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Postscript To APA Photo-Essay

I was surprised how many people responded to my APA photo-essay with comments like “Seems psychiatry as a field is broken beyond repair” or “This proves you should never trust psychiatrists”.

The mood I was going for was more “let’s share a laugh at the excesses of the profession” than “everything must be burned down”. Looks like I missed it.

I was disappointed to see a lot of the most hostile comments coming from people in tech. It would be easy to write an equally damning report on the tech industry. Just cobble together a few paragraphs about Juicero and Theranos, make fun of whatever weird lifestyle change @jack is supporting at the moment, and something something Zuckerberg something Cambridge Analytica something. You can even throw in something about James Damore (if you’re writing for the left) or about the overreaction to James Damore (if you’re writing for the right). And there you go! Tech is a malicious cancerous industry full of awful people and everyone should hate it. We’ve all read this exact thinkpiece a thousand times.

I’ve tried to push back against this line of thinking. A lot of the most visible and famous things in tech are bad, because scum tends to rise to the top. But there’s also some extraordinary innovation going on, and some extraordinarily good people involved. “@jack invents new health fad of rolling around naked on glaciers” is a much juicier story than “we can now fit twice as many billions of transistors on a chip as we could last year”, but tech journalism that only reports on the former is missing an important part of the story.

I feel the same way about psychiatry. There’s a lot of cringeworthy stuff going on at conferences, but conferences are designed to be about signaling and we shouldn’t expect otherwise. There’s also a lot of great people working really hard to help fight mental illness and support the mentally ill. “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety” isn’t sexy any more than “Internet continues to connect billions of people around the world at the speed of light” is sexy. But it’s a much bigger part of the story than the part where silly people do silly things at conferences.

Michael Crichton invented the term Gell-Mann Amnesia as a reference to Nobel-winning physicist Murray Gell-Mann, who remarked that even though the newspapers were always wrong about his area of expertise (physics), he always found himself trusting them about everything else. If you don’t trust hatchet jobs against tech, try to be a little less credulous of hatchet jobs against psychiatry, even when I’m the one doing the hatcheting.

(also, RIP Murray Gell-Mann, who passed away last week – at least if you believe obituaries)

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273 Responses to Postscript To APA Photo-Essay

  1. #1 there are 2 reply fields https://imgur.com/a/szRssbT

    #2. People are more likely to trust hatchet jobs from people within the profession. Imagine if say economist Paul Krugman was giving a hatchet jot of economics. Calling it to have various major issues regarding a poor understanding of market power. Or if Stuart ritchie was complaining about intelligence research for being too “inverse-woke” or whatever. In both cases people’s opinions would carry orders of magnitude more weight than a reporter to a person in this community. Since reporters are often pushing an agenda or are badly wrong because they aren’t in the field. While people who *are* experts in the field will be given less resistance.

    • Harry Maurice Johnston says:

      #1 there are 2 reply fields

      That’s normal. You usually only notice it briefly, before people start posting comments, because one of them appears at the top of the comments and the other one appears at the bottom.

    • Jack V says:

      “economist Paul Krugman was giving a hatchet jot of economics”

      It was published under the title “End this depression now” 🙂

      But yes. But then, Scott didn’t seem to be pushing “everything is worthless”. “Drug companies lobby directly to doctors” is pretty bad, but individual doctors still range from corrupt to idealistic whether they do or not. And “all abuzz about identity politics and climate change” is pretty good: the topic du jour is always going to be disproportionately represented at conferences, but there’s always going to be more to say about new things people are forming opinions about.

      • joncb says:

        “Drug companies lobby directly to doctors” is pretty bad

        Is it really though? If someone ran up to me and excitedly informed me of that, i’d almost certainly reply with “and?”. I feel like i’d be more surprised by the opposite.

        Granted the race to the bottom implied by the desperation in the advertising is sort of bad in a “my world is clearly not optimal enough” way but ther are so much bigger targets on that front that worrying about it seems recursive.

        • Edward Scizorhands says:

          Scott has some previous essays [1] about how even simple trivial gifts to doctors seem to influence their prescribing patterns.

          He has others about how the expensive medications that are literally fish oil off-the-shelf [2] do serve some social function, by letting doctors just get away with prescribing The Best.

          [1] I am 99% sure, but I cannot find them now, so maybe I’m wrong.

          [2] https://slatestarcodex.com/2014/06/15/fish-now-by-prescription/

  2. Evan Þ says:

    If all someone knew about tech was a photo-essay about Juicero and @jack and Zuckerburg, how do you think he’d feel about it? I can dismiss that sort of essay because I know what great things tech’s done for the world (I say while typing on a computer with more power than sent Apollo to the Moon), and because I know something of the extraordinary innovation going on now. But if I didn’t, I’d have a lot more negative reaction to that essay – especially if it was written by a self-proclaimed software developer.

    I think one big reason your photo-essay got such an unintended reaction is because many of us don’t really know much about psychiatry. From growing up in America, I myself got a general sense of Freudian excesses leading to a cocktail of poorly-understood medicines that (sometimes after months of trial and error) do some good, goodness knows why. I personally know people who those medicines have helped, so I can’t dismiss the whole field… but its successes aren’t so visible. Even here on your blog, you spend a whole lot of time trying to peer through the clouds of those dubious studies that haven’t already been torn down by the Replication Crisis. If someone did say the whole field’s moving in the wrong direction, I would have trouble doubting it.

    In short, if you-as-a-culture and you-as-a-subculture and you-as-a-somewhat-prominent-blogger let the good stuff that shouldn’t be burned down go without saying for too long… well, it doesn’t get said and might not get heard.

    • jooyous says:

      Except Scott posts about psychiatry all the time? And says stuff like: it usually takes one or two medication/dosage changes and then people find an antidepressant or anti-anxiety pill they like and they continue functioning.

      • Evan Þ says:

        Yes, it usually works in practice. I’ve seen people it works for. Scott describes a lot more. Maybe I fell into my own trap by not emphasizing that enough in my parent comment!

        What I’m saying I deem more dubious are the theoretical underpinnings of psychiatry – stuff ranging from “how does the brain work?” through “how does this medicine work?” to “how can we tell which antidepressant to give someone next rather than guessing and hoping for the best?” That’s the sort of stuff I think would (should?) be talked about at a national conference, and Scott’s posts on that subject don’t leave me with too rosy a picture. Maybe I’m wrong and there’s a lot more good theoretical work going on behind the surface; if so, I’d love for Scott to post more about that!

        • ChrisA says:

          @jooyous and Evan – “it usually takes one or two medication/dosage changes and then people find an antidepressant or anti-anxiety pill they like and they continue functioning” – could that not simply be placebo or perhaps spontaneous recovery? Sort of like if I take this pill, my cold goes away after 1 week type thinking. People love to create narratives about causes and effects. This is why we do the double blind tests of course. And in them most (all?) psychiatric medicines don’t do well at all.

          Maybe this is very unfair, but I have worked in lots of different countries around the world for longish periods, developed and undeveloped countries. And the access and attitude to psychiatry and use of psychiatric medicines varies widely in countries but the number of mentally ill people do not seem to follow, in fact in places where psychiatry is not really available, mental illness and depression seems to be non-existent or at least not at all discussed. Maybe their attitudes are simply to ignore or hide the problem, but it is quite striking when you spend time in the US and just about everyone you meet seems to need some kind of pill to function.

      • HeelBearCub says:

        Actually I find the general thrust of Scott’s writing to be “Here is the frustratingly wrong thing about psychiatry that hasn’t been fixed or solved and by the way most of the medical institution is broken in a Kafkaesque way”.

        It’s not abnormal for younger people to feel this way, especially if they are in a larger organization. It’s not uncommon for newer professionals. Scott just fails to pick his head up from the problems and give the broader context. He only talks about broader context when he is examing something that is new to him, especially something “far group”.

        If Scott is surprised he has attracted a pool of people who are willing to jump to the conclusion that Scott thinks psychiatry is broken, he may want to examine his own writing.

        • Spookykou says:

          How consistently do people misinterpret written work, and how much more likely is comedy to be misinterpreted? Does this incident really call his writing into question, or just the ideological makeup of the comments section. I think the reaction mostly reflect biases that any regular already knew existed.

          Scott says he is surprised by the reaction, and maybe that is true. However I assume this post is largely a utilitarian one in which he wants to make sure that nobody is discouraged from getting professional medical help from a psychiatrist based on his writing. If you instead asked him “Do you think there are some commenters here who will hate on any organization that is shown to endorse woke/SJ ideas?” I think the answer is yes, and I find it hard to believe that Scott would be genuinely surprised by that.

          • HeelBearCub says:

            Go back and look at the general thrust of Scott’s writing on:
            – Psychiatric practice
            – The FDA
            – Psychiatric medicines
            – Sociology studies
            – Social Justice
            – Debate (and the ability to engage in it)

            If you don’t see a general pattern there … well, I’m not sure I can convince you by showing examples. People may be misinterpreting Scott, but if so, my thought is that’s Scott’s fault.

            And I’m also not entirely sure people are misinterpreting Scott. We all have a natural cynic in us, and Scott seems to channel his on a frequent basis. It may not represent his net feelings about science and psychiatry, but he has told us that all “those people”, those latte-drinking, urban dwelling, Prius driving, college graduating folks, are blue tribe, and that blue tribe is his hated enemy.

            I believe him when he says that. I also believe he doesn’t really hate anyone and he is a genuinely loving and accepting person. Both can be true at the same time.

          • Spookykou says:

            I wasn’t speaking to Scott’s writing in general or the influence that has had on building the comment section, just to this particular post. I do agree with you that the current comment section is something that Scott has very intentionally had a hand in shaping, I just also think that it is more or less where he wants it, which is why my second paragraph calls into question the idea that Scott was really ‘surprised’ by the reaction.

            I think it is probably helpful for Scott to have people in the comments who call him out when he fails to live up to the standards of discourse and civility that he has laid out, at the same time, I enjoy Scott’s writing style, in particular his humor. I want him to be comfortable making more casual humorous posts like the APA photo-essay(which is my favorite post in a while), and so I am trying to push back against the idea that there is any reasonable way for him to have made a similar post, that was similarly enjoyable, without eliciting the undesirable responses that he got. I think the push back in the comments on this post serve as some evidence to that effect.

          • HeelBearCub says:

            I wasn’t speaking to Scott’s writing in general

            Isn’t his writing in general evidence of how he generally views the profession of Psychiatry?

            And the humor only works if everyone understands that it is intentionally hyperbolic for comedic effect. A roasting. That, or it’s dark humor meant to emphasize how fucked we really are. Given, I don’t know, just the last two month’s of posts on this subject, it very much reads like the second. I understood he was trying to be funny, but it very much looked like he was making mockery of the convention.

            And it becomes very hard to parse out which things he means, and which things are meant to be funny, and which things are meant to be sardonic. Everything and everyone is awful, but we somehow made progress through the heroic efforts of individuals. He ends by simply emphasizing his own personal desire to make people more empathetic.

            Like I said before, it reads very much to me as disillusioned and sardonic.

          • Plumber says:

            @HeelBearCub

            ‘…he has told us that all “those people”, those latte-drinking, urban dwelling, Prius driving, college graduating folks, are blue tribe…’

            My wife doesn’t drink lattes, but does do those other things, and between the two of us she’s less likely to “vote blue”.

          • HeelBearCub says:

            @Plumber:
            It’s a reference to this post.

            There is a fair amount of overlap between voting tendencies and the tribes he describes, but the tribes are not the same thing as “Vote D” and “Vote R”.

            I made exactly the mistake I am trying to warn everyone else about, and it wasn’t until I was almost done that I noticed.

            I’m pretty sure I’m not Red, but I did talk about the Grey Tribe above, and I show all the risk factors for being one of them. That means that, although my critique of the Blue Tribe may be right or wrong, in terms of motivation it comes from the same place as a Red Tribe member talking about how much they hate al-Qaeda or a Blue Tribe member talking about how much they hate ignorant bigots. And when I boast of being able to tolerate Christians and Southerners whom the Blue Tribe is mean to, I’m not being tolerant at all, just noticing people so far away from me they wouldn’t make a good outgroup anyway.

            I had fun writing this article. People do not have fun writing articles savagely criticizing their in-group. People can criticize their in-group, it’s not humanly impossible, but it takes nerves of steel, it makes your blood boil, you should sweat blood. It shouldn’t be fun.

            Basically I think Scott is making the same mistake over again.

          • but he has told us that all “those people”, those latte-drinking, urban dwelling, Prius driving, college graduating folks, are blue tribe, and that blue tribe is his hated enemy.

            The post you linked to tells us that they are one of his out groups, hence criticizing them is fun, but that’s well short of “hated enemy.”

          • HeelBearCub says:

            @David Friedman:
            Let me requote for you, since you love technical correctness.

            in terms of motivation it comes from the same place as a Red Tribe member talking about how much they hate al-Qaeda or a Blue Tribe member talking about how much they hate ignorant bigots.

            Hate for your outgroup is essentially the entire theme of the piece. It starts off with an anecdote of people wishing to burn someone alive when they find they are a member of their outgroup. The word hate is used over and over in the piece to describe an emotion people have towards their outgroup.

          • HeelBearCub says:

            And just to be perfectly clear, I think Scott went into psychiatry because he loves it, and he thinks it’s great and can be helpful and it might also be (as is common in the field) that he was helped immensely by psychologists and psychiatrists when he was growing up.

            And I think he still loves it.

            But that doesn’t mean he doesn’t carry a five piece set of Sampsonite with him at all times, because we all do. And the more cynically inclined and contrarian you are, the harder it is to keep that baggage closed.

          • Viliam says:

            Seems like the concept of “I like something in general, but there are details that suck and now I’m going to complain loudly about them” is too complex for internet.

        • Dan L says:

          The first words written to this blog under either the topics of Medicine or Rationality were “my attempts to promote things tend to meander into attempts to steelman the case against them”. I think this often continues to be accurate, and is responsible for a lot of the mixed messaging.

          • HeelBearCub says:

            That’s not the kind of writing I am talking about. I recognize he does it, but when writes things like:

            ALL.

            OF.

            THIS.

            IS.

            LIES.

            He hasn’t accidentally stumbled into steelmanning.

      • deciusbrutus says:

        people find an antidepressant or anti-anxiety pill they like that allows them to function and they continue functioning.

    • Garrett says:

      I initially took this as a “here’s some wacky shit at a major conference”. If you are involved in *any* field, you’ll know that there is a certain amount of absurdism present. But for fun, I started looking through the list of sessions.
      The meeting claimed to have 675+ sessions.

      Of these, there are a number of 4-8 hour “courses”. Of the courses starting at 8am on Saturday alone there is:
      * Advanced Pharmacological Management for Depression: Applying the Latest Evidence-Based Treatment in Clinical Practice
      * Functional Neurological Disorder (Conversion Disorder): Update on Evaluation and Management
      * Good Psychiatric Management for Borderline Personality Disorder
      * Talking With and Listening to Your Patients About Marijuana: What Psychiatrists Should Know
      * Updates in Geriatric Psychiatry
      The “master course” of Office-Based Buprenorphine Treatment of Opioid Dependence

      The shorter sessions (about 1.5h) also at 8am on Saturday include:
      * The Melancholy of the Lincolns: What We Can Learn About the History of Psychiatry Through the Cases of the President and His Wife
      * Binge Eating in Bipolar Disorder: A Clinically Severe Phenotype With Important Treatment Implications
      * I’m Facing 87 Years: Group Therapy in Juvenile Detention
      * Implementing an Educational Trauma-Centered Specialty Clinic in an Academic Setting: From a SAFE Healing Project to an Engaging RESTART Program
      * Diagnostic Errors in Psychiatry (and Corrective Strategies): Clinical Cases (Ours and Yours!)
      * CBT for Suicidal Behavior
      * Psychopharmacology and Sleep: A Review of Psychiatric Medications and Their Effects on Sleep Physiology
      * Geriatric Forensic Psychiatry: Development and Content
      * Climate Psychiatry 101: What Every Psychiatrist Should Know
      * Comprehensive Mental Health Care of the Transgender Patient
      * Making the Invisible Visible: Using Art to Explore Bias and Hierarchy in Medicine
      * The Fundamentals of Mentalizing-Based Therapy for Personality Disorders
      * Autism Spectrum Disorder: Essentials of Cutting-Edge and Evidence-Based Treatments
      * Cultural Issues in Psychiatric Administration
      * Crossing the Psychiatric Quality Chasm From Different Angles: Perspectives for Administration, Education, and Clinical Practice
      * Revitalizing Psychiatry—and Our World—With a Social Lens
      * Academia Meets the Opioid Epidemic: A Complex Journey
      * Implications and Challenges From Marijuana’s Evolving Legal Status and Access for Adolescents and Emerging Adults
      * Emerging Roles of C-L Psychiatrists: Addressing Interdisciplinary Care Transitions for the Medically Complex Patient
      * Computers and Psychiatry: How Might Our Practice Change?
      * Treatment of Dangerous Patients on Both Sides of the Atlantic: Comparison of the Medical-Legal Aspects of Patient Care in France, U.S., and Canada

      Some of this is culture-warry. Some of it is fluff. Some of it is probably in-joke entertainment. And a good amount of it seems like it would be valuable education. If there were videos available, I’d watch a good number of them at least to better understand what this part of healthcare is facing. And these are just the panels at 8am!

      Go use the moderately-annoying interface to look at the complete list yourself.

  3. erinexa says:

    I thought the original article was hilarious and definitely didn’t take it to some crazy extreme. I don’t work in psychiatry. Didn’t read the comments on the last article, but count me one person who really appreciated and understood your jokes.

    Of course, I also assume most people in most industries are good people working hard to advance things they care about. I’ve grown to realize that, sadly, many don’t get that. Anyway, please don’t change to only writing for takes-things-too-seriously readers.

    • shakeddown says:

      +1 to this. I read it more as a criticism of conferences (which are universally terrible across disciplines) than of psychiatry.

      • shacklesburst says:

        Just coming back from KubeCon Europe (a tech conference), I could definitely just write a similar post about that. Conferences are really just a universally bad idea (at least when you think of them as gatherings of people teaching each other the “newest and best” stuff). Even science cons are ~75% about giving poor grad students an excuse to get shit-faced on a sponsor’s tab.

      • Joseph Greenwood says:

        Data point: the math conferences I have attended have been extraordinarily useful and productive for me. The trick is to have a research problem that requires a few key lemmas you are pretty sure someone else has already figured out.

        Also, my response to Scott’s Photo Essay was (looking at the title) “This doesn’t sound very interesting,” and then (reading it) “This is really funny.” I didn’t go much deeper than that.

        • Jliw says:

          Exactly my two reactions as well. I almost skipped it, but found it to be quite amusing and then didn’t think about it any further.

    • domenic says:

      I came here to say the same thing, in the hopes that it would lighten Scott’s spirits a bit. I work in tech, and found the post funny and enjoyable and relatable. Even among all the jokes and excesses, Scott spent a bit of time on the story of John Fryer, which I hadn’t heard before, but was pretty heartwarming.

    • Telminha says:

      +1. I enjoyed the article and like when he’s humorous, too.

    • JPNunez says:

      Yeah, this is where I am. I get that Psychiatry is a field with some problems, and obvs companies will drop hilarious amount of money trying to get doctors to use their Vraylar medicine, but that’s to be expected?

