How Bad Are Things?
December 31, 2015 10:39 AM   Subscribe

One “advantage” of working in psychiatry is getting a window into an otherwise invisible world of really miserable people. Scott Alexander writes about mental health and well being in America.
"I work in a wealthy, mostly-white college town consistently ranked one of the best places to live in the country. If there’s anywhere that you might dare hope wasn’t filled to the brim with people living hopeless lives, it would be here. But that hope is not realized. Every day I get to listen to people describe problems that would seem overwrought if they were in a novel, and made-up if they were in a thinkpiece on The Fragmentation Of American Society."
posted by boo_radley (62 comments total) 36 users marked this as a favorite
 
This guy knows way too much about statistics to be making this particular error. Half of the things he's counting are pretty clearly co-morbid, the other half have strong hedonic adaptation effects, and of course he's got a biased sample in his work! Jeeze.

SSC has had some really great posts in the last few months, but this one disappointed me.
posted by anotherpanacea at 10:43 AM on December 31, 2015 [8 favorites]


I almost think this piece is actively bad.

"The people who come to a psychiatrist are disproportionately the unhappiest and most disturbed."


Well, but people who come to a psychiatrist of their own volition at least have it together enough to be able to pay for that (through insurance or cash), and are well enough to know they need help, or have family/friends who are getting them help. Those are lucky damn people.
posted by roomthreeseventeen at 10:52 AM on December 31, 2015 [30 favorites]


I liked it. I think chipping away at the just world hypothesis and the general tendency of people to think that if they and people they know seem ok, the rest of people are probably pretty ok if they just try hard enough is actually part of the same process as solving problems and getting people to agree we even need to solve these problems to begin with.

I'm not sure how accurately the author describes this problem, maybe others could add depth and research to it, but it's a valuable concept to explore.
posted by xarnop at 10:53 AM on December 31, 2015 [13 favorites]


This one also disappointed me, because it fails on first principles. What if his data is wrong? His first example is the woman whose daughter is married to a drug addict. How does he know this is true? What if his patient is deluded or lying to him? What if "drug addict," in her mind, includes anyone that has smoked a bowl, ever (making her identical to my own 70-year-old mother)? How does he call this patient "perfectly average?" By what standard is she perfectly average? He says this is not a person, but a type. Is he saying then that every patient he sees walks in with a near-identical set of circumstances? Really?
posted by Cool Papa Bell at 10:54 AM on December 31, 2015 [7 favorites]


Here's a good paper that Justin Wolfers co-authored. Check the chart on page 8.

Time use studies are probably the gold standard here. I'll rustle one up.
posted by anotherpanacea at 10:55 AM on December 31, 2015 [2 favorites]


Well folks the good news is that many of those problems that the author includes in the "script" tend to be comorbid -- multiple afflictions piling up on the same person. It's sort of like money: the more problems you have, the easier it is to get additional problems. Yay, a relatively small group gets disproportionately huge bowls of shit!
posted by Vic Morrow's Personal Vietnam at 11:00 AM on December 31, 2015 [8 favorites]


I'm as willing as the next person to go down the Blue Velvet/American Beauty path and hesitantly sniff the decaying corpse of US civilization beneath the shiny veneer, but this man's post about how bad things are -- and by implication how stupid and rage-inducing we all are for not making ourselves aware of it, even though bad news about American life is all we're pumped with 24/7 if we hook ourselves up to the nearest internet connection -- is patently ludicrous.
posted by blucevalo at 11:11 AM on December 31, 2015 [4 favorites]


When I started doing political door-knocking, I was a little overwhelmed by all the misery I randomly encountered. I was mostly sad about how many lonely older people seemed so totally happy to see me and so desperate for me not to leave, given that political door-knockers are universally considered to be annoying. I find those people much more difficult to deal with than the hostile folks. But to be honest, part of what surprises me about this post is his basic naïveté. If I think about my extended family, or my friends' families, or my neighbors, there's plenty of misery and marginalization to go around. He seems to live in a pretty extreme bubble outside of work, and maybe it would be good if mental health professionals were not drawn from that bubble.
posted by ArbitraryAndCapricious at 11:12 AM on December 31, 2015 [39 favorites]


