff, wanting to dive into a pool of water. He stood there for 20 minutes trying to make himself do it, and could not. This is clearly not a physical impossibility, and he clearly wanted to do it, in a conscious sense, but there was another desire resisting it, and the latter won out. Similar things could happen with beliefs.

            It seems to me that the general difference between e.g. politics and the existence of God, on the one hand, and the number of fingers and the place of Greenland, on the other, is that in one case your brain is estimating that it doesn’t matter much whether you are right or wrong, but in the other case it matters. This would basically be for evolutionary reasons, because holding objectively wrong political and religious opinions isn’t going to get you killed, but holding political and religious views against those of your tribe may well get you killed. But being wrong about whether there is a pit of spikes in front of you is always going to get you killed, so your brain will insist in getting this one right.

            This is also why someone might assert something false e.g. about whether GDP rose under Bush’s presidency, and then change his mind either to say he doesn’t know, or even to the opposite, if he is forced to bet on it. Because first he chooses his belief in the first way, without caring for truth, and then he changes to choosing with some care when it matters.

        • Nornagest says:

          I’m not a botanist or a farmer, so the worst thing that would happen if I believed, say, that apples were a highly derived type of mushroom is that I’d frustrate my biologist relatives at family dinners. The information is almost perfectly irrelevant to my life, and the downside risk involved is nowhere near a million dollars’ worth of bad.

          I’m not dogmatic about truth either. But I still don’t think I could successfully believe it for a million dollars.

      • Also, another issue with the $1 million for a false belief thing, is that it is not a real offer by a real person, and that affects how we think about it. If someone offered that in real life for a belief which would not have bad consequences, e.g. suppose Bill Gates made a real offer, and people knew it was a real offer, of $1 billion to anyone who would change his mind about whether God exists or not. At first people would react to that like the couple reacts at first in the movie Indecent Proposal. But very soon afterwards, someone would take him up on it.

    • stargirl says:

      I would happily kill myself for 10 million dollars tax free, which I can distribute as i choose in a tax free manner. (if I, or my recipients pay taxes you need to pay me more).

      I also think if you offered me 1 million dollars to believe Greenland was in the southern Hemisphere I would certainly try hard to believe this! Though I feel this would require some pretty extreme methods. Maybe hypnosis would work? But I feel like even if you offered me 10 million dollars I am not sure I actually could believe Greenland was in the south. Though maybe I could?

      • If I offered you $10 million to stick your hand in a fire until it is burned off, you might want to do it for altruistic reasons, give what you said about killing yourself. But you might not be able to do it anyway. That doesn’t mean that moving your hand around doesn’t happen on purpose. It does. It might be the same with the belief.

        • stargirl says:

          Lets assume I cannot do something like lock my hand in place with some sort of tool. In this case I do not have any choice of whether or not to put my hand in a fire and let it burn off. I am fairly sure I do not have the ability to hold my hand in a fire for a long period of time regardless of the potential benefits to me or anyone else.

          If I was offered 10 million dollars to incinerate my hand I would also gladly take this deal. But I am only physically capable of taking the deal if I can somehow lock my hand in place.

          Nothing happens for no reason. But if my hand is in a fire at some point it is coming out regardless of how hard I try to keep it in. I do not have any meaningful choice about whether I burn my hand off in this fashion or not.

          • I agree, at least that all of this might be true. That’s what I was saying, namely that it might be impossible for you to believe that Greenland is in the south in the same way it might be impossible to hold your hand in the fire. But putting your hand places, generally speaking, is still voluntary, and likewise with believing things.

          • swerj says:

            The reaction to take your hand out of the fire happens without input from the brain. The sensations travel up the spine and the response comes without conscious decision. You could no more keep it in than you can control your heart beating. Your word ‘voluntary’ is doing a lot of work and I think you are using it in a way that is non-standard. Voluntary usually means with input from the deliberative conscious mind and does not apply to reflex actions.

      • Vegemeister says:

        I am surprised that your estimate of how much money you would need to be given power over in exchange for suicide has small enough error bars that the taxes make a difference.

    • Chris Conner says:

      You say, “If someone offered me $1 million to believe that Greenland is in the southern hemisphere, could I do it?”

      I say, “If someone offered you $1 million to go kill yourself right now, could you do it?”

      No for both, because you don’t want to. It’s that simple.

      Your hypothetical million dollar offer doesn’t distinguish between these two cases because it’s not sufficient inducement. If I were bedridden, wracked with pain, and I knew that the only way to end my suffering was to kill myself, I might well do that. Plenty of people in that situation have chosen to die. But if you were to tell me that you could relieve my suffering with some miracle drug you have, and you will give it to me if I start believing that Greenland is south of the equator, then I’m not going to be able to do it. Even if I believe that you have this miracle drug and you really won’t give it to me unless I meet your bizarre demand, I still won’t be able to do it.

      Your claim that I won’t believe in southerly Greenland because of the bad consequences won’t wash. I would gladly claim to believe just about anything you like about Greenland for a million dollars. For that kind of money, I would be willing to create a website giving 200 proofs that Greenland is the largest island in the Indonesian archipelago, located just south of Java, start a Twitter account so I could tweet about it constantly, and pester all my friends and family with theories about conspiracies of cartographers. This would have all kinds of negative consequences for my reputation and credibility, but for a million, who cares?

      On the other hand, if you told me you would give me a million dollars for sincerely believing in southerly Greenland, but gave me the out that I could play along with the common delusion that it’s actually in the north so that I don’t seem like a weirdo, then I still couldn’t do it. There would be no negative consequences, because my belief would never be disclosed to anyone, but I still couldn’t do it. Factual beliefs simply aren’t a matter of voluntary decision like that.

      But you claim that they are, based on what you see as common experience. Can you give an example of such an experience? When have you chosen to change your belief about some fact, and how did you do it? Can you do it for anything you believe? Could you choose to change your belief in, for instance, direct doxastic voluntarism?

      • When you talk about “factual beliefs,” do you mean a specific kind of belief, like about Greenland, as opposed to beliefs about things like God and politics? If so, then it seems to me that you are being confused by the “factual” character of certain beliefs. In other words, those are just beliefs where it is particularly obvious that there would be at least one bad consequence to changing your belief: you would end up being wrong. And then there could be any number of other bad consequences. That is true even if you keep it to yourself, since your thoughts affect one another. I suspect that not wanting to think that Greenland is in the south is like not wanting to hold your hand indefinitely in a fire: maybe you can’t do that, in a sense, but that doesn’t mean moving your hand is a non-voluntary action.

        All of my beliefs are voluntary, and they are affected by all sorts of motives. Evidence that they are true is one motive, but not the only motive.

        I choose to believe that 2 and 2 make 4, yes because it seems true to me, but also because I would probably go insane if I thought anything different, and I don’t want to go insane.

        I choose to believe that UFOs are not aliens, yes because there is pretty good evidence that they are not, but also because I don’t want to look like a weirdo, and because thinking they are aliens might mess with the rest of my views about the world.

        I choose to believe that moderate drinking is healthy, yes because there is some evidence for this, but also because I happen to like drinking.

        I choose to believe that various social policies are good policies, yes because there is some evidence for the goodness of those policies, but also because those are the views held by my social circle and I don’t want them thinking badly of me.

        I choose to believe that direct doxastic voluntarism is true, yes because there are good arguments and evidence for it, but also because it makes me “free”. That is, I can actually be more responsive to evidence because I know that I am capable of modifying my views however I like. I can simply say, “you know, that guy just presented good evidence for his position, it would be good to modify your opinion a good deal in that direction,” and I can do so as soon I want. If I thought that direct doxastic voluntarism was false, I would be much more likely to just do what people normally do, and ignore his evidence. But in fact I would just be making the choice to ignore his evidence, but without noticing that it was a choice.

        Of course these are examples of things I currently believe, not of changes per se. But it is already perfectly clear to me that I hold them on purpose, and could change my mind as soon as I like.

        As I understand it, all the changes of mind I have ever had were voluntary, and in that sense giving them as examples might not be very helpful. But maybe you mean cases where it was particularly obvious to me that it was voluntary. Changing my position regarding quantum mechanics from “MWI is probably false,” to “MWI is probably true” was certainly one case like that, but nowadays it is obvious to me that all changes are voluntary, every slight modification due to reading something new, and so on.

        As for how one does that. There’s a short story by Graham Greene about a former Catholic, an old man, and a discussion he has with a (non-Catholic) visitor. The old man explains that he left the Church because he was living in adultery, and that he no longer believes. The woman he lives with died five years ago. So the visitor asks, “so why can’t you go to confession and return to the Church? Is it because of what the priest would say?” The old man says, “Not at all. The priest would say nothing.” He goes on to say that he doesn’t want to go to confession because he is afraid: he fears that if he went to confession, his faith would not come back. This is a fearful thing because at the moment he doesn’t believe, but he thinks his faith would come back if he went to confession. If he went to confession and his faith didn’t come back, well that would be the ultimate proof that the faith was false, since the sacraments wouldn’t have any power.

        His faith would have come back. But the reason isn’t because of some special power in confession. The reason is that deliberately choosing to go to confession and say, “I sinned by believing that this was false,” is committing your life to the claim that the thing is true. And doing that, namely committing your life to that claim, is choosing to believe that it is true.

        So basically if you want to choose to think that something is true, you have to be willing to commit your life to that claim. So you can’t just choose to believe that Greenland is in the south and then act like everything is normal for the rest of your life. If you book an airline ticket that goes through Greenland, you will have to say, “wait a minute, that timing and that flight route is impossible, there’s no way I could go to the southern hemisphere to get there,” and then you will call the airline to get them to fix your ticket.

        This is why you can often get people to correct political biases by asking them to bet on objective facts. Because they choose to think a thing for the sake of feelings when it doesn’t seem to have any costs whether it is right or wrong, but then when you propose a cost of being wrong, they choose to proportion their belief to the evidence they have.