      I know that Scott has written several articles pointing at the problems in psychiatry and medicine but the point is…the scientists know that these are problems and are trying to fix them. If these were fixed problems they would be history, not news.

      I didn’t dive into the comments for that article, cause I expected it to be endless jokes about Vraylar. The article had managed to be humorous, of course.

  4. eh says:

    Tech is fundamentally broken, though. I haven’t written any code in three weeks except for a tiny benchmark suite for bloom filters because I’ve been too busy filling out forms, chasing up other engineers, reading PRs, sitting in meetings about tools that don’t work like the two paragraphs of documentation suggest they should, making poor suckers draw boxes on a whiteboard, wrangling with IT over whether it’s SOX compliant to let contractors do their jobs, trying to unfuck a bad architectural choice that nobody noticed, and a million other things that didn’t need to be problems in the first place.

    When I read about the FDA approving the wrong isomer of ketamine because of strange and arcane rules about patentability, I felt like I was discovering the cousin to Gell-Mann amnesia, where I don’t notice that every other field is also held together by duct tape, luck, heroic effort at 3am with no overtime pay, and a fierce determination to avoid being sued.

    • Liface says:

      It sounds like it’s your company that’s “fundamentally broken”, not tech.

      • eh says:

        Maybe. On the other hand, I once interviewed someone from Google who literally started crying when asked why they were leaving, and it’s never been much better for me anywhere else.

        • shacklesburst says:

          I mean, sometimes you really have an a-ha moment or discover a really cool tool (the downsides of which you only notice in the weeks and months to come).

          But I love that comparison to an anti-Gell-Mann amnesia. Something pointing into that direction is definitely the fondness of people in almost any industry to trade anecdotes with each other and call them war stories.

    • DinoNerd says:

      I just wanted to express my sympathy. I remember enjoying working in tech, but now I’m dragging myself to the office, using anti-depressants and caffeine to keep coping, and counting the days till I can afford to retire.

      Some places are worse than others, and some roles are worse than others – but I could write essays on why working in tech sucks. And I’m at one of the “good” companies, not e.g. Amazon or Uber.

      • Randy M says:

        but now I’m dragging myself to the office, using anti-depressants and caffeine to keep coping, and counting the days till I can afford to retire.

        This isn’t meant to be personal, but since this is a psychiatry post, I’d like to clear up some confusion–if someone’s depression is caused by actual bad things in their life, is medication appropriate?
        Or is this the kind of thing where most people can bounce back, but people lacking whatever medication X provides get stuck when harsh circumstances appear, and medication helps them have a normal response to bad times?

        • DinoNerd says:

          I think part of the problem is that it’s a bit like global warming. There are more storms etc. But did global warming cause this particular storm? There’s no way to tell.

          Likewise, am I depressed because of bad things in my life, or because I am failing to bounce back/adapt to my new (and objectively less desireable) normal, as a normal person would, and therefore need anti-depressants. It’s hard to tell in general, but the drugs usually don’t get brought in until the problem has persisted long enough that it doesn’t look like emotional adaptation to the new normal is happening.

          Then we throw in the extra question – am I chronically stressed (for job reasons), and that’s why my biochemistry isn’t doing the normal adaptation thing, and instead leaving me sleeping excessively, generally eager to bite heads off coworkers, etc.- or are those reactions a direct response to the stress, not mediated by serotonin metabolism? I don’t think that can be determined either.

          It’s also possible that I’m more negative about tech – and about my work environment – than is realistic, and the cause of that is depression. I don’t think that’s the case, but some people claim to like the current environment. And while I discount their claims somewhat, since management strongly incentivizes positivity, in general some people really do like things others hate, so it’s possible they aren’t just performing positivity for management consumption.

    • Squirrel of Doom says:

      Tech isn’t broken. You just need to leave your big company and join a startup. We write code all day and build the future!

      Sure, the company may be gone any given Monday, but there are always tradeoffs. Live a little!

      • Eponymous says:

        I could use a dose of optimism right now. What future are you guys building? And what’s your revenue model?

      • DinoNerd says:

        How do you manage to write code in an open-office noise pit?

    • Matthias says:

      The meetings might be a bit unproductive, but reviewing at PRs is as important as writing the code in the first place. The ‘making poor suckers draw boxes’ probably refers to hiring? And it sounds like you are just senior enough to be involved in major design decisions.

      Alas, your company seems to make those decisions in meetings, which sucks. But there’s a reason they are (hopefully) paying you more now than when you were a junior programmer.

    • Eponymous says:

      Another way “tech is fundamentally broken” (at least in the average case) is that a lot of the products boil down to seizing and maintaining peoples’ attention to sell advertising. The services are actually not good for the customer, and the revenue comes mainly from third parties, not in payment for service rendered, creating misaligned incentives.

      A lot of tech stuff probably has the ultimate effect of making people unhappy (e.g. social media, video game and internet addiction), which is probably the underlying cause of rising levels of depression, anxiety, and suicide, not to mention singleness, loneliness, childlessness, and so on.

      Look at the big companies. Facebook: probably a net negative for humanity; mainly serves to make people unhappy. Google: they made a nice search engine in the 90s, and probably are net-negative value since then (but still +value overall). Apple: sells overpriced hardware thanks to their brand; main innovation in the last two decades was the iPhone, which was probably a net-negative for humanity. Amazon: selling stuff over the internet, truly an innovative idea! They moved first and now squat on the rents.

      Really, what value for humanity have tech companies created since ~2000? They’re mostly just monopolies based around first-mover advantage or one good idea from the 90s, or hosting platforms for user-created content. Oh, and they’re a threat to privacy and freedom of expression online through their stranglehold on information flow.

      • Edward Scizorhands says:

        “Do you want to sell sugar water for the rest of your life, or do you want to come with me and change the world?”

        Steve Jobs said that to the PepsiCo executive to get him to come to Apple.

        These days, a lot of Tech is really just selling an electronic version of sugar water, but still thinks they are changing the world.

      • tayfie says:

        “…products boil down to seizing and maintaining peoples’ attention to sell advertising.”

        This describes every industry that uses advertising in the business model. Are you willing to throw TV and radio out too? What about newspapers?

        The only reason these companies make people unhappy is that they work so well people become dependent, which makes them feel powerless. The benefits have been huge, but we take them for granted.

        • Eponymous says:

          Are you willing to throw TV and radio out too? What about newspapers?

          I never said to throw out technology, although there are some particular services we’d be better off without. Similarly, I’m not against painkillers, but we’d be better off without fentanyl. And yes, I’d put some TV and radio shows in the same category, and plenty of newspapers.

          There’s nothing wrong with an ad-based business model per se, though I think it lends itself towards certain kinds of problems (misuse of user data and maximizing user engagement at the cost of their welfare).

          I do think the dominance of this model reflects certain fundamental problems in the tech industry, at least relative to what it could be. Trying to build the future vs. just another addictive media platform. Peter Thiel has expressed similar sentiments.

  5. Plumber says:

    “….It would be easy to write an equally damning report on the tech industry…”

    Please do.

    “…RIP Murray Gell-Mann…”

    I knew Murray Gell-Mann’s son Nick in the mid 1990’s when we worked together at a motorcycle shop in Oakland, when he started there he drove an old Morris Minor which eventually needed more repairs than he could afford, in time he got an old KZ750 from me which he rode to Los Angeles. 

    My wife checked out a biography of Nick’s father from the library, and from the pictures inside we could tell that really was his Dad.

    Nick described his sister as “she works for the post office”, but from the biography I learned that she was estranged and fancied herself a Marxist (nothing in the book about where she worked).

    My chief impression of Nick Gell-Mann was that he was friendly (he’d usually greet you with “How’s ever little thing”, and that he smoked a lot, and like most of those I knew growing up he fit the pattern of being downwardly mobile compared to his parents. 

    • Scott Alexander says:

      “Nick described his sister as ‘she works for the post office’, but from the biography I learned that she was estranged and fancied herself a Marxist”

      Maybe “she works for the post office” = she works to create a world after offices?

    • eric23 says:

      If your dad is a Nobel Prize winner, it’s hard NOT to be downwardly mobile. Regression to the mean and all that.

  6. Harry Maurice Johnston says:

    For what it’s worth, I thought it was funny.

  7. jensfiederer says:

    I didn’t comment. I suspect a lot of people didn’t comment.

    It seemed like a cute article, filled with the sort of excesses that we have all seen, whatever our fields (and I am NOT a psychiatrist!).

    I suspect that there is some sort of bias that made the people that DID respond give you a far more “Oh, no, I am destroying the reputation of psychiatry in the world!” reaction than would actually have been rational.

  8. Faza (TCM) says:

    Scott,

    I’m not particularly keen to stick up for the tech industry (even though it is technically my line of work), but someone has to point out one thing:

    Tech is a malicious cancerous industry full of awful people and everyone should hate it.

    There it is in a nutshell.

    The problem with tech isn’t the tech, it’s the people in tech.

    The people in tech are a problem, because a lot of people not in tech have been bending over backwards to accommodate the a-holes. Starting from the legal environment, to the media climate around tech right up until Trump got elected, or thereabouts, tech was everyone’s darlin’ and those “awful people” could do no wrong. What did you think was gonna happen?

    The tech itself works. It works exactly as designed and usually as intended. That’s an issue if those with intent, doing the designing, don’t have your best interests at heart. Some of us have been beating the drum about it for years. I’ve mostly stopped now, ‘coz I’m waiting for the rest of the world to catch up. It’s slowly getting there.

    Nevertheless, the tech actually works rather well. When it doesn’t, we can typically spot the problem (once we actually take a closer look).

    For contrast, let’s pull up the money quote from your review of 5-HTTLPR:

    ALL.

    OF.

    THIS.

    IS.

    LIES.

    Or how about a selection from the piece on psychedelics:

    Some of the most exciting psychedelic findings have already failed to replicate; for example, a study two years ago found that psilocybin did not permanently increase the Openness personality trait. This was one of the most exciting studies and had shaped a lot of my thinking around the issue. Now it’s gone.

    The gold-standard FDA studies are abysmal, worse than most other antidepressant medications. I’m sure ketamine works great for some people, just as SSRIs, therapy, and diet/exercise work well for some people.

    Seriously, the graveyards are littered with revolutionary new treatments for treatment-resistant depression that have great success in anecdotes and preliminary studies.

    I occasionally hear stories like “I did LSD and my depression went away”, but I also occasionally hear stories like “I did LSD and then my depression got worse”, so whatever. I know plenty of people who use heroic amounts of LSD all the time, and are still nervous wrecks.

    I could go on and pull out quotes from earlier pieces, but I think that’ll do.

    The impression one gets isn’t just that there’s a problem with (a subset of) people in psychiatry. It simply doesn’t look like the actual science is particularly strong.

    There’s also a lot of great people working really hard to help fight mental illness and support the mentally ill.

    This is great, but how much is the science contributing? From the psychedelics piece, again:

    I think of psychotherapy as a domain where people can get as many amazing success stories as they want whether or not they’re really doing anything right, for unclear reasons.

    The “unsexy” result:

    “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety”

    … can just as easily be explained by noting that people have evolved to survive. Most people remained alive and basically functional for thousands of years, despite not having access to modern medicine. The parsimonious explanation is that most people are made of sterner stuff than we might give them credit for.

    (Aside: A case can be made that prior to psychiatry as a science, people had a whole lot more stuff to be depressed or anxious about. Realistic existential threats have been removed from the modern Western reality to such an extent, that people are making up new ones out of whole cloth just to fill the gap.)

    There’s a better thing you could do than writing a hatchet job on the tech industry (entertaining though it may be): write a piece on the great successes of psychiatry. Those of us not in the field trust people like yourself to give us an insider’s view. If that insider’s view only highlights the problems, we’re going to get a skewed idea.

    • Radu Floricica says:

      The “All of this is wrong” quote comes a coupe of weeks after The Control Group is out of Control, and I at least took it very much in context, i.e. to mean “Science is hard, this is one place where it fucked up”. Definitely not “The problem was trivial, it took an incredible amount of ill will/incompetence to get here”.

      Remember Asch conformity experiments. It’s all it takes to get a chain of positive results.

    • sclmlw says:

      I second the motion about writing a Psychiatry’s Greatest Hits post.

      As for the problems mentioned above, I guess I see much of what tech is doing as fundamentally different from psychiatry. Tech is primarily involved in engineering solutions, where the science is done in the background. Sure, there are problems with inventing a quantum computer, or figuring out how to make batteries not explode, but for the most part by the time you commercialize the product the science behind it has been refined, and it’s the engineers who take center stage getting it out to the public.

      With clinical trials, new therapeutic approaches, etc., Scott is calling out all the ins and outs of basic science. That’s a tougher nut to crack. I suspect if people’s well-being were dependent on the most cutting-edge research into a 5nm process we’d be having a different discussion.

    • j r says:

      Is psychiatry a science? I’m not sure that I’d call any medicine a science. Biology is a science, as is chemistry and genetics and neuroscience, etc.

      Medicine is the application of scientific tools to discrete situations. There’s a reason why we talk of practicing medicine.

    • Faza (TCM) says:

      To address some of the points made:

      1. Science is indeed hard, but what we get at the end of the process matters. A lot of this seems to be long past the “revolutionary new idea” phase.

      For me the most damning bit is:

      I’m sure ketamine works great for some people, just as SSRIs, therapy, and diet/exercise work well for some people.

      I may be getting this wrong, but the second part of that sentence reads to me like a laundry list of mainstream psychiatric interventions. Is that really the best we can say for them? They work some of the time?

      So does alternative medicine. Even downright magical practices can be observed to “work” some of the time.

      It surely wasn’t Scott’s intention, but reading his posts on psychiatry makes it seem like throwing stuff at the wall and seeing what sticks.

      2. Medicine as a science – I would differentiate between medical science and medical practice. The first is where we try to understand how the body works, the second – where we apply what we learned in the first step to achieve desired outcomes. It is akin to engineering, in a sense.

      There’s a quip that mainstream (as opposed to alternative) medicine is medicine that works; the assumption being that if an “alternative” intervention can be shown to be reliable, it simply gets incorporated into the mainstream. It’s worth reminding ourselves that medicine does, in fact, work – surprisingly well, given that humans are far from “easy”. Contemporary medicine – seen through the lens of simply reducing mortality and/or disability from common causes – is remarkably reliable.

      Can the same be said for psychiatry? I’m not really sure.

      • eric23 says:

        So does alternative medicine. Even downright magical practices can be observed to “work” some of the time.

        Alternative medicine works no better than a placebo. SSRIs, therapy, diet/exercise, and presumably ketamine work significantly better than a placebo.

      • sclmlw says:

        I’d like to address the complaint that things only work ‘some’ of the time. This is to be expected past a certain point. Sure, everyone has a heart, blood, lungs, and whatnot. Some basic mechanisms should be expected to work all of the time, such as surfactant for premature babies, respirators, defibrillators, etc. But the more finely tuned you look, the more you’ll run into the problem of biological diversity. This is frustrating if you’re coming from chemistry or physics, where you can deal with pure materials that always act the same, or conditions that can be standardized.

        I once worked in a lab studying asthma. We had two strains of mice – one in which we could induce asthma, and one we couldn’t. We looked at genetic and biological differences between the two strains to help us understand the molecular pathology of the disease.

        Other researchers had the same idea, but they had different mouse strains for their susceptible/resistant to developing asthma models. They came up with different lists of genes/mechanisms for the development of asthma. Their research was useful at developing treatments for some asthmatics, and ours was useful for helping others. But neither line of research was useful at helping all asthmatics.

        It turns out even with something you’d think is a simple condition, like asthma, there are multiple different ways to develop it, along multiple genetic pathways, with susceptibility to different types of triggers active in different people under different environmental and/or genetic circumstances.

        Biology is complex, as I’m sure is psychology, not just because the underlying pathways are so convoluted but because of the differences at the group level and even the individual level.

        • Faza (TCM) says:

          What you say is fundamentally true. But…

          There’s a modal difference between “works for some people” and “doesn’t work for some people”. Both could be used to describe the same situation, but their implied sense is rather different.

          If a particular treatement has been shown effective in 99% of cases, which of the two would more likely be used? We could say it “works for some people”, but it would be more accurate to say “doesn’t work for some people” (the 1%) or – most likely – “works for most people”.

          A lot of medicine is like that, I understand. There are odd cases, but for most typical interventions, you can make a solid prediction before you walk into a doctor’s office what the treatment will involve, how long it will take and what the results will be.

          • sclmlw says:

            Yes and no. For example, a cancer drug I worked on just got approved last year. It’s phenomenally effective, and was actually fun to work on because – unlike so many cancer drugs that work marginally okay on some people (~30% +/- depending on the drug) – this drug worked really well and/or cured nearly everyone who took it.

            The catch? It only works on the <1% of cancer patients with a specific genetic mutation. So if we weren't testing for that gene, we'd see an efficacy of almost nothing (and it wouldn't have been approved or been featured on Good Morning America).

            Now look at something like depression/anxiety, which is not only influenced by multiple genes (different ones for different people) but also by different environmental factors (again different for each patient) and you have the makings of a very complicated and individualized situation. As a biologist, I would be surprised if psychiatry didn’t struggle with the problem of having to individualize treatment.

            Yes, there are some diseases that only involve one gene, but outside of cystic fibrosis and the CFTR they’re the exception, rather than the rule. The reason so many medical treatments are of the ‘works for 99%’ variety isn’t because people are mostly interchangeable. It’s because that’s the low-hanging fruit we picked first in clinical development. Or in the case of pathogens, we find some broad-spectrum antibiotic a plant or fungus invented for us and we run with it.

            One more example of the ridiculous complexity at stake here. There are multiple types of leprosy, and in grad school we learned about one of the pathogens responsible for causing the disease. However, in some people the pathogen activates an immune response that is basically non-pathogenic whereas in others it activates an immune response that makes their skin rot and their fingers fall off. The difference has nothing to do with the microbe and everything to do with subtle genetic differences between people.

            These differences are at the core of research, development, and treatment of disease in different humans. Most humans don’t have clinical depression, but a small subset do. Of those who do, not all of them have the same genetic background, or if they do maybe they have depression and their sister doesn’t. “It’s complicated” really is an explanation, not a cop-out. Or rather, it’s an invitation, “do you want to know how complicated?” 🙂

          • sclmlw says:

            For fun, here are some more thoughts on the complexity of biology.

      • teageegeepea says:

        Robin Hanson is known for his argument that medicine is wasteful on the margin. Perhaps there’s a problem in viewing a field in terms of its current margins rather than the boring things so old & standard we don’t think about them.

        • sclmlw says:

          I think this can be said about a lot of research. We often don’t know what was the best use of research funds/time until after the fact. That’s because the nature of research is ‘investigating things nobody knows yet’. It’s akin to exploration. You might find more of an endless ocean/desert/tundra. Or you might find a whole new continent nobody knew about. You don’t know which you’ll find until you go. And it won’t be until years later that people will be able to accurately judge how worthwhile each experiment was.

          There’s a great story I heard Mario Capecchi tell about the grant he wrote for knockout mice. The grant had three aims, and only the third had anything to do with knockout mice. The grant was funded, but with the comment that he should drop the third aim. He didn’t drop it, which is fortunate for research because that’s what he won the Nobel for.

          He had some life-lesson to be learned from the experience, but I can’t remember what it was because he went on to talk about how they were grafting whale genes into mice.