Well he acknowledges the conditional probablility issue (though it's kind of funny that he'll just do something like this and brush it off given his enthusiasm for Bayesian whatever.)
posted by atoxyl at 11:13 AM on December 31, 2015 [1 favorite]


"I work in a wealthy, mostly-white college town consistently ranked one of the best places to live in the country . . . filled to the brim with people living hopeless lives . . . "

So how long have you lived in Ann Arbor, "Scott"?
 
posted by Herodios at 11:14 AM on December 31, 2015 [26 favorites]


If I think about my extended family, or my friends' families, or my neighbors, there's plenty of misery and marginalization to go around.

Yeah - I'm personally from a really great environment but there are multiple people I could name in my extended family who have had awful shit pile up. (And I guess I have matched at some point ~2 of the items on his list myself).
posted by atoxyl at 11:19 AM on December 31, 2015 [2 favorites]


He does mention the conditional probability issue: "This will likely underestimate both the percent of people who have no problems at all, and the percent of people who have multiple problems at once." But there are also problems that it's not even taking into account—as roomthreeseventeen says, at least the people coming to him with these issues are lucky enough to have access to help. It's not rigorous enough for a scientific study, but for a blog post, I think this gives a good first approximation of how afflicted a population can be even in "one of the best places to live in the country."
posted by Rangi at 11:21 AM on December 31, 2015 [2 favorites]


This is part of why I get enraged whenever somebody on Tumblr says “People in Group X need to realize they have it really good”, or “You’re a Group X member, so stop pretending like you have real problems.” The town where I practice psychiatry is mostly white and mostly wealthy. That doesn’t save it.

Again, he's being like this in his posts. Nobody serious would make this simplistic argument, so why should he get enraged (and not the "somebodies" on Tumblr?)? Here he's subtly repeating the rather tired reply "But white people experience oppression too!" Of course they do; that's obvious to anyone who knows a bit of statistics about humans.
posted by polymodus at 11:33 AM on December 31, 2015 [19 favorites]


I think the likely level of American unhappiness is roughly in the 10%-15% range, from the big study I liked above. The blogger has pegged it at 55%+ based on a really biased sample and analysis.

I'm not saying 15% is good. I'm just saying it's a lot less than 55%+ and a lot better supported.
posted by anotherpanacea at 11:36 AM on December 31, 2015 [2 favorites]


The collinearity for his misery checklist is not just something he can ignore with a well-placed "Nevertheless." Abuse, alcoholism, mental illness, domestic violence, incarceration, etc are massively interdependent and interlinked problems. Treating them as totally independent factors doesn't give you biased results, it gives you nonsense results.
posted by theodolite at 11:47 AM on December 31, 2015 [11 favorites]


I have chronic pain. It is decently managed by a combination of drugs and exercise, but it is a thing that limits my daily activities and affects my sleep and is really annoying. I am not unhappy, though, let alone miserable. The 8 years since my pain became chronic have included some of the happiest moments of my life, and my day to day life now is much happier and more fulfilling than it was 10 years ago. I know happy wheelchair users and happy people with cognitive disabilities. And to stick to his area of expertise, I know people with depression and anxiety, people who were abused as children, people with PTSD, and people who are bipolar who also are not miserable, and indeed some of the happiest, most full of life people I know also have mental illness.

