Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0].
Importantly, this tracks with what we know about the protective effects of things like religiosity against depression. As such, the qualitative experience of the drug might not be something we can (or should) do away with. I would even go as far as suggesting that an absence of transcendence in one’s life is precisely what causes a large segment of people to become depressed in the first place, and that perhaps drugs are helpful only insofar as they produce a transcendent experience.
This isn’t to say we can’t take a scientific approach to treating depression, but that has to be balanced with something profoundly metaphysical: the actual qualia of life experience. Wellness isn’t the absence of disease; it’s the presence of thriving, and that includes within it a component of things like hope, inspiration, and elevation above the ordinary. We used to have various ceremonies designed to turn us towards the numinous, but we’ve pretty systematically dismantled those in favor of a grounded hyper-rationality [1]. As a scientist, I can’t really object to rationality on its own, but it may be worth considering non-rational, transcendent experience as a fundamental psychological need.
[0] If you’re a materialist, you might object that neurological machinery is not differentiable from qualia. Fair enough! I even agree! My point is simply that medicine needs to consider qualia as a major parameter in the treatment of depression. Fixing depression is not like fixing a car.
[1] I suspect most people here are familiar with Nietzsche’s “God is dead quote”. Many people in my entourage are floored to discover that he correctly predicted the dramatic increase in anxiety, depression, neuroticism and nihilism that is present in modern life.
Clipping
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web > Drugs for depression are missing the trip
[https://news.ycombinator.com/item?id=37949336]
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web > Irrationality makes my live empirically better
[https://news.ycombinator.com/item?id=37949878]
It only sounds silly to our modern sensibilities, which I am increasingly considering regressive on the specific question of “what is a life well-lived”.
To a pre-modern society that considers e.g. dreams to be vehicles of important meaning, religiousity to be a good thing in measure, idle time to be a gift and introspection to be one of the major points of existence, it doesn’t sound silly at all. It sounds wise.
I’m a scientist by training and an engineer by trade, but as an empiricist, I am forced to admit that my life has gotten better by making room for the irrational, superstitious, obliquely-associative, self-contradictory omginternets to exist. Make of that what you will ;)
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books > The Wise Man's Fear (Patrick Rothfuss)
No man is brave that has never walked a hundred miles. If you want to know the truth of who you are, walk until not a person knows your name. Travel is the great leveler, the great teacher, bitter as medicine, crueler than mirror-glass. A long stretch of road will teach you more about yourself than a hundred years of quiet introspection.”
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books > The Wise Man's Fear (Patrick Rothfuss)
“It must be hard to be a man,” she said softly. “A woman knows she is part of the world. We are full of life. A woman is the flower and the fruit. We move through time as part of our children. But a man …” She turned her head and looked up at me with gentle pity in her eyes. “You are an empty branch. You know when you die, you will leave nothing of any import behind.” Penthe stroked my chest fondly. “I think that is why you are so full of anger. Maybe you do not have more than women. Maybe the anger in you simply has no place to go. Maybe it is desperate to leave some mark. It hammers at the world. It drives you to rash action. To bickering. To rage. You paint and build and fight and tell stories that are bigger than the truth.” She gave a contented sigh and rested her head on my shoulder, snugging herself firmly into the circle of my arm. “I am sorry to tell you this thing. You are a good man, and a pretty thing. But still, you are only a man. All you have to offer the world is your anger.”
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books > The Wise Man's Fear (Patrick Rothfuss)
“She is also an excellent fighter, of course. We would not have a leader who could not fight. Shehyn’s Ketan is without equal. But a leader is not a muscle. A leader is a mind.”
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web > MDMA is not just a feel-good drug
[https://news.ycombinator.com/item?id=37652031]
Before trying MDMA I had mostly written it off as a feel-good drug: an artificial high like cocaine or meth, useful only for escapism. Why bother chasing that sort of experience? But now having tried most of the commonly used psychedelics, I’ve come to believe that MDMA is the most profound of them all.
MDMA does feel good, of course, but it’s not escapist. It’s a deep, wholesome, fundamentally healing sort of goodness. It is unconditional, redeeming love and forgiveness — the core of Christian spirituality. It is the revelation that you really are lovable, even your darkest, hidden parts, and that you are capable of love. Debatably, there is no more profound lesson to be learned about the human condition. It really is magical.
Even so, the experience is surprisingly subtle. It doesn’t particularly force positive feelings (“ecstasy” is a total misnomer, IMHO). At first you don’t necessarily even notice any effect at all, maybe just a mildly better-than-average mood. But gradually it becomes clear that this subtle sense of well-being is infinitely deep: nothing you might experience can possibly disturb it. All sense of shame and self-judgement, fear of rejection, hang-ups that get in the way of connecting with people --- all dissolve immediately on contact. And from that sense of absolute safety, the capacity to love emerges naturally. The drug doesn’t generate it. It just helps you get out of your own way.
