It was scary to me how fast even my doctor wanted to medicate my grief to put it behind me. I was seeing her six weeks after my sister and nephew had died, only two weeks after I had returned from their hometown 1500 miles away where I had spent a month trying to help my parents not absolutely collapse. I was having trouble working full-time, and a friend had told me a diagnosis of "adjustment disorder non-specified" was basically code for "situational grief" and should be able to get me some FMLA flexibility for a couple months until I could handle full-time reliably again.
I told the doc I thought the grief I was feeling only six weeks after a sudden and devastating loss was entirely appropriate, and that suppressing it seemed like it would make things worse, not better, but I'd let her know if things changed.
When it had been a year and I was still struggling to function (granted that year had been full of other awful things), I finally did ask for help with an antidepressant, which did provide the boost I needed to start exercising agency in my life again, so it's not like it was altogether the wrong suggestion. It was just much, much too early.
I found that the real friends in that situation were the ones who didn't need me to be someone else or somewhere else (emotionally) to love me.
I agree with so much of what you're saying. That grief is devastating and appropriate - you can't love somebody with your whole heart without also grieving them with your whole heart.
What I've never been able to figure out for myself is if antidepressants and their ilk are "suppressing" the grief. Or are they more like a cast that helps a broken bone to heal? I just honestly don't know.
Like you I've decided to largely avoid them and fight through on my own. I never know if I'm making the best choice.
I'm sorry for your loss and I'm glad things sound like they're heading in a better direction.
This felt like it was so soon nobody had even had time to set the bone yet.
I think I would have appreciated it more if she had just put more context around it, like, "This is a really big thing you're going through. It's going to take a lot out of you, and it's going to take a lot of time. There's a lot I can't do, as your doctor, like bring them back. Some things just take time. But also sometimes antidepressants can help, whether at this stage of the journey or later on, and if that's an option you'd like to consider at some point, know I'll be available for that conversation."
Maybe she was just inexperienced with grief. I don't know. It was just way too soon.
When my dad was in the hospital after having bypass surgery, a lady came around doing aromatherapy. I know in my heart it's a bunch of crap, and I know 100% my dad would think so in better health, but in this beat down state he seemed to take some sort of solace in it so I didn't say a word.
All this is to say, sometimes you just need let people have their placebos, because it can be more cruel not to.
Not only that, but the placebo effect is one of the most reliably powerful effects in all of medicine. It's not just a form of solace, it is often a critical part of recovery. In many cases it is more important to receive an "effective" placebo than to receive actual medical intervention.
Perfumes have been used for thousands of years and shops are investing into the right aromas to make their customers buy more.
I wouldn’t be surprised if the right aromas can have a positive influence on a patients mood, compared to “the uplifting smell of a hospital ward”.
Like, basically all clinical trials with a placebo arm and a no treatment arm (particularly for pain and depression) show a pretty significant difference between the two arms, suggesting that something's going on there.
There was that famous meta-analysis from 2001 that showed no significant effects, but that averaged over a _lot_ of trials where we wouldn't expect much of an effect (cancer, particularly).
When you look at trials that could plausibly be placebo-susceptible you do find an effect.
Can you explain why you think it's mostly regression to the mean?
> There was that famous meta-analysis from 2001 that showed no significant effects, but that averaged over a _lot_ of trials where we wouldn't expect much of an effect (cancer, particularly).
This is the exact meta-analysis that I was referring to.
I'd need to go back to my PhD to remember all the flaws I found with that approach, and the vast number of studies (including meta-analyses) that found statistically significant placebo effects following this.
Particularly for pain, there's biochemical evidence of placebo effects being created due to sugar pills, and these effects being reversed by opioid antagonists (naloxone, particularly), so the evidence is particularly strong for this.
If I get a chance this week, I'll review my thesis for the citations that I knew back then (but it's been over 10 years since my viva and I no longer work in the area so can't recall off the top of my head).