        Yes, I could change my mind about anything, if I wanted to, including about direct doxastic voluntarism. But I don’t want to, because I think I would end up with a false belief which also has other bad consequences.

        • 27chaos says:

          Can we ban this commenter under the new reign of terror? Because the ideas in their comments all look like unproductive memetic parasites to me. So much effort invested in absolutely nothing.

          • Chris Conner says:

            Direct doxastic voluntarism isn’t some idiosyncratic position made up by entirelyuseless, it’s an idea that at least a few clever people take seriously. It seems plausible to me, even likely, that some of our beliefs are at least somewhat under our control. Entirelyuseless takes this to the extreme by saying that “all beliefs are completely voluntary,” and I think that is too far, but I’m still interested in exploring where the line between voluntary and involuntary beliefs lies.

            Scott can run his reign of terror as he likes, but I hope that “this idea looks useless to me, let’s toss the poster out” does not become the new way of things.

          • Princess Stargirl says:

            WTF man. This is pretty uncalled for. And you will notice I was just arguing against entirely useless.

        • Chris Conner says:

          When I speak about factual beliefs, I am making the traditional distinction between matters of fact and matters of opinion. And no, the distinction does not come down to a belief’s bad consequences. There are all kinds of factual matters upon which I could have beliefs with no consequences whatsoever: that Lucy the australopithecine was left-handed, for instance, or that there were exactly 301 noodles in the yakisoba I had for lunch. If I could pick an exact number of noodles and decide to believe that it was true, I would have no occasion to act on that belief. I would probably forget about it five minutes later. What’s the negative consequence?

          Your analogy between choosing your beliefs and choosing to move your hand isn’t very persuasive. “All hand motion is voluntary” is a hypothesis, and a pretty easily refuted one — consider muscle spasms, reflexes, or your arm falling asleep. Indeed, you’ve acknowledged as much in your reply to stargirl above when you wrote that “putting your hand places, generally speaking, is still voluntary, and likewise with believing things.” This contrasts with your very strong claim that all beliefs are completely voluntary.

          I take your perception of the voluntary nature of your beliefs at face value, but my beliefs about the same subjects don’t seem at all voluntary to me. I don’t think introspection is going to be very useful here; I could point out how common confabulation is to you, and you could point out how common being oblivious to one’s own decisions is to me. But in all of the cases you cite, there doesn’t seem to be any operative difference between what I think I do and what you think you do. I say I think moderate drinking is healthy because the evidence points that way even though I don’t drink at all, you say you think that because of the evidence and also because you like drinking. It appears that the evidence alone is enough, so why should we conclude that your preference for drinking has any effect? What would be an example of something where the evidence pointed one way and your preference pointed another?

          And also — because what you claim that all your beliefs are voluntary makes it seem like a superpower, and that makes me want to see it in action — can you decide to believe some arbitrary, inconsequential fact any time you want? Can you, for instance, believe that Lucy was left-handed, even for just five minutes? Can you then switch to believing that she was right-handed, and then back to having no belief about it one way or the other? That’s what your strong claim about direct doxastic voluntarism seems to entail, and I’d like to know if there are people who can actually do that.

          • Marc Whipple says:

            “Reality is that which, when you stop believing in it, doesn’t go away.”

            Classic example: I can hypnotize someone into acting as if a wall were not there. For all observable purposes, I can hypnotize them into believing that the wall is not there. However, no matter how skilled I am at hypnotism, no matter how suggestible they may be, they will not be able to walk through the wall. (Although that would be extremely cool.) The wall is real. Its existence is a fact.

            Although it takes a few common definitions (more than you might think, fewer than you might fear) I can likewise say that Greenland is in the Northern Hemisphere, and no matter what anyone believes, it will remain there.

    • RCF says:

      You seem to be denying the entire concept of “can’t”; anything someone does, they’ve done, not merely been able to do, and anything they haven’t done, they must not have been able to do. While this is true from a reductionist perspective, it’s not true on the level that most people talk about ability.

  41. Jonathan Paulson says:

    Typo: “when a schizophrenic person has a formal thought disorder is is there to stay until they are treated.”

  42. Deiseach says:

    If interferon produces depression, then can depression be looked at as a preference in that case?

    And if not, then what makes non-interferon-caused depression different?

    If Szasz and Caplan wish to remove the stigma of mental illness and say that we are making negative ethical judgements about people, that’s very nice – but is their advice then to the person on interferon “Embrace and enjoy your new mental state of feeling like absolute shit! Don’t buy into the rent-seeking psychiatric nonsense of ‘illness’ that is amenable to ‘cure’!”

  43. John Ohno says:

    Caplan seems to be under the same misapprehension that a lot of people who complain about ‘the medicalization of normal variation’ are under — that the set of diagnostic criteria are the end-all and be-all of diagnosis & the social and cultural situation isn’t taken into account. Now, a psych 101 course (at least, the one I took) would have corrected him on that. But, I feel like it’s a little bit dangerous to have some large set of people (who might be voting on health care policy) believing that psychiatric care can be executed against the patient’s will at the sole discrimination of the shrink outside of extreme circumstances.

    Szasz’s position is extreme in some sense and not at all extreme in another — things that constitute mental illnesses in one cultural context may not constitute mental illnesses in another not because the symptoms are different but because the latter culture minimizes the negative repercussions of the symptoms, and this is an idea that even Freud didn’t consider controversial. Szasz took an extreme position of inclusivity, but one must keep in mind that he was operating during a period and in a context in which psychiatric authority was being systematically abused both in the united states and in the soviet union to lock up protesters indefinitely, and that kind of abuse of authority can be fully expected to result in a backlash.

    I am not convinced that Caplan’s motivation lies in preventing the indefinite detention of political dissidents; instead, it seems as though he’s presenting mental illness as a get-out-of-jail-free-card (which is common in pop culture but by no means realistic) and means to reintroduce agency — and thus blame — to a situation where he thinks canny malingerers are cheating the system by denying it. It’s hard to paint a positive picture of this, unless (like Caplan) you consider all forms of mental illness to be play-acting!

    • Jon H says:

      It seems to me that Szasz:psychiatry::Ayn Rand:Communism

      Something in their experience while young drove them to go a bit too far in the opposite direction, a position which they maintained for the rest of their life.

  44. Economic theory really has no way of dealing with preferences besides treating them as givens. Preferences are there to be satisfied, if we satisfy them, we are happy. The more we satisfy them, the happier we are (or the more utility we have, but whatever).

    Utility theory can help explain a lot of economic behavior that we take for granted; (such as the income effect, the substitution effect, why demand slopes downward, why people trade, etc) and can predict some behavior that is counter intuitive. In short, it is very useful.

    But it say nothing about people who wish to change their preferences. In fact, this is a contradiction in terms (within the context of the theory); if you wish to change preferences, then you have different preferences; you can’t wish to change preferences. Yet people wish to do this all the time.

    We have a simple model that explains a lot of activity in the real world; which, in my opinion, is pretty damn good for the social sciences. I know of nothing in Sociology or Psychology which can explain more behavior with fewer assumptions (not to say no such theories exist, but if they do I’d love to hear them).

    Yet to say this model is useful is a far cry from saying that it is true. Bryan Caplan seems to want to treat utility theory not as a useful base for explaining behavior, but as an immutable truth regarding humans; which strikes me as very unwise. Sure, I suppose that you can construe a set of preferences such that utility theory holds even for the mentally ill, just like one can create a set of motions and positions for the sun and planets such that the earth is in fact the center of the solar system; but if you try to use this obscene model to make any conclusions, moral, ethical or practical, about the universe as a whole then you’re fooling yourself.

    • PGD says:

      I came here to post this but you got here first. Preferences over preferences is a big problem for economics, and obviously a huge element of human life. A very large amount of human behavior, including economic behavior like buying self-help books, is explicable by attempts at investing in changing your own preferences. Economists aren’t dumb and have done work on this, but it just doesn’t fit into the core rational agency theory well at all.

    • Bill Murdock says:

      This is a misunderstanding of “preferences” in the economic jargon. In normal life you might “prefer” Coke to Pepsi, but see that Pepsi is cheaper and so choose Pepsi in that case. In economic theory if you choose the Pepsi it is because you “preferred” Pepsi at that price over Coke. Your preference is revealed by your action.

      There is no “My preference is to walk to work today, but it’s too cold so I’ll take the bus” in econ. In econ you preferred the bus that day. It’s just a confusion on the meaning of the word in the context. Science would be easier if each discipline had its own completely distinct set of words. At least, that would be my preference…

      • Marc Whipple says:

        I think something you said just then is worth emphasizing: Preferences are entirely circumstantial. You prefer Pepsi at that price. That is all an economist cares about. Which soda you actually like the taste of better is entirely irrelevant to them.

        In a post-scarcity society, it would be very difficult for an economist to use the term “preference” the way they do now about a lot of things. 🙂

        • Bill Murdock says:

          We are EMPHATICALLY not, nor will we ever be (on this side of Eden) a “post-scarcity” society or world or anything.

          Did it take time to write your comment? Scarcity.

          Did it take resources to get the computer you typed it on? Scarcity.

          Does, in fact, anything cost money (i.e. resources)? Scarcity.

          This is a very important point.

          Just because there is a grocery store doesn’t mean that food isn’t a scarce resource.

          • Marc Whipple says:

            I said “about a lot of things,” and I otherwise cede the point so we don’t get into the whole “what is a post-scarcity society” thing again. I admit, fully and without reservation, that short of perfect individual VR worlds a literally post-scarcity society is not an achievable thing. 🙂

          • Bill Murdock says:

            @Marc Whipple

            This is another important (perhaps most important?) concept in economics, and another word that is more specific in econ theory than IRL. Preferences themselves mean nothing without scarcity in the economic sense.

            Scarcity of all “goods” is basically foundational to the science. The law of demand comes directly from scarcity. So, I’m sorry for my reaction.

          • Marc Whipple says:

            Apology accepted, think nothing of it.