I find his assumption that people with mental illness or physical disabilities must by definition be miserable to be offensive and especially unfortunate given his choice of profession. Not having a life that meets his apparent personal standards for perfection is not the same a misery.
posted by hydropsyche at 11:50 AM on December 31, 2015 [55 favorites]


he might as well be estimating that 25% of people are hermaphrodites because 50% are male and 50% are female
posted by theodolite at 11:52 AM on December 31, 2015 [11 favorites]


This is interesting to me because lately I have been struggling with people in my immediate circle, who have various serious problems. And the issues are real ones, not fake. But I am left wondering where all of this trouble and strife came from? 20 years ago I didn't know anyone who had these kind of situations, and now it seems like they are everywhere. I don't think it's just that I am 20 years older - a lot of the people struggling are a generation younger than I am. Is it worse now, or did I just not meet these people, 20 years ago?

I have a serious chronic physical condition myself, but I am in great shape compared to people with the various kinds of mental illness. And I struggle to figure out how to set boundaries. Am I supposed to be infinitely patient even though it costs me my own physical health, or damages my ability to remain employed? I don't think so. But where's the line?

You can be in decent shape yourself, and people with this stuff can still take you down. Or people who are in decent shape themselves, but who are letting someone else take them down, can really push you to drown with them, and get angry when you don't.
posted by elizilla at 12:00 PM on December 31, 2015 [5 favorites]


The writer mistakenly thinks everyone needs to hear from him. It is bizarre he characterizes most Psychiatric patients as miserable. One way or the other they are at least insured. He is not giving it away for free. Calling people with a need for psychiatric services "types" seems lazy, seems like chumming for a cozy cuddle up of dismissive like think. He doesn't know any miserable people, really? He must take those blinders of his off, outside of work at least now and then.
posted by Oyéah at 12:01 PM on December 31, 2015 [4 favorites]



Well, but people who come to a psychiatrist of their own volition at least have it together enough to be able to pay for that (through insurance or cash), and are well enough to know they need help, or have family/friends who are getting them help. Those are lucky damn people.


How do you know? No one can make that judgement from the cuff.

And if you go through all that and nothing gets better, then heaven help you. I do not understand people's compulsion to put a sunny spin on rot. If you feel compelled to go, it's bad. If the courts or some other authority makes you go, it's bad. If you have problems and you can't afford to go, it's bad. It's different kinds of bad and different levels of bad, but you are not lucky when it's bad.

It's just bad.
posted by Alexandra Kitty at 12:06 PM on December 31, 2015 [13 favorites]


Tax is another one of those areas where you get to know people way better than you'd like to. My sympathy is more limited when what I see are the financial issues of privileged white upper-income (or formerly-upper-income) Americans, but it still staggers me how often I see people come in who drive nice cars, dress nicely, present like they're doing Just Fine, and they're, like, keeping their business open by taking advantage of multiple credit cards and multiple checking accounts with liberal overdraft policies. After depreciation, they've posted losses every year for the last five years, but this year even their cash flow is negative. And those are still people in the realm of "folks who still think they're doing pretty okay mostly".

The post itself is kind of meh, but the idea that we're all totally normal and totally fine is a really destructive one that keeps people from looking for help until things have totally imploded. Everybody thinks they're a uniquely bad parent, uniquely bad spouse, uniquely bad employee. Everybody thinks that, okay, even if they know other people who were abused as kids, those people got over it. Yeah, you had that accident at work, but it was thirty years ago, get a grip, you're an adult. Yeah, you get heart palpitations because your spouse loads the dishwasher wrong, but your life is basically okay, right? You can't be the person with problems. You want to be normal. But everything being fine isn't very normal at all. Talking about not being fine? That's the thing that's still weird.
posted by Sequence at 12:07 PM on December 31, 2015 [39 favorites]


Poor statistics aside, I work in primary care and identify quite a bit on a personal level with the author's perspective. The so-called "high users" of my health care services contain a high degree of misery. Certainly there are people dealing with chronic pain, disability, mental illness, poverty and addiction who are happy, but it would be foolish to assume that is the majority or even a large minority.

In particular what I identify with in this article is the point of view that my work affords me a glimpse into a world that is by and large completely invisible. Were I not a family doc I would have very little knowledge of this subset of society and thus my understanding of the world around me would be disproportionately composed of my middle class, educated, mostly healthy peers. Having done this job for a good while now, I can't imagine how this skewed perspective would inform my views on the world in general.

