Scott Alexander explores conflicting descriptions of Internal Family Systems therapy, questioning whether it involves trance-like states and real internal entities or more mundane visualization techniques. Longer summary

Scott Alexander discusses the confusion surrounding Internal Family Systems (IFS) therapy, particularly regarding the nature of the 'parts' or entities encountered during sessions. He contrasts his understanding from a book review, which suggested a trance-like state where patients discover real internal entities, with feedback from IFS therapists who claim this description is exaggerated. Scott explores various perspectives, including quotes from therapists and a book on IFS, trying to reconcile these different views and understand how IFS actually works. 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 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 examines a theory proposing that depression, anxiety, and trauma are characterized by low precision of sensory evidence, leading to overreliance on negative priors. Longer summary

Scott Alexander discusses a paper by Van der Bergh et al. that proposes a unified theory of negative emotionality, including depression, anxiety, and trauma. The theory suggests that these conditions are characterized by a processing style that assigns unusually low precision to sensory evidence, leading to an overreliance on negative priors. Scott explores the implications of this theory, including its support for various psychotherapies, somatic therapies, and meditation. He also discusses potential pharmacological interventions and how this model ties together various concepts in psychiatry and predictive processing. Shorter summary

The post explores how emotional learning creates hard-to-update mental models, drawing parallels between psychotherapy, psychedelics, and rationality techniques in overcoming these 'mental mountains'. Longer summary

This post discusses the book 'Unlocking The Emotional Brain' (UtEB) and its implications for understanding biases and mental processes. The author explores how emotional learning creates unconscious predictive models that guide behavior, and how these models can be difficult to update even in the face of contradictory evidence. The post draws parallels between UtEB's approach, psychedelic therapy, and rationality techniques, suggesting that they all aim to overcome mental 'mountains' that separate different areas of knowledge or belief. The author proposes that these mental separations might be a necessary feature of how our brains generalize from experiences, but can also lead to problems like cognitive biases and psychiatric symptoms. The post concludes by considering how this framework might help understand and address deeply held but irrational beliefs. Shorter summary

Scott Alexander critiques therapy books, highlighting their exaggerated claims and questioning the validity of their approaches, based on his clinical experience and historical misdiagnoses in psychology. Longer summary

Scott Alexander reviews the common patterns in therapy books, noting their tendency to promise miraculous results and criticize previous methods. He observes that while these books claim extraordinary success, his clinical experience doesn't match these claims. The post explores the concept of 'historicism' in therapy, where current problems are linked to past traumas, and questions the validity of this approach. Scott expresses skepticism about the dramatic transformations described in therapy books, comparing them to past misguided theories about mental health conditions. He concludes by warning readers to be cautious when evaluating individual therapy books, as they can be convincing in isolation but problematic when viewed as part of a larger trend. Shorter summary

Scott Alexander presents survey results on people's satisfaction with mental health care, showing varied preferences across different types of therapy and conditions. Longer summary

Scott Alexander analyzes the results of the SSC survey regarding people's experiences with mental health care. The post presents various graphs showing satisfaction ratings for different types of therapy, medication, and mental health issues. Key findings include an average rating of 5.7/10 for both psychotherapy and medication, higher satisfaction with therapy from books compared to in-person or online therapy, and varying preferences for medication vs. therapy depending on the mental health condition. The author emphasizes that the results are exploratory and subject to biases. Shorter summary

Scott Alexander reviews three books: a controversial psychotherapy text, an introduction to Lacan's philosophy, and a rationalist-themed fantasy novel. Longer summary

Scott Alexander reviews three books in this post. He starts with 'Method of Levels' by Timothy Carey, a book about psychotherapy based on perceptual control theory. Scott criticizes the book's extreme claims but finds some value in its approach. Next, he reviews 'How To Read Lacan' by Slavoj Zizek, finding it surprisingly readable but not entirely coherent. Lastly, he discusses 'The Steerswoman', a fantasy novel popular in the rationalist community, which he finds fun but not particularly deep. Shorter summary

Scott Alexander reviews Jordan Peterson's 'Twelve Rules For Life', finding it surprisingly insightful and impactful despite some philosophical criticisms. Longer summary

Scott Alexander reviews Jordan Peterson's book 'Twelve Rules For Life', finding it surprisingly good despite initial skepticism. He compares Peterson's writing to C.S. Lewis in its ability to make clichés feel meaningful and impactful. The review analyzes Peterson's ideas about order vs. chaos, his grounding of morality in the alleviation of suffering, and his approach to psychotherapy. While Scott has some criticisms of Peterson's philosophical foundations, he ultimately sees Peterson's work as a positive force, albeit one he's not personally drawn to join. Shorter summary