            The ironic part is I actually meant it as a joke, which would only be funny if you understood the economic meaning of scarcity. Apparently I overshot. 🙂

          • Bill Murdock says:

            I don’t understand the economic definition of scarcity, apparently. …

          • Marc Whipple says:

            No, you do, it just wasn’t funny. 🙂

          • Bill Murdock says:

            Okay, I’m done for the night! Cheers Mr. Whipple!

  45. Murphy says:

    Re: Gay people and trans people,

    Scott: Have you ever read the book Blindsight by Peter Watts?

    It included a semi-posthuman character with multiple personalities who viewed the [in the story] historical practice of treating multiple personalities by trying to make all but one go away as murder of distinct individuals on a genocidal scale.

    It may not be how the future plays out but I strongly suspect that we’re nowhere near to the point of being safe believing we won’t look back on how we did things the same way as we currently do with gay and trans people.

    Anorexics may be a better example of the line between strong preferences vs illness being very fuzzy. Sometimes they can fully understand that they’re killing themselves yet still not want treatment and may articulate it well.

    If there’s a strong shift towards bodily autonomy and away from protecting people from themselves we could very well end up with history looking on force-feeding anorexics(which can be quite traumatic) negatively.

    Someone thanking you afterwards doesn’t mean something is safe from being viewed negatively in future. After all, some people thank the people who run Pray the Gay away camps afterwards.

    • Anonymous says:

      One thing that’s interesting is if dedisorderization will not lead to there being much, much fewer people affected. It seems like allowing these people to just do what their non-standard mindset tells them to do will reduce their number substantially in the long run, because their conditions are damaging their (evolutionary) fitness. Whereas a policy of normalizing these people by force arguably leads to there being substantial amounts of them, due to social pressures keeping up their normally substandard fitness values.

      • Mary says:

        The most obvious is homosexuality, which directly affects their ability to reproduce. Even those homosexuals who passionately desire children will have suppressed fertility because it costs money, unlike equivalent heterosexuals.

        Those heterosexuals who do not desire children, of course, fall under the same rule. One wonders what the effect on society will be of a few dozen generations where the desire for children was heavily selected for.

  46. PGD says:

    A close friend of our family went to see Thomas Szasz for therapy when she was really depressed after her divorce. She thought she was clinically depressed but he told her, basically, that she was really sad because a really sad set of things had happened to her, that this was totally normal and to be expected, and she had to both allow space for mourning and gradually take practical actions to rectify her situation. This actually seemed to really help her and she was able to get things under control more. (There was actual talk therapy involved so this is obviously quite simplified, but still).

    In tribute to this, I always try to spell his name correctly.

    • Anonymous says:

      The “deal with it” school of psychotherapy.

    • Deiseach says:

      Which is still a far cry from saying “There is nothing wrong with you, you are choosing to behave like this, either go around being miserable if that’s what you want or change how you behave if you like that better, but there’s nothing I or anyone else can or indeed should do to guide you.”

      • PGD says:

        Exactly Deiseach — it wasn’t just ‘deal with it’, it was framing the problem a different way and continuing to help her with it.

        (Although in the end ‘deal with it’ is always an end goal of therapy since the capacity to deal with things within the ordinary course of life is central to psychological functioning).

        • DavidS says:

          And specifically, it sounds like in this case he was saying to someone who was sad for concrete reasons they were sad for concrete reasons. This is obviously different to telling people that they’re sad for concrete reasons when they’re sad because of brain chemistry. Even outside of people with massively tragic circumstances or mental illness that distinction is sensible and helpful. Sometimes I’m upset because there is an actual thing that has happened to be upset about. Sometimes because I’m hungover – which is a cause, but not a reason.

          • PGD says:

            The distinction between ‘concrete reasons’ and ‘brain chemistry’ is a lot less clear than you think it is. The concrete circumstances of your life directly affect your brain chemistry and vice versa.

  47. Peter says:

    I came across that article earlier this year. I noted that even with his physical illnesses, injuries and disabilities, there’s an element of preference involved. Random example. Last year, I broke my elbow and sprained my ankle. Needless to say, there was some sick leave after it. More complicatedly – there were a few days of sick leave, then a half-day at the office followed by a few days at a conference that weren’t sick leave, then some more sick leave.

    Basically, I’d put a lot of work into preparing for the conference and really wanted to go, even though doing so might not have been the most conducive thing to my recovery. Afterwards, speeding my recovery and not messing my elbow and ankle around took priority over going into work. Everyone involved respected this.

    Just last week I had a cold, and with a cold you have to make the judgement call “do I want to drag myself in, work at decreased efficiency, infect everyone else and delay my recovery, or can I honestly ask for some sick leave.” Last week my cold was severe enough to have sick leave; this week there’s still a bit of it there, but I’m at work – still not as efficient as usual though.

    There’s the whole spoons thing which seems to be a long-winded way of saying, “Most people can do X without a second thought and in theory I could do X too, but then I’d have to give up on doing Y, Z or W, and all three take priority over X. So if you don’t mind, I’m going to save my energy, and if you do mind, I’m still going to save it anyway.”

    I couldn’t scrape together the cash for a Ferrari even if the God of Hypothetical Situation pointed a gun at my head – I could buy a Rolex out of savings quite comfortably… but I don’t want a Rolex. However the Leica M9 is the Rolex of cameras and if I won the lottery I’d totally buy one. I could buy one for cash today, but my money is earmarked for more important things, like a deposit on a mortgage when I stop renting a flat. In ordinary speech, it would be fine for me to say “I’m not rich enough for a Leica” even though technically I could buy one and still be in the black.

    People don’t work at the very edge of their capabilities unless they are exceptionally motivated; even Usain Bolt doesn’t run as fast in heats as he does when there’s a gold medal at stake. So when your capabilities are reduced, then your preferences change too, maintaining a buffer around the capabilities.

  48. Tim Martin says:

    From the post:
    “Therefore, all psychiatric diseases can be conceptualized in the form of preferences. This makes them very different to physical diseases, which are budgetary limitations, and we should stop saying they’re the same thing…”

    Not to make the argument sound simpler than it is, but I feel like Caplan’s whole idea falls apart right here. He’s ignoring the fact that people have preferences that run counter to other preferences that they also have. The reason I think of having the flu as a “budgetary limitation” is because I *want* to be active. If I didn’t have that desire, I wouldn’t feel limited by the need to stay in bed all day. Similarly, ADHD feels like a budgetary limitation because I *want* to get shit done. Yes I do have a preference for excitement and novelty and moving around, but that preference gets in the way of my preference for getting shit done, so it’s a limitation as far as I’m concerned.

    ****
    Another, very different, way of conceptualizing this is: an ADHD person (Alice) and a non-ADHD person (Bob) have generally the same preferences. They both want to get things done, and they both want to not feel bored or distracted while doing so.

    Bob has a certain ability to sit down and work on a project, whereby he both gets things done AND feels relatively content doing it. He doesn’t feel unfocused or restless. Alice can sit down to work on a project, but she either feels bored and stops, or she exerts a lot of effort to stay on-task. In the latter case she gets things done, but she doesn’t at all feel content while doing it. The work feels effortful and ughy.

    So Bob’s meeting his preferences, and Alice isn’t. It’s not that Alice has a preference for wandering around the office and flitting from task to task – it’s that, just like Bob, she wants to feel absorbed by something. And if you have ADHD, it takes a very novel or exciting activity to make you feel absorbed.

    So Alice and Bob have the same preferences, but Alice requires different stimuli to satisfy (one of) her preferences.

    I imagine this conceptualization might break down for other psychiatric illnesses (perhaps schizophrenia?), but I think this demonstrates that there are multiple ways of looking at the issue.

  49. Vaniver says:

    I think that this is a result of a larger problem with economics as applied to humans; economists, focused on actions, see preferences as an object with a single level, defined by the tradeoffs you are willing to accept between various options.

    But to psychologists and people, it looks like preferences are objects with many levels, and many different flavors of desire. There aren’t just values, but also meta-values, and meta-meta-values, and…

    To which the economists reasonably respond, “yes, it’s nice that you have this internal complexity, but you still need to make a single choice.”

    Also, it seems worth investigating the links to Hanson. Hanson, Szasz, and Caplan in this article all seem like people willing to take ‘near mode’ much more seriously than others, and I suspect the mainstream discussed view is far too biased towards far mode.

    • RPLong says:

      This is an odd criticism of Caplan’s paper, which nudges the state of economic theory away from “We have no way of modeling mental illness” to “If I’m right, then we have at least one, imperfect way to model mental illness.”

      It seems Caplan’s undertaking should appeal most to people who share your criticism of economics.

      • Vaniver says:

        It’s an odd criticism because it’s not quite intended as a criticism. I think that, whatever my reservations about revealed preferences as a person unwilling to endorse all my choices, they’re the clear best guess for what someone “really” wants.

        (I first read Caplan’s paper… five years ago? Six? It’s been a while.)

        But it also brings up the question how much we should ‘care’ about what we ‘really want.’

        • RPLong says:

          My view is, we should care a whole lot, or hardly at all, depending on the context. There is no, one, single answer that applies everywhere.

      • Nita says:

        I don’t think “let’s assume there’s no such thing as X” really counts as a way to model X.

  50. Michael Powell says:

    Economists display some of the most spectacular intellectual hubris.

    • Peter says:

      They’ve got competition though; sociologists, physicists and (continental?) philosophers spring to mind, and I’m sure there are others.

      Chemists are probably safe from that accusation, though.

      (This is all in a “sharks eat people” sort of way even when most of them have never and will never eat anyone).

  51. It took a long time for you to mention formal thought disorder issues. Reading essentially the entire piece I was thinking constantly about the more serious problem of schizophrenics frequently having highly disordered speech with very strange wordplay and stream of consciousness. I’m curious though why you waited so long so mention that? It seems like such a slamdunk argument that it makes the rest of the discussion about Caplan’s argument almost unneccessary.

  52. Whatever Happened To Anonymous says:

    I am very distressed at the distressed reactions to the Szasz jokes. Either people are really easily offended (on behalf of someone else) or they’re taking themselves far too seriously (so as to think such a joke, funny or not, unbecoming of some blogpost).