Of course, one can argue that my perspective is skewed another way, towards the human misery that poor health and difficult social circumstances can create. Still, what I remain struck by is the complete lack of representation of this rather large segment of society in any sort of culture at large.
posted by thelaze at 12:10 PM on December 31, 2015 [36 favorites]


How do you know? No one can make that judgement from the cuff.

My point was that it is unlikely that people who can get medical help are the most miserable in the world.
posted by roomthreeseventeen at 12:10 PM on December 31, 2015 [3 favorites]


This is part of why I get enraged whenever somebody on Tumblr says “People in Group X need to realize they have it really good”, or “You’re a Group X member, so stop pretending like you have real problems.”

It frustrates me that he doesn't recognize that these two statements are completely different from each other. The first one is something that's often true and which people say a lot. The second is something that's not really true at all and I kind of don't think of it as something people actually say. Why conflate them?
posted by escabeche at 12:11 PM on December 31, 2015 [13 favorites]


I think the point is not that the statement isn't true, but rather that when dealing with individual, real people with real world problems it's astonishingly crass to respond to their statements about their own lived experience with something along the lines of 'but people X like you are privileged & have it better than people Y'. The follow-on idea that 'therefore I feel justified in minimising your problems which can't possibly be as bad as you say they are because of all your privilege' is implied, but not usually explicitly stated.
posted by pharm at 12:44 PM on December 31, 2015 [10 favorites]


"Never forget the advantages you have, as an accident of birth, that other people do not" is something people should live by and my ultimate takeaway from the privilege concept - which is in itself perfectly straightforward and useful. "People in Group X need to realize they have it really good" though is not actually something you can tell somebody who is a member of Group X who is suffering and I absolutely do see people fuck this up sometimes. Which is not to say that all resistance to anti-oppresive notions could be avoided if they were simply explained better (or that it's everybody's job to do this) but I happen to think there are plenty of people who could be reached (but currently are not) if more thought was put into how to convey these ideas.
posted by atoxyl at 12:47 PM on December 31, 2015 [13 favorites]


Also, I suspect this is really another in Scott's list of blogposts on the topic of in-group self-selection & the way we tend to surround ourselves with people like us & how that radically distorts the way we view the world, so there's a bit of context which is missing from the bare post all by itself.
posted by pharm at 12:49 PM on December 31, 2015


My point was that it is unlikely that people who can get medical help are the most miserable in the world.

Well, he does follow his statement on disturbed and miserable people by saying "to a degree", and the rest of his paragraph he writes "I" and "I thought" to indicate it's based on his limits of observation. And also, I recall when he does his shorthand calculations he says "that's not even stepping out of America".

So, I think he would agree with you. For nearly all of us the "most miserable people in the world" out of seven billion is something we can only think about in abstract and not know in real life.
posted by FJT at 12:49 PM on December 31, 2015


I work in a city with a population over 150K, and a practice size of 3000+ persons. It's very rare that any of our patients in our group practice (i.e. 30 more like me) ever sees a psychiatrist for their mental health issues. They're like unicorns, and getting into see one is like witnessing the aurora borealis. 95% of mental health care is a primary doc managing meds and a therapist (hopefully) doing the heavy lifting of CBT. He makes some excellent points in his essay, but he ought to be aware of how few cases he is likely managing in the overall context. That said, the good psychiatrists in our area take on some of the most difficult and hopeless cases and often find ways to make a meaningful difference when we have tried everything, and for that we cannot say enough for their role.

The most miserable people I see don't even have the most basic expectation that someone would help them get better. And that's more endemic than ever.
posted by docpops at 12:59 PM on December 31, 2015 [15 favorites]


it is unlikely that people who can get medical help are the most miserable in the world.

