A review of David Foster Wallace's 'The Pale King', examining its themes, the author's style and personal struggles, and the reviewer's evolving perspective on Wallace's work and legacy. Longer summary

This book review discusses David Foster Wallace's unfinished novel 'The Pale King', focusing on its themes, Wallace's writing style, and his personal struggles. The review explores Wallace's attempt to transcend postmodernism, his critique of consumer culture, and his vision for a more sincere and morally engaged society. It also delves into Wallace's mental health issues, his suicide, and the posthumous controversy surrounding his personal life. The reviewer reflects on their own journey with Wallace's work, from initial admiration to eventual disillusionment, while still acknowledging the value and limitations of his literary contributions. Shorter summary

Scott Alexander discusses various responses to his post on mentally ill homeless people, emphasizing the need for specific, detailed plans. Longer summary

Scott Alexander responds to comments on his previous post about mentally ill homeless people, addressing various objections and proposed solutions while emphasizing the need for specific, detailed plans rather than vague calls for toughness. Shorter summary

Scott Alexander explains why 'doing something' about mentally ill homeless people is more complex than it seems, detailing current processes and challenges in implementing alternatives. Longer summary

Scott Alexander critiques the common call to 'do something' about mentally ill homeless people, explaining why seemingly simple solutions are often impractical or ineffective. He details the current process for dealing with disruptive mentally ill homeless individuals, highlighting its limitations and the numerous challenges in implementing alternative approaches. The post emphasizes the need for specific, well-thought-out plans rather than vague demands for action, and critiques articles that criticize 'soft' approaches without offering concrete, feasible alternatives. Shorter summary

Scott Alexander reviews a book on Internal Family Systems therapy that controversially claims some mental health issues are caused by literal demons. Longer summary

Scott Alexander reviews 'The Others Within Us', a book by Robert Falconer about Internal Family Systems therapy and its controversial approach to dealing with 'demons' or malevolent spiritual entities in patients' minds. The review explores the book's claims, the history of IFS therapy, and the potential implications of treating mental health issues as spiritual possession, while also providing a skeptical, materialist interpretation of the phenomena described. Shorter summary

Scott Alexander examines the problematic nature of emotional support animal letters, highlighting the ethical dilemmas for psychiatrists and the system's shortcomings. Longer summary

Scott Alexander discusses the issue of emotional support animal letters, highlighting the challenges and ethical dilemmas faced by psychiatrists when asked to provide these letters. He explains the legal requirements, the lack of clear evaluation criteria, and the pressure on mental health professionals to approve these requests. The post explores various scenarios and potential responses, ultimately pointing out that the current system creates a form of gatekeeping that favors those who can navigate the process, resulting in a disguised class system. Shorter summary

Scott Alexander argues that schizophrenia should be described as predominantly genetic, addressing counterarguments and emphasizing the importance of this perspective for prevention strategies. Longer summary

Scott Alexander argues that it's fair and accurate to describe schizophrenia as predominantly genetic. He responds to various arguments against this characterization, comparing the situation to how we discuss smoking causing lung cancer. Scott emphasizes that while environmental factors play a role, genetic factors account for the majority of variance in schizophrenia risk. He argues that acknowledging the genetic nature of schizophrenia is important for developing effective prevention strategies, such as polygenic screening, rather than focusing solely on hard-to-control environmental factors. Shorter summary

Scott Alexander uses simulations to explain why seemingly counterintuitive arguments against the genetic basis of schizophrenia are misleading. Longer summary

Scott Alexander discusses two seemingly counterintuitive arguments against the genetic basis of schizophrenia and explains why they're not as compelling as they might appear. He uses a simplified simulation to demonstrate how a highly heritable disorder can have low twin concordance rates and why eliminating affected individuals doesn't significantly reduce prevalence in the next generation. The post aims to clarify common misunderstandings about polygenic disorders and their inheritance patterns. Shorter summary

Scott Alexander summarizes and responds to reader comments on his Elon Musk book review, covering various aspects of Musk's life, work, and personality. Longer summary

This post is a compilation of highlights from comments on Scott Alexander's review of Elon Musk's biography. It covers various aspects of Musk's career and personality, including debates about his intelligence and mental health, discussions about his companies (Tesla, Twitter, SpaceX, Boring Company), his Mars colonization plans, and comparisons to other historical figures. The post also includes critiques of Scott's original review and updates to his views based on the comments. Shorter summary

Scott Alexander critiques Emil Kirkegaard's evolutionary definition of mental illness, arguing for separate terms to distinguish between social dysfunction and evolutionary fitness concepts. Longer summary

Scott Alexander responds to Emil Kirkegaard's proposal for defining mental illness based on evolutionary fitness. Scott argues that while Kirkegaard's definition may be useful in evolutionary psychology, it doesn't align with practical needs in mental health care and social policy. He proposes keeping two separate concepts: one based on social dysfunction (Scott's definition) and another based on evolutionary fitness (Kirkegaard's definition). Scott provides several examples to illustrate the differences and limitations of Kirkegaard's approach, including ADHD, alcoholism, and ephebophilia. He concludes that Kirkegaard should coin a new term for his concept, such as 'genetic maladaptation', while preserving the term 'mental disorder' for its more common usage. Shorter summary