    Anyway, relating to the subject. It seems like a lot of this backlash to this has to do with the ever changing definitions of what constitutes or not a mental disease. I see it’s been somewhat discussed, but I want to know, what’s the “scientific consensus” regarding pedophilia? I’ve seen it pushed around by the usual suspects that it should be thought about as a disease, but I can’t see any reasonable standard by which it would be one while homosexuality wouldn’t (unless there’s a known mechanism behind it, despite Scott’s best efforts, I don’t know a lot about psychiatry). So maybe this is a case of the media quoting some dude in a labcoat and declaring “scientific consensus”?

    • anodognosic says:

      Re: pedophilia, my general approach is that you can’t entirely separate social considerations from what you consider a psychiatric disease in many cases. Many autistics, for example, can thrive in spaces that are more suited to them. Psychopaths can only be considered disordered in relation to what they do to other people. Same here with pedophiles and homosexuals: you can’t divorce the condition from the social consequence. Homosexuals can have sexual relationships with the objects of their attraction ethically. Pedophiles can’t. We can discuss to what extent the label of “disease” is appropriate and useful, but it’s not like pedophilia in particular would be this glaring exception in psychiatry.

      • Whatever Happened To Anonymous says:

        > We can discuss to what extent the label of “disease” is appropriate and useful

        Well that’s exactly what I want. I agree 100% with the rest, gays can consent, kids usually can’t, so Homosexuality is accepted while Pedophilia isn’t. But this seems like not a great way to define one as a disease and the other as “not a disease”.

        >but it’s not like pedophilia in particular would be this glaring exception in psychiatry

        That would be all the worse for psychiatry. What examples do you have in mind, though?

      • kerani says:

        Homosexuals can have sexual relationships with the objects of their attraction ethically. Pedophiles can’t.

        I think this is a circular argument. We(*) have defined “sexual relations between two consenting adults, regardless of gender” as “acceptable” and defined, by statue sexual relations between an adult and a minor, regardless of consent on the part of the minor” as a crime.

        So it has nothing to do with the sexual behavior, and everything to do with how we define it.

        (*) For a value of “we” which doesn’t include everyone on this forum, much less everyone in the USA or everyone in the world.

        • anodognosic says:

          It’s not circular because it’s not a vacuous definition – there are actually moving parts and references to psychological, social and other insights that go beyond law and assertion.

          Homosexuality being okay may involve, for example, a conscious rejection of natural law, believing that pair-bonding is a crucial aspect of life for most people, that a sexual dimension is similarly important, and so on.

          A rejection of pedophilia is likewise well-grounded in an understanding of what meaningful consent is, of the lopsided power dynamics between a child and an adult, of the consequences to a child of having sexual relations with an adult, etc.

          Like, sure, this is all arguable, reasonable people may disagree, and we could definitely get into it if you want. But please don’t give me this tired BS about it being a simple matter of definition. Do better.

          • keranih says:

            If you were going to insist that somehow homosexuality differed drastically from pedophilia on the basis that one contained consent and the other did not –

            – you ought not, imo, confuse the issue by saying “there are fundamental differences and changes in simple social definitions don’t cover it”.

            Who is and who is not permitted to consent to XYZ is absolutely a matter of social definition, and is nearly completely arbitrary, to a degree that gender/sex is not (because at least the sex of a person is largely objectively defined.)

            It may very well be more Just for homosexuality to be socially permitted, while pedophilia is not, but you have not demonstrated this, nor have you (nor anyone else) demonstrated that the reason for treating the two differently is based on rational choice, instead of preference.

            Don’t fall back on the shaky defense of “everyone can see its rational to tolerate homosexuality while condemning pedophilia” – because there is very little rationality at play in this debate, and we should be prepared to back up our claims.

          • onyomi says:

            In terms of whether pedophilia is a “disease” and homosexuality is not, I see no difference between the two: they are both just sexual preferences which differ from the norm. The problem is that pedophilia, unlike homosexuality, is a sexual preference one can’t ethically act on. Does that make it a “disease”? I don’t think so. Should we expect “treatment” of pedophiles to be any more successful than “treatment” of homosexuality? Probably not, to be honest, unless the treatment consists of training people how not to act on their desires, rather than on eliminating or changing those desires.

            I do wonder if maybe prosecuting/persecuting the kiddy porn consumer is not counter-productive, since watching the porn might relieve the urges and lessen the chance someone might act on them. Unless it only strengthens the urges until the person acts on them. And there’s also the problem that, in order for people to consume kiddy porn, someone has to make kiddy porn, which is obviously problematic unless it is animated or done with actors pretending to be kids, etc.

            The pedophile strikes me as a truly, truly unfortunate individual, as I don’t see their sexual preferences as differing fundamentally from other less common preferences; yet they are cursed with a preference for something they can’t ethically enjoy.

          • anodognosic says:

            >Who is and who is not permitted to consent to XYZ is absolutely a matter of social definition, and is nearly completely arbitrary

            I really don’t want to get into this too much, but: precisely where the line is drawn is arbitrary, but the distinction between a 9-year-old and a 20-year-old consenting to sex is grounded in the real differences, mental and social, between people at these two ages, making it very much not fucking arbitrary. You can do your own damn homework on figuring out how.

            Maybe the problem is taking ethics and social context, to which I say: if you take the time to look, a large proportion of psychiatric conditions have assumptions about what normal functioning is, as well as assumptions about what is good.

            (Oh shit, I got into it.)

            I have said elsewhere in this thread that the definition of delusion excludes commonly held beliefs, for instance, so that belief in Xenu is made non-pathological by the existence of Scientology.

            In the Middle Ages, there was a phenomenon by which girls would starve themselves, sometimes to death, for religious reasons. Today, they would be labeled anorexics and pathologized. Who’s right? You can’t actually make a judgment without bringing ethics into it. The idea of a definition of mental illness free of philosophy is a mirage.

            @onyomi I agree with basically everything you said. I think the medicalization is useful not because I think treatment would be any more helpful that gay conversion therapy, but because it might provide options beyond the threat of permanent ostracism.

          • keranih says:

            @ anodognosic

            the distinction between a 9-year-old and a 20-year-old consenting to sex is grounded in the real differences, mental and social, between people at these two ages, making it very much not fucking arbitrary. You can do your own damn homework on figuring out how.

            1) The difference between pedophiles and homosexuals is not that one wants to have sex with 9 years olds and one wants sex with 20 year olds. That is not the issue under disagreement.

            2) The history of defining sexual/marriage consent is long and complicated, but in western tradition, the age-in-years cut off – which was acknowledged as arbitrary was based on typical physical development, and not mental or emotional. You have managed to completely fail to acknowledge this, while harping at other people for “failure to do homework” and not being rational.

            Congrats, you’ve removed yourself from the pool of people who have leave to lecture me on this subject.

            (You’ve also provided evidence supporting the hypothesis that people promoting full normalization of homosexuality tend to be irrational assholes, but I’m still trying to judge people on their own particulars and not fall into stereotypes.)

            @ onyomi

            The problem is that pedophilia, unlike homosexuality, is a sexual preference one can’t ethically act on.

            This assumes a non-universal set of ethical standards, as well as facts not in evidence. It’s not a good basis for making one set of behaviors legal while punishing the other.

          • onyomi says:

            @Keranih

            “This assumes a non-universal set of ethical standards, as well as facts not in evidence. It’s not a good basis for making one set of behaviors legal while punishing the other.”

            Doesn’t it assume a universal set of ethical standards that I can say sex with a 7-year old is always wrong, everywhere, at all times?

            I do, however, think there is a big difference between sex with a seven year old and sex with a fourteen year old. In many premodern cultures, a fourteen year old was a young adult, and fourteen year olds are also sexually mature. Furthermore, there exist emotionally mature and emotionally immature fourteen year olds, whereas I don’t think any 7 year olds are mature enough to understand the ramifications.

            Also when we talk about historical pedophilia/pederasty like in Ancient Greece, China, and many other places, it is almost always with adolescent boys: something like 30-40 something man sleeping with 14 year old boy, in some cases as part of a “mentorship” relationship, in others as a form of prostitution. This, again, strikes me as very different from an adult engaging in sexual activity with a 7 year old boy or girl not even close to puberty.

            There are many historical cultures which see sex between a 40 year old man and a 14 year old man, or marriage of a 14 year old girl to a 30 year old man as very normal and acceptable. There are no historical cultures I know of in which sex with a 7 year old is considered normal.

          • Anonymous says:

            the distinction between a 9-year-old and a 20-year-old consenting to sex is grounded in the real differences, mental and social, between people at these two ages, making it very much not fucking arbitrary. You can do your own damn homework on figuring out how.

            Ok, cards on the table. I’ve read Wertheimer and Westen. I’ve done my homework. Westen totally avoids the question, saying that youth probably fail the knowledge prong, but completely punting the question of what the knowledge prong actually consists of. For him, the legislature can make a determination, and we’re pretty close to done. (Homework for you: if children fail the knowledge prong, can suitable early sex education justify lowering the age of consent?)

            Wertheimer punts the question in a different way. He likens children to mentally retarded people (this vocabulary was used by the professional philosopher of ethics, not my invention), and says that for these groups, we can appeal to some empirical determination of whether they tend to be harmed by sexual behavior. In the comments above, Vox Imperatoris embraces this type of reason as “basing moral opinions on facts”, but it’s clear that this is based on empirical facts and not conceptual facts. It leaves completely open the possibility that a society could adopt attitudes about sex that leave children unharmed by it (…according to whatever magic metric you use for harm).

            I think Wertheimer is wrong and that Westen is closer to right. There seems to be very little reason to import some other measure of harm just for a couple theoretically thorny cases, especially when we run into precisely the problems we were trying to avoid. Decades ago, homosexuality had major social consequences (and high physical consequences due to the AIDS crisis). Nevertheless, we didn’t say, “Look at homosexuality – it’s empirically harmful. Therefore, it’s unethical.” Instead, we did ethics (and even some conceptual analysis!).