This isn't the Olympics of human suffering. I most certainly have never been one of the world's most miserable people. Even at bottom I've had basically unlimited, unearned support and resources to help me back out, combined with all the privilege there is. Despite all that, I have been so desperately miserable that death seemed like a valid way out.
posted by justsomebodythatyouusedtoknow at 1:20 PM on December 31, 2015 [26 favorites]


This isn't the Olympics of human suffering.

That was exactly my reaction to the OP's blog post.
posted by roomthreeseventeen at 1:21 PM on December 31, 2015 [1 favorite]


yeah idk. I think it's good and important to talk about covert misery especially in the age of digital self-curation, but the straw-SJW stuff is silly and disappointing.
posted by en forme de poire at 2:01 PM on December 31, 2015 [6 favorites]


Agree with hydropsyche's comment, above. "Really miserable," "a type," "misery," "sort of people," "these people," "Normal-Person-Me," "miserable people." With the weird white people get suicidal aside and a link to a charity. Really not helpful, in my opinion, for advancing the interests of the people he's talking about (e.g. strengthened systems of care, integrated affordable housing, disability rights, the perspective of individuals being on a spectrum with respect to disabilities, etc.).
posted by ClaudiaCenter at 2:11 PM on December 31, 2015 [4 favorites]


This might be worth looking at, if you want a sense of Scott Alexander's background.
posted by goodnight to the rock n roll era at 2:49 PM on December 31, 2015 [3 favorites]


This might be worth looking at, if you want a sense of Scott Alexander's background.

Wow.

The whole rationalist / less wrong thing is fascinating to me but I can never convince anyone who is into it to talk to me because in addition to finding it fascinating, I also tend to find it incredibly funny. There's just something about the whole idea of being able to overcome an inherent human weakness by trying really, really hard (and being smart, smarter than those other humans) that I find hilarious.
posted by internet fraud detective squad, station number 9 at 3:04 PM on December 31, 2015 [12 favorites]


Let me sum it up, all of it. People hate change more than they hate misery. Once you see that, you see it everywhere, and no one understands this more than the ruling class.
posted by Beholder at 3:10 PM on December 31, 2015 [11 favorites]


also, how would this guy "get in trouble" for including single mothers? lol @ him
posted by internet fraud detective squad, station number 9 at 3:18 PM on December 31, 2015 [5 favorites]


If I should ever need the services of a psychiatrist, I now at least know one judgy shrink to avoid.
posted by raysmj at 3:24 PM on December 31, 2015 [5 favorites]


Loose militias of marauding single moms with sharp talons and powerful arms for ripping/tearing, obv
posted by en forme de poire at 3:48 PM on December 31, 2015 [3 favorites]


About 10% of people were sexually abused as children, many of whom are still working through the trauma.

One of my preceptors in medical school told me that one of the most helpful questions he could ask when taking a medical history was, "when were you molested?"
Not, "were you molested?" but "when?"
posted by gemutlichkeit at 4:43 PM on December 31, 2015 [4 favorites]


I think the point is not that the statement isn't true, but rather that when dealing with individual, real people with real world problems it's astonishingly crass to respond to their statements about their own lived experience with something along the lines of 'but people X like you are privileged & have it better than people Y'. The follow-on idea that 'therefore I feel justified in minimising your problems which can't possibly be as bad as you say they are because of all your privilege' is implied, but not usually explicitly stated.

But this is totally mixing up who is calling whom privileged. It's not minimization if that member of X acts in a racist way towards member Y, and Y calls them out for it. X could be having the worst day of their lives, but that doesn't mean X gets off scott-free participating in structural racism against Y. That wouldn't be fair to Y. And to suggest, in that context, Y doesn't care about X's problems or troubles - that's the standard deflection. That's the minimization; minorities' problems are always so easily made to take second place/focus.
posted by polymodus at 4:54 PM on December 31, 2015 [6 favorites]


"Never forget the advantages you have, as an accident of birth, that other people do not" is something people should live by and my ultimate takeaway from the privilege concept - which is in itself perfectly straightforward and useful. "People in Group X need to realize they have it really good" though is not actually something you can tell somebody who is a member of Group X who is suffering and I absolutely do see people fuck this up sometimes.