Scott Alexander explores various explanations for why some people don't respond to 'woo' practices, questioning whether non-responders are defective or if woo itself might be ineffective or even harmful. Longer summary

Scott Alexander discusses the concept of 'woo' (alternative wellness and spirituality practices) and explores different possibilities for why some people might not respond to these practices. He presents four possibilities: 1) Woo is universally great but harder for some people due to being 'dissociated from bodily experiences', 2) Different people process emotions differently and woo works better for some than others, 3) Woo treats a specific defect of storing emotions in the body, and 4) Woo correlates with a specific defect but doesn't actually help. Scott provides evidence and counterarguments for each possibility, drawing on psychological theories, cross-cultural observations, and personal anecdotes. He concludes by highlighting the difficulty in determining whether practices like woo are helpful coping mechanisms or potentially harmful risk factors for mentally unhealthy individuals. Shorter summary

Scott Alexander addresses feedback on his post about bisexuality and Long COVID, discussing alternative explanations and defending his methodology. Longer summary

Scott Alexander responds to comments on his previous post about the correlation between bisexuality and Long COVID. He addresses alternative explanations, concerns about sample size and methodology, the nature of psychosomatic illness, and various other points raised by readers. Scott maintains that while the association exists in the data, the cause remains uncertain and could be due to various factors including response patterns, biological differences, or a combination of organic and psychosomatic elements. Shorter summary

Scott Alexander replicates and analyzes data showing higher rates of long COVID among bisexuals, suggesting a significant psychosomatic component to the condition. Longer summary

Scott Alexander attempts to replicate a CDC finding that bisexuals were 50% more likely to report long COVID than heterosexuals. Using data from his own ACX survey, he finds that bisexual women were twice as likely, and bisexual men 50% more likely, to report long COVID compared to their heterosexual counterparts. He also notes correlations between long COVID and various mental illnesses. Scott suggests these results indicate that a substantial portion of long COVID cases may be psychosomatic, potentially classifying excess cases as a culture-bound mental illness. He proposes compassionate treatment for unavoidable cases alongside 'unawareness campaigns' to minimize avoidable psychosomatic ones. Shorter summary

A review of 'The Arctic Hysterias' by Edward Foulks, exploring culture-bound mental disorders among Eskimos and their decline with westernization. Longer summary

This book review examines 'The Arctic Hysterias' by Edward Foulks, which explores culture-bound mental disorders among Eskimos, particularly focusing on 'piblokto' or Arctic hysteria. The review discusses various Eskimo mental conditions, Foulks' investigations into their causes, and the decline of these disorders as Eskimo society westernizes. It also considers the cultural context, the impact of colonialism, and potential explanations for these phenomena, including comparisons to panic disorders and the effects of societal changes on mental health. Shorter summary

Scott Alexander discusses reader comments on his 'Geography of Madness' review, revising views on culture-bound syndromes and exploring various mental health topics. Longer summary

This post discusses various comments on Scott Alexander's review of 'The Geography of Madness'. It covers topics like culture-bound syndromes, the prevalence of brief psychotic disorder, the history of school shootings, the universality of PTSD, the rise of transgender identities, and the correlation between believing in ghosts and experiencing PMS. Scott revises some of his previous views, becoming more skeptical about many traditional culture-bound syndromes and acknowledging the complexity of cultural influences on mental health conditions. Shorter summary

Scott fact-checks and disproves a claim that all healthy people have mystical experiences using SSC Survey data. Longer summary

Scott Alexander fact-checks a tweet claiming all healthy people have mystical experiences using data from the 2020 SSC Survey. He defines a 'very mentally healthy' category and compares their reported spiritual experiences to the general survey population. The analysis shows that very mentally healthy individuals are actually less likely to report spiritual experiences, disproving the tweet's claim. Scott expresses relief at this finding, noting that spiritual experiences can be helpful for people during difficult times. Shorter summary

A detailed review of Michael Shellenberger's 'San Fransicko', examining its critiques of San Francisco's progressive policies on homelessness, drugs, and crime. Longer summary

This post reviews Michael Shellenberger's book 'San Fransicko', which criticizes progressive policies on homelessness, drug addiction, and crime in San Francisco. The review examines key claims in the book, fact-checking statistics and comparing them to other sources. While finding some of Shellenberger's criticisms valid, the review also points out areas where the book presents a one-sided narrative or misrepresents data. Overall, the reviewer sees the book as a flawed but thought-provoking critique of San Francisco's approach to urban problems. Shorter summary

Scott Alexander provides a detailed guide on understanding, preventing, and treating nightmares, covering causes, lifestyle changes, therapies, and medications. Longer summary

This post provides a comprehensive guide to understanding and treating nightmares. It covers the potential causes of nightmares, lifestyle changes that can help reduce them, and various therapies and medications that can be effective. The author discusses the role of stress, sleep quality, and medical conditions in nightmare occurrence. The post also details specific therapeutic approaches like Image Rehearsal Therapy, Systematic Desensitization, and Lucid Dreaming Therapy, as well as the use of prazosin as a medication for nightmares. The author concludes by recommending resources for further information. Shorter summary