            Bringing the discussion back to psychological disease, it’s really not clear what you’re arguing for. Are you arguing, “Empirical determinations of harm specify what is ethical; what is ethical specifies what is a disease”? If so, we’re back to my comment below about how we’re hanging everything on the idea that diseases track ethics (and that we have identified the right ethics).

          • Earthly Knight says:

            He likens children to mentally retarded people (this vocabulary was used by the professional philosopher of ethics, not my invention)

            “Retarded” was the official term for people with an IQ below 70 until 2013, when the DSM 5 came out.

          • Anonymous says:

            Yea. I’m the old-fashioned type that learned the word as a term that didn’t only describe a human condition. First and foremost for me, it described engine timing. Nevertheless, people freak out about it today, so I’m definitely going to include the disclaimer just to keep crazy people from killing me.

      • Anonymous says:

        First, I think the sentences, “Homosexuals can have sexual relationships with the objects of their attraction ethically; pedophiles can’t,” are going to distract from your point. Suppose I really desire to set foot on Alpha Centauri Bb. This is literally impossible for me to do. Nevertheless, such a benign desire certainly can’t be considered a disease.

        Instead, you point to social consequences, which seems to be getting warmer. If all I do is talk about my desire to set on Bb, and this makes me lose my job, ruins my relationships, and leaves me homeless and alone, we are right to think that it’s Serious Business That Must Be Addressed By People With Important Titles. Nevertheless, saying that something is SBTMBABPWIT (henceforth known as SPWIT) is quite different from saying that something is a disease. Trivially, national security is SPWIT. I jest, of course. Maybe it’s only Individual Behavior That Is SPWIT that is a disease. Except murder.

        Take your time to add a few more qualifiers. Maybe try some of Scott’s (and ignore the fact that we could probably say that pedophilia fails (4) right alongside homosexuality). Still, social consequences seem to be a terrible distinction. Suppose I go to college for rocket science and I do really well. Sure, my aerodynamics prof is wondering why the hell I would choose to postulate an atmosphere for Bb in which to fly for my term project, but the propulsion profs love that I go to the trouble of researching cutting edge or theoretical methods of propulsion when I present on a hypothetical 500 year interstellar mission (…while I hide my desire to reduce this timeline by an order of magnitude).

        Then, I graduate and get a job. My new overlords do not have time for this shit. At all. I don’t last six months. Soon, I’m blackballed and homeless. Did my desire suddenly turn into a disease? Was it a disease all along that was just tolerated better? It seems flatly wrong to have the determination of whether something is a disease depend on the extent to which it is tolerated (and how well a person can hide it, which is really just a proxy for the extent to which it is tolerated). Is a pedophile that knows better than to campaign for pedophile rights not diseased? What if they campaign for other queer rights, but sneakly avoid the pedophilia issue such that society doesn’t pin them down and shun them? What if they slip and society pounces? Are they suddenly diseased?

        EDIT: Immediately after posting, I realized a much simpler encapsulation of my problem. Are you implying that homosexuality circa 1950 actually was a disease, and then it became not-a-disease after it became socially acceptable? If not, then we’re probably hanging a lot on the idea that diseases track ethics (and that we have identified the right ethics).

        • anodognosic says:

          Definitions are imperfect, categories are fuzzy and leaky, and sometimes we gotta go with the Chesterton fence that we get, not the one we wish we had. The best definition of a psychiatric disease may well be “that which is best dealt with through the psychiatric care system” (come to think of it, that’s a fair encapsulation of my position). And in determining what belongs in this category, you can’t get away from social and ethical considerations.

          • Anonymous says:

            Suffice to say, I think it’s just gotten worse. It wasn’t clearly circular before… but it is now.

          • anodognosic says:

            No, it’s just a pragmatic definition rather than a conceptual one.

            The difference is not particularly subtle either. A circular argument or definition only makes reference to itself, or circles back to itself rather quickly, and is both logically airtight and useless. But what I’m proposing here requires loads of real-world input regarding the state of psychiatry, the tools it has at its disposal, what other institutions or methods are available, the ethical issues involved, the nature of the conditions, and so on and so forth.

            And that is a far, FAR more useful approach than oversimplifying the issues to fit everything into conceptually neat categories, bulldozing all our Chesterton fences in the process. Especially given that we are nowhere near a clear, coherent general definition of mental illness.

          • Anonymous says:

            I’m not against pragmatic thinking, and it’s fine to do things that are useful… just don’t hide it under a conceptual word like, “These things are diseases; those things aren’t.” Don’t try to explain the conceptual division with sentences like, “Homosexuals can have sexual relationships with the objects of their attraction ethically. Pedophiles can’t.” This is straight-up acting like you have a conceptual distinction when you don’t. Instead, just be honest. “We have no idea how to determine whether something is a disease. All we can say is that current psychiatry in today’s society has success rates X1, X2, …, Xn with error bars Y1, Y2, …, Yn for conditions Z1, Z2, …, Zn. Obviously, the definition of ‘success’ is highly dependent upon societal inputs, so it’d be bloody stupid of me to try to say anything worthwhile about the psychiatric nature of homosexuality or pedophilia.”

            Of course, the further down this line of thinking we go, the more Caplan seems to have a point. Of course societal inputs massively penalize schizophrenia today, and while modern psychiatry is somewhat capable of conforming a schizophrenic to society’s demands, we have no conceptual reason to call it a disease. Another society may be totally understanding of schizophrenics. They won’t take away your friends, your money, and your ability to live. Then, suddenly, the metric of ‘success’ has changed, and schizophrenia is no longer a disease.

            The only way I can see an objection to Caplan working is to create some categories. (…why some people are so opposed to the very idea of categories, even if our current working definitions are fuzzy, is a mystery to me.)

        • Jon H says:

          “I don’t last six months. Soon, I’m blackballed and homeless. Did my desire suddenly turn into a disease? Was it a disease all along that was just tolerated better? It seems flatly wrong to have the determination of whether something is a disease depend on the extent to which it is tolerated ”

          I suspect it wouldn’t be considered a disorder itself, but perhaps how another disorder was expressed. If it’s interfering with your employment, there’s probably some impulse control issues, poor judgement, social cues unread, etc.

          I mean, think just how much an enthusiasm for Bb would have to interfere with one’s job duties before being fired. If that enthusiasm was for home brewing beer, you’d probably have to be drinking at work and filling closets with carboys of wort.

          • Anonymous says:

            The problem with this is that we’re still just taking, “I have an extreme preference for X,” and determining whether that preference is a disease or not based on how society interacts with that preference. In the example, the most subtle shift completely changes the diagnosis. Suppose that instead of being so focused on Bb, I’m obsessed with Mars. I manage to get a job with NASA at a time where this aligns with their goals. Unless I have a family that is pissed with me, no one is going to care. No negative repercussions will follow. If, for some reason, I also have a preference for other things, then psychiatry can probably help me do them. If not, then everyone will treat it exactly like homosexuality. “He’s happy with it; that’s great.”

            Unless we start accepting some global definitions for what is “healthy” based on something other than, “Society will punish you,” then it seems entirely plausible to think that psychiatry is simply a method of managing preferences so that society doesn’t punish you. In which case, it seems just as plausible that a homosexual of fifty years ago would be an appropriate psychiatric patient since that preference could lead to social punishment… just like a pedophile today.

          • onyomi says:

            I think this is hitting on a key point: for psychological disorders, and arguably maybe for all disorders, it is precisely the bother–to oneself or to others–that makes the disorder. If you are obsessed with Mars and translate that into a successful career at NASA which makes yourself and those around you happy then we can hardly say you have a “disorder.” If you are obsessed with cleanliness to the point you spend all day washing yourself and avoiding germs with the result that you and those around you are made miserable, then that’s a disorder.

            If you are lacking in empathy but that fact doesn’t bother you or anyone else, and maybe you even use it to run a successful business with coolheaded care, then it’s hard to say you have a disorder. If you are lacking in empathy and that fact torments you or results you in becoming a serial killer, then there is a problem.

            Now, of course, there are cases when people are bothered by things which shouldn’t bother them: I am right to be bothered by a psychopath trying to derive pleasure from killing me. I am wrong to be bothered by my homosexual neighbors having sex in private (or, at least, wrong to try to force my preferences on them when they are making no demands on my time, energy, or property other than to be left alone). Thus, what society thinks DOES matter, though when society is being a bunch of busybodies, it is also right to tell society to go to hell.

          • Anonymous says:

            This is what I get for arguing the reductio so strongly. I tried to argue that if we subjugate conceptual analysis to society’s whims, our definitions are fickle and probably fundamentally flawed. Instead, I think we should do conceptual analysis and ethics. We can’t go back to throwing away the categories and just riding the wave of culture. Your final paragraph seems to be trying to hold on to this type of idea.

            what society thinks DOES matter, though when society is being a bunch of busybodies, it is also right to tell society to go to hell.

            Basically, I’m saying no… what society thinks DOESN’T matter. What matters is ethics/categories. The class of times when “society is being a bunch of busybodies” is really just the times when society thinks wrong things.

    • Anonymous says:

      I haven’t been keeping up with more recent literature, but a while ago I tried to read all the relevant papers I could, and at that time there was basically no work being done that could be convicted of being “scientific research” by a fair, impartial body. I’d be surprised if that’s changed much.

      The definitions have shifted around a bit. The status of one who has fantasies, doesn’t act on them, and stays “stealth” is the most uncertain. Fred Berlin (one of the few people in the field whose work is at all valid) has a good and recent paper on this. Actually, now that I give that paper a quick read, I think it touches deeply on many of the questions raised in this thread.

      In any case, Szasz certainly is a favorite among people who feel that pedophilia is wrongly classified as a psychiatric disorder, and especially people who are distrustful of psychiatrists.