That's definitely one issue with the whole "privilege" concept. It's fairly aggressive for one person to say to another person that they are privileged in a way that others are not (the question of whether that assessment is correct or not being a separate issue). That said, it's a good thing for a person to realize this independently and "count blessings".

It kind of reminds me of the recent thread about grieving and well-meaning people saying " is in a better place now" or "everything happens for a reason". It's harsh when someone says such a thing to you; comforting when you think it yourself.
posted by theorique at 4:59 PM on December 31, 2015 [5 favorites]


It's not minimization if that member of X acts in a racist way towards member Y, and Y calls them out for it.

It's also not what we're talking about.
posted by atoxyl at 5:10 PM on December 31, 2015 [3 favorites]


I appreciated the fundamental thrust of this piece, regardless of the potential hyperbole, bad statistics, and the presumption of equating [X condition] and Misery. It seems to be a product of frustration and emotion, and it comes off as pretty honest.

I also clicked through to this piece mentioned upthread and found it to be a very interesting read.
posted by Room 101 at 5:19 PM on December 31, 2015 [3 favorites]


I'm not so much concerned with the way members of Y call out members of X who are being actively Y-ist than with the way members of X call out members of X. And more than that I just think that formal and informal *education* about the concept of privilege would be better if it encouraged *everybody* to consider real or hypothetical contexts in which they would personally be disadvantaged as well as advantaged. It seems to me there is a reluctance to do this because one doesn't want to draw a false equivalence - e.g. being the only white person at your school isn't *really* the same as being the only black person. But that's a *secondary* realization and simple empathy is the first step. (If you think I'm wrong either about the way this should be taught or the way it's *already* taught let me know this is just anecdotal)
posted by atoxyl at 5:33 PM on December 31, 2015 [1 favorite]


I'm one of those people who sees a psychiatrist, and I will tell my you my family history in brief:

My grandmother went to court in the early 1960s for an incest case which is fucking unheard of. All 7 girls testified. They were forced to go back. Abuse got worse.

My grandmother married my grandfather both had college educations. Grandfather abused kids - incest again. Never reported. They had 3 children. All three have college eduation. My father sexually abused me, my brother was also abused. I never pressed charges. I have a master's degree but I'm an anonamly. My brother dropped out of highscool in 9Th grade, but eventually got his GED. Out of my cousins on my dad's side (there are 8 total) 6 girls and 2 boys. 5 of the 6 girls had children before 20. None of college education. All 3 live with mother (there is 11 people in total)1 has Fetal Alcohol Syndrome (no kids) because my uncle married an alcoholic who managed to get him discharged from the Army and subsequently tried to kidnap her children multiple times before ending up in jail. 1 boy ended up in foster care with substance use issues. The Other boy went to the Army and has a college degree and an okay job. Married no kids!

There is poverty and misery everywhere in the story and this doesn't even touch my mom's side which is less dramatic but still troublesome. I think the history of downward spiral of wealth and education in the family is also shocking.

I think he is right, but I could very well be projecting as well.
posted by AlexiaSky at 5:48 PM on December 31, 2015 [4 favorites]


MetaFilter: as willing as the next person to go down the Blue Velvet/American Beauty path and hesitantly sniff the decaying corpse of US civilization beneath the shiny veneer
posted by Halloween Jack at 6:11 PM on December 31, 2015 [1 favorite]


It's very rare that any of our patients in our group practice (i.e. 30 more like me) ever sees a psychiatrist for their mental health issues. They're like unicorns, and getting into see one is like witnessing the aurora borealis.