I’ve taken MDMA a few times now just on my own at home (lacking a rave community, although I’m sure that’s a fantastic experience also), where it’s relatively easy to implement harm reduction measures: stay hydrated, take protective supplements, get a full night’s sleep before and after, and wait multiple months between doses (doing all these, I’ve never experienced a ‘hangover’, just a positive afterglow). I’ve found the most rewarding results from trying to keep my attention grounded in bodily sensation, gently returning to the body whenever I notice I’ve become lost in thought. Often, difficult memories or associations will surface of their own accord, sensing that it’s safe to do so, and seeing them from a loving perspective can be immensely healing.
I really hope we can eventually find our way to making this experience legally and safely available to everyone who wants it. Yes, MDMA has sharp edges; it’s not as physiologically benign as the classic psychedelics, but it’s not addictive and it can be used safely. Not everyone has good experiences every time, but compared to the classical psychedelics, it’s much more reliably positive. It apparently has some effectiveness as a medicine for specific illnesses like PTSD, but IMHO the real condition it treats is much broader: the universal human condition of feeling more walled off than we’d like to be.
One last galaxy-brain thought: if we ever figure out a way to replicate MDMA’s pro-social effects that people could safely use on a day-to-day basis, it might be the most valuable thing we ever invent. One could even see it as the metaphorical second coming of Jesus, his kingdom on earth achieved through purely secular means. How’s that for a career goal? :-)
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books > The Wise Man's Fear (Patrick Rothfuss)
There are three things all wise men fear: the sea in storm, a night with no moon, and the anger of a gentle man.”
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web > Luck over success
Tim Minchin giving a commencement speech:
“Remember, It’s All Luck You are lucky to be here. You were incalculably lucky to be born, and incredibly lucky to be brought up by a nice family that helped you get educated and encouraged you to go to Uni. Or if you were born into a horrible family, that’s unlucky and you have my sympathy… but you were still lucky: lucky that you happened to be made of the sort of DNA that made the sort of brain which - when placed in a horrible childhood environment - would make decisions that meant you ended up, eventually, graduating Uni. Well done you, for dragging yourself up by the shoelaces, but you were lucky. You didn’t create the bit of you that dragged you up. They’re not even your shoelaces.”
“Understanding that you can’t truly take credit for your successes, nor truly blame others for their failures will humble you and make you more compassionate. Empathy is intuitive, but is also something you can work on, intellectually.”
Conan O’Brien interviewing Bo Burnham:
“What’s your advice for young people?”
Bo Burnham: “You just gotta take a deep breath and… give up… The system is rigged against you. Your hard work and talent will not pay off. I would say don’t take advice from people like me who have gotten very lucky. Like, Taylor Swift telling you to follow your dreams is like a lottery winner saying, ‘Liquidize your assets, buy Powerball tickets, it works!’?’’
Conan O’Brien: “I say, I work really hard, I think I have some ability, but I also got really lucky… And when some people act like that’s not part of it, it makes me a little crazy.’’
Bo Burnham: “Yeah, of course. And we’re tall white guys! We overcame nothing to be here. There was nothing standing in our way and we barely got here… You have no chance.”
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web > Chakras are easy to feel
[https://news.ycombinator.com/item?id=37243624]
Well, it’s a low-resolution model that ancient people converged on for a reason, which is that it is starts from a readily-attainable subjective experience, which is then used to explain things in ways that surely go too far.
It is relatively easy to feel some of your chakras, I’ve done it, it took about a week of effort via a hodgepodge of breathwork, stretching, yoga, and “somatic” meditation facilitated by THC. You try to awaken muscles all over the body, “unblocking” points of tension, and eventually you start to have this impression of “energy”/“heat” flowing in loops from points on the spine, out along muscles and back again; in my case “unblocking” some of these caused buried emotions to pour out, and temporarily gave me near-perfect posture. It’s interesting: these are clearly a description of something real.
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web > Enlightenment
[https://sashachapin.substack.com/p/the-spirit-does-whatever-it-wants]
You’re not the only one who knows about this. A lot of people access it in prayer, for example. And most people are comfortable with brief glimpses of this thing, knowing it’s there, communing with it occasionally. But you really crave it. You want more! So you become an effective seeker of this thing. You learn how to access it in more situations—when you’re driving, when you’re cooking. More and more, you can do this neat mental gesture, where you surrender what feels like a ‘small’ self into a ‘big’ self.
And then, one day, you realize: oh, there’s no secret technique. There’s no secret anything. The question itself is what’s stopping me from fully embracing reality. I’m not seeing what’s already there, precisely because I’m searching for it. The last distortion I’m placing between myself and the Spirit is the urge to see it. The search is the final problem, that little nagging mental process that says, ‘not here, not this, surely not this.’