  9. j r says:

    I dug the post and found it amusing. Can’t say that I was surprised by the psychiatrists are liable to put me in a straight jacket for being a straight white male takes. Being a victim is so hot right now.

    I was surprised that no one brought The Last Psychiatrist. By coincidence, I happen to be rereading one of his posts on the links between pharma and the psychiatric profession (https://thelastpsychiatrist.com/2009/09/is_more_regulation_needed.html). His take seems right to me. Complaining about pharma advertising is kind of pointless, because the entire structure of the health care industry is set up with pharma in a key roll. Pharma puts up most of the capital for research and in return they get to charge market rates for their products. The real problem is the tweaking of existing medications and then negotiating monopolistic deals with prescription benefit managers that effectively block low cost alternatives from the market.

    TLP also has a few very good posts that talk about how psychiatry and the health care industry more broadly has expanded into the delivery of services that have more to do with social services and criminal justice, not because medicine is better at addressing these problems but because that’s where the billing codes are. The opiod epidemic has its roots in these tendencies. Probably going to get worse before it gets better.

    • Aapje says:

      Can’t say that I was surprised by the psychiatrists are liable to put me in a straight jacket for being a straight white male takes. Being a victim is so hot right now.

      There is evidence for high masculinity being considered an illness, though. ADHD is diagnosed based on difficulty paying attention, excessive activity, and behavior without regards to consequences. Those sound like masculine traits to me. ADHD is diagnosed far more often in boys and also considerably more often in the younger boys in their school class.

      • eric23 says:

        An illness being correlated with X does not mean that X is an illness.

        For example, preeclampsia is more often diagnosed in women, but that does not mean that femininity is an illness.

        • Aapje says:

          Pregnancy is a female trait, not a feminine trait. Very butch women can get pregnant, but very feminine men cannot. So I don’t think that your counterexample is valid.

          A more valid counter-example would be to argue that women get treated for anxiety more and that this is a feminine trait.

          Ultimately, the weakness of both the argument and the rebuttal is that it hinges on a judgment whether what society considers normal is actually reasonable. For example, once upon a time, gay people were considered ill because same-sex attraction and sodomy were considered abnormal. Nowadays this is far less the case.

          For a person who believes that same-sex attraction and sodomy is abnormal, treating gay people as mentally ill is presumably not going to seem like the medicalization of perfectly normal people, while it is going to seem that way to people who consider being gay a normal and non-problematic deviation from the default/average.

          • March says:

            Your more valid counterexample also destroys your initial problem statement.

            Women get treated for anxiety more, but that’s because anxiety can be a huge problem. If a woman has it, she can benefit from treatment.

            Inability to pay attention/excess activity/recklessness can also be huge problems. If they happen to be more prevalent in men, so be it. (Well, disregard for consequences is hardly a problem to the person afflicted by it, but it can be to those who care about him.)

            (I also don’t think inability to pay attention or excess activity are part of the toxic masculinity narratives. Recklessness might.)

            Today’s culture has narrow bandwidths for acceptable characteristics, that’s true and that sucks. But watching my book-loving nephew not being able to concentrate on the book that he WANTS to be reading also sucks. Ritalin is a lifesaver.

          • Baeraad says:

            What @March said. Your counter-argument quite convinced me.

            And I don’t care if some men enjoy being hypermasculine, either. I’m sure they do – permanently feeling like you’re the most awesome person who ever lived must be wonderful. It feels less wonderful to be one of the less-masculine types that the manly-men walk all over, so if they can be medicated into behaving themselves, I’m all for it.

            I am less sure that frail and nervous women enjoy being frail and nervous, but again I don’t care one way or the other. Their constant claims of being victimised because someone breathed in their general direction places an unreasonable burden on the people around them, so if there’s a pill that might make them man up a little, I would very much like them to take it.

          • Aapje says:

            @March

            I also don’t think inability to pay attention or excess activity are part of the toxic masculinity narratives. Recklessness might.

            Not listening to others women seems to definitely be part of the toxic masculinity narrative. With teachers mostly being women now, especially at the lower levels where entire schools can have no male teachers, a boy who doesn’t listen to teacher can easily be interpreted as a misogynist boy who refused to listen to women.

            But watching my book-loving nephew not being able to concentrate on the book that he WANTS to be reading also sucks.

            Sure, but what if it’s not the child that has a problem with their behavior, but the teacher?

            What if the boy’s real problem is that he doesn’t get enough exercise, or doesn’t get the kind of learning material that engages his interests (perhaps because most teachers are women who teach to feminine interests)? Is the appropriate response then to start medicating the kid?

            @Baeraad

            And I don’t care if some men enjoy being hypermasculine, either. I’m sure they do – permanently feeling like you’re the most awesome person who ever lived must be wonderful

            I think that this is both incorrect and very ungenerous to the outgroup.

            Lots of masculine men/boys seem to feel quite unhappy and frustrated at how their natural inclinations are received. I strongly suspect that quite a bit of bullying, disruption, etc is due to frustration of how they don’t get to use their natural desires and traits.

            Pretty common parenting advice to deal with misbehaving kids is to allow them to feel/be useful.

          • March says:

            @Aapje

            Not listening to women seems to definitely be part of the toxic masculinity narrative. With teachers mostly being women now, especially at the lower levels where entire schools can have no male teachers, a boy who doesn’t listen to teacher can easily be interpreted as a misogynist boy who refused to listen to women.

            Yeah, but that’s inverting the problem statement.

            If a teacher refers a boy for not listening to any of the women around, she’s not referring him for misogyny. You can’t medicate misogyny. She’s referring him because it may NOT be misogyny.

            Sure, but what if it’s not the child that has a problem with their behavior, but the teacher? What if the boy’s real problem is that he doesn’t get enough exercise, or doesn’t get the kind of learning material that engages his interests (perhaps because most teachers are women who teach to feminine interests)? Is the appropriate response then to start medicating the kid?

            Well, no. And nothing I said implies that.

            If the teacher has a problem with a kid, the teacher should be given support to deal with that problem (or the kid needs to be moved to a teacher who is more resilient in that way). Education isn’t set up to benefit individual students, but that doesn’t make disruptive students not a problem.

            Anyway, teachers don’t medicate. Teachers refer to psychologists/psychiatrists, who are the people who should know if you’re dealing with ADHD, ADD, autism, learning disabilities, budding misogyny (it does happen) or something else.

            And if THEY do immoral things like handing out ritalin like candy, then that’s where the problem is.

          • Aapje says:

            @March

            You seem to have misread my comment. I never said that it was the female teachers who would do the judging. Psychiatrists can judge boys for how they interact with female teachers

          • March says:

            @Aapje,

            Could be, but seems unlikely. Who knows how afwul pre-teen diagnosis is going to get in the future but they do still look for independent corroboration of whatever the referrers say.

      • thisheavenlyconjugation says:

        There is evidence for high masculinity being considered an illness, though.

        Maybe it is.

        • Aapje says:

          Perhaps. But if people who are happy with their level of masculinity get called ill, it is not surprising if they feel themselves abused by the medical establishment.

          Ultimately, it is extremely subjective. People who agitated openly against Marxist-Leninism were a minority with traits fairly far from the average. Was it legitimate for the Marxist-Leninists to put them in psychiatric institutions? They were not “functioning at a satisfactory level of emotional and behavioral adjustment,” at least according to the Marxist-Leninists.

          Is a high level of aggression in some an evolutionary useful adaptation, where those people protect the group from major treats? Or is it maladaptive? Is it contextual? Did some people stop being mentally ill when WW II broke out and go back to being mentally ill when it ended?

          • ConfusedBeans says:

            The people who were institutionalized as schizophrenics in Latvia for being against the Soviet system, now are demanding to be recognized as politically oppressed and compensated for deprivation of their rights. Of course, it is a sensitive issue because how do you know if they were not really psychotic?

            Nevertheless, the head of the psychiatry professional association refused to recognize any mistreatment in the past by saying that a person who didn’t know what he was allowed to speak during Soviet times must not have been normal. It seems that psychiatry still haven’t changed since then and still serve to the current political establishment.

          • thisheavenlyconjugation says:

            Perhaps. But if people who are happy with their level of masculinity get called ill, it is not surprising if they feel themselves abused by the medical establishment.

            Their feelings aren’t super important; I expect a lot of schizophrenics feel unjustly persecuted too.

            Ultimately, it is extremely subjective. People who agitated openly against Marxist-Leninism were a minority with traits fairly far from the average. Was it legitimate for the Marxist-Leninists to put them in psychiatric institutions?

            People often get a pass for behaviour that would otherwise be considered a sign of mental illness if it’s morally praiseworthy. You describe one instance of this, but I think e.g. John the Baptist is a clearer example. But I don’t think it’s applicable here; no-one seems to view hypermasculine behaviour that way.

          • Aapje says:

            @thisheavenlyconjugation

            Their feelings aren’t super important

            People’s feelings is actually a key component of this post by Scott. If people conclude that psychiatrists are biased against them, then negative feelings seem quite sensible.

            It also matters a great deal in the psychiatric praxis, as unhappy patients are known to evade/refuse treatment.

            People often get a pass for behaviour that would otherwise be considered a sign of mental illness if it’s morally praiseworthy.

            That was not my point at all. I was trying to argue that there is no objective standard for what is adaptive and maladaptive.

            From the perspective of those in power, who believe very strongly in their agenda, the dissenter is insane for opposing the obvious truth.

            Yet the belief that the agenda is obviously correct is subjective. The very same person who may be considered fully sane and perhaps even hyper-sane by some, may be considered a basket-case by others.

        • What is high masculinity though? Being strong, tough and brave, enjoying mechanical things, having a high sex drive, and not easily showing fear or emotional disturbance?

          These traits seem useful for society to function, just as much as their stereotypical feminine counterparts. So long as human society is human and we don’t yet have a robot underclass to wipe our asses (so maybe not that long), we will need specialization, and hyperspecialization in some fields, and we will have to no choice but to face the trade-offs (hypermasculinity can also be described as domineering, rapey, emotionally cold and unempathetic etc).

    • Walter says:

      Wow, I haven’t read TLP in forever. That takes me back.

      Did anyone ever figure out if TLP and HotelConcierge were the same person? The style makes it seem like it, but there could be any number of reasons for that.

      • pqjk2 says:

        I personally felt like HC is a younger writer aping TLP’s style. Not sure how well I can articulate my gut feeling, but basically, reading HC felt like overconcentrated TLP – like how a caricature overemphasizes the features that stand out. He rails against the Atlantic, mercantilism, fetishism. He namedrops his medical background/residency program. His tongue-in-cheek “I swear I’m not TLP” statements seem over-engineered.

        Maybe I’m overthinking it and he sounds like TLP because he is TLP.
        But I also feel like, if TLP wanted to start over on a new blog he wouldn’t have been so obvious about it. And if he just wanted to keep writing as TLP he would have done it on his old site.

        (also, sorry, I accidentally reported your comment when I meant to reply)

    • The Nybbler says:

      I dug the post and found it amusing. Can’t say that I was surprised by the psychiatrists are liable to put me in a straight jacket for being a straight white male takes. Being a victim is so hot right now.

      And here you are, using traditionally masculine tendencies (to not want to be seen as a victim) as a tool to sneer at male concerns. If that’s the sort of take men can expect when discussing their fears, no wonder stoicism (in the common sense) seems like a better alternative.

      • j r says:

        And here you are, using traditionally masculine tendencies (to not want to be seen as a victim) as a tool to sneer at male concerns.

        It is possible that’s what I was doing. It’s also possible that I was not and you are here displaying the very kind of overly sensitive reactions that have become fashionable.

        You should think a bit on the possibility of alternatives.

        • The Nybbler says:

          A valiant effort at a kafkatrap, but I’m afraid the phrasing “Being a victim is so hot right now” is too unambiguous.

          • j r says:

            I made an observation about how people are looking to view themselves as a victim. You made a comment complaining… about men being victims. That’s not a very elaborate trap.

          • greenwoodjw says:

            He didn’t say men were victims. He said their concerns were being sneered at.

          • j r says:

            So what? Those concerns deserve to be sneered at.

            This is a spectacularly uninteresting conversation, so I’ll just say this and be done. If you (the proverbial you) are one of these guys complaining about how institutional feminism in one form of the other is making it so hard to be a real man, then you’re every bit the beta male that you claim you’re being made into. Honestly, if you’re one of these guys, you should be happy for institutional feminism and the constraints it put on the men who really don’t care. Otherwise, you’d be getting stuffed into a locker as we speak.

          • Aapje says:

            @j r

            True, and if you’re not a Jew who actually controls the banks/media/etc, you don’t have to worry about Neo-Nazis either. They only go after the bad Jews…right???

          • DarkTigger says:

            @j r
            Yeah, you know I would take third wave femminst talking about “manliness” a lot more serious if two thirds of their arguments wouldn’t sound like:
            a) Saying “Real men don’t cry” is problematic.
            b) Stop your unmanly whining, crybaby.
            c) Meanspreading, Mensplaing, and all the other stuff that I once was told, is how “the Turk” behaves, by people who tried to convince me that “the Turk” is bad for Germany.

            But yeah, go ahead tell me how noticing incoherence makes me unmanly in a way that deserves to be sneered at.

          • The Nybbler says:

            So what? Those concerns deserve to be sneered at.

            I believe my point is made.

          • Edward Scizorhands says:

            Honestly, if you’re one of these [beta men], you should be happy for institutional feminism and the constraints it put on the men who really don’t care.

            Except the constraints aren’t being put on the grr-raaah-macho-alpha men. The men who listen to and care about institutional feminism, the ones who want to Stop Rape Culture are those who were less likely to rape in the first place. The real grade-A asshole men? They don’t give a singular shit what the feminists think.

            There are men who are sad and hurting and have no desire to be the alpha men. Sneering at them with “I ThoUGht YoU wEre SuPOSed To be An AlFHA MAn LOL LOser” demonstrates that you aren’t listening.

            Otherwise, you’d be getting stuffed into a locker as we speak.

            Unnecessary and unkind. Deliberately unkind, in fact. Reported.

          • greenwoodjw says:

            So what? Those concerns deserve to be sneered at.

            Why? Because they come from people weaker then you are?

            I can understand dismissing concerns for lack of validity, but I cannot understand sneering at them.

            This is a spectacularly uninteresting conversation, so I’ll just say this and be done. If you (the proverbial you) are one of these guys complaining about how institutional feminism in one form of the other is making it so hard to be a real man, then you’re every bit the beta male that you claim you’re being made into

            You can Be A Man without being Richard the Lionheart. An honorable life doesn’t require being the top dog in everything, but you seem to believe that among the institutional feminist crowd anyone other than Alpha sociopaths deserve to be stepped on.

            Honestly, if you’re one of these guys, you should be happy for institutional feminism and the constraints it put on the men who really don’t care. Otherwise, you’d be getting stuffed into a locker as we speak.

            The modern move to demasculinize men and boys has made it easier, not harder, for thugs and bullies to operate and harm people.

          • Scott Alexander says:

            JR is banned for four months

  10. Puuha Pete says:

    At least tech dont torture you out of your money health like psychiatrists do.

  11. bzik says:

    While the original article was amusing, I feel it would have benefited from the second part/follow up in the vein “But here is all the great stuff that was going on despite the surrounding insanity”. As is it might have given some readers somewhat of a lopsided view of the situation.

    • Bugmaster says:

      I agree completely… assuming, of course, that there actually was some great stuff to write about.

  12. Lucid Horizon says:

    Psychology in particular has a long history of being weaponized against undesirables by the powerful, and the most recent big psychology news story that made it to the public awareness was the thing about masculinity as a whole being officially Considered Harmful. (Maybe it was more nuanced than that, but that doesn’t seem to be the position of either side of culture war, which at least suggests the psychologists involved didn’t think very hard about their responsibility not to be used as ammunition.) It would be cringeworthy to see panels like this a geology conference or whatever, but it probably wouldn’t have touched a nerve so much.

    When people see an article like this posted even by an insider who supposedly loves their work, well, it seems to confirm some suspicions. If you would like to dispel the idea that psychology has been co-opted yet again and is nothing more than a malignant force in the culture wars, perhaps a well-cited article to that effect is in order.

    Also, why should we expect that “conferences are designed to be about signaling”? Not everyone goes to conferences, but naively one would expect them to have some substance beyond simple networking – otherwise they could instead just put on an ice cream social (catered by Fanapt®!)

  13. Aapje says:

    Scott,

    But there’s also some extraordinary innovation going on

    Name 3 extraordinarily innovative psychiatric drugs that were developed in the last 3 decades. Or even one. I can’t think of any. Where is the extraordinary innovation in psychiatry?

    If we expand to all treatments, then EMDR barely makes the cut off, being first published about exactly 30 years ago. Yet it was pioneered by an English teacher, so it doesn’t even come from the psychiatric field. Also, psychiatric research seems very divides on it’s efficacy, suggesting that they can’t actually measure how well treatments work. No wonder that little progress is made.

    “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety” isn’t sexy any more than “Internet continues to connect billions of people around the world at the speed of light” is sexy.

    Psychiatry has no explanation for why there are record-breaking amounts of depression and anxiety, though. They just cycle through a bunch of slightly different medications until they find one that more or less suppresses the worst symptoms.

    There’s also a lot of great people working really hard to help fight mental illness and support the mentally ill.

    Mother Theresa worked really hard to help and support the ill, but seems to have ignored what actually works in favor of things that made her feel good.

    If a field works very hard on the wrong things, that is a reason to condemn it, not to praise it for working hard and having their heart in the right place.

    If you don’t trust hatchet jobs against tech

    Many of these ‘hatchet jobs’ (begging the question, there) are wrong because of their lack of understanding, but there are also many very harsh criticisms that are quite fair.

    • Scott Alexander says:

      Brexanolone, aripiprazole, pimavanserin. Do I wish there were ones that were better than this? Yeah. Is it nothing? No.

      Stuff is hard. Mathematicians haven’t solved P = NP either, I still trust there are a lot of good people in math working on the problem in an admirable way.

      • Aapje says:

        Is it nothing? No.

        I feel that you are moving the goal posts to another continent, by going from “extraordinary innovation” to ‘not nothing.’ Unless you consider minor advances to be extraordinary in the field of psychiatry, of course, which in itself would be telling.

        Anyway, let’s look at your examples (with the caveat that I’m very much a lay person who is above average at Google-fu), based on your original claim of “extraordinary innovation”:

        Brexanolone is extremely new, with as of yet apparently only two phase 3 trial studies having been performed by the same group, funded by the drug company (which has been shown to correlate with more impressive findings). Looking at the studies, I see that all test subjects have a strong regression to the mean, going from a severe or very severe depression to a mild or moderate depression. With the placebo group just barely ending up with a moderate depression in the first study (14.6 with 14-18 apparently being a moderate depression in HAM-D) and ending up with a mild depression in the other, it seems likely to me that treatment with other anti-depressants would also result in a mild depression on average for these test subjects.

        According to Vox, traditional anti-depressants have not been tested for efficacy and safety on pregnant and breastfeeding women. If true, that reflects badly on psychiatry, for not doing these studies, rather than well on Brexanolone.

        Note that Brexanolone is very expensive and fairly hard & unpleasant to administer. So women with post-partum depression may still be better off with other anti-depressants, even if they are a little bit less effective, which isn’t clear at all.