I have spent weeks trying to get into a decent psychiatrist (nothing serious, just anxiety med management). They don't return my phone calls, or don't take new patients, or don't take my insurance, or something. The only one I could get an appointment with has terrible reviews and bars on the windows (!!). I can see how a lot of people would just give up. My PCP specifically will not prescribe the meds I need on an ongoing basis so I have no choice. It's a terrible state of affairs here.
posted by desjardins at 8:51 PM on December 31, 2015 [5 favorites]


Clearly this is as we like it.
posted by pfh at 1:04 AM on January 1, 2016 [1 favorite]


He uses 'wheelchair bound', which is a red flag for me; it's well-known that medical professionals grossly underestimate the quality of life experienced by people with for example, spinal cord injury (and this varies by speciality - rehab doctors, who see people learning to live with their disability, are more optimistic than ER doctors). My understanding of the research is that a new disability causes a drop in various measures of quality of life/happiness - but that this drop is in no way as significant as non-disabled people, especially doctors, think. This piece I think is typical of disability advocates' views: "Doctors might know about our biology, but it doesn't mean they know about our lives."

It seems to be working on an assumption that not to have Scott Alexander's privileges in life is to be miserable; then using this as a springboard to expound that, gosh, even people who do have Scott Alexander's privileges in life may also be miserable.

And as for fragmented society and miserable people, how about:
- having had problems at work, became very depressed. Employers took him to court, while he was being cared for for his depression, accusing him of stealing money from them, which was likely a malicious suit. This was dropped, but the reputation meant that he could not get another job, and the family were relying on the tiny income that his wife brought in.
- a difficult pregnancy, an alcoholic partner who spends money leaving little or none for her, can be gone for weeks at a time without any word.

Those are both admissions to Bedlam in 1895, since I happened to have 'Presumed Curable' on the desk in front of me. If I went and looked through other books on social and psychiatric history I'm sure I'd find more ('London Labour and the London Poor' has very many examples). While he makes the point that people think that things are better than the bad old days, I get the impression that he believes that mobility for work, and so separation from social/family networks is somehow new; or even that the impacts of illness, substance abuse, interpersonal problems are as well?

I'm still trying to work out exactly why this article has bothered me so much. Is it that the author is a medical professional, but seems to lack insight that having problems doesn't necessarily mean that someone is miserable? Or that he has managed to get so far into adult/professional life before realising that not everyone has Rich White Man privileges? Or that it seems really so incoherent in talking about why people are unhappy, if he assumes that problem = unhappy, but also lack of problem = quite possibly also unhappy? Or that his rallying call that Something Must Be Done seems so utterly and completely incoherent in the context of the rest of his article?
posted by Vortisaur at 2:32 AM on January 1, 2016 [17 favorites]


Or that he has managed to get so far into adult/professional life before realising that not everyone has Rich White Man privileges?

He is pseudonymous; he is not anonymous. If he said anything threatening or offensive to his bosses they know exactly who he is. Do you think you will ever read on his blog that prozac is almost exactly as effective as a placebo within the uncertainty range of such a question? While he does not understand the lack of logic loop he happens to be stuck in, the fellow is going through the process in real time in front of us all that the android in Star Trek was going through when Kirk melted him down using the liar's paradox?

(Actually you can read stuff like that in the comments to his posts but the whole thing requires way too much time because those folks are PROLIX and they LIKE PROLIXITY. They read Yudkowsky and Moldbug for goodness' sake.)
posted by bukvich at 5:45 AM on January 1, 2016


This might be worth looking at, if you want a sense of Scott Alexander's background.

thanks. the tone of the posts here was confusing me completely until i saw that. knowing that he's already been categorized as a bad person explains a lot.
posted by andrewcooke at 5:59 AM on January 1, 2016 [4 favorites]


bukvich: If you want a prolix deep dive into the evidence surrounding SSRIs from Scott, that would be right here.