(This is standard for Cochrane reviews, btw and definitely a good thing). I fundamentally disagree with the approach of this review and analysis (placebos are not a generic effect (apart from pain)) but love Cochrane in general).
Line will always be different. There's healthy and realistic worrying where it motivates you to think and act if your situation is improvable, and there's the type of worrying where it's just wallowing and it just makes your situation worse.
But overall I think it's better to lean positive, in a similar sense to how overconfident people tend to be more successful.
The current trend for quite some time has been positively in every thing. Prosperity churches, only talk to people that are positive (let’s face it real friends are there when things go bad), … etc
There is a good book about this- Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America
Eh, a counter argument to the book also is that, it makes the US what it is. I haven't read that book but I have travelled and worked extensively in countries like Canada and UK and let me tell you - first hand, I have seen just the sheer increase in productivity in the US and the hopeful nature it has.
Compare that to Canada whose slogan is "We have tried nothing but are all out of ideas.".
So the positive thinking and forward and upward mindset that is present in most American large cities is palpable and contagious. It makes things happen and keeps stagnancy at bay.
Talking through the inevitability of death is a fixture in philosophy and really does make it easier to bear.
One of the most popular works through the middle ages was Boethius's On the Consolation of Philosophy, a treatise on not lamenting death through philosophy. Of course, the author's point about speaking about consolation is often for the speaker, and Boethius was no different.
Formerly one of the most powerful men in Rome, he wrote the work while imprisoned by the Ostrogothic king Theodoric the Great and facing imminent execution on sham charges of treason.
Sure, it's not a terminal illness, but he was rugpulled to death in a very similar manner. It's basically basically Martis cum Moriar and I highly recommend it for anyone concerned about death, dying, the inevitability of decay.
One of the weird things I've come to appreciate about death is it is actually a fairly communal activity in a philosophical sense. We all go through it, vanishingly few people like it and we all approach it with similar prospects of surviving for 150 years (nil, none, nothing, zip, zilch). I don't think these concepts of "positivity culture" and "denial" are really on the same spectrum. Any and every culture can devolve into delusion - in some fairly practical sense the default state of every culture is delusion (riddle me any culture that doesn't boil down to doing what "we do what we do because we can" at its logical root). We're all dying, some faster some slower, and it is possible to deal with death productively at any speed in most cultures.
The issue is more that people honestly don't know how to deal with bad situations and for obvious reasons don't have personal experience with being terminally ill to fall back on to generate instinctive empathy. It transcends the cultural aspects, I expect you can go anywhere and people will be uncomfortable with pain, sickness and suffering. One of the major things that unites humans is they'd much rather that trio of feelings stayed well away from them and this leads to some fairly harsh treatment of the people who are not doing well.
There are 2 approaches that I'm aware of - ignore death or turn to religion (I personally recommend Buddhism). Beyond that and symptom mitigation there isn't a lot that can be done although loosening up the regulations on the medical industry would probably help make life a little more bearable. I can imaging sitting in the medical system and watching it crush the life out of someone through economic inefficiency would be its own journey through hell.
> You lie there for a while and dwell on the fact that, barring technological innovation like the Singularity, you’re going to bite it one day.
The singularity won't save anyone. The maths of "forever" is unforgiving.
Jean Baudrillard (the French philosopher known for his concept of "simulacra") explores this uneasiness towards death in modern society in his magnum opus "Symbolic Exchange and Death" (recommend reading the whole chapter, it is essentially his defining work):
"Our whole culture is just one huge effort to dissociate life and death, to ward off the ambivalence of death in the interests of life as value, and time
as the general equivalent. The elimination of death is our phantasm, and ramifies in every direction: for religion, the afterlife and immortality; for
science, truth; and for economics, productivity and accumulation.
No other culture had this distinctive opposition of life and death in the interests of life as positivity: life as accumulation, death as due payment.