        So my verdict: I’m not convinced that Brexanolone is actually better than other anti-depressants for pregnant and breastfeeding women. I’m not convinced that the phase-3 trial results will fully hold up when more studies are performed by researchers who are not corrupted paid by the drug company in question. So based on the evidence, I’m not seeing extraordinary innovation, but most likely a slight to moderate improvement.

        Aripiprazole seems to be less effective than olanzapine, but with fewer side effects, and about just as effective as risperidone. So my verdict: perhaps a useful new drug that works for some patients where the other medicines don’t work or have severe side effects, but nothing extraordinary.

        Pimavanserin seems to increase the efficacy of risperidone, allowing lower dosages of risperidone with mostly the same outcomes (although it acts sooner), but lesser side effects and risks. It also seems to reduce side effects for haloperidol, although not its efficacy. So my verdict: a small to moderate improvement for schizophrenia patients.

        Stuff is hard. Mathematicians haven’t solved P = NP either, I still trust there are a lot of good people in math working on the problem in an admirable way.

        If those mathematicians actually only solve minor math problems with very limited impact on our daily lives, then they would also not be achieving “extraordinary innovation.”

        You are equivocating between intent/effort and outcomes, which is sloppy. That these things are not the same is exactly the point of Rationalism/LessWrong/EA/etc, is it not?

        PS. Note that the high standards I have for you reflect in part how capable I think you are.

        • Spookykou says:

          Humans are comparison shoppers, if a minor improvement to depression treatment substantively improves the lives of millions of people(lots of people have depression), how does that stack up against other innovations in other fields?

          • Aapje says:

            Minor improvements with large effects due to scale still don’t count as “extraordinary innovation” to me.

        • Scott Alexander says:

          You asked for “innovative”, so I chose drugs that were new and exciting, like brexanolone, rather than ones that were undoubtedly very effective but boring (like olanzapine). So I feel like you’re changing the goalposts more than I am.

          I think you’re really underestimating aripiprazole – “like Zyprexa but fewer side effects” is like describing a surgery as “like getting stabbed in the chest, but with fewer side effects” – the difference for patients is pretty profound.

          Pimavanserin is another one interesting for its innovativeness. It’s also one where the indication really matters – you *can’t* use traditional antipsychotics on Parkinson’s patients, and you can use pimavanserin. Again, not the most exciting thing for the general non-Parkinson’s population, but really innovative and exciting for what it does.

          I’m not equivocating between effort/outcome, I’m answering the question you asked. If you’d asked about outcomes, I would talk about all the borderline people getting DBT and coming out the other end feeling a lot better (or something), which isn’t that innovative or effortful but is an impressive outcome.

          Also, looking back, you seem to have successfully tricked me into defending a claim I never made – the “extraordinary innovation” was my complement to tech, and for psychiatry I said it had “a lot of great people working really hard to help fight mental illness and support the mentally ill.” I do think some good innovation is going on in psychiatry, but it probably wouldn’t have been the first compliment that came to mind.

          • Evan Þ says:

            Can you write a main post going into detail on some of this? I, for one, would be very interested!

            Still, my point upthread was there’s a difference between “throw drugs at people and see what helps” and actual subject-matter understanding. Tech has that. Math has that (as much as Godel allows). Does psychiatry?

          • Aapje says:

            Scott,

            When you wrote: “I feel the same way about psychiatry,” I interpreted this to refer to the entire earlier paragraph, but apparently this only referred to the last sentence of that paragraph.

            With that clarification, it is indeed not necessary for you to give evidence for extraordinary innovation in psychiatry.

            So sorry for drawing you out, but also not so sorry, because your answers were very interesting. I agree with Evan that a main post about this would be interesting.

      • Garrett says:

        No love for duloxetine?

        • Aapje says:

          “A 2014 Cochrane review concluded that duloxetine is beneficial in the treatment of diabetic neuropathy and fibromyalgia but that more comparative studies with other medicines are needed.[13] The French medical journal Prescrire concluded that duloxetine is no better than other available agents and has a greater risk of side effects.[14] Thus they recommend against its general use.”

          https://en.wikipedia.org/wiki/Duloxetine

      • Mark Atwood says:

        Mathematicians haven’t solved P = NP

        And yet Automated Reasoning gets noticeably better every year, by dint of grad students and post grads thinking very very hard, and each such incremental improvement is immediately put to work hauling freight (or more literally, computing how to route freight), with real measurable dollar value.

  14. Bugmaster says:

    I was disappointed to see a lot of the most hostile comments coming from people in tech. It would be easy to write an equally damning report on the tech industry. Just cobble together a few paragraphs about Juicero and Theranos…

    Speaking just for myself, it certainly wasn’t my intent to appear hostile, merely disappointed.

    That said, there’s a difference between “Juicero and Theranos” and this APA convention: Juicero and Theranos are individual companies that were doing unquestionably bad things; whereas the APA is the chief convention that is supposed (as far as I understand) to represent the best of the industry. If the best of the industry is incessant ads and wokeness, then what does that tell you about how much you should trust your local psychiatrist ?

    Naturally, there are ads and wokeness at tech conventions as well (PyCon comes to mind). But organizations such as IEEE, ACM, ISMB, etc. are IMO doing a decent job of tamping down on the worst excesses. If you go to an average tech convention, your main focus would be on attending lots of talks about cutting-edge research (almost certainly too many at once to fit on your schedule); participating in hands-on workshops focused on practical tools and techniques; and, naturally, visiting some vendors — though even the vendors would be prepared to answer detailed technical questions.

    By contrast, the impression you gave of the APA made it look like it’s basically a sea of ads with woke sprinkles on top, with little else of substance to it. This paints (perhaps inadvertently) a pretty damning picture of the industry.

    • Scott Alexander says:

      Juicero and Theranos are individual companies that were doing unquestionably bad things; whereas the APA is the chief convention that is supposed (as far as I understand) to represent the best of the industry. If the best of the industry is incessant ads and wokeness, then what does that tell you about how much you should trust your local psychiatrist ?

      I think this only represents the best of the industry as much as the President represents the best of the American people. I don’t want to make too many extraordinary claims about Americans, but I think we’re at least better than you would think if you judged us by our highest echelons.

      • Bugmaster says:

        As I said, I was comparing the APA conventions specifically to top-tier conventions in tech (such as ISMB or PyCon or maybe SIGGRAPH). As I said, these conferences are meant to represent the state of the art in the industry. For example, if you’re a bioinformatician, and you are thinking to yourself, “hmm, I wonder where I can learn about the state of the art in the field while also networking with all my colleagues, and maybe picking up some of the latest tools, where should I go ?”, the answer is “ISMB“. Additionally, if you look at the front pages of organizations such as ACM or IEEE, you can see a list of upcoming professional conferences, most of which are fairly technical in purpose and execution.

        Honestly, just based on your responses, we might be having a paradigm conflict of sorts. Perhaps psychiatry simply doesn’t have anything analogous to SIGGRAPH/ISMB (or heck, even AWS Re:Invent) ? It is really starting to sound like the concept of “professional conference” doesn’t exist in psychiatry, so you have nothing to compare it to (other than analogies about the President).

        • Aapje says:

          @Bugmaster

          ISMB or PyCon or maybe SIGGRAPH

          Those conferences are all specialized, though. Perhaps generic conferences that try to cater to an entire industry are worse than specialized ones.

      • vV_Vv says:

        I think this only represents the best of the industry as much as the President represents the best of the American people. I don’t want to make too many extraordinary claims about Americans, but I think we’re at least better than you would think if you judged us by our highest echelons.

        This claim is strange: the President, before becoming President was a successful billionaire businessman, tv celebrity and best selling author. He then ran as an outsider and won the presidency against all predictions, while being constantly attacked by the media. Looks like pretty above-average competence.

        Maybe you meant morality rather than competence, but do you really think the median American is above the stuff that your President pulled?

    • tossrock says:

      Theranos was doing unquestionably bad things, but I think Juicero was just garden-variety profit-motivated and fundamentally silly. The juice was actually quite good, too, at least in my opinion.

      • vV_Vv says:

        Juicero business model wasn’t in fact any different than that of those companies that sell expensive coffee machines which work only with their expensive branded coffee capsules.

        I wonder why Juicero got so much backlash while Nespresso remains profitable. Maybe coffee is seen as an inherently high status drink thus a reasonable target for conspicuous consumption, while pressed cucumber juice isn’t?

        • crilk says:

          IIRC the Juicero machine was entirely superfluous, you just needed to squeeze the capsules and the juice would come right out.

          • tossrock says:

            Well, superfluous in the same way all juice presses are superfluous, in that you can get some juice out of pulp by manual squeezing. But you will get a lot less juice than using a press, which can exert much more pressure than your hands, over a much more even surface area. So, the press saves you some manual labor and reduces your wastage. At a certain number of bags multiplied by the amount of extra juice extracted, combined with the value of your time spent not squeezing bags, the machine (theoretically) pays for itself.

          • greenwoodjw says:

            Except you needed to operate the machine, which took more effort and time to do. (Net negative value)

        • Nornagest says:

          Well, personally, I’d never buy a capsule coffee machine for exactly the same reasons I’d never buy a Juicero. But the fact remains that the Juicero was set at a significantly higher price point than your average Nespresso or whatever — both for the machines and for the packages.

          Consumers are also used to seeing espresso machines as luxury items, while making juice, if they make it at all, in forty-dollar blenders.

  15. Frederic Mari says:

    “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety”

    Not to sound flippant but I would dispute this being presented as a positive. Either fix whatever is causing depression and anxiety (income inequality, imho) or let people go gently into that good night (to slightly misquote stuff).

    • niohiki says:

      I agree that there’s a bigger underlying problem, but I think it is not the job of psychiatrists to fix the socioeconomical problems from which this depression and anxiety originate (any more than it is the job of any other citizen with a right to vote). Do we judge trauma surgeons by their ability to campaign against drunk driving, or by saving people who have been in accidents?

      • Aapje says:

        @niohiki

        Do we harshly judge doctors who assist in torture to ensure that the maximum amount of pain can be administered without killing the subject?

        I do…

        • niohiki says:

          I… I do too? Yet I fail to see the relation with the response to Frederic’s point?

          Sure there’s a whole other discussion about the problems and methods of the field. About that, personal experience, even if not in the US, makes me judge psychiatry with a much less harsh eye than you seem to. But in any case, that is not what was being discussed in this subthread (there are plenty of those in this post already).

          • Aapje says:

            Frederic seemed to be implying that our economic system is increasingly exploiting people, which causes depression and anxiety. If medically untreated, this will cause people to drop out, which makes the increased exploitation unprofitable. So there is then a limit to how much exploitation is worthwhile, putting a limit on it.

            Psychiatrists are then increasing the amount of exploitation and perhaps even the total amount of suffering (where many people suffer at a level that is just low enough for them to still be productive).

            This is then somewhat comparable to my torture example, where a torturer without help from a doctor would need large safety margins to torture with only a small chance of causing deaths. In contrast, a torturer that gets medical help can torture very close to the limit of endurance of the person being tortured.

          • niohiki says:

            @Aapje

            I see.

            Since I doubt there is an actual underground masterplan of psychiatrists keeping people just at the border of the tolerable to please their capitalist overlords (@Scott can correct me if I am wrong?):

            Should we blame surgeons for the car accidents in our societies, because with their hospital care they are harming the incentives people have to drive responsibly, allowing drivers to behave on the road very close to the limit of their own survival, armed with the knowledge that even if something goes wrong their safety margin is guaranteed by solid-and-functional medical care?

            Or maybe it is one of those infinity cases where we have “inadequate incentives” and the answer definitely isn’t “let’s pre-emptively scrap the one part of the system that kind of works because it is not actively fixing all the problems”?

          • Aapje says:

            @niohiki

            Mere ignorance of 2nd order effects is sufficient. Psychiatrists aren’t even very good at analyzing the 1st order effects of their medications, so their apparent lack of interest in 2nd order effects may be regarded as justified humility.

            However, their ignorance doesn’t change the actual facts, in the same way that a train driver who brought Jews to Auschwitz, but who didn’t know that Auschwitz is an extermination camp, facilitated the holocaust just as much as a train driver who knew. Ignorance may effect moral culpability, but it doesn’t make the outcome any better.

            Anyway, I don’t have high confidence that psychiatrists are enabling abuse (but neither that they aren’t), but IMO psychiatrists should worry about how their interventions actually work out and be restrained in taking credit for things whose full consequences they cannot understand.

          • niohiki says:

            @Aapje

            psychiatrists should worry about how their interventions actually work out and be restrained in taking credit for things whose full consequences they cannot understand

            I absolutely agree. Applies to many other sciences and fields, and I absolutely agree.

            But. First accusing them of “[assisting] in torture to ensure that the maximum amount of pain can be administered without killing the subject” or comparing the whole field to mother Theresa, to then saying that they are mostly having a hard time identifying 2nd order effects… I’m not even sure if the point is the quasi-tautological and generic “[insert profession/group] should be more careful and consider more thoroughly the consequences of their actions” or the more concrete and contrarian (and in my opinion, very bad?) “we should ignore/eliminate psychiatry”. Or anything in between. I’m sorry, it is all just a bit too much motte-and-bailey-ish for me.

      • John Schilling says:

        I agree that there’s a bigger underlying problem, but I think it is not the job of psychiatrists to fix the socioeconomical problems from which this depression and anxiety originate

        “A hundred billion people found happiness and contentment in lives that were objectively worse than yours by almost every objective metric; the only reason you are stressed and anxious is because you keep staring at that flatscreen display peddling lies, fear, and envy, maybe read a good book or go for a walk in the park instead?”, seems like the kind of thing psychiatrists and psychologists might have a role in fixing.

        But given the vast disparity in resources between those who promote stress and anxiety and those who try to treat those conditions, I do agree that psychiatry is doing a fairly good job of it.

        • niohiki says:

          “[…] the only reason you are stressed and anxious is because you keep staring at that flatscreen […]” seems like the kind of thing psychiatrists and psychologists might have a role in fixing

          True, true. It is not an underlying socioeconomical problem, though, at least of the kind Frederic was suggesting.

          Sure things like (income inequality, etc) may indirectly cause an existential void that people fill with flatscreens. My point was that psychiatrists are meant to fix the part that goes from [alienated life]=>[needs a flatscreen], not [insert your tribe’s explanation]=>[alienated life]. And, like you say, they have a pretty tough starting point right now…

          • John Schilling says:

            Sure things like (income inequality, etc) may indirectly cause an existential void that people fill with flatscreens.

            For income inequality, I call the flatscreens a direct cause. Income inequality can cause psychological harm only to the extent that the victims know/believe it exists, which comes from the flatscreens. Whether the flatscreen tales of other people living wondrous lives that you are locked out of, bwuahaha, are actually true, is largely irrelevant and so actual inequality is maybe a root cause but not a direct cause.

            But yes, there are other cases where the direct cause is socioeconomic and whether or not you are fully informed (or misinformed) is secondary.

    • Baeraad says:

      Don’t knock it. I’m depressed and anxious most of the time, but I am still grateful for the ability to keep it at sufficiently managable levels that I don’t end up harming myself.

    • Steve Winwood says:

      Yeah, that line stood out to me. Why should psychiatry get credit for people remaining alive and basically functional? Afaict, human history is a testament to mankind’s ability to stay, more or less, alive and functional in tremendously difficult circumstances (subject to nutrition, disease, and warfare constraints). And, if we’re creating systems of blame and credit for intangible Molochian entities, why should psychiatry escape blame for the rise in anxiety and depression?

      I think you can create stories where psychiatrists help people adapt to modernity as best they can. I think you can also create stories where psychiatry, as a whole, has medicalized the ways in which modernity has failed humans, told the humans fake stories about chemical imbalances, and sold them a lifetime of poorly-understood treatments with wildly varying results.

      I have zero doubt that Scott, and likely the psychiatrists he knows, are, on net, improving people’s lives. But this is all within a certain system that psychiatry has contributed to. If there’s a strong case that psychiatry as a whole has helped people over the past, say, 20 years, I’m genuinely curious and receptive. Because I’ve seen a lot more people that are giving kids stimulants so they can sit still in prisons for eight hours than I see Scotts out there.

      (I’m unable to remove all bitterness from this comment — I had strongly negative experiences as a child being inappropriately thrust into the psychiatric world — but I mostly stand behind the challenges within it as worth addressing. It genuinely is not clear to me that psychiatry has done net good, and it seems like, from people’s reaction to the first piece, that others are in the same boat. Therefore if Scott thinks it can be clearly argued it is it imo is worth his time to explicitly lay out that case.)

    • Scott Alexander says:

      Most depressed people are not suicidal. I’m on (sort of) antidepressants as I’m writing this – do you think I should just give up and die?

      • Bugmaster says:

        FWIW, it would be interesting to read a detailed article about all the most common manifestations of depression — seeing as this appears to be the most common, and possibly the most misunderstood, mental illness.

      • RandomName says:

        While the answer for basically anyone reading this (Including me) is “Obviously no”, I do think it’s generally bad form to ask questions that the commenting rules only allow one answer to.

    • (income inequality, imho)

      The claim was “record-breaking amounts of depression and anxiety”

      Income inequality isn’t unusually high by historical standards and poverty is extraordinarily low by historical standards. So I don’t see how hour explanation works.

      • Quiet Lurker says:

        Income inequality isn’t unusually high by historical standards and poverty is extraordinarily low by historical standards.

        It seems possible to me (though by no means certain) that “record-breaking amounts of depression and anxiety” could nevertheless develop as a result of envy due to routine exposure to the lifestyles of the people much richer than oneself.

        I’m thinking of the kind of crass celebration of the excesses of the very rich which you might see on TV. Rich teenagers crying about not getting the specific car they wanted for their sweet sixteen or an in-depth tour of some celebrity’s luxurious home for example.

        If this is a problem I expect it might actually improve over time as people spend less time watching TV and more time playing video games.

        • Orion says:

          “If this is a problem I expect it might actually improve over time as people spend less time watching TV and more time playing video games.”

          I guess we’d better hope no one replaces all the single player games with online-only ones that force you to interact with other players wearing fashionable in-game skins purchased for real money.

      • ARabbiAndAFrog says:

        Perhaps it is not income inequality but overwhelming complexity of life and delayed gratification disappearing into the horizon. Subsistent farmer’s life is tough, but simple – his objectives clear. It’s clear what needs to be done (Grow food, build house etc) and it’s usually easy to gauge whenever you are doing things right, as it’s pretty easy to tell if you are still alive.

        Modern people spend their entire life working towards an elusive goal that is impossible to tell if it’s ever going to realize or not because you are doing the wrong thing. I think that’s pretty depressing and anxiety inducing.

      • vV_Vv says:

        Might the collapse of the traditional family be the cause?

        For example, in the comment above Scott claims that he is on (sort of) antidepressants. As a medical doctor he’s probably in the top 1% income bracket, yet he’s depressed. I don’t know why exactly, but it might have something to do with the fact that he is a 30-something unmarried and childless man.

        There are many people in different variations of this situation, some quite worse. From the divorced estranged father to the bitter incel to the apathetic herbivore man to the angry man-hating feminist to the #instaddict traveling girl to the menopausal single cat lady. These are the people who end up on antidepressants, or opioids, or worse.

        I don’t know if the traditional family collapsed because of woke ideology, or woke ideology became popular because the traditional family collapsed, but the two things seem related.