To channel Ben Goldacre: It’s probably a bit more complicated than that.
posted by pharm at 8:50 AM on January 1, 2016 [2 favorites]


thanks. the tone of the posts here was confusing me completely until i saw that. knowing that he's already been categorized as a bad person explains a lot.

you're the only true objective person here, I see
posted by internet fraud detective squad, station number 9 at 10:24 AM on January 1, 2016 [4 favorites]


The noblesse oblige really comes through in this post of Alexander's. Clearly, he is not like "those people." He is also very much a biochemical reductionist and skirts the edges of the evo-psych and human biodiversity movements, which have come out of the same spawning grounds as the neoreactionary libertarianism of the transhumanist movement. I read the comments on the post and had to stop because the thinly veiled sexism and racism in the derail about evolution was making me sick.
posted by Beethoven's Sith at 11:09 AM on January 1, 2016 [6 favorites]


The comments are not by Alexander. Do you happen to know what he thinks of that stuff? (It's true that SSC is less heavily moderated than, say, Mefi, so you may see things which alarm you.)
posted by pw201 at 11:29 AM on January 1, 2016


Again, he's being like this in his posts. Nobody serious would make this simplistic argument, so why should he get enraged (and not the "somebodies" on Tumblr?)? Here he's subtly repeating the rather tired reply "But white people experience oppression too!" Of course they do; that's obvious to anyone who knows a bit of statistics about humans.

To be honest, that ruined the entire thing for me even ignoring the other problems. I couldn't unsniff the loud and noxious fart that hung in the air after I got to that. He even throws in a jab at tumblr, which stops just short of saying "SJWs".

Once I read that, the entire thing so clearly fit the lens of "look at how hard white people have it".
posted by emptythought at 11:33 AM on January 1, 2016 [1 favorite]


The quiz: Do you live in a bubble?
posted by gemutlichkeit at 12:15 PM on January 1, 2016


The issue over the use of the term "misery" is not a simple one I think. "Wheelchair-bound" also stuck out to me, because I've known wheelchair users - or even people with pretty severe motor disabilities - who were doing just great. Nothing on his list has to ruin your life. A term like "wheelchair-bound" suggests a degree of limitation that many of the people he would apply it to would probably disagree with. But I'm also really, really not a fan of when people strain to avoid mentioning any link between mental or physical illness and suffering because it's almost a denial of people's pain and frustration, of their permission not to be happy. I mean I've experienced ~3 of the things on that list - I added one because after standing for six hours last night I realized how limiting my back pain can actually be - and it's not always a great time.

Did he at any point say that his patients' lives are not worth living? I didn't see it. He said they had a lot of problems.
posted by atoxyl at 3:20 PM on January 1, 2016


But I'm also really, really not a fan of when people strain to avoid mentioning any link between mental or physical illness and suffering because it's almost a denial of people's pain and frustration, of their permission not to be happy.

No one in this thread has said that. All that has been said, repeatedly, is that it is really unfair to equate all physical or intellectual disability or physical or mental illness with misery, especially in the particular statistical-torturing way that was done in this blogpost.
posted by hydropsyche at 3:57 PM on January 1, 2016


Well I don't think he said what you think he said either, on balance, though I was also struck by a couple of phrases.
posted by atoxyl at 6:45 PM on January 1, 2016


He was trying to calculate the frequency of misery in the US by using the frequency of the occurence of unemployment, domestic violence, sexual assault, and various physical and intellectual disabilities and physical and mental illnesses. Since he was already making huge assumptions, he could have made another assumption like "I recognize that many people with chronic illnesses and disabilities lead happy lives, but I'm going to assume that 50% of them are miserable" and then adjusted his statistics accordingly. His analysis was already deeply statistically flawed, as others have noted above, and I don't know that he knows enough stats to know that, but the way he phrased it, it really seems as though he thinks every single person who falls into one of those categories is miserable. Certainly, as you and others have noted, the phrase "wheelchair bound" suggests that he doesn't know a lot about the actual lives of people with physical disabilities.
posted by hydropsyche at 5:15 AM on January 2, 2016 [2 favorites]


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