  53. NZ says:

    Scott,

    Are you familiar with a book by Robert Pirsig called “Lila: An Inquiry into Morals”? It’s the follow-up book to his classic “Zen and the Art of Motorcycle Maintenance”.

    “Lila” mostly expands on the Metaphysics of Quality he introduced in “Zen”, but both books–especially “Lila”–also talk a lot about mental illness. Pirsig, who suffered from mental illness, was institutionalized, and received scary old-timey electroshock therapy, seems to believe that mental illness really does just mean you value things differently than the society around you. Though, it isn’t clear whether he’d have defended this notion if he was pressed on whether he meant ALL mental illness or just the kind he was familiar with.

  54. An Addict says:

    It seems to me that I can’t trust this paper, not because Caplan is not a psychiatrist, but because he is not mentally ill. This passage stood out for me:

    “It is also implausible to interpret most mental illness using a
    ‘hyperbolic discounting’ or ‘multiple selves’ model (Ainslie 1992).
    These might fit a moderate drug user who says he ‘wants to quit’;
    one symptom (albeit not a necessary condition) of substance dependence
    is ‘a persistent desire or unsuccessful efforts to cut down or
    control substance use’ (APA 2000: 197). But they do not fit the hard-core drug addict whose only wish is to be left alone to pursue his habit.”

    I’ve spent a lot of time in circles with addicts, both those active in the disease and those seeking treatment, and I can’t say I’ve ever seen someone fitting the description of the hard-core drug addict that Caplan describes. I can’t say that no such person exists, but I can say that in both the environments where there’s a strong incentive to change (e.g. rehab), and those in which there is an incentive to keep going to fit in (the circle of addict friends I had), pretty much everyone acknowledged that a successful career and family life that we might have if we could quit was better than the life we were living. If we continued, it was because we still believed that we could still maintain addictive behavior with minimal damage to the rest of our lives (usually this was incorrect, but not always), or because we had fought for so long and failed so many times that we had given up.

    I’m not quite sure why the concept of meta-preferences is so alien to the more clod-headed of the economists. Has Caplan never experienced akrasia? Never procrastinated on writing a paper and regretted it later? I guess he’d retreat back to “revealed preferences” and say that since he chose it, that must have been what he desired all the time, but I think this is an impoverished view of human nature. This seems particularly odd in light of the success of pharmaceuticals, which is the first time in human history we have actually had a limited shot at imposing our meta-desires from without. I don’t like the preferences I have when I’m manic; therefore, I take lithium.

    Methinks Caplan could stand to read Nicomachean Ethics. Many times.

    • NZ says:

      Indeed.

      Caplan also presumes a lot about autonomy and free will. For example, do I choose to be attracted to women with skinny waists but big butts and boobs? No, for the most part evolution “chose” that for me prerationally, and it’s only later that I intellectualize it and say “I prefer women with hourglass figures.”

      Addiction to this day is very poorly understood, but we know that the experience of doing drugs rubs the pleasure centers in people’s brains, and some people respond to this in a way that is seemingly beyond their control, sacrificing things that are important or healthy in order to get another squirt of dopamine. The same is true of other addictions like internet and gambling which have nothing to do with the imbibing of chemicals. The physical brain has prioritized that squirt of dopamine wrong, and the conscious mind–the thing that recognizes and articulates preferences–must fight extra hard, and often fails, to correct it.

  55. RPLong says:

    This whole blog post is an enormous straw man. The second sentence in the paper clearly states that Caplan is making the case that economic theory should treat mental illnesses as “extreme preferences.”

    Caplan is writing about how mental illnesses should be treated in economic models. Scott Alexander has failed to provide a viable alternative for how better to model mental illness in economics, instead preferring to write a five-chapter essay on why Caplan’s point doesn’t hold up beyond the confines of economic modeling.

    The truth is, it’s Scott Alexander, not Bryan Caplan, who has overreached here.

    • Murphy says:

      You seem to have neglected this bit:

      “From a rent-seeking perspective, skepticism about psychiatry is common sense. Rent-seeking is only a side activity for the auto industry, but it lies at the core of psychiatry.”

      He isn’t just saying “sure, we’ll just model it like this for the purposes of modeling” he’s taking potshots at a whole profession based on his model.

      • RPLong says:

        No, he’s specifying a model with which you disagree. Fine, then adjust his model and move science forward a step. That’s why academics publish articles in the first place.

        • Stuart Armstrong says:

          That argument only works if you assume a strict division between denotation and connotation. Ie Caplan is proposing a model purely to model mental illness in economics terms. Within that model, psychiatrists are purely rent seekers. However, we shouldn’t assign them the opprobrium normally associated with rent-seekers, because the model leaves out key non-economic issues.

          I didn’t see that last sentence in Caplan’s work…

          • RPLong says:

            “Within that model, psychiatrists are purely rent seekers. “

            I didn’t get that from Caplan, did you?

            The whole point of Caplan’s argument is to lay out sufficient skepticism in psychology to justify an economic model that treats mental illness as extreme preference sets. If he had begun his paper with the sentence immediately preceding this one, then we wouldn’t even be debating anything. Psychological disorders are usually referred to as “spectra,” meaning we all carry varying shades of disorder as part of our normal, healthy personality traits.

            If normal people can be analyzed in the context of economic models, then people with higher degrees of certain personality traits on a given spectrum can, too – and the model that makes the most sense is one of “extreme preferences.”

            Example: An OCD clean-freak probably has a higher-than-expected demand for Lysol.

            Raising objections to this concept seems really surprising to me.

    • swerj says:

      Except for scott’s point that if psychiatry is rent-seeking than all medical care and all assistance of any kind is also rent-seeking, because if people really preferred to do something they wouldn’t need help. Somehow I dont think Caplan would go that far.

      • RPLong says:

        Rent-seeking is behavior that simply must be included in economic models. If it’s not, then the model overlooks an important economic behavior.

        No one’s going to argue that everything about psychiatry is rent-seeking – Caplan certainly doesn’t go that far. Similarly, no one should argue that rent-seeking in the field of psychiatry doesn’t exist. That’s silly.

        It’s especially silly to make that argument at SSC, where one of the first links at the top of every page goes to TheLastPsychiatrist.com, at which the argument has been made, repeatedly, by an actual psychiatrist, that psychiatrists engage in rent-seeking.

        So it’s important for Caplan to have that in his model.

    • whateverfor says:

      The blog post is correctly stating that Caplan’s proposed economic model of mental illness has little to no relation to reality. If the model doesn’t correspond to reality, how can the outputs reflect reality?

      • RPLong says:

        That’s how economic models work. The simplest example I can think of is a “demand schedule,” i.e. a table of values outlining how many apples you, personally, will buy at a given price-per-apple.

        In the real world, you don’t make decisions like this. But the purpose of a demand schedule is to highlight and discuss the ramifications of, say, a price change with regard to your personal demand for apples. All you really need to know is that you buy “some” apples, and if the price of apples goes up or down, you will probably buy “some more” or “some less.”

        I don’t have to predict exactly how many apples you will buy at exactly every conceivable price in order to justify a simple demand schedule.

        Models, by definition, are simple theoretical constructs designed to shed light on the various nuances of economic decisions. If they perfectly reflected the conditions of the real world, they would be too complex to teach us anything about economics.

        Think of it this way: We already have a human brain – what do we need psychology for? Well, maybe we need psychology to devise and test theories about isolated conditions, so that we can use that knowledge in the real world.

        The same is true for economics. We’re not trying to create a model that IS the real world, because we already have the real world. We need models to conduct analysis.

  56. peri says:

    I’m afraid I read rather slowly and skippingly, anymore – so I may have missed this, but I was just wondering if anyone could explain how Caplan came to privilege the brain over other bodily organs in considering the brain impervious to illness or impairment? Or does he accept ailments of the brain in later life, like dementia, just not those that manifest in younger people?

    • anon says:

      >Scott Alexander has failed to provide a viable alternative for how better to model mental illness in economics

      > Most people with mental disorders and substance abuse disorders wants to get rid of their disorder or at least alleviate the worst parts of it. If you are willing to accept complicated “multiple selves” models for those, then that is what you should be using to model mental disorders

      Plus, have you got any evidence that Caplan’s point holds up within the confines of economic modelling? What use or predictive value or policy implications does the model he proposes have? (Other than leading him to the conclusion that psychiatrists are rent seekers.)

      Edit: this reply was intended for the comment above, sorry!

      • An Addict says:

        I can’t find the study right now, but I do recall a study involving putting addicts in a controlled environment, allowing them access to their drug, but providing financial incentives not to take it. The financial incentives were successful at reducing the amount consumed. This is an experimental result that Caplan’s model predicts but some of the narratives of standard psychiatry, which can emphasize the automatic or instinctual response, do not. Admittedly, the addicts were probably saving money in order to be able to do more drugs later, but that kind of proves Caplan’s point: addicts have well-ordered and consistent preferences and can do things like plan ahead or trade off their addictive substance against other goods.

        It also points to some different interventions to reduce addiction. For my part, I’m pretty sure I would never have developed my alcoholism had the $10/handle super cheap stuff not been available when I was a student. “Trivial inconveniences,” in the LW parlance, might be more effective than generally believed, and points in the direction of erecting more barriers, like some states’ decision not to allow alcohol to be sold at grocery stores or anywhere other than approved liquor distributors.

    • Jon Gunnarsson says:

      What makes you think that Caplan believes the brain to be impervious to illness or impairment? That seems like a straw man to me.

      • peri says:

        Oh, I think it was the core of psychiatry = rent-seeking business that gave me to think he was dismissing all psychiatrists as charlatans, but I suppose he could very fervently affirm the reality of mental illness and also believe that it has uniquely resisted all the medical progress that has been made in the last 150 years. In any case, the comments above have convinced me that he would just as prominently feature rent-seeking in an economic modeling of podiatric patients.

  57. John Schilling says:

    The psychiatric profession will never live down the thing about homosexuality…

    No, nor “Female Hysteria”, nor whatever it was that Soviet psychiatrists officially called Insufficient Communist Enthusiasm Sufficient To Warrant Institutionalization, nor lobotomies.