Scott Alexander shares his experiences and reflections as a final-year psychiatric resident, discussing communication techniques, challenges in psychotherapy, and the anxiety of managing patient risks. Longer summary

Scott Alexander reflects on his experiences as a final-year psychiatric resident. He discusses the differences between resident years, the challenges of dealing with patients and attendings, and the techniques he's learned for effective communication. He also shares his struggles with psychotherapy, his frustrations with psychoanalysis, and the constant anxiety of managing suicide risk among patients. The post ends with Scott contemplating the 'reverse lottery' nature of psychiatric practice and how a patient's suicide attempt has affected his approach to patient care. Shorter summary

Scott Alexander examines a study comparing the effectiveness of drugs and therapy for psychiatric disorders, discussing the results and methodological limitations of the research. Longer summary

This post analyzes a study comparing the efficacy of pharmacotherapy and psychotherapy for various psychiatric disorders. The author discusses the graph showing effect sizes for different treatments, noting that most psychiatric treatments have an effect size around 0.5. He expresses some uncertainty about the statistical methods used and highlights three surprising findings: drugs appearing more effective than therapy for borderline personality disorder and insomnia, and drugs being more effective at preventing relapse than stopping acute episodes. The post also discusses the limitations of psychotherapy trials, noting that lower quality trials tend to show much higher effect sizes than high-quality ones, and that psychotherapy research often lacks sufficient blinding and control groups. Shorter summary

Scott examines phatic communication and anti-inductive systems, exploring their roles in social interactions, job-seeking, and psychotherapy, and suggests the value of balancing both approaches. Longer summary

Scott explores the concepts of phatic communication and anti-inductive systems, using examples from small talk, job interviews, and psychotherapy. He explains that phatic communication is talking for the sake of talking, often serving as social grooming or signaling. Anti-inductive systems are those that become more complex once understood. Scott discusses how job-seeking and dating profiles can become anti-inductive as people try to stand out. He then reflects on his experiences in psychotherapy, realizing that sometimes a phatic approach works better than trying to be uniquely insightful. The post concludes by suggesting that people may fall into 'phatic culture' or 'anti-inductive culture', and that learning to appreciate phatic communication can be beneficial in certain situations. Shorter summary

Scott analyzes various criticisms of antidepressants, concluding they have modest but real benefits over placebo, with important considerations about side effects and efficacy. Longer summary

This post examines various criticisms of SSRIs and antidepressants, addressing claims about their efficacy, side effects, and comparisons to placebo and psychotherapy. Scott analyzes studies on antidepressant effectiveness, discussing issues like publication bias, effect sizes, and the meaning of 'clinical significance'. He explores side effects, particularly sexual dysfunction, weight gain, and emotional blunting. The post concludes that while antidepressants are not miracle drugs, they do have a modest but statistically significant benefit over placebo and can be a reasonable option for many people with depression, especially if they understand and prepare for potential side effects. Shorter summary

Scott Alexander examines a study showing no significant difference between CBT and psychodynamic therapy, challenging the idea that CBT is superior and exploring the possibility that most psychotherapies work through non-specific factors. Longer summary

Scott Alexander discusses a recent study in the American Journal of Psychiatry comparing the efficacy of cognitive-behavioral therapy (CBT) and psychodynamic therapy for depression. The study found no significant difference between the two therapies, challenging the common belief that CBT is superior. Scott reflects on how this contradicts the 'foundation myth' of psychiatry, which claims that evidence-based therapies like CBT replaced less scientific approaches like Freudian psychoanalysis. He explores the possibility that most psychotherapies work through non-specific factors rather than their specific theories or techniques, a concept known as the Dodo Bird Verdict. Scott suggests that CBT's reputation as evidence-based may be due to its proponents conducting more studies, rather than superior efficacy. He concludes by stating his belief that only very basic, targeted therapies have specific effects, while more complex theories of the mind likely rely on non-specific factors. Shorter summary

Scott Alexander presents a roundup of recent scientific and medical studies, covering topics from hallucinations to obesity genetics to schizophrenia treatment. Longer summary

This post is a collection of various scientific and medical studies and news. It covers a range of topics including hallucinations, diet and longevity, gene-environment interactions in psychiatry, life-extending drugs, fibromyalgia, chemical education, drug company tactics, sleep theories, psychotherapy effectiveness, obesity genetics, and schizophrenia treatment. Scott provides brief summaries and commentary on each item, often with a mix of scientific insight and humor. Shorter summary