Scott Alexander examines the Hearing Voices Movement, discussing its benefits and limitations in treating psychosis while emphasizing the need for a balanced approach to mental health care. Longer summary

Scott Alexander discusses the Hearing Voices Movement, which advocates for treating hallucinations and delusions as normal rather than medicalized. He argues that while the movement has some positive aspects, such as providing community support for people with mild psychosis, it shouldn't be seen as a replacement for medical treatment in severe cases. The post explores the complexities of mental health advocacy, the role of community in treatment, and the importance of balancing different approaches to mental health care. Shorter summary

Scott Alexander provides a comprehensive guide on ketamine as a depression treatment, covering administration methods, effectiveness, safety, dosage, and potential side effects. Longer summary

This post is a comprehensive guide on ketamine as a treatment for depression, covering various aspects such as methods of administration, effectiveness, safety, dosage, and potential side effects. Scott Alexander explains the differences between IV ketamine, esketamine (Spravato), and oral/intranasal ketamine, discussing their relative costs and accessibility. He also delves into ketamine-assisted psychotherapy, the duration of ketamine's effects, and current theories on how it works. The post is written in a FAQ format, aiming to provide thorough and evidence-based information while acknowledging areas of uncertainty in the research. Shorter summary

Scott Alexander reviews 'Crazy Like Us', exploring how Western mental health concepts spread globally and whether raising awareness of mental health problems might make them worse. Longer summary

Scott Alexander reviews 'Crazy Like Us' by Ethan Watters, which explores how Western mental health concepts are spreading globally. The book presents case studies on anorexia in Hong Kong, depression in Japan, PTSD in Sri Lanka, and schizophrenia in Zanzibar. While Scott finds the book's main thesis only moderately interesting, he's intrigued by a recurring sub-theme: whether raising awareness of mental health problems might actually make them worse. He discusses each case study, offering his own insights and critiques, and concludes by imagining a culture that runs 'Mental Health Unawareness Campaigns'. Shorter summary

Scott Alexander directs readers to his essay on Works in Progress examining why suicide rates didn't increase during the COVID-19 pandemic as expected. Longer summary

Scott Alexander refers readers to his essay published on Works in Progress, which discusses the unexpected trend of suicides during the COVID-19 pandemic. The essay, titled 'Why didn't suicides rise during Covid?', likely explores the counterintuitive finding that suicide rates did not increase as many had predicted during the global health crisis. While the post itself doesn't provide details, it suggests an in-depth analysis of suicide statistics, mental health trends, and potential explanations for this phenomenon during the pandemic. Shorter summary

Scott Alexander presents a detailed guide on depression, covering its causes, symptoms, and various treatment options, including lifestyle changes, therapies, medications, and other interventions. Longer summary

Scott Alexander provides a comprehensive guide on depression, covering its causes, symptoms, and various treatment options. He discusses lifestyle changes, therapies, medications, supplements, and other interventions like TMS and ECT. The post offers practical advice on how to approach treatment, including specific regimens for different situations, and guidelines on how long to continue treatment once it starts working. Shorter summary

Scott Alexander proposes a Bayesian theory of willpower as a process of weighing evidence from different mental processes to determine actions. Longer summary

Scott Alexander proposes a new Bayesian theory of willpower, disagreeing with previous models like glucose depletion, opportunity cost minimization, and mental agent conflicts. He suggests willpower is a process of weighing evidence from different mental processes: a prior on motionlessness, reinforcement learning, and conscious calculations. The basal ganglia then resolves this evidence to determine actions. Scott explores how this model explains the effects of dopaminergic drugs on willpower and discusses implications for understanding mental illness and productivity. Shorter summary

Scott Alexander examines mental disorders through the lens of dynamical systems theory, exploring how this perspective complements and contrasts with taxometric approaches. Longer summary

Scott Alexander explores the concept of mental disorders as dynamical systems with attractor states, contrasting this with the taxometric approach. He uses examples like Alice's health insurance situation and Bob's depression to illustrate how complex systems can have stable states that attract nearby unstable situations. The post discusses how this perspective can help understand the nature of depression and other mental disorders, showing how they can be both dimensional and categorical. Scott also draws parallels between the complexity of mental disorders and the global economy, emphasizing the intricate interconnections and the difficulty of predicting outcomes or effective interventions. Shorter summary

Scott Alexander examines taxometrics in psychiatry, finding that most mental health conditions are dimensional rather than categorical, and discusses the implications for diagnosis and treatment. Longer summary

Scott Alexander explores the concept of taxometrics, which studies whether psychiatric conditions are categorical or dimensional. He explains the difference between categorical distinctions (like humans vs. rabbits) and dimensional variations (like height), and discusses how taxometric methods attempt to determine which psychiatric conditions fall into each category. The post then reviews recent meta-analyses suggesting that most psychiatric conditions are dimensional rather than categorical, contrary to some expectations. Scott reflects on the implications of this for psychiatric diagnosis and treatment, suggesting a move away from binary thinking about mental health conditions. Shorter summary