        • Eponymous says:

          There are potentially many causes, but I think there’s a very good case that the specific increase in depression/anxiety/suicide over the last decade is related to technology (especially social media, but also internet/screens in general). This is based on the timing, and also studies showing a direct connection. Plus common sense and personal experience.

          I doubt there’s a direct causal connection to “woke ideology” or the decline of the “traditional family”. Though I agree that both are general symptoms of modernity, which has produced a lot of both good and bad things that we’re grappling with as a culture, and have been for over a century (Marx wrote about it!)

          Also, while I don’t know Scott personally, what little I know suggests your speculation about him is wrong, and I found it a bit rude as well.

          • This is based on the timing, and also studies showing a direct connection.

            Can you provide links? It doesn’t strike me as a particularly plausible conjecture, but I haven’t seen the evidence.

          • Eponymous says:

            I’m going off things I’ve read in news articles, but I understand there’s been at least one good experimental study. Googling turns up these two. Plus there are many observational studies, though those are suspect for all the usual reasons.

            There have been many popular articles about this. This one stood out for me. Not sure how much you want to conclude from such pieces, but the research seems to back them up.

            And I’ll just throw in a word for personal experience and common sense here.

          • From the popular article you linked:

            Rates of teen depression and suicide have skyrocketed since 2011.

            So I googled for data on teen suicide rates, and found this. It looks as though teen suicide rates have gone up in recent years, but are still substantially below what they were in 1990, which isn’t the impression that article gives.

            It’s possible that smart phones are really making teens miserable, but I would want more evidence before being confident of it. A lot of other things have changed, and it’s tempting to attribute whatever effects look bad to whatever cause one is against.

          • Eponymous says:

            Thanks for the link David.

            It seems the recent data does indeed show increasing rates of depression and suicide, both among teens and overall. However, this follows a decrease in suicide in the previous period, so recent numbers are not unprecedented.

            After looking into it a bit more, I still think technology is playing a significant role, particularly among teens and educated urban populations. But the particular rise in suicide rates among middle-aged white rural populations doesn’t fit with this explanation; nor does the fact that the US trend seems to be an international outlier.

            Btw, if I were given to explaining things according to my ideological proclivities, I would favor breakdown of traditional morality/religion over technology, since I’m one of the more traditionalist conservative commenters here, and a technophile.

          • Btw, if I were given to explaining things according to my ideological proclivities, I would favor breakdown of traditional morality/religion over technology

            I would be inclined to a variant of that. Traditional societies have worked out ways for people to interact that work tolerably well. Our society is changing rapidly, in large part due to technology–for an older example, consider the birth control pill. A change in a functional system due to a random external force is likely to make it less functional.

  16. niohiki says:

    Another vote here for “found it sadly funny, didn’t feel the need to burn everything down”.

    The comments have the same problem the conference itself has: the ones more likely to speak out are those who have something more eccentric to say.

  17. Steve Sailer says:

    No profession’s convention raises its dignity level.

  18. Peter says:

    Something about the conference reminded me of the ACS (American Chemical Society) conference. I’ve been to other (smaller) chemistry conferences, I’ve been to smaller conferences in America, but the ACS was unique, and not in a good way. The APAs excesses were bigger, more obvious, and more in your face, but I think there was enough for someone to do a hatchet job on the ACS, and for commenters to go “there was I thinking chemistry was a science, but no, it’s a quasi-religion” (I forget the precise slogan that might have given that impression) which would have everyone who had actually spent any time in chemistry – academia or industry – to roll their eyes at those commenters.

    The other memorable think about that conference was the conference centre; gigantic and sprawling, and on a hillside, so the main entrance was on the fifth floor (American floor counting) and the further away from it you went the lower the floor numbers got. And Atlanta. Weird city. Obsessed with security scanners. Only airport I’ve been to where you have to go through security to get off a plane, there were two tourist attractions that had security checks too.

    • mcpalenik says:

      I didn’t go this year (I go to APS–the American Physical Society conference–more often), but I heard ACS was pretty weird this time, because they had talks in little cubicles with headsets for the listeners, instead of in meeting rooms, like normal.

      • Peter says:

        I’ve heard of the whole “silent disco” thing that involves lending everyone a radio and some headphones – there was an outdoor film-screening thing that used that system to screen three films in close proximity to each other. It was sometimes quite good fun to watch one film to the sound of another.

        But for a conference? Weird.

  19. nameless1 says:

    But in one’s industry one can tell the good from the bad and avoid the bad. While in other industries you know little about, all that you know is that there is a mixture of the good and bad, the presence of the bad makes you distrust the whole thing.

    But of course life is such that everything is a mixture of good and bad. But then again, human nature is so that when we like something we try very hard to not notice the bad parts. Consider countries, for example. How US liberals love Sweden and try not to notice the hand grenade attacks on police stations. How some European conservatives love America and see America as far more capitalist and libertarian than actually is. How conservatives idolize Singapore. They don’t notice things like 20 years of working and saving in Singapore maybe buys you a small studio apartment. Everybody idealizes what they like. And when they are forced to admit there are also bad aspects of it, they will dislike it. Just out of cautiousness. Because they don’t have enough experience to navigate in it and avoid the bad.

    People who live in a crime-ridden part of a city learn to navigate it. Where not to go when. Knowing that gang tends to hang out at this corner and just taking one corner north or south is completely safe. But what do people who don’t know all this do? They write off the whole neighborhood as too dangerous. Of course. Without the local knowledge it is.

    Or some dude you know did time for brutally beating up someone. If you know what exactly triggered him to do so and if you can avoid that topic he can be perfectly safe to hang out with. But if you don’t know that you categorize him as a dangerous person to avoid, despite him being super nice 99.999% of his life except those once ten minutes.

    If there is one poisoned apple in a barrel of apples, and if you know exactly which one, you eat all the rest. If you don’t? Of course you avoid the barrel. That is a bad barrel. That is a dangerous barrel.

    • AlesZiegler says:

      I know that it is not central to your point, but criminality in Sweden is way lower than in USA.

      • criminality in Sweden is way lower than in USA.

        That does not seem to be the case.

        Looking at the webbed ICVS data on overall victimization (Figure 3), Sweden is about average over the whole sample and only a little better than the U.S. For 2003-4, the figure for Sweden is about 16, for the U.S. about 17.5. Another source, for 2002, shows Sweden a little worse than the U.S., measured by the percentage of the population victimized by crime.

        There should be more up to date figures somewhere, but that’s what I was able to find.
        The U.S. has a high homicide rate for a developed country, but overall crime rates are pretty average.

        • AlesZiegler says:

          Oops, I stand corrected. I admit that I commited an improper extrapolation from homicide rate, which I know is worse in US.

          (first link however does not seem to work)

  20. vV_Vv says:

    Most people here have been exposed to psychiatry only though your writings, so if you write critically about it people will get a critical view of it.

    Btw, I thought the post was a tongue-in-cheek review of the APA conference, not a take down of the whole industry.

    “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety”

    Shouldn’t you guys be doing something about this record-breaking? I get it’s hard and nobody really knows why depression and anxiety are on the rise, but I have the impression that psychiatry is uniquely focused on disease treatment or management, rather than prevention.

    • Jaskologist says:

      That quote jumped out at me as well, but I’m of two minds about it. On the one hand, those record-breaking levels are probably due to deep societal issues that we can’t expect the APA to fix. On the other, my bias is that record-breaking levels of depression and anxiety are exactly what you’d expect from a society embracing Wokeism as a religion, and to the extent the APA has also embraced it and shut out other perspectives, they’re not going to be able to even see the root cause, and will probably make recommendations that make it worse.

      • Garrett says:

        Alternative: We’ve gotten much better at detecting depression and anxiety. Such a person might be (or have been) the town drunk but now is recognized as masking other issues and thus can possibly be treated effectively.

        • cuke says:

          Looking at my extended family’s history over the past three generations, as well as many of my patients’ family histories, I’d say this is exactly right.

          My mother was “tightly wound” and was a functional alcoholic to deal with it, like all her siblings and cousins. She had panic attacks that she thought (and the doctors thought) were low blood sugar “attacks.” It took me until my early 40s to say “I have anxiety” and to begin to understand all of what that meant in my life and all the ways it showed up. I stopped medicating my anxiety with alcohol in my 20s but I didn’t understand the contours of it until much later. My son could say by age 14 that he has anxiety and describe the various ways it shows up in his life and he already has tools on board to deal with it that I didn’t have until my 40s. The picture is much the same in my husband’s family.

          The people who didn’t — or currently don’t — have a language for their anxiety or depression are drinking like crazy, acting out rage in their relationships, or burying their discomfort in other unhealthy obsessions. More and more people are able to name the experience as anxiety or depression, which now gives them choices they didn’t have before (medication, therapy, meditation, exercise, CBD, etc). It also means way more people can answer “yes” on a survey when asked whether they have experienced anxiety or depression or whether they’ve been diagnosed with either.

        • vV_Vv says:

          If the true rates of depression and anxiety was approximately constant and there was a substitution effect between alcohol and antidepressants then we should observe a decrease in alcohol consumption as antidepressants consumption increases.

          But data show that alcohol consumption in the United States has remained approximately constant over centuries. (Btw, what the heck was going on in France in 1920?)

          A similar substitution effect should be probably observed between antidepressants and opioids, instead they are both on the rise.

          This strongly suggests that the true rates of depression and anxiety are increasing.

  21. benquo says:

    “@jack invents new health fad of rolling around naked on glaciers” is a much juicier story than “we can now fit twice as many billions of transistors on a chip as we could last year”, but tech journalism that only reports on the former is missing an important part of the story.

    But also, the second story … ISN’T TRUE! Has never been true! And is increasingly farther from the truth! And isn’t really helpful unless there are specific things you can DO with the extra transistors aside from software bloat or figuring out how to automate increasingly humanlike word salad.

    • Steve Winwood says:

      And, on the other hand, I think fictional Jack might be onto something.

    • Scott Alexander says:

      It’s an awkward framing, but isn’t this basically Moore’s Law?

      (Moore’s Law says 1.5 years, but if it’s December 2001, then you could fit half as many in June 2000, hence “last year” within the boundaries necessary to justify the slightly snappier framing)

      • Said Achmiz says:

        Moore’s Law isn’t true anymore, and hasn’t been for a while.

        • Tivi says:

          Have to sort of disagree. At least plotting transistor counts and densities for big chips from the Wiki for the last few years (2010..2018), both of those have gone up at Moore’s Law pace. It helps that foundries finally got EUV working after a decade or two of false starts.

          I mean, Moore’s law is definitely running on fumes, it’s about to run into hard physical limits, and the extra transistors are a worse deal in almost every way compared to the 1990s. But the transistors are still scaling for now.

  22. pacificverse says:

    It’s because most people are unfamiliar with conferences in general.
    Dental conferences I know of are exactly the same. A hundred stalls and a million ads selling a thousand different products – lasers, toothpaste, CNC milling machines, tooth-scanning machines, etc. – of dubious or limited improvement over previous generations of product – and most attendants don’t really take any of it seriously.
    Everyone’s mostly here for the credits (you need to attend a certain number of conferences, lectures, etc. to keep your license), to keep up to date with the state-of-the-art, some stalls selling cheaper products (e.g. made-in-China mirrors, scaling picks, etc), etc.
    One must note that many attendants at conferences are not total idiots, and do indeed take the gargantuan amounts of over-the-top advertising with many grains of salt. Also, many people are not really that interested in all the advertising.

    • Lambert says:

      What are dentists doing with CNC mills?
      Are they tiny little ones needed to machine teeth into materiel needed by the Tooth Fairy’s war machine?

      • Simulated Knave says:

        Bridges, crowns, implants, etc (at a guess). Dentures often need adjustment for fit as well.

  23. Conrad Honcho says:

    Scott, the sorts of people who attend or are nonplussed by an “Misogyny and Incels: Recipe for Violence?” talk…whose side do you think they’d be on in the events described in your Untitled and Radicalizing the Romanceless essays? Assume a low status male is anxious and depressed because of his inability to find a mate (or can’t find a mate because of his anxiety and depression). How comfortable should he be opening up about that to the people who attended/produced that talk?

    I’m not saying burn it all down, but you’ve got people who get deeper into your personal life than basically anyone else who also think “the personal is political.” And their politics don’t like your person. Perhaps caution is not unwarranted?

    • Saint Fiasco says:

      How do you know the talk wasn’t titled following Betteridge’s law of headlines?

      We weren’t there, but we shouldn’t assume the worst without more evidence. The stereotypical mainstream psychiatrist always complains that the mentally ill are stigmatized, that they are mostly a danger to themselves, that they are more often victims of violence than perpetrators, and so on. Even in the worst case scenario, if they somehow decide not getting laid is a mental illness, most of them still wouldn’t say it’s a recipe for violence. It’s not their style.

      • John Schilling says:

        How do you know the talk wasn’t titled following Betteridge’s law of headlines?

        The subtext of Betteridge’s law is, “But the headline writer really wants you to believe the answer is Yes”. This is I think even more reliable than the text of Betteridge’s law.

        • Saint Fiasco says:

          I didn’t know that subtext. I thought those headlines were to catch the attention of people who know it is wrong, to surprise them and make them check it out.

      • Conrad Honcho says:

        I wonder if the slides from the talk are available online. Or perhaps the presenter has written about the issue elsewhere and we can find out where they’re coming from.

        But, the political slant of the conference is woke left, and there are surveys that yes, psychiatrists tend to be democrats and surgeons republicans. The feminist line about incels is “entitled proto-rapists who think women owe them sex.” It seems unlikely that this is the one instance of political commentary at the convention going against the progressive mainstream.

        If they wanted to dispel the myth that incels are violent (for every one Eliot Rodgers there’s millions of dudes who can’t get laid and aren’t shooting anyone) then they could title the talk “Destigmatizing Incels” or “Treating Depression and Anxiety in the Romanceless Patient” or something.

        Just sayin’, I would never title a talk about my ingroup or people I was sympathetic with in a way that implies they’re violent, evil or depraved. I would never title a talk “Republican Ideology: Recipe for racism?” in order to make people think Republicans aren’t racists. “Progressive Ideology: A Recipe for Totalitarianism?” That I might do, but I think progressives would (rightly) think I was being a tad uncharitable.

      • Edward Scizorhands says:

        Instead of debating how many teeth a horse has. . .

        https://www.psychiatry.org/File%20Library/Psychiatrists/Meetings/Annual-Meeting/2019/virtual-registration-bag/Syllabus-Proceedings.pdf

        EDUCATIONAL OBJECTIVES:At the conclusion of this session, the participant should be able to: 1)Review history of the online subculture, Incel; 2)Evaluate the current beliefs promoted by Incel.; 3)Discuss recent violent acts attributed to Incel.; 4)Examine the interplay between mental illness and this online hate communities.; and 5)Consider possible treatment options for patients affiliated with the Incel subculture.

        The advent of the Incel online subculture can serve as a breeding ground for violence. Those struggling to find a romantic or sexual partner pose the greatest risk of becoming attached to Incel ideology. Incel forums provide a platform for resentment, self-pity, misogyny, a sense of entitlement to sex, and the endorsement of violence against sexually active people. Psychiatrist sneed to have an understanding of what such groups believe and promote, as well as violent acts that may flow from an affiliation with this group. Vulnerable patient populations need to be identified and treatment options explored to address the underlying mental states. In this session, we will review the history of Intel and evaluate the current beliefs espoused. The various recent mass murders and violent acts attributed to affiliations with Incel will be reviewed, along with an examination of the underlying mental health issues and treatment considerations.

        • The Nybbler says:

          I think the horse has halitosis.

          Certainly if I were an incel, I wouldn’t want to be treated by someone who considers my problem mostly in the light of how it presents a threat to others.

          • Conrad Honcho says:

            Perhaps I wouldn’t object so much if they made a strong attempt to differentiate between “incels” (people who cannot find mates and are sad about it) and “the Incel community” (the group of people online who get angry, bitter and resentful at society because they cannot find mates). But I don’t really expect that level of awareness, differentiation or charity.

  24. J.D. Sockinger says:

    Scott wrote, “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety”. Perhaps those record-breaking amounts of anxiety and depression are caused by psychiatry (or, at least, exacerbated). Robert Whitaker has done some excellent investigative reporting on how how psychiatric drugs, when taken over the long term, can actually worsen the very problems that they are ostensibly treating (see Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America). I find his work to be convincing, or at least convincing enough to be taken seriously. I’m also currently reading Anne Harrington’s recent book, Mind Fixers, about psychiatry’s long-standing, disturbing tendency to jump from one ridiculous fad to another. “Oh, sure, the whole ‘hydrotherapy’ thing was bogus, but if we cut off this person’s frontal lobes, then surely his schizophrenia will go away.”

    Scott’s photo essay on the APA was not surprising to me and was evidence that the whole field of psychiatry is in much deeper trouble than Scott claims.

  25. Urstoff says:

    All conferences are 90% ridiculousness, but perhaps people (naively, incorrectly) expect non-business conferences to be a bit less ridiculous. Or it’s just classic “see the hits, ignore the misses” (or the inverse, I guess) bias.

  26. Some Troll's Serious Discussion Alt says:

    Tech is a malicious cancerous industry full of awful people and everyone should hate it

    Well, yeah?

    • Walter says:

      Oh enough of this. We aren’t merely unobjectionable, we are a boon to the damn world, and yeah, I get that being in favor of stuff isn’t cool, and you are double awesome for being snide, but go ahead, tell me what is better than the internet.

      The palaces of the olden times really existed, so they were only for the bosses. The modern palace is the smart phone, and we are working overtime to get one into the hands of everyone in the world. Quality of life is pretty exactly equal to time spent online (want proof, what do people choose to do when they have the option? What’s the ratio of long walks taken vs. people posting from the mind palaces we gave them about how great it used to be when people took long walks?), and we are the engine that made that possible, and continues to improve upon it.

      We gave you the internet you use to whine about us. If you were right or even sincere, if you genuinely thought we were malicious, you’d just put the phone down. But you don’t, and you won’t.

      • Some Troll's Serious Discussion Alt says:

        I wasn’t going to be so crass as to post a heroin metaphor, but if you want to do it for me, go ahead I guess.

      • Said Achmiz says:

        I work in tech. I also don’t own nor use a smartphone. I say this because you apparently think that anyone who either doesn’t work in tech, or uses a smartphone, doesn’t have standing to comment on this. Well, neither of those apply to me, so here is my comment:

        You’re wrong. Horribly, diametrically wrong. Time spent online decreases quality of life. Time spent on a smartphone decreases it even more. Smartphone use literally makes you less conscious.

        and we are working overtime to get one into the hands of everyone in the world

        You are, indeed, working overtime to destroy our societies and our minds, at an ever increasing rate. Good job. Good job making your destructive product so addictive that people can’t put it down, even when it’s making them depressed and anxious, even when it’s quite literally shortening their lives with every tweet and Facebook post they read. Good job engineering the ecosystem of online services so as to force people to be online more and more, to use smartphones, even when they hate it.

        go ahead, tell me what is better than the internet

        The internet is wonderful. But as you clearly speak for the tech industry as it is now, when you ask this question, here is my answer:

        You are not building the internet. You are destroying it.

        You are a boon to nothing. You actively make the world worse, every single day. That you take pride in your work is all the more damning.