    And it’s not safe to assume that all the things the psychiatric profession will never live down are safely in the past. Oppositional Defiant Disorder looks almost like it was custom-tailored to apply to anyone who strongly prefers not to sit down and shut up through the abomination that is a modern public-school education, and that one is still in DSM-V.

    We need a good way to distinguish between the psychiatric profession treating people whose brains are malfunctioning in a harmful way, and the psychiatric profession providing excuses to dismiss, drug, or institutionalize people who chose not to conform to social norms. Because both of those things have happened, and both of those things will happen again. One of them we want to strongly encourage, the other we want to even more strongly discourage.

    Caplan’s approach of “always assume it’s the bad one”, seems less than ideal in general, and particularly in an era where psychiatry seems to get it right most of the time.

  58. PGD says:

    I don’t think it’s at all clear that psychiatry gets it right most of the time today. I think the problems with over-diagnosis and concomittant use of powerful psychiatric drugs among children will be looked back on one day as a scandal. Things like ADD diagnosis are pretty clearly related to social issues of teachers desire to control the classroom, stressed lives among parents who no longer have enough time to spend with their kids, etc.

    From that perspective, I would like to see a clearer take on psychiatric rent-seeking. As this post points out, Caplan is wrong to say that the very claim that some preference structures represent disorder or illness is rent seeking. But the promiscuous expansion of the definitions of ‘disorder’ or ‘illness’ to encompass all kinds of personality variation, an expansion that increases the influence/billing power of psychiatry and the market for psychiatric drugs, can very usefully be discussed in terms of rent-seeking I think.

    The restriction of a lot of ordinary performance enhancing drugs to prescription access can also be seen as a form of rent-seeking.

    • PGD says:

      I also think that the delegitimization of difficult, time and effort-intensive forms of treatment that require sustained community intervention, like e.g. therapeutic communities, in favor of drug-based solutions can be seen as a form of rent seeking. It minimizes effort while maximizing financial return by leveraging psychiatrists market power in terms of drug prescriptions, and increases the institutional power of psychiatrists as compared to other therapeutic professions.

    • TrivialGravitas says:

      The restriction of PEDs to prescription is typically to prevent them from being used as PEDs at all. That is, if I tell a doctor I would like to pursue bodybuilding he will not prescribe me Insulin, I would have to somehow fake diabetes (or more realistically find a black market).

    • Jon H says:

      “The restriction of a lot of ordinary performance enhancing drugs to prescription access can also be seen as a form of rent-seeking.”

      The government does that. Not psychiatrists.

  59. onyomi says:

    To steelman Caplan against what many people (myself included) are saying about failures of willpower, non-unitary deciding self, metajudgments, etc.

    I’m pretty sure he knows that people sometimes claim to want to do one thing (lose weight, quit drinking) and yet do another, and he muddies this a bit by pointing out that sometimes (but not always, nor probably even usually, I’d say) these claims are just a defense mechanism, but I think his point is that, even if you say you want to quit drinking, if you have not, in fact, quit drinking yet, that indicates, on some level, that your “true” desire, at least for the time being, is to keep drinking, insofar as that wholistic situation (including the fact that you like drinking, are comfortable drinking, etc.) must, seemingly, be more appealing than the alternative wholistic situation (including not just the good things which would happen if you quit drinking, but the discomfort which will surely attend that process), given that you have continued to opt for the former.

    • kerani says:

      I think this is the root of it. It’s not that the alcoholic wants to be a prematurely aged drunk sleeping on the sidewalk, it’s just that there are a number of actions that need to be chosen in order to become (or stay) a healthy person who is productive in their job and engaged with their family.

      Get out of bed.

      Get a shower.

      Dress.

      Eat a healthy breakfast that includes no alcohol.

      Go to work. Deal with customers. Be polite to the boss. Accept boss’s critical review of last week when you were drinking. Eat lunch and ignore co workers talking about you.

      I’m not a drunk (I swear!) but I *can* see how tempting a drink – just one drink would be, if the option is between “take a drink” and “do any one of the above, without drinking.” Crawling up out of that hole takes a great deal of effort.

      Most of us, though, don’t struggle so much with the choice. That doesn’t make us awesome, though – refusing a second helping of cold pea soup is not hard, if one is running to catch a movie one is looking forward to, and doesn’t like pea soup very much.

      • onyomi says:

        In further support of the idea that the alcoholic who hasn’t yet quit drinking doesn’t *really* want to quit drinking, at least not yet: I’ve commonly heard it said (not knowing a lot of serious addicts myself, I’m not sure how true it really is), that many addicts must “hit rock bottom” before they can truly recover. That is, they must reach a point at which the pain of continuing their life as an addict is greater than the pain caused by making a serious effort to go sober.

        The key is in comparing wholistic situations rather than isolated variables: if they could wave a magic wand and be instantly cured of their addiction, most addicts would probably do it; but that is not an option. The real options are: keep doing what you’re doing now, which is not great, but which brings you some pleasure and comfort and which you’re used to, OR go through a painful process of feeling uncomfortable much of the time for days, weeks, (and months? and years?).

        I do know, for example, someone who was very overweight for many years until her doctor told her she needed to lose a lot of weight or face knee surgery. She lost 100 lbs. in remarkably short order because the prospect of knee surgery was more unpleasant than the prospect of a strict diet. It’s not that she didn’t *want* to be thinner before that: she did make efforts to lose weight, but they had previously been half-hearted, perhaps, Caplan might say, because she didn’t really prefer weight loss (and all the discomfort that entails) to continuing as she was–at least not until the new factor tipped the balance and she did, in fact, lose weight.

        In other words, I doubt Caplan would deny that there exist conflicting motivations, but rather, he seems to say, we can always tell which motivation is winning out at any given time. A schizophrenic may wish his schizophrenia could be cured painlessly, for example, but if he refuses the one medicine which will help him because it causes terrible side effects, we might say “what’s wrong? Don’t you want to get better?” To which his most accurate response would be, “yes, but not that badly.”

        Does this patient “really” “want” to be cured? In some sense yes; in some sense, no.

  60. “There’s a lot of epistemological complexity here – can we believe something just because we prefer to believe it?”

    I’m very surprised to see you make this argument, and I hope I’m misinterpreting you. Isn’t believing what you want to believe (e.g. my tribe is better than the other tribe, my tribe’s God is the only true god, true virtue is whatever I happen to be doing, etc.) an extremely common way of forming one’s non-consequential beliefs?

    • Earthly Knight says:

      “Believing what you want to believe” is being used in two importantly different senses here.

      The first is “your desires are playing an illicit (but involuntary) causal role in the formation of your belief.” This is what the expression typically means, and you’re right that the phenomenon is extremely common.

      The other is “choosing to believe x while knowing full well that your evidence does not support x,” which, I gather, is what Scott intended. This type of believing what you want to believe is either rare or non-existent– we just don’t seem to have the requisite conscious control over our doxastic states.

  61. Good Burning Plastic says:

    My answer: dichotomies sometimes break down outside a certain scope.

    Actually that dichotomy doesn’t even make that much sense to me within its scope — a sizeable fraction of all people in the developed world could afford a Ferrari if they worked their ass off on soulless occupations while otherwise living as frugally as possible for a few decades (and practically everybody in the developed world could regularly buy the most expensive brand of shampoo in the supermarket with much less inconveniences than that), but most people have plenty of better things to spend their money and energy on, so…

  62. ButYouDisagree says:

    It seems like some of your disagreement with Caplan could be dissolved by noting that people have preferences about their preferences. An alcoholic who falls off the wagon may prefer drink to sobriety, but may also prefer that they do not have that preference.

    • Juandonson says:

      I think that with one important addendum, this sums up the problem.

      People generally don’t know how to change their preferences. If I prefer intoxication to sobriety, I know how to buy and drink beer. If I prefer to *not* prefer intoxication, well, that I don’t know how to do. I’m left carrying out my object-level preference because it’s what I know how to achieve.

      Caplan’s “validate preferences” model only rejects psychiatry if we assume that people are already capable of pursuing their preferences. If my meta-preference is to not have ADD symptoms, then psychiatric medication is how I fulfill that preference. Suddenly everything aligns if you grant that people want to stop having an illness more than they want to act on their illness, but they don’t know how to achieve the former.

  63. Juandonson says:

    Obviously a simple-preference-only model is absurd – the fundamental experience of akrasia is one of “preferring to have different preferences”. The result is people acting on their object-level preferences (like drinking or procrastination) because they don’t know a way to achieve their meta-level preferences (like being better at concentrating). ADD meds, meditation, and a dozen other possibly-effective techniques, then, are ways to help people satisfy their meta-level preferences.

    Then what of psychiatry? Voluntary ADD treatment is suddenly about *fulfilling* preferences, rather than *destroying* them. So is treatment for depression, suicidal ideation, or substance abuse. The complicated question is “When do we overrule people’s preferences?” This happens in two directions, though we usually only discuss one.

    1) Involuntary psychiatric treatment is about treating people against their express preferences. This is the heavily-discussed direction, with a consensus of “Their preferences endanger them, and if we medicate away those preferences their new preferences will be grateful to us for the decision”.

    2) The unmentioned, scary question at that point is “When should we refuse to treat people despite their desire for treatment?” This is easy for most non-mental treatments – assume the patient’s highest preference is health and treat accordingly (so don’t give antibiotics for viruses no matter what they ask for). It’s much harder for psychiatry.

    Gay people from anti-gay groups/cultures regularly sign themselves up for (dangerous, nonfunctional) treatments to make them straight. I would imagine that if Ted Haggard could have pressed a “make me straight” button, he would have done it in an instant. For reasons from cultural pressure to religious beliefs, a lot of people have *wanted* treatment for homosexuality. At this point responsible psychiatry has agreed not to provide it. It’s an easier decision because we don’t have an effective way to change someone’s sexuality, but not all questions can be dodged with “we can’t do it.”