No other culture had this impasse: as soon as the ambivalence of life and death and the symbolic reversibility of death comes to an end, we enter into a process of accumulation of life as value; but by the same token, we also enter the field of the equivalent production of death. So life-become-value is constantly perverted by the equivalent death. Death, at the same instant, becomes the object of a perverse desire. Desire invests the very separation
of life and death."
I'm not afraid of dying, I'm honestly planning on intentional death if specific conditions are met, (dementia or "locked in"). I have DNR on my medical necklace next to my conditions because if they bother to slow down enough to check, im probably in a situation where that fate is worse than death.
I am terrified of not finishing my todo list. I have things i want to make and changes to effect on the universe before i am ok with leaving it.
I take a very utilitarian and brutal view of the future, and inevitable fates don't merit my fear, only my planning. However, I don't think the world would be better should my point of view be universal. I evangelize it only to those I think could benefit.
I am more terrified of getting old. I don't have much on my to-do list and every year feels like I get weaker and more things become impossible forever
I have multiple medical issues that all have the effect of "you will go downhill fast in your 60s". I'm actually optimizing my health choices for QoL now over long term survival. Lots of more intense medications have side effects that get felt at point (high dosage Prednisone makes you go blind early, my most likely flavor of chemo makes you go deaf similarly)
Decide now on what QoL isn't acceptable to you and plan accordingly. The idea you have to wait around forever to die is a strong cultural belief, but you get to pick how you live your life. That includes how and when it ends.
It's pretty easy to ensure that everybody around you is miserable and that nearly all of your outcomes are terrible. However, the opposite is unfortunately not possible: you can't make everything great just by being positive.
Therefore, it is best to be pragmatically positive. Recognize that positivity gives you the best chance to succeed... while recognizing its limitations.
When you cross that line, that's when it becomes "delusion and denial."
I've found there's a dark connection between the positive thinking movement and multilevel marketing. Virtually all of the "teachers" mentioned in The Secret, for instance, serve on the MLM motivational-speaking circuit, and those who don't have side scams of their own.
Motivational speaking as a thing fizzled out except among MLMs, as people realized that the only honest motivational speaker was Chris Farley's character Matt Foley, and the motivational message did not result in the expected productivity gains among legit companies. But for keeping suckers in a pyramid scheme they are effective, because those people have already proven willing to delude themselves into believing in something that won't materialize.
Damn, I have a hard time reading articles like this since it feeds into my health anxiety I have developed over the years after having many issues with my bowels.
I have several issues due to this, reflux being one and I am afraid of getting a diagnosis like this man. Somehow, by reading about it, I can catch myself almost convincing me that I must have something else badly going on even if it is just the same old problems that I have had ever since the symtoms first started appearing.
I sincerely hope that he survives his disease and that researches can develop vaccines against cancer.
Your writing is yet another confirmation for my tentative (yet ca. 20 years old) life phylosophy about that we should seek balance in everything (means: most of things, because the other one is about no absolutes) and the extremes are the devil. Extreme happyness and goodness too. That's actually a blatant - or clulessly idiotic - lie, not good or happy.
Ironically your writing about having less positivity made me feel affirming and good. Sounds like my kind of thinking.
I'm reminded of a tweet by Elon Musk, which struck me as the ultimate in explicit, unapologetic reality denial: "Better to be optimistic and wrong, than pessimistic and right!" https://twitter.com/elonmusk/status/1633208268238757888
From your snippet I was wondering whether he was butchering the concept that pessimism is suffering twice (both in anticipation and when your pessimism is confirmed) whereas optimism is only suffering once.
But the context of Elon's tweet actually makes more sense than I was expecting from a tweet from Elon. If everyone's pessimistic about the future and doesn't even try then we'll never accomplish anything.
There's nuance to this topic - we shouldn't strip it out.
> If everyone's pessimistic about the future and doesn't even try then we'll never accomplish anything.
But if optimists are wrong and pessimists are right, then you won't accomplish anything.
> There's nuance to this topic - we shouldn't strip it out.