        • greenwoodjw says:

          I own a smartphone, but make a conscious effort not to use it more than necessary. I have a rule not to follow more people on Twitter than follow me, not for vanity, but to limit the number of people I follow. (Currently, that stands at about 78/100.) I occasionally purge my friends list on every service I use, sometimes to zero. I almost never post anything to social media, but will interact with people. There are only a handful of apps on my phone, mostly related to shopping and work. (5 apps, 1 of which is an authenticator and another is Google Docs, mostly for grocery lists, excluding factory ones.)

          I think social media has harmed political discourse, especially Twitter, because the character limits enables insults while prohibiting serious discussion. I think the monetization systems have created a media sphere focused on keeping people angry and scared to “drive engagement”, and since the systems are automatic, there are no people holding back or exercising judgment.

          I think the new normal of “We made our web page an app to serve you even more ads” has harmed the internet overall. The new ad systems for smartphones that hijack your browser and force you to navigate past them are terrible.

          When Tech is actually about new technology, it’s great. When Tech is about optimizing for ad revenue, it’s basically the APA Convention all day every day.

          I think smartphones have made driving significantly more dangerous and have contributed significantly to traffic back-ups that I have directly observed.

          • Said Achmiz says:

            @greenwoodjw:

            I think smartphones have made driving significantly more dangerous and have contributed significantly to traffic back-ups that I have directly observed.

            This is so obvious and commonplace that I didn’t even think to mention it—thanks for bringing it up! Of course you’re quite right.

            (I have direct experience with this effect, in the form of someone quite close to me being hit by a car whose driver was glued to his smartphone… not fatally, thank god, but resulting in serious injury, surgery, months of painful recovery and incapacitation, and permanent reduction of mobility. How many cool smartphone games or cute emoji does it take to make up for that, I wonder?)

          • greenwoodjw says:

            I’m not even talking about that obvious case. I’m talking about the guy who’s traveling 25 miles below normal travel speed in the left lane of the highway because he’s watching the road just over the top of his phone and making sure just that bit is clear.

            That creates a backup behind him, open road ahead of him, 500+ people delayed and 30-40 people fighting to get in front of him.

            All so he can browse Facebook.

        • David Shaffer says:

          “Time spent online decreases quality of life. Time spent on a smartphone decreases it even more.”

          The first part makes sense-internet use is often jumping between very short soundbites, and doing this too much seems like it might damage attention span and feel unsatisfying (at least personally, it’s a lot more rewarding to get deeply invested in one thing then slightly invested in ten). What would make a smartphone worse than conventional internet though? Is it that it’s always available, and we tend to use it in small bursts (thus worsening the non-investment and inattention problems)? Are you sure that it is worse?
          Apologies if the linked articles covered this; a cursory examination showed poor mental health outcomes from internet use and harmful brain changes from smartphone use, but not that there were fewer such changes from conventional internet activity (and yes, I’m aware of the irony of a cursory examination of articles when we’re talking about the dangers of not fully engaging!)

          • Said Achmiz says:

            What would make a smartphone worse than conventional internet though? … Is it that it’s always available …

            Obviously exactly that. (Also several other, more subtle, effects.)

            Take a look at the paper I linked, about smartphones vs. consciousness, for one small taste.

            That said, you’re quite right that this is an interesting question. But—with apologies—I don’t think this deep into a comment thread is the best place to entertain this particular tangent. Perhaps you might bring it up on the next Open Thread, and if you do, I’ll try to make time to comment at greater length.

        • Bugmaster says:

          Well, I work for the tech industry, and I take a measure of pride in my work, so go ahead and hate me, if you want — but maybe hear me out, first.

          Smartphones are, beyound the shadow of a doubt, a massive net boon to society. For example, you might be too young to remember this, but the very notion of traveling across the country (not to mention, to other countries) used to involve a lot of careful planning and preparation. Today, I can just grab my phone and go. I don’t need to worry about having the right maps in my glove box, or finding a place to stay, or finding my friends, or even translating common phrases into another language… and that’s just a single example. Yes, smartphones have some very major downsides, but the overall effect is undeniably positive.

          That said, smartphones are just the tip of the iceberg. The industry I work in — bioinformatics — had made some truly impressive strides toward curing diseases and reducing hunger (though, yes, also many opportunities for massive corporations to enrich themselves). The book industry has been revolutionized to the point where anyone can publish a book if he wants to. We’ve got medical implants now that turn terminal illnesses into inconveniences. If you disbelieve in anything I say, your first stop would probably be the freely accessible global repository of all human knowledge — and yes, you can use it on your phone.

          Would you, personally, be happier without smartphones, the Internet, medical implants, translation AI, and all that other stuff ? Well, maybe, I don’t know you personally. You might be happiest living a hunter-gatherer lifestyle, with just your trusty spear for company (though maybe not, seeing as we’re having this conversation). But most people are much happier with modern technology — especially those who wouldn’t even be alive today without it.

          • greenwoodjw says:

            Would you, personally, be happier without smartphones,

            Yes

            the Internet,

            No

            medical implants,

            No

            translation AI,

            Insufficiently impacted to care

            I’m not saying it’s all net-negative. But there are huge costs that I’m concerned aren’t getting seriously addressed.

          • LHN says:

            This is a side issue, but I’d be interested in examples of medical implants that turn terminal illnesses into inconveniences. Not out of disbelief, but because having seen a few too many of the things that are still intractable show up in my circles in recent years, I’d appreciate some anecdotal reassurance of recent dramatic wins in the medical field.

            The remaining fruit probably by its nature does hang higher than the really big wins of generations ago, like cleaning up water and food distribution, vaccinations, or antibiotics. And incremental advances and basic science are still really important in the long term. But some Really Bad Things either cured or thoroughly defanged recently would be nice to hear about.

          • Said Achmiz says:

            Smartphones are, beyound the shadow of a doubt, a massive net boon to society.

            Ridiculous.

            For example, you might be too young to remember this

            … hah!

            … but the very notion of traveling across the country (not to mention, to other countries) used to involve a lot of careful planning and preparation. Today, I can just grab my phone and go.

            I remember quite clearly what it was like to travel cross-country, and indeed to other countries, before smartphones. I’ve done so, quite a few times (including since smartphones were invented, since, as I said, I do not own one). It was fine. It is fine. You don’t actually need detailed instructions to find a roadside motel. Navigating isn’t hard either. Read the goddamn signs.

            That said, while the magnitude of this effect is wildly exaggerated, travel (specifically, both navigation and things like calling Uber in an unfamiliar city) is one of the very, very few use cases for smartphones which I consider legitimately positive and useful [EDIT: for other people, not for me] [EDIT 2: but not purely positive; there are also serious downsides, which this margin is too small to contain…]. (I do not think this even begins to suffice to make your point about smartphones being good on net—but I am content to grant you this point, here.)

            That said, smartphones are just the tip of the iceberg. The industry I work in — bioinformatics

            I have worked with bioinformatics researchers myself (helping develop some of the exciting new technologies which, one hopes, are being put to use curing diseases and so forth), so I am somewhat familiar with the good work being done in this area.

            Would you, personally, be happier without smartphones

            Unquestionably. I don’t have one, and it’s great. If no one else had them either, that would obvious be even better.

            the Internet, medical implants, translation AI

            Much of this is fine.

            and all that other stuff

            Depends on the stuff.

            Don’t get me wrong: I am not saying, nor have I ever said, that everyone in tech is actively bad and is making the world a worse place. There’s lots of useful things being done!

            But the part of the tech industry that’s responsible for the ascension, and continued spread, of smartphones, adtech, and much of the way the modern Web works… is, overwhelmingly, a detriment to humanity, to this country, and to me personally. And that is very obviously the part that Walter was speaking for. (It is even worse when they try to take credit for the good stuff, when in fact they are, more often than not, actively destroying the good stuff!)

          • Spookykou says:

            I am deeply confused by the people posting on the internet, about how much they personally don’t want/have a smartphone.

            Are you internet addicts who wish it was harder for you to get internet access, would your life also be better without a personal computer?

            Or do you not have one out of protest, because while obviously you personally could just use a smart phone as a normal phone with the added bonus of mobile internet connection in the event of an emergency, you don’t like what smartphones do to society?

            Did you/do you oppose cell phones, as a mobile communication device?

            Is there some sort of principled opposition to mobile access to information? Is there a line somewhere between the information you can get with a phone call and the information you can get with a google search that is important?

            It’s weird for me because I remember what I used to do, before smart phones, where I would call someone who I knew to be at a computer, and ask them to look things up for me, when I needed information, but was away from a computer. Now I have a smart phone, I use it to make phone calls, send messages, and look up information that I need when I happen to be away from a computer. I don’t think I violated the TOS by not using instagram.

          • Said Achmiz says:

            @Spookykou:

            Are you internet addicts who wish it was harder for you to get internet access, would your life also be better without a personal computer?

            No.

            Or do you not have one out of protest

            No.

            Did you/do you oppose cell phones, as a mobile communication device?

            No.

            Is there some sort of principled opposition to mobile access to information?

            No.

            Any other questions…?

          • Spookykou says:

            What is it that you find objectionable?

          • John Schilling says:

            For example, you might be too young to remember this, but the very notion of traveling across the country (not to mention, to other countries) used to involve a lot of careful planning and preparation.

            I am old enough to remember all of that, and the intermediate cases, and you are massively overstating your case. The amount of planning actually required for cross-country travel in the Olden Days was fairly minor, particularly when compared with the physical preparation that is still required. Note, for example, that you still have to fill your gas tank (or charge your battery) – and gas stations at least used to sell cheap road maps if you forgot yours.

            Furthermore, most of the low-hanging fruit was taken care of by basic internet on desktop PCs, and non-smart mobile phones. 4G and 5G smartphones are well into the realm of diminishing returns in that regard. As Said Achmiz notes, intracity travel would be a stronger case. But even there I think most of the benefits were captured by 2G or maybe 3G.

            Meanwhile, the harms continue to escalate and for as near as I can tell no better reason than because you can and because your customers are addicts. It’s a free country, so feel free to keep selling higher grades of silicon crack. We’ll feel free to be dissatisfied with this.

          • Bugmaster says:

            @LHN:

            This is a side issue, but I’d be interested in examples of medical implants that turn terminal illnesses into inconveniences.

            Disclaimer: I don’t work in that field personally, but I know someone who does. As I understand, there is a set of disorders that cause damage to the nerves in the spine, resulting in constant, excruciating pain. Until relatively recently, the patient’s options were “death” and “constant morphine intake” (in doses that are basically indistinguishable from death). Now, there’s an implant that sends out a signal to destructively interfere with the signal sent by the nerves. It’s inconvenient, because the timing has to be constantly adjusted (based on a variety of changes the body goes through) and charged (through a magnetic field, with the emitter usually embedded in a hand-held unit or a chair); but it beats the alternative.

            And, of course, there are a variety of brain implants that prevent the onset of epilepsy; some of them were in the news a while ago, due to having criminally bad firmware.

          • Bugmaster says:

            @Said Achmiz:
            As I said, I agree with you that sometimes people who work in tech do bad things; sometimes they do good things that end up being bad in the long run. However, the original statement I was responding to was much stronger: that the entire field of modern technology was essentially a ploy created by Satan himself, with few, if any, redeeming features. I’m typing this on a computer, after finishing some excellent tacos that I bought from a taco truck that I found on the Internet and drove to in my car with aid from navigation software, while listening to a podcast and enjoying the air conditioning and being able to actually see where I’m going thanks to my glasses… so, forgive me if I’m not fully sympathetic.

            Regarding smartphones specifically, one interesting thing I’ve noticed is that you, as well as greenwoodjw, seem to be unable to decouple the device itself from social media apps that run on it. I would probably agree that social media is a net negative for society, but… did you know that you could actually turn it off ?

          • Said Achmiz says:

            @Bugmaster:

            Hold on, hold on. You’re assigning credit to the tech industry, not just for air conditioning (very unusual classification already) but for glasses?!

            “We deserve credit for all technology ever, therefore your complaints about smartphones and web apps are silly” is exactly the sort of perspective which (a) leads Silicon Valley[1] to do all the horrible things it does, and, not coincidentally, (b) leads people to hate Silicon Valley.

            [1] I am using SV as a synecdoche for a broader cluster here.

            Regarding smartphones specifically, one interesting thing I’ve noticed is that you, as well as greenwoodjw, seem to be unable to decouple the device itself from social media apps that run on it.

            Why do you think this? I haven’t said anything about social media being the only problem, or the whole problem, or even most of the problem. My problems with smartphones go much deeper than that.

            However, the original statement I was responding to was much stronger: that the entire field of modern technology was essentially a ploy created by Satan himself, with few, if any, redeeming features.

            This would, indeed, be a gross overstatement of the case. But then, even the OP of the current comment thread does not say this… what he said was this:

            Tech is a malicious cancerous industry full of awful people and everyone should hate it

            Well, yeah?

            Now, I think that this, too, is an overstatement. (My own comment was in response to Walter—not, as such, in agreement with Some Troll’s Serious Discussion Alt.) But, crucially, it is getting less and less of an overstatement with every day. Already it is dismayingly close to unimpeachable truth. 30, 20, even 10 years ago—perhaps not quite (though the process was already visibly on its way, a decade ago).

            So, to borrow your Satan metaphor… suppose we’re currently in the middle of an invasion by the fiendish hordes of the Prince of Lies; they’ve taken Canada, Mexico, and 39 of the 50 states; they’re currently advancing on the Potomac, and look to cross into the capital within the day; and someone says “we’ve been taken over by the forces of Satan himself!”—would you protest against this obviously ridiculous claim? “Taken over?? By whom?! Absurd! Hysterical!”—yes?

          • Bugmaster says:

            @Said Achmiz:

            You’re assigning credit to the tech industry … for glasses?!

            Yes, I am. Last time I went to get my prescription, my eyes were imaged using a high-speed camera, that saw in an extended spectrum. The images were analyzed by doctors with assistance of some very basic AI software. My blood pressure (both regular and ocular) was likewise taken using a variety of electronic sensors. Then I got my glasses, which were made out of materials that were optimized through computational chemistry. Now, I can’t tell you whether the hardware and software powering all those advances was physically built in Silicon Valley, but you get my drift.

            My problems with smartphones go much deeper than that.

            What is your problem, then ? Do you find ubiquitous access to information, as well as on-demand video streaming and broadcasting capability, inherently offensive in some way ? I honestly am struggling to understand your objections.

            Already it is dismayingly close to unimpeachable truth.

            Once again, I categorically deny this. I will not deny that the amount of negative side-effects from modern technology is increasing; but that’s because its scope is increasing in general. Modern technology, and especially information technology, allows you to do things you simply were unable to do before; and, as I said, in some cases, these things can be summed up as “being alive at all”. You are just focusing on the failures, and ignoring the massive successes, because (IMO) you kind of take them for granted.

            For example, anti-epilepsy implants sometimes fail due to a criminally disastrous firmware bug; and we should absolutely work to prosecute the people responsible and make sure this never happens again. What we should not do is throw out the implants altogether, because they allow epileptic patients to live normal lives.

          • Edward Scizorhands says:

            A lot of things that aren’t Tech at all have gotten sucked into Tech, and enjoy Tech’s Halo effect. I can’t say Tech is blameless because Tech loves cashing the checks.

            Compare:

            1. Spending a year of your life making a car 1% more efficient.

            2. Spending a year of your life making people 1% more likely to click on an ad.

            One of those things is more likely to count as Tech these days, and it’s the wrong one.

          • Said Achmiz says:

            @Bugmaster:

            (separating this out into its own comment)

            What is your problem, then ? Do you find ubiquitous access to information, as well as on-demand video streaming and broadcasting capability, inherently offensive in some way ? I honestly am struggling to understand your objections.

            On-demand video streaming and broadcasting is, of course, a bad thing—that much is clear. So is social media, so are mobile games, so is mobile access to email and chat applications like Slack, etc. These things are all detrimental, and we would be better off if they didn’t exist. I consider all of this to be fairly obvious. If you don’t see why it’s true, or what are the reasons to believe this—well, I’m sorry, but I won’t be the one to explain it to you. Too many others have written too much on the subject, at least as eloquently as I ever can, for me to justify investing the time. If you’re simply not aware of the very serious and weighty (and quite convincing—IMO, of course) arguments for these views (as your puzzlement about my motivations strongly suggests), then, quite frankly, you’ve not bothered to look, or pay attention.

            But I do want to say a bit about this notion of “ubiquitous access to information”, especially since other commenters in this thread have brought up the same idea.

            For one thing, this phrase—“ubiquitous access to information”—equivocates quite casually between a whole host of very different things. What is this “information” that we’re talking about, to which I have “ubiquitous access”? Is it some specific information, or a specific sort of information, to which constant access is so very valuable? Or is any information equally valuable? Is there any difference—value-wise—between “information” which I have generated myself (whether that be my notes about my newest brilliant, world-changing invention, or my grocery shopping list), or “information” which comes to me from elsewhere?

            How exactly do we determine the value of information? If I have access to twice as much information, is that twice as good? Or must we take the nature and source of that information into account? Is it possible for information to be negative in value, and if so, how negative can it be?

            Is there any difference between knowing something, and being able to look it up? What is the role of synthesis in determining the value of available information? Conversely, how is synthesis affected by availability?

            Is information-acquisition an intentional act, or a passive process? Or is it sometimes one, sometimes the other—and if so, when is it which? How does availability bear on this? What consequences, conversely, does it have, for the effects of information-acquisition?

            What incentives are created by “ubiquitous access to information”, if any? What are the consequences of these incentives?

            Now, these are all questions, not arguments; nor should the above enumeration be taken as complete, or even comprehensive. And obviously, none of what I’ve just said does anything to prove that “ubiquitous access to information” is bad.

            Yet answering these questions, and others like them, is necessary, in order to even begin to evaluate the question of whether “ubiquitous access to information” is a positive or not! It seems to me absolutely foolish—to say the very least—to simply assume that it’s a good thing, without even considering any of the sorts of issues I’ve listed, and others like them.

            So, no, I don’t consider those things you listed “inherently offensive”. (And what a silly formulation, by the way—fully as straw-mannish as, for example, the claim that speciesism consists of disvaluing some creatures “merely” for reason of species membership… as if there are no differences between species, which one may take notice of, when deciding what to value…) I consider them to be bad things, not “inherently”, but for the same reason anyone considers anything to be good or bad: because of their various properties and characteristics, their consequences, and so forth.

          • Said Achmiz says:

            @Bugmaster:

            Last time I went to get my prescription, my eyes were imaged using a high-speed camera, that saw in an extended spectrum. The images were analyzed by doctors with assistance of some very basic AI software. My blood pressure (both regular and ocular) was likewise taken using a variety of electronic sensors.

            The last time I went to get my prescription, none of that happened. The only electronic device involved was the old desktop computer at the checkout counter (used as a point-of-sale system and appointment keeper).

            Yet somehow, I nonetheless received a pair of glasses that let me see everything just fine. Hm.

            Now, perhaps you have some unusual medical condition that necessitates the involvement of such advanced gadgetry in your routine eye exams. Certainly I won’t ask you to divulge information on such thing. But in that case, you may (at best!) credit “tech” with “providing superior treatment options for [medical condition]”—and not with glasses, period.

            Then I got my glasses, which were made out of materials that were optimized through computational chemistry.

            Well, perhaps, perhaps. I don’t know if my glasses are made out of anything so fancy. Maybe they are. Let’s stipulate it, for argument’s sake. And yet—

            Now, I can’t tell you whether the hardware and software powering all those advances was physically built in Silicon Valley, but you get my drift.