    Where do we draw these lines? Caplan’s “all treatment is wrong” outlook is silly, but there’s a genuinely difficult question of when to refuse treatment for people who do want it. “Preferring different preferences” is well and good, but I don’t have a good metric for when we refuse to help with those meta-preferences.

  64. Juandonson says:

    The discussion of schizophrenia in Caplan’s paper is particularly unfortunate. At that point he seems to have abandoned his earlier “societal analysis” claims – he’s no longer discussing automobile tariffs, he’s arguing carburetor design.

    It seems difficult to believe that anyone with personal or firsthand familiarity with hallucinogens or psychiatric disorders could advance a claim that most or all schizophrenic symptoms are simply ‘extreme’ versions of normal internal monologues and imagery. When someone is terrified of a home intruder because they’re hearing voices downstairs in an empty building, that’s not a monologue. The claim that hallucinatory symptoms belong on a continuum with conventional internal processes (at least, a continuum as small as the one being proposed) just speaks to an extreme lack of familiarity with them. A belief that reality is fundamentally different than it is does not equate to an internal narrative trick.

  65. P. George Stewart says:

    Fascinating article and discussion.

    I think the thing Caplan’s analysis misses is that there are “budgetary constraints” not just on the body functioning and self-regulation, but also on the brain’s modelling of the world, its self-image, etc., and of course that both the body’s “autopoesis” and the brain’s are intimately interwoven.

    And in fact the “preferences” side of things rides on the basis of the way the brain models the world/self.

    So then you have roughly three tiers of things here:-

    1) things inherently wrong with the way the brain is modelling things (bad wiring, so to speak). Of course from a metaphysical standpoint, there’s nothing “wrong” with those patterns, they’re just alternative patterns of brain activity mandated by a particular genetic code; the “wrongness” comes in terms of the activity not fitting the world in a way that allows the person to survive, get on with their fellows, etc.

    2) things that develop wrongly as a result of either real long-term trauma (rarer) or imagined trauma (extremely common) in childhood (pre about 7 years of age), or singular traumatic events later in life. In all cases, it’s the way the brain is interpreting reality that’s the main driver, and what you’re looking at is the organism not getting an expected response to its activities (e.g. in the worst case type of scenario, “Mummy! stop!”), and then in one way or another shutting down some portion of its activity (because it proved to be useless to effect anything). This then has a knock-on effect in all sorts of ways (feeding forward to cognitive functioning, and back to body functioning). I say also “imagined trauma” because of course a child is ignorant – it doesn’t know that its harrassed parent isn’t ignoring it because it doesn’t love it, it just feels the pain of being ignored; the final result can sometimes be little different from the result of real trauma.

    I think if you delve deeply, most human beings are actually pretty much wrecks, stuck together with duck tape and glue, putting a brave, functional front on it. And this is, in fact, the root cause of most of the world’s problems: evolution has accidentally created an exquisitely sensitive cognitive mechanism that gets born in all sorts of random circumstances that pain it – for the most part, it makes the best job it can of the circumstances, and in fact for the most part makes a pretty good job of the circumstances (that’s its evolutionary raison d’etre after all), but the cost is a rash of raw/tender spots all over the body and mind that are constantly being freshly poked and re-opened. The final result: a lot of variability in the scope and accuracy of the way the brain models the world/self, with some brains more “damaged” than others, more prone to bias, odd obsessions, avoidance behaviours, etc., etc. The thing that prevents this from being utterly disastrous is the “protection” from nature that society and civilization give us (so long as when the rubber hits the road of effective co-operation we function reasonably normally, we can earn a living, survive, despite whatever mad shit is noodling around in our minds, but if we can’t get that interpersonal game right, we’re in trouble).

    3) The system of preferences then has this basis to work on – so you get all sorts of things varying from rational decisions through unwise life choices to outright life disasters (which can then get repeated unto the next generation, and so on). The kind of psychological “malingering” Szasz talks about is on this spectrum – somewhere in the middle, a partly-rational, partly-pain-driven attempt to manipulate, stop people bothering you, cajole, etc.

  66. Albatross says:

    Pretty sure the preference is just that economists a.) would rather not pay for mental health and b.) worry that mental illness muddles many economic theories because too many people aren’t rational.

    Also, “rent seeking” only works when a product is desirable. Cable rent seeks because people love watching TV for many hours a day. Automotive companies rent seek because cars are really very nice compared to bicycles.

    Many people avoid treatment for years out of shame or denial. They go to great lengths to conceal their problems from spouses, coworkers, family and friends. When they do seek treatment it is private and completely taboo. The “preference” to deny depression, avoid treatment for years, then quietly and discreetly seek treatment, then carefully follow doctors instructions and perhaps finally open up to a close friend with similar problems years later or take the secret to the grave… the private lonely struggle against mental illness isn’t a choice. Anyone who ever paid a bill for therapy can probably think of LOTS of stuff they would rather buy. The price of therapy only makes sense when viewed as a physical problem like a broken arm that prevents other enjoyment until fixed. The brain is part of the body and pretending it isn’t real and doesn’t require medicine is a really stupid idea.

    • “Also, “rent seeking” only works when a product is desirable. Cable rent seeks because people love watching TV for many hours a day. ”

      In this example this is true enough, but many rent seeking examples are due to government mandates and stupid regulation.

    • TrivialGravitas says:

      As somebody incredibly critical of the idea of rational economics I still don’t think that mental illness qualifies as irrational in the economic sense.
      irrationality is basically poor ability to make a decision that leads to the outcome you want, without being AWARE that you’re doing so. That is, the alcoholic is economic-rational, he drinks at work understanding that he drinks at work and knowing if caught he’ll lose his job. A classic example of economic irrationality is that cab drivers tend to go home once they make a certain amount of money. This action is bad for BOTH the desires of going home early and making money. They could make more money and work less hours by working long hours on days they make money quickly (doubly so if the other cab drivers don’t catch on) because making good money tends to happen for a reason (IE, if its raining the demand for cabs goes up), and sitting around waiting for a fare tends to happen for reasons too.

  67. Dain says:

    “This is why it is disingenous to call it a gay rights movement, when they want to reduce the rights of some gays, namely those who don’t want to be gays.”

    This goes for women’s rights too. Feminism isn’t about sticking up for Ann Coulter and Camille Paglia (I’d say undoubtedly in the latter case, by this point), even though women qua women is supposedly the crux of the ideology. They’re just a weird anomoly. One’s ideas ABOUT women are more important.

    Having said that, feminists generally did rise to the defense of S.E. Cupp after that lewd photo thingy.

  68. Jonathan says:

    A serious question: why haven’t you compiled a selection of your essays into a self-published book? I know I and many friends who consistently read SSC would more than willingly shell out funds (either via crowd-sourcing or as a standard purchase) for a copy (even if partly to serve as a social signal on our bookshelves, ha, ha).

    • jaimeastorga2000 says:

      Just a few days ago nino released an ebook compilation of Scott Alexander’s greatest hits, as arranged into a thematically coherent and logical reading order by RobbBB. Truly, The Library of Scott Alexandria is a sight to behold.

      Unfortunately, there is no physical version which you can use for signalling purposes (yet; growth mindset).

      • OldCrow says:

        So I clicked through to the list of links on LW, thinking I’d read some classic SSC essays, and I noticed that on some of the links it redirects through the api of a company called VigLink.

        That was when I was reading on my phone. Checking the list now, on desktop, it uses the ordinary urls.

        From their website, it looks like they provide ‘monetized’ versions of the site that you link to. They seem to have a real-time bidding system in place with advertisers, but the flow of advertiser money to the person who creates the link isn’t really clear. It’s also not clear to me whether the monetized site always embeds new links into the content – their docs include some example that just add a parameter to the existing link, but they definitely offer the ability to change the site content.

        What’s bugging me is that there doesn’t seem to be any guarantee that the person making money off this is the same person who writes the content. Plus the mobile-only links just seem sketchy.

        Does anyone know more about VigLink? Does Scott know anything about it? All I’ve done is skim the docs, so maybe there doing something non-sketchy. But I have to check.

  69. Anthony says:

    In the book of Szasz’s I started, he nods to the idea that some mental illness may be “organic brain disease”, and thus should be treated differently than “problems of adjustment” that he mostly wants to talk about, but I got the strong impression before I gave up on it that he doesn’t really believe that “organic brain disease” actually exists. I never got far enough to figure out what he thought should be done for people who did have physical problems causing mental illness, if he ever did explain it.

  70. Autonomous Rex says:

    Reading Bryan Caplan is like watching a large child torture an ant farm.

    His recipe for Hell-on-Earth, viz. NoMedsNoFeds,
    a.k.a. OpenBorders and Mental Disorders
    could only be prescribed by someone
    safely ensconced in a very high tower.

  71. SFG says:

    Isn’t this the Open Borders idiot?

    Well, Scott, you did a masterful job refuting this guy anyway. You should write textbooks.

  72. Francis Fukyumama says:

    Mental illness is simply part of the Narrative devised by the Cathedral to create Official Victims presided over by priesthood of scientists who have no enemies to the left. All descended from ultra-calvinism progressive religion cthulu swims left fnargl.

    • Scott Alexander says:

      Wooo, got to ban three commenters in a row! This is my lucky day!

      • Nornagest says:

        Where are all these trolls coming from?

        • TrivialGravitas says:

          The Reign of Terror is sortof like a batsignal to a certain kind of troll who likes destabilizing petty internet dictatorships. I used to do it a lot, we’d go some place, rack up ban count, switch IPs and do it again and again. Petty internet dictators either become paranoid and begin assuming nontrolls are trolls and start banning at the slightest hint of disagreement, or adopt policies that discourage new members in an effort to filter the trolls (application processes, insistence on real name, demanding a work email address etc). A couple times we ended up having the servers and domain name legally transfered to one of our members just to make it stop, good times.

          I don’t think that’ll work here though, Scott is both quite self aware (see: naming it the reign of terror) and seems to have a signal to noise ratio goal in mind, not an attempt to create uniformity of thought.