Musk was responding to and agreeing with a tweet, "The biggest problem in the West right now is many people no longer believe the future will be better than the past."
With regard to, say, global warming, I would say it's rationally undeniable the future will be worse than the past, and the biggest problem isn't a lack of optimism in the present but rather a lack of pessmism in the past. We've known about global warming for many many decades but have done almost nothing to stop it. And a luxury car brand hasn't even made a dent in the problem, a much bigger problem than one person can solve, no matter how wealthy, and it certainly doesn't help that this one person is using any political influence he might have to support people who are in denial of climate change.
One might also wonder, by the way, whether the optimism-fueled and rocket-fueled pollution of the upper atmosphere in pursuit of "Mars" is offsetting any small environmental benefit of the luxury car brand. There are consequences of "trying" things. Oh, and the optimist also wants to try increasing the Earth's human population. More "consciousness". (Not to mention more consumption.)
I think your issue is that you are just a pessimist and aren't able to, or don't want to understand the optimist's viewpoint.
> With regard to, say, global warming, I would say it's rationally undeniable the future will be worse than the past, and the biggest problem isn't a lack of optimism in the present but rather a lack of pessmism in the past.
Life is primarily about problem-solving.
From a quantified perspective, the world is improving over time. There is less suffering now than in the past. This progress is driven by optimists who put in the effort to make the world better.
We constantly face problems to solve, both on a personal and global scale. Even as the world improves, there will always be significant challenges to address.
Despite your passive-aggressive swipes at Elon, he has done much more than you or I for the betterment of the planets. He's made EVs and renewable energy mainstream.
> We've known about global warming for many many decades but have done almost nothing to stop it.
What are you talking about? The world has done a lot to combat global warming. Just a few things:
- Paris Agreement
- Kyoto Protocol
- Significant investments in wind, solar, and hydro-electric.
- Drastically improved energy efficiency standards and regulations for buildings, vehicles, appliances, and industrial.
- Increased focus on large-scale reforestation and conservation.
- Development of carbon capture technologies.
- EV advances
- Public awareness programs and grassroots movements.
- Carbon and energy taxes
PS: I assume you are "lapcatsoftware" Jeff? Because your pessimism is so signature? I encourage you to try and look at the bright side of things, if only for your own benefit.
> From a quantified perspective, the world is improving over time. There is less suffering now than in the past.
How are you quantifying that exactly?
> This progress is driven by optimists
Citation needed.
> What are you talking about? The world has done a lot to combat global warming. Just a few things:
> - Paris Agreement
> - Kyoto Protocol
Mostly fluff for politicians to preen.
> - Significant investments in wind, solar, and hydro-electric.
"Significant" is questionable.
> - Increased focus on large-scale reforestation and conservation.
"focus" is not action.
> - Public awareness programs and grassroots movements.
"awareness" is not action. We've already been aware.
You've listed mostly minor steps.
If the world has done a lot, then why have we failed to stop global warming? Why are we continuing to blow through the temperature thresholds that scientists warned about?
Putting band aids on problems may be optimistic, but such optimisim is not a solution to problems.
> PS: I assume you are "lapcatsoftware" Jeff? Because your pessimism is so signature? I encourage you to try and look at the bright side of things, if only for your own benefit.
This kind of personal comment is totally out of line here. You've never met me and know absolutely nothing about me. Moreover, I have zero interest in or use for unsolicited, oversimplistic advice from random anonymous internet commenters.
I'd answer your questions and cite stuff like World Bank, WHO, UNICEF and UNESCO reports and findings, but I do "know" you from formerly following your writings to the extent that I know it would do no good.
FWIW, I do have no ill will towards you, I still pay (and will continue to, on its merit) for your excellent software, and wish you the best, whether you choose to believe it or not.