            Do I get your drift? I’m not sure that I do. It seems to me that the overlap between those parts of “tech” which inspire such loathing as we see displayed in this comments section, and those parts of “tech” which provide the tools to do computational chemistry, is not very high. Do you disagree?

            I will not deny that the amount of negative side-effects from modern technology is increasing; but that’s because its scope is increasing in general.

            Indeed it is.

            And that is a bad thing.

            That technology pervades our lives more and more with each passing day—you take this to be good? I see it as dystopian, quite frankly.

            Modern technology, and especially information technology, allows you to do things you simply were unable to do before; and, as I said, in some cases, these things can be summed up as “being alive at all”.

            Yes. In some cases. But not in most. And the share of the technological conquest of every area of our lives which may rightly be called life-saving (or even life-improving…) is ever shrinking.

            You are just focusing on the failures, and ignoring the massive successes, because (IMO) you kind of take them for granted.

            No, I really do not take them for granted. I am acutely aware of the success stories of technology—from plumbing to pharmaceuticals to cars with crumple zones to modern dentistry to Skype, and many more besides.

            I am also acutely aware of the need to prevent halo effects from those successes from fooling us into thinking that “technology”, in general, is a good thing, because that delusion is precisely why we allow the tech industry to corrupt our lives more and more with each day. That some of that corruption is the product of people genuinely thinking that they’re making the world a better place makes it worse, not better (although there is absolutely no shortage of moral cowardice masquerading as righteousness, either).

          • Bugmaster says:

            @Said Achmiz:

            These things are all detrimental, and we would be better off if they didn’t exist. I consider all of this to be fairly obvious. If you don’t see why it’s true, or what are the reasons to believe this—well, I’m sorry, but I won’t be the one to explain it to you.

            Well then, I fear we’ll have to agree to disagree, since I certainly can’t disprove your point if I don’t even know what it is.

            You’ve posted a lot of philosophical questions about the value of information, and while I agree that they might be worth discussing, they are tangential to my point. Was the invention of the printing press a good thing or bad thing, in the long run ? How about ubiquitous literacy ? If not, why not ? Keep in mind that you are in the position of being able to discuss the deep philosophical implications of information precisely because you have access to it.

            Now, perhaps you have some unusual medical condition that necessitates the involvement of such advanced gadgetry in your routine eye exams.

            Bingo. However, even person such as yourself could benefit from these advances; for example, optical images had replaced eye dilation, so now I don’t need to spend half a day doing nothing while my eyes return to normal after the exam.

            in that case, you may (at best!) credit “tech” with “providing superior treatment options for [medical condition]”—and not with glasses, period.

            I don’t see the difference. The end result is that I have much better glasses than before. I credit modern technology with allowing me to see better. A while ago, I had an extremely painful stomach ulcer (trust me, it’s an experience I do not recommend); in that case, I credit tech with the doctors’ ability to literally see through my body in order to speedily diagnose and treat it. As I’m sure you’re aware, MRI and CAT scans would be impossible without modern information technology.

            It seems to me that the overlap between those parts of “tech” which inspire such loathing … and those parts of “tech” which provide the tools to do computational chemistry, is not very high. Do you disagree?

            Yes, absolutely. Computational chemistry, computer imaging, ML-driven design, plus the seemingly mundane (and yet nearly miraculous) ability of scientists to instantaneously publish research papers — all of these things are the culmination of modern electronics and computer science. And yes, you can apply the same techniques to optimizing ad conversions. So what ? You can use metallurgy to make a knife that you use to stab someone, does this mean that we should reject knives along with metallurgy ?

            That technology pervades our lives more and more with each passing day—you take this to be good?

            Undeniably so. You are kind of like a farmer who is complaining that he has to pull out more and more weeds every day — even as his fields grow big enough to feed every hungry person in the world. Honestly, given that we are having this discussion on an Internet forum, I am somewhat tempted to call your objections hypocritical.

            I am acutely aware of the success stories of technology—from plumbing to pharmaceuticals to cars with crumple zones… I am also acutely aware of the need to prevent halo effects from those successes from fooling us into thinking that “technology”, in general, is a good thing

            Wait, didn’t you just imply that cars are a good thing ? But what about global warming ? Traffic congestion ? Car accidents ? Long commutes ? All of these things are terrible ! Shouldn’t we go back to the days of the horse and buggy ?

          • mcpalenik says:

            es, absolutely. Computational chemistry, computer imaging, ML-driven design, plus the seemingly mundane (and yet nearly miraculous) ability of scientists to instantaneously publish research papers — all of these things are the culmination of modern electronics and computer science

            I work at the US Naval research lab in DC and my job title is “research physicist”. I’m actually in a chemistry division and my work involves computational chemistry, both in developing the theory (I’ve done a lot of development in the defining the way degenerate perturbation theory in density functional theory works) and in doing actual computations on materials/molecules.

            1) I wouldn’t consider myself a tech worker. I’m a government employee paid to do basic research. The environment here is about as different from the tech industry as it could possibly be. And by working on basic research, there’s not even necessarily an immediate or direct connection between what I do an a specific technology. On the other hand, a lot of the techniques used in computational chemistry packages were developed by my former postdoc adviser here at the lab. A lot of techniques are developed by national labs. Most of the cutting edge research developing new techniques is coming from research groups at universities. The tech industry as such can’t really claim credit for this. Nor can it claim credit for the millions (I don’t know the actual number, but some of the methods go back to the 1930s, although they weren’t applied on computers until later) of scientific papers published in peer reviewed journals on the topic.

            2) Most claims of “we can use computational chemistry to design new materials” are pure garbage, plain and simple. It can do an ok job of explaining certain properties of existing materials, predicting reaction energetics, and finds reasonable transition states (which are more useful for energy barriers than actual reaction kinetics due to the exponential dependence of the latter on the former). But despite pervasive attempts to start incorporating machine learning into quantum chemistry, improvements in computational power, and improvements in approximation methods (which mostly happens at universities), the “I want a material to do X”->”computational chemistry can design it for you” doesn’t really work.

            I’ve talked to people from startups that say they’re putting together some sophisticated pipeline that puts together all these different computational techniques, then they’ll throw some machine learning on top, and they’ll be able to computationally design materials for any property you want. But. . . garbage in garbage out.

            I don’t actually know what’s going on with the materials in the glasses that you’re talking about, but I wouldn’t be surprised if its existence isn’t quite as dependent on the use of computational chemistry as you think, or if it isn’t doing much more than automatically taking over some role that would have been filled by hand before.

          • John Schilling says:

            One of those things is more likely to count as Tech these days, and it’s the wrong one.

            “Tech” is I think properly understood not as a simple contraction of “technology”, but as its own thing that means roughly “consumer electronics and software”. And this largely is a distinct industry with a distinct culture, only loosely connected to the technological development of better automobiles, spaceships, powerplants, weapons, medical devices, etc, etc.

            Well, unless the cars are being considered as just a fancy smartphone accessory that allows one to implement the “actually go someplace” app, ideally without requiring any pesky human driving skill. But if e.g. someone proposes a new type of hydrogen fuel cell to extend the range vs. performance curve of pure electric cars, I’m more likely to find news of that in BBC’s “Future” or “Science” section than in “Tech”.

          • DinoNerd says:

            Regarding smartphones specifically, one interesting thing I’ve noticed is that you, as well as greenwoodjw, seem to be unable to decouple the device itself from social media apps that run on it.

            This!

            The ad-driven business model that focuses on ever-increasing engagement via any feasible method, many of which amount to promoting addictive behaviour, seems to me to be the main source of the reported (and very real) problems created by “tech”.

          • Bugmaster says:

            @mcpalenik:
            I’ll defer to your expertise on computational chemistry, since I don’t know that much about it. That said:

            And by working on basic research, there’s not even necessarily an immediate or direct connection between what I do an a specific technology. … Most of the cutting edge research developing new techniques is coming from research groups at universities. The tech industry as such can’t really claim credit for this.

            Well, obviously not; software engineers aren’t chemists. However, the clusters you use for your computation likely run on commodity hardware, using commodity software (I know for a fact this is true for bioinformatics). That commodity hardware and software was developed by the tech industry (that’s how it became a commodity). While the domain knowledge is the province of experts, the underlying algorithms you use on those clusters for optimization, sorting, and of course machine learning. were developed by computer scientists; the same algorithms power social media networks as well as airplane design labs. You might like your software tools, or you might hate them, but without them you’d be stuck in the mud — and their UI/CLI interfaces run on the same libraries that are used by Microsoft and Amazon. And, of course, you ultimately communicate with your colleagues over the Internet.

            Sure, if you define “tech” as “all the stuff I hate”, then you’re not using any “tech’; but that’s just a tautology. A cluster doesn’t care if it’s being used for Twitter or CERN; it just runs your computation. A sorting algorithm sorts things, be they ad conversions or particle energies. Technology is morality-agnostic.

            Nor can it claim credit for the millions (I don’t know the actual number, but some of the methods go back to the 1930s, although they weren’t applied on computers until later) of scientific papers published in peer reviewed journals on the topic.

            Hmm, if only there was some sort of a distributed information network we could use to look up stuff like that 🙂

          • mcpalenik says:

            @Bugmaster:
            Lol, ok
            1) I don’t use all the tools that you seem to think I do
            2) There are a lot of computational tools that have been developed outside of the tech industry, and many not even by computer scientists
            3) The tech industry can’t claim credit for everything you think.

            In slightly more detail:

            1) The tools I use work via a command line interface and dump out plain text. I write code in C and Fortran, which I don’t think the “tech industry” as people typically define it these days can claim credit for. I never use machine learning, although one of my colleagues (a chemist) does have a grant to develop machine learning techniques. My work involves solving (approximations to) the Schrodinger equation for chemical systems (exact solutions, even in a minimal basis set are computationally intractable).

            Note, I also never claimed that none of the tools I use were developed in or improved at one point in time by people in the tech industry.

            2) We have a computer science section here at the lab. Again, the environment here is totally different from the tech industry, and the people I’ve spoken to, when I asked, had no interest in moving into that industry (I think this has more to do with the idiosyncrasies of the people that end up here doing computer science than actually being a strike against the tech industry). There’s a lot of university research that I don’t think qualifies as “tech industry”, etc.

            3) As I mentioned before, one of my colleagues has a grant to develop machine learning techniques. Two more are developing quantum computing algorithms. And this is in a *chemistry* devision. The people here are PhD chemists, physicists, and materials scientists, not computer scientists. And without actually looking it up, wasn’t the internet originally a military project?

          • HowardHolmes says:

            John Schilling

            gas stations at least used to sell cheap road maps if you forgot yours.

            For the record in my day gas stations gave away free maps (I’m 71)

        • Saint Fiasco says:

          Honestly this comes across as a Tocqueville effect. The evil capitalists are giving you exactly what you want and instead of being happy, you are angry because you want to want other things.

          If there existed technology that could change your short term desires to be more like your long term desires you’d complain about something else, like about the scary mind control tech that can change your desires.

          • John Schilling says:

            Honestly this comes across as a Tocqueville effect. The evil capitalists are giving you exactly what you want and instead of being happy, you are angry because you want to want other things

            The Tech Industry is giving some of us exactly what other people want, in some cases removing or displacing what we want from the market, and we are angry because people keep telling us we should be happy that they gave us “exactly what we want”.

          • DinoNerd says:

            I agree with John Schilling. What I want in many cases used to exist, and is no longer available. I suspect that much of it might still be profitable to produce, but wouldn’t produce the kind of growth that makes stock markets excited.

            Sometimes my objection is to the change in itself – I already know how to use some huge number of text editors, markup languages, etc. – but here’s a new one, and suddenly it’s all that’s available, even though it’s no more than 1% better (often more like 10% worse), even before you add in the cost of learning the new tool.

            Slack is not better than IRC, just easier to monetize. This year’s cell phone is not better than last year’s, unless you personally care about 2 or 3 niche features – that I mostly can’t even identify. Web pages that constantly call home and self-refresh create load on my computer and internet connection, and the tech that enables them involves new improved security risks, beyond the denial-of-sevice attack implicit in their resource consumption – but I’ve no clue what “benefit” they are supposed to give me.

            I don’t require shoes with tech gadgets in place of laces – and using more plastic does not make me value the product more.

            I could go on … and on … and on.

            The only tech innovation I’ve sought out and bought recently was a room air conditioner that claims to be unsually quiet. The one before that was a fitness tracker (any tracker, not an innovation among trackers), and that was not at all recent.

            I don’t want it, don’t need it, and don’t like it.

        • raj says:

          You’re both being incredibly hyperbolic.

      • jaimeastorga2000 says:

        The modern palace is the smart phone, and we are working overtime to get one into the hands of everyone in the world. Quality of life is pretty exactly equal to time spent online (want proof, what do people choose to do when they have the option? What’s the ratio of long walks taken vs. people posting from the mind palaces we gave them about how great it used to be when people took long walks?), and we are the engine that made that possible, and continues to improve upon it.

        Are you seriously patting yourself in the back for helping to increase the number of people who spend most of their free time trapped in Skinner boxes?

        Weird flex, but OK.

  27. DinoNerd says:

    FWIW, I didn’t follow the comments to that article, and don’t think I posted. To me, it was more like yet another example of American business interests in action, and their apparant lack of self-restraint or shame, probably because it wouldn’t occur to them that they were doing anything shameful – no matter how mercenary, even rapacious they’d appear to anyone unaccustomed to their habitual behaviour.

    I’ve been to trade shows, and to conferences with large trade shows attached, and they feel to me primarily like an opportunity for massive advertising, sometimes to people who pay for the privilege of being targetted. Some conferences are less bad, with the advertisers decently restricted to an area set apart for the purpose, and the presentations not easily mistaken for infommercials – but basically I’ve stopped attending conferences, unless I need to be there for some self-serving reason generally involving career advancement. (Not merely learning, or enjoying interacting with peers.)

  28. The Nybbler says:

    If you go to some tech conferences, you will find as much wokeness (or more) than you did at the APA conference. And this wokeness is reflected in the composition of the people in the industry, and it does come through in the product. The Google Doodle promoting obscure leftist women of color or Google Search downranking “alternative facts” from one side of the political spectrum only, or Twitter and Facebook booting people off their networks for the wrong political views, these are all manifestations of that. But at least so far, the damage done there to individual users are far less than could come of the same thing of psychiatry. Google can’t 5150 you for toxic masculinity, nor can Twitter prescribe Depo Provera for scrupulosity. Perhaps those would never actually happen. But when we see the same kinds of woke attitudes in psychiatry as we do in tech, it’s hard not to project the consequences over to it.

    • Scott Alexander says:

      I could go the other way: “Psychiatry can’t delete all of your data and lock you out of your email account because of toxic masculinity”.

      Could Google delete all of your data and lock you out of your email for political reasons if it wanted? I mean, it’s physically capable of doing that. But there’s not a lot of evidence that this is a reasonable fear, and if it happens enough, the government is pretty likely to pounce on them.

      • eh says:

        At one point, Google would lock your account out of all their services, including Docs and Gmail, if you didn’t use a real name on Google Plus. Whether or not you were using your real name was determined by an algorithm with no human review process or identity verification step.

        Thankfully this was harmful to trans people instead of just being a normal Kafkaesque nightmare, and so they stopped doing it.

      • Randy M says:

        Eh, I got to give this one to The Nybbler. Being locked out of the internet would suck, but a padded cell it ain’t.

        (edit: was not directed at Eh, just a filler word modifying certainty).

      • The Nybbler says:

        Could Google delete all of your data and lock you out of your email for political reasons if it wanted?

        No, because most of my data isn’t stored with Google. That which is, is duplicated elsewhere, except my gmail account which is mostly used for short-term commercial transactions that would be no big deal to lose. That is, I _don’t_ trust Google. But there’s no doubt Google could do this with the data they have on any particular person, and that person would have little to no recourse. Psychiatrists, on the other hand, can put you in a padded cell and use your reaction to being put in such a cell as an excuse to keep you there indefinitely. This seems worse. But I’m not defending tech here; I’m pointing out that tech people might be likely to take this stuff to mean “I shouldn’t trust psychiatrists” because we see the similar problems in our own industry and agree that “I shouldn’t trust tech companies”.

        • Saint Fiasco says:

          Sure, most people can take measures to reduce the influence of companies like Google in their lives. Some people like artists or small business owners are less lucky, because they could really use the cheap ads and exposure they provide.

          But most people can take measures against psychiatrists too, and most of the time it’s even easier than with Google.

        • Scott Alexander says:

          I think your threat model is 30 years out of date.

          Almost-worse-case scenario if a psychiatrist commits you is you stay in the hospital three days until they complete their evaluation and let you go. You have to be unusually unlucky (the same kind of unlucky where a police officer arrests you and a jury convicts you even though you’re innocent) to get more than three days in a hospital, and it’s basically inconceivable to get more than a month or two (unless you’re in the child psych system or some other weird system I don’t know about).

          I’d honestly rather be wrongly committed to a psych hospital (three days of misery) than have my Google accounts perma-deleted.

          (I realize this is a weird discussion to be having.)

          • The Nybbler says:

            I know someone who spent the month (this in PA rather than CA, but same idea), much more recently than 30 years ago, so I’m dubious about how unlucky you have to be. It’s also the kind of thing I’d be unlucky about.

            But again my main point isn’t whether tech is worse or psychiatry is worse. It’s that to some of those of us in tech the outward manifestations _are_ indicative of a serious problem in the field, so seeing those same outward manifestations in psychiatry looks like strong evidence of a serious problem there.

          • jaimeastorga2000 says:

            I’d honestly rather be wrongly committed to a psych hospital (three days of misery) than have my Google accounts perma-deleted.

            It is a testament to your class privilege that you don’t even mention the monetary cost of being locked up in a psych ward for three days, merely dismissing it as “three days of misery”. According to this reddit post, getting Baker acted cost someone $20,000+; that’s what I make in a year.

      • Could Google delete all of your data and lock you out of your email for political reasons if it wanted? I mean, it’s physically capable of doing that.

        How? My data is on my hard drive and, while I have a gmail account, I hardly ever use it.

        Google could make it harder for people to find material on my web page or for me to find information I want. Short of somehow hacking into my computer, I don’t see much else they can do to me.

        • JPNunez says:

          Google could upload a little video saying that this david friedman guy, along with a photo of yours, is part of a conspiracy to traffic and have sex with children. Then post your home direction as center of the conspiracy. It also mentions that Hillary Clinton was in the conspiracy. Then Google directs the algorithm to recommend this video to everyone.

          Later, copycat videos start appearing because, well, turns out the video somehow has a ton of views, and there are economic incentives to copying this video. The recommendation algorithm then decides that similar videos should also be viewed by everyone.

          Then a year later a right wing guy shows up at your door and starts shooting.

          The data in your hard drive remains safe. Good thinking having offline backups.

          • Google could do that, but so could practically anyone else, and I thought the comment I responded to was about Google’s power. And if Google did it, my potential legal recourse—suing for damages—would be a good deal stronger than if you did it.

            With no malice at all, my picture showed up in stories on the David Friedman that Trump appointed as ambassador to Israel, presumably because I’m easier to find online than he is. No rocks through my windows resulted. I’ve been arguing unpopular positions online for thirty+ years, and so far without retaliation.

          • JPNunez says:

            I’m just saying your -and the whole thread- threat model is all wrong. It’s weird to me that SSC is v prone to histerics on the information brokers being biased one side or another, but when the moment of thinking “what’s the worst Google could do to me” the only thing mentioned is “lock me out of gmail”.

          • Conrad Honcho says:

            Are you suggesting we be more prone to hysterics re: intentional malice from large companies? I’ve never much liked Microsoft. Should I be concerned Bill Gates is going to pay someone to firebomb my house?

          • greenwoodjw says:

            “Google could disable the accounts on which I have most of my data stored.” vs. “Google could Rube Goldberg someone into showing up at my house with a gun” is a useless comparison, especially since SWATing exists. And the level of direction is completely different. And the level of effort. And the number of people involved. And…

          • JPNunez says:

            I think the problem is not as much Sundar Pichai could suddenly wake up one day and decide to fuck up the life of JPNunez or David Friedman. The thing is that tech has given a ton of people the tools to do so.

            See also: Swatting, which is a good example too, yeah. Could be done before, the internet has made it an usual practice done as a prank by kids.

  29. Chlopodo says:

    Michael Crichton invented the term Gell-Mann Amnesia as a reference to Nobel-winning physicist Murray Gell-Mann, who remarked that…

    I don’t think this is right. Crichton named it after Murray Gell-Mann more or less, I think, as a joke, just so that he could associate the idea with the name of someone famous:

    http://larvatus.com/michael-crichton-why-speculate/

    Media carries with it a credibility that is totally undeserved. You have all experienced this, in what I call the Murray Gell-Mann Amnesia effect. (I refer to it by this name because I once discussed it with Murray Gell-Mann, and by dropping a famous name I imply greater importance to myself, and to the effect, than it would otherwise have.)

  30. Walliserops says:

    I am still mildly worried that Vraylar® and its ilk will break loose of the conference center and convert the entirety of San Francisco into a medication-themed Dogscape.

    That said, agreed with the “people inside a field can see many ways that the field is strange or broken, and many ways that it’s working decently, and can talk at length about either” sentiment. Every field incentivizes some unscrupulous behavior, it’s not like paper mills and p-hacking (for the academic types), gratuitous virtue signaling (for the woke types), and in-your-face advertisements (for pharma companies) are unique to psychiatry. It’s constructive to talk about how to reduce these things, but I don’t think any of it makes a field fundamentally broken.

    Besides, how do you judge? It’s not like you can ask everyone to go to their own profession’s major conference, collect all its failings into one big horrible Katamari, and then compare the sizes to see which fields are broken and which are okay.

    • sorrento says:

      I am still mildly worried that Vraylar® and its ilk will break loose of the conference center and convert the entirety of San Francisco into a medication-themed Dogscape.

      You mean it’s not already?

      Then I’m really confused about what goes on up there.

  31. warrel says:

    “Conferences are designed to be about signalling” , … and Comments Sections ??…

  32. JRM says:

    I thought the piece was brilliant and helpful, and I enjoyed the hell out of it. I did not think worse of psychiatry leaving the article than I did coming into it, and I learned some things. (Some of which I should have already known, but didn’t.)

    Please do more posts like this. It wasn’t a hatchet job; it was a good writeup focusing on what actually happens, what works, and what’s funny. Don’t be deterred by the angry folks. Please. Please. Please.

  33. fwiffo says:

    What’s remarkable about this post is that you cared to write it and were dismayed by the “burn it all down” reaction.

    Because it seems like the incentives of just about everyone in media / social media is to say, “hey, if motivating people to burn it all down gets us more clicks, let’s write more articles like this!”

    So thanks for this. Also, the original article was great as well and did not leave me with a particular desire to light anything on fire.

  34. Eponymous says:

    I didn’t comment on the last post, and I didn’t read many of the comments. But
    personally, I found it incredibly depressing, and am surprised you didn’t
    intend it approximately as I read it.

    The invasion of the APA by SJWs is discouraging, but neither surprising
    nor fatal by itself.

    The big problem is the pattern you described in the pharmaceutical industry:
    basically that there’s little innovation, only run-away rent-seeking taking
    advantage of the flaws in the system. Quite disturbing in light of past
    discussions on this blog of cost disease and slowing innovation.

    I don’t see these issues as specific to psychiatry — and that’s exactly the
    problem. They’re widespread, particularly in medicine (though not only there).

    And then there’s the fact that life expectancy has dropped for three years in a row,
    which last happened over 100 years ago in the midst of a world war and worldwide
    influenza pandemic. And this is mainly driven by suicides and overdoses, which is
    sort of your guys’ area, which raises the question of why the APA wasn’t just about
    that?

  35. ilikekittycat says:

    I’m not going to be hyperbolic and say a plurality… but definitely more than a few members of the commentariat here have the stereotypical “internet STEM guy” way of looking at the world, where anyone with any intelligence got into a (hard-)science job and has some flavour of libertarian politics, and everyone else has fallen for a ruse/social contagion

    How many posts in the open threads have there been along the lines of “It seems like people in the world claim there’s a lot of rigor in X, Y, and Z, but does anyone else feel like they’ve got the secretly correct intuition they’re just cargo cults without substance?”

    *social sciences
    *humanities
    *philosophy (in the Sam Harris/Neil deGrasse Tyson/Dawkins way where the premoderns are worthy of veneration but anything new is ridiculous)
    *pedagogy (esp. public school)
    *modern art
    *the literary canon/literary criticism
    *modern architecture
    *heterodox economics

    There’s a lot of good posters that have read things and have expertise, but there’s also a number of people that just read wikipedia summaries and take the reddit pulse on a topic and present that as expertise, genuinely believing they are gifted and incisive enough to be able to rapidly cut through the pablum where others cannot. A well-crafted hatchet job (or, as in your case, a sharp criticism that can be read as a hatchet job) will spread amazingly fast with these sorts of people, because the idea of the “redpill*” others have overlooked is the catnip of internet STEM guy stereotypes. Everyone wants to be the Galileo from the legends they teach in you in school where he had a simple, demonstrable truth that the controllers of knowledge and power rejected; no one wants to deal with the real story of the Catholic side who noticed that Galileo still believed in circular orbits and didn’t have the size of the stars right and other flaws that meant his view didn’t really make rigorous sense in the pre-Newtonian world and led honest, logical people to judge that the case for heliocentrism was maybe 60/40 and shouldn’t be proclaimed as a physical truth

    *in the Matrix sense of an instant epiphany that reveals the deeper truth, not the man-o-sphere way

    • The Nybbler says:

      It’s a long sneer, but still a sneer. And an unfair one, as usual.

      no one wants to deal with the real story of the Catholic side who noticed that Galileo still believed in circular orbits and didn’t have the size of the stars right and other flaws that meant his view didn’t really make rigorous sense in the pre-Newtonian world

      In fact, plenty of people were discussing this in the comment sections of several SSC posts including this one.

      If you want to suggest that people here have a stereotypical “internet STEM guy” way of looking at the world that leads them to dismiss that list of things you posted and therefore we’re bad somehow, it’s on you to at least provide some substance for both sides of the claim. That is, both that people are dismissing those things, and that they are doing so incorrectly.

      • Reasoner says:

        I don’t think it was a sneer; it seemed friendly and civil. “Sneer” is about tone and lack of substance/lack of supporting evidence. You can have the same thesis as those who sneer without sneering yourself.

        • The Nybbler says:

          Tone is notoriously hard to demonstrate from text, but “internet STEM guy” and “these sorts of people” are definitely not friendly and civil, for instance. As for lack of supporting evidence, taken one way, the OP asks his targets to provide the evidence. Taken another way, the OP presents bare assertions (that posters here reject all those things based only on “secret intuition”) and asks the audience to accept them on faith. It’s a sneer; you’re being too charitable.

    • Bugmaster says:

      I’m the spitting image of the hateful STEM guy, so why not, let me take a shot:

      *Social Sciences: Obviously a useful field of study, but the replication crisis and massive political bias should give us pause. These disciplines IMO deserve to be handled with a lot more rigour than they are currently.

      * Humanities: That’s too broad of a category, I can’t really comment on it one way or the other.

      * Philosophy: IMO it’s mostly a dead discipline that consists of endlessly re-hashing the same pointless arguments and obsessing over non-issues. Obviously, philosophy had led to some very important advances, but so did alchemy. We have better tools today.

      * Pedagogy: Same comments as what I said about Social Sciences. Public schools are a total disaster, but I don’t have a working solution and neither does anyone else. It’s an open problem that has to be solved.

      * Modern Art: IMO it’s mostly without value, and involves more self-promotion than actual art, but I acknowledge that it’s a matter of taste. I’m not going to stop anyone from studying, producing, or enjoying it.

      * The literary canon / Literary Criticism: Mostly the same as modern art; although obviously the study of literature can be quite useful — it’s just that “Literary Criticism” as a field is mostly about self-promotion.

      * Modern Architecture: believe it or not, I actually like it. I wouldn’t want every building everywhere to be constructed in this style, but I enjoy looking at the Disney Concert Hall whenever I drive by it. Anyway, it’s an art form, so once again it’s a matter of taste.

      * Heterodox Economics: I don’t know enough about it to render an opinion.

      I would like to say something like, “if you think I’m wrong about one of these topics, I’d be glad to discuss them”; but I simply don’t have time to get a 6-year degree in each of these subjects. So, if you feel that this is the minimal standard that is required for an informed discussion, then I’m afraid we’re at an impasse.

    • Scott Alexander says:

      I wish I could post about how I think people are seizing on some mildly negative commentary to make sweeping negative claims and justify all their worst stereotypes, without people seizing on this mildly negative commentary to make sweeping negative claims and justify all their worst stereotypes 🙁

      I think everyone is aware of the holes in the Galileo story here (and I’ve blogged about them before). Imagining that you’re a bold iconoclast by pointing out the holes in the Galileo story is like some kind of weird meta-level LARPing fake-Galileo.

    • Garrett says:

      IDK. I was always a fan of the joke that things which have “science” in their names aren’t really sciences, such as christian science, political science, computer science.

      As a guy in “tech” who also has a degree in political “science”.

    • sorrento says:

      I’m not going to be hyperbolic and say a plurality… but definitely more than a few members of the commentariat here have the stereotypical “internet STEM guy” way of looking at the world, where anyone with any intelligence got into a (hard-)science job and has some flavour of libertarian politics, and everyone else has fallen for a ruse/social contagion

      I don’t think the most prolific commenters here have “hard science jobs.”

      How many posts in the open threads have there been along the lines of “It seems like people in the world claim there’s a lot of rigor in X, Y, and Z, but does anyone else feel like they’ve got the secretly correct intuition they’re just cargo cults without substance?”

      A lot of things in the world are cargo cults without substance. Maybe it would help if you actually argued for your case rather than sneered at “that sort of people.”

      Everyone wants to be the Galileo from the legends they teach in you in school where he had a simple, demonstrable truth that the controllers of knowledge and power rejected; no one wants to deal with the real story of the Catholic side who noticed that Galileo still believed in circular orbits and didn’t have the size of the stars right and other flaws…

      I think anyone who actually read and understood Scott’s writings understands that science is complicated and almost never boils down to “a simple, demonstrable truth” or “an instant epiphany.”

      Also, SSC was where I found a link to the real story about Gallileo (sadly, I don’t have it now.) And yes, it’s a lot more interesting than the “hero of science” version that gets trotted out.

  36. teageegeepea says:

    There’s also a lot of great people working really hard to help fight mental illness and support the mentally ill. “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety” isn’t sexy any more than “Internet continues to connect billions of people around the world at the speed of light” is sexy.

    That doesn’t seem comparable to Moore’s law in computers. The charge that many mental illnesses are iatrogenic seems just as plausible as the claim that it wouldn’t be the case that “Most Americans remain alive and basically functional” even though that was also the case prior to the advent of psychiatry.

  37. ec429 says:

    There’s a lot of cringeworthy stuff going on at conferences, but conferences are designed to be about signaling and we shouldn’t expect otherwise.

    I don’t know if it’s overloading of the word “conference”, but this really fails to match my experience (in tech). I haven’t been to many conferences, but the ones I have been to have consisted pretty much entirely of soberly discussing outstanding problems and weighing up solutions, with no sign of signalling (beyond “$firm has paid for this evening’s dinner and we’ll mention that once“) and certainly nothing like the Vraylar® Staircase™. Some possible explanations:

    1) No-one at these conferences was a ‘manager’ in the sense of having any kind of control over spending decisions, so there just isn’t much rent to seek.
    2) The word ‘conference’ is used to describe two very different things, honest-to-goodness technical conferences and trade shows, and the latter very much are about signalling. That they call themselves “conferences” is just another bit of signalling to defend their flanks.
    3) Linux kernel folks are just uniquely good people somehow 😉
    3a) Hey, maybe we’re all so autistic that signalling doesn’t work on us, so no-one bothers to try!

    • Enkidum says:

      I think some version of 3 is most likely the truth – if you’re working on open source software, there is a VERY strong pressure from within to avoid whoring yourself out to corporations. I’m in psychology/neuroscience and the conferences look much more like what Scott presented – even the lanyards used to hold our name tags were branded at the last one I went to.

      I suppose the amount of advertising will be some function of (at least) (a) the amount of money advertisers can make from the target group, and (b) the amount of hostility to advertising in said group. For Linux, (a) is relatively low and (b) is extremely high. For psychiatry, (a) is massive and (b) is likely quite low, particularly in a country like the US where psychiatrists are all essentially businesspeople.

      • gbdub says:

        there is a VERY strong pressure from within to avoid whoring yourself out to corporations.

        Isn’t that just a different sort of signaling?

        • Enkidum says:

          Absolutely it would be if it was real (see Sorrento’s correction below). But if it did exist, it would be a pressure against corporate staircases and the like.

      • sorrento says:

        I work on open source software, and have always whored myself out to corporations. In fact, most Linux kernel contributors have corporate jobs. I’m not a big target for advertisers simply because I don’t have much purchasing power at the company I work at. I imagine the same is true for the kernel developers.

        • Enkidum says:

          Ah fair, I hadn’t thought about the fact that every company runs linux servers. Less internal pressure against the ads than I’d thought, then.

    • Bugmaster says:

      FWIW, I’ve attended AWS Re:Invent a couple of times. It is a conference that is explicitly organized by a vendor (Amazon), and it didn’t have anything nearly as spam-tastic as the Vraylar® Staircase™. Mostly, it consisted of hands-on workshops regarding different aspects of the AWS platform; lectures about new developments on AWS; and talks about people who’d built interesting stuff using the platform. I’ve learned a lot of useful stuff there — not just about AWS, but about all the other stuff that can run on it — and at no point did anyone attempt to buy my endorsement with ice cream. Well, perhaps they did and were successful, I guess you’ll never know 🙂

      • greenwoodjw says:

        Isn’t that whole conference one long ad/training session for their product? Blizzcon and Spaceworld probably don’t have many ads/sponsorships either.

      • sorrento says:

        I mean, if Vraylar® created VraylarWorld®, I’m sure it would have “hands-on workshops regarding different aspects [of Vraylar]; lectures about new developments [in Vraylar]; and talks about people who’d [solved problems with Vraylar]. Amazon didn’t give you ice cream simply because you aren’t as valuable to them as a psychiatrist is to Vraylar.

  38. Caf1815 says:

    Perhaps fittingly, Gell-Mann’s name is misspelt several times in the obituary you linked to, including in the title…

  39. Eponymous says:

    “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety” isn’t sexy any more than “Internet continues to connect billions of people around the world at the speed of light” is sexy. But it’s a much bigger part of the story than the part where silly people do silly things at conferences.

    This is an odd line to take in light of the three-year decline in national life expectancy driven by rising suicides and overdoses. I don’t doubt that many individual psychiatrists are working hard on these issues, but it’s not a good look for the national conference to be wrapped up in silliness in the midst of a national crisis.

    And the drug stuff is doubly disturbing in light of the role of prescription opiates in fueling the crisis.

  40. name99 says:

    Amusingly, my reaction to your photos was that you’ve clearly never been to a tech conference! Exactly the same level of ads EVERYWHERE! Even a not especially public-facing conference, like Photonics West.

  41. Roakh says:

    I was disappointed to see a lot of the most hostile comments coming from people in tech. It would be easy to write an equally damning report on the tech industry. Just cobble together a few paragraphs about Juicero and Theranos…

    To be fair, there seems to be a bit of an asymmetry. Psychiatry, and not tech, can be evaluated as an epistemic field, attempting to generate knowledge. Whether or not it’s warranted in this case, it’s not unreasonable to judge that a field might be “broken beyond repair” epistemically based on evidence of epistemic vices (personally I think a lot of fields are broken beyond repair, so the bar isn’t too high).

  42. noahyetter says:

    If you don’t trust hatchet jobs against tech, try to be a little less credulous of hatchet jobs against psychiatry, even when I’m the one doing the hatcheting.

    What if I work in tech, and find most of the hatchet jobs against tech to be shockingly accurate?

  43. eqdw says:

    I was disappointed to see a lot of the most hostile comments coming from people in tech. It would be easy to write an equally damning report on the tech industry. Just cobble together a few paragraphs about Juicero and Theranos, make fun of whatever weird lifestyle change @jack is supporting at the moment, and something something Zuckerberg something Cambridge Analytica something. You can even throw in something about James Damore (if you’re writing for the left) or about the overreaction to James Damore (if you’re writing for the right). And there you go! Tech is a malicious cancerous industry full of awful people and everyone should hate it. We’ve all read this exact thinkpiece a thousand times.

    I wrote this comment immediately after reading the quoted section, so apologies if it’s irrelevant in light of whatever I’ll read next

    For the record, I was one of the people who expressed the idea that psychiatry appears broken beyond repair. And I am also in the tech industry.

    I will go on record as saying that I 100% agree with what I think you think is a reducio ad absurdum. The tech industry, or at least the part people think of when you say the tech industry, is also broken beyond repair. Ironically, I believe that much of that is for exactly the same reason I was concluding that about psychiatry, but tech has some additional idiosyncratic problems as well.

    —-

    EDIT: reading farther, I see this

    I feel the same way about psychiatry. There’s a lot of cringeworthy stuff going on at conferences, but conferences are designed to be about signaling and we shouldn’t expect otherwise. There’s also a lot of great people working really hard to help fight mental illness and support the mentally ill. “Most Americans remain alive and basically functional despite record-breaking amounts of depression and anxiety” isn’t sexy any more than “Internet continues to connect billions of people around the world at the speed of light” is sexy. But it’s a much bigger part of the story than the part where silly people do silly things at conferences.

    I am not bothered by the fact that the APA conference was 90% signalling and 10% medicine. I am bothered by the obvious and aggressive slant in the signalling. I am bothered by the fact that that itinerary had like half a dozen talks scheduled about how to deal with someone who is freaking out over the results of the election, but didn’t have any talks scheduled about (for example) how to deal with people like me, who were freaking out about the fact that my coworkers were going around in the office threatening physical violence against people they thought were insufficiently progressive, to the point that the CEO had to send an email to everyone telling them to knock it off, before our midwestern boomer customers found out, boycotted us, and our business collapsed.

    • Aapje says:

      I am not bothered by the fact that the APA conference was 90% signalling and 10% medicine.

      That seems very much an exaggeration.

      But I agree with you that the bias is more worrying than the actual percentages.

  44. Steve Sailer says:

    No profession’s annual convention augments its prestige.