> I'd answer your questions and cite stuff like World Bank, WHO, UNICEF and UNESCO reports and findings
Are you referring to suffering? I wasn't so much disputing your claim as suggesting that it was far too vague to make an intelligent comment either way. Surely, though, you must admit that some things sometimes get worse? That our earthly existence is not a magical uniform stairway to heaven but rather, to use a different analogy, like a series of peaks and valleys, punctuated by the occasional pieces of rock falling from the sky?
> FWIW, I do have no ill will towards you, I still pay (and will continue to, on its merit) for your excellent software, and wish you the best, whether you choose to believe it or not.
I believe that you wish me the best. I have no objection to that. However, I don't believe that you know what's best for me, and in general I strongly object to unsolicited advice, especially from strangers. It should also be noted that my online writing is just one small portion of myself.
Being pessimistic is not the same thing as not trying. On the contrary, if you want to make the future better, focusing on what looks to be going wrong is often the best place to spend your effort.
The optimists in this context are people who don't believe in problems like climate change or the fall of democracy, and therefore do nothing to prevent them. Their optimism is what will destroy society.
> If everyone's pessimistic about the future and doesn't even try then we'll never accomplish anything.
Historically people can and do rise to the occasion in face of impending tragedies (eg wars, famines, genocide) and try to mitigate and cope with the disaster. Sometimes more, sometimes less, but generally a bad outlook is not enough to render people passive.
You have clearly misunderstood the concept. It's not reality denial in that case, it's a call to try things. Just sitting around all doom and gloom will create exactly zero new science and technology. You have to try shit, even if the odds are bad.
> It's not reality denial in that case, it's a call to try things.
But he didn't just say "try things, even if the odds are bad". That would be unremarkable, though also bad advice in general, like a lottery winner telling everyone to buy lottery tickets. I feel that you're in denial of the reality of what he said, which explicitly mentions being right or wrong, not just trying things.
I would say that it's better to know the truth in any case, whether the truth happens to be pleasant or unpleasant.
He started a car company when everyone said it was impossible.
He started a rocket company when everyone said it was super hard.
He made that rocket company land the first stages, when everyone thought it was impossible.
He's an ass, but you can't argue with the results. Twisting some of his words out of context might feel good because you can bash on the outgroup, but it also makes you look silly and makes your group (MY GROUP!) look bad. Please stop.
> He's an ass, but you can't argue with the results.
I wasn't. None of your reply is even relevant to mine.
I'm just opposed to the idea pushed by the "positivity cult" that one's personal attitude is more important than the truth, and it's better to be wrong than right if wrongness comes with optimism.
I actually suspect that Musk is not consistent in his stated views, and he doesn't allow his subordinate engineers to be consistently wrong but overly optimistic. At least I hope not.
You seem to want to talk about his accomplishments. But wouldn't that make him optimistic and right? The tweet, on the other hand, is talking about being optimistic and wrong. You have clearly misunderstood the concept... Perhaps you're under the misapprehension that what he does outside of social media justifies the stuff he says on social media? That isn't true.
Incidentally, "everyone said"/"everyone thought" is almost always an exaggeration/falsehood.
> I actually suspect that Musk is not consistent in his stated views, and he doesn't allow his subordinate engineers to be consistently wrong but overly optimistic. At least I hope not.
Yea, context is everything. You should watch the interview he did with Everyday Astronaut where the interviewer made him redesign Starship with a question. There are tons of good lessons and self reflection in there.
edit: the assorted "you are misinterpreting them they just mean hello" responses are fundamentally missing the point of this comment. This is an implicit part of the "positivity culture" being discussed here. We have an entire ritual where you have to lie about things being fine.
One thing i hate about our culture right now is the casual "How are you doing?" in service jobs.
"Well, this week i found out i have testicular cancer and my doctor can't seem to get insurance approval for my Crohn's medication" are the things top in my mind.
They are just being friendly in the superficial way. Having talked with folks, they really do mean it and they care, but they are also entirely unequipped for the real answers. The truth would offer me no satisfaction but the cruel catharsis of sharing my pain and they would only be hurt for it.
Lying like this is really hard for me, these people don't deserve infantalized lies, so i have settled on "Horrible, but I'm having fun anyway!" with what is probably a manic smile, it reduces the damage to "mildly unsettled".
Its ok to admit that your role in somebody's life is ephemeral and to act like it. "Good luck" or "I hope you have a good day" go so much further than the superficial simulation of intimacy and connection of asking how somebody's life is going while not expecting a real answer.
This sounds like you are using rules for one language game in the context of another. Let's say a cashier asks you "how are you?" then it is just a phrase. The purpose of the phrase is to acknowledge your existence and open the transaction. That's one kind of language game. You are not lying when you say "fine" here, you are playing the game.
If your doctor asks you "how are you?" it's another language game with different expectations. If your mum asks you "how are you?" it is yet another language game with a different context and so on.
I guess, this is just a roundabout way of saying the meaning of words, phrases, sentences change by context, even if they seem 100% identical, and the context determines a great deal what is an acceptable, ie. understandable, answer here. Get context savvy and save yourself and the others confusion and hurt.
Except that when you're dealing with grief or another type of extreme stress, that whole sense of light-hearted context dependent word play goes out the window. The patterned responses are no longer appropriate, and falling back on literal interpretation is the only thing you have in you.
GP, I feel you. Personally I often just said/say "okay" or "alright", which decidedly means not okay in the cultural context, but I don't particularly care about ruffling feathers.
It’s a cultural custom, most likely you are talking about North America. Other places might not have the same custom but will have others that may seem odd or fake to us.
If I’m not having a particularly good time I just respond “I’m alright” and people take the cue.
Its hard for me, maybe too much of the 'tism to be able to not take people literally. All of the people i have actually talked to about it don't actually feel like it is "just a custom", they aren't operating at that level of abstraction. They think they mean it, or at least lie about it afterwards. It seems fundamental dismissive to their intent to blatantly lie.
I suspect i would have similar issues in other places as you describe them.
I'm from Midwest America and do this. I think what makes it weird is that it straddles the border between sincere and insincere. What I really mean is something like, "Hello fellow human, fare thee well!" <Tip of my hat> I actually do wish well for you as a fellow human being, but I also know that we aren't acquainted and so it would be inappropriate to be overly familiar. It's meant to strike that balance, but it's often taken to be all the way to one side of the spectrum or the other (fake or expecting an intimate, detailed response).
I've felt this to the point that I attempt to preempt the fake concern with my own rhetorical "Hope everything is going well for you." I'd like to think this alleviates the other party from feeling like they have to share anything they aren't comfortable with but allows them room to respond if they choose.
I've started treating "How are you?" or "How's it going?" as a greeting in that context, and just responding with another greeting, like, "Hi! Lovely weather we're having!" or something similarly irrelevant and disengaged.
People probably assume I didn't hear them or something, but not once has anyone reiterated the question.
My personal path was first learning to lie about it - then later on understanding that nobody was lying about it per se, but they might appreciate the offer of concern without actually wanting to take advantage of it. Or they might just not want to confide in a casual acquaintance.
I think the tricky and important part is actually navigating levels of intimacy, e.g. by phrasing questions in a way that doesn't ask to cross too many boundaries all at once. Conversation is like a dance, it goes better when everyone is giving and taking feedback on where it goes. In this sense "how are you" is just an invitation to dance. Don't be surprised when most people don't want to start dancing to a mournful tune!
I told the doc I thought the grief I was feeling only six weeks after a sudden and devastating loss was entirely appropriate, and that suppressing it seemed like it would make things worse, not better, but I'd let her know if things changed.
When it had been a year and I was still struggling to function (granted that year had been full of other awful things), I finally did ask for help with an antidepressant, which did provide the boost I needed to start exercising agency in my life again, so it's not like it was altogether the wrong suggestion. It was just much, much too early.
I found that the real friends in that situation were the ones who didn't need me to be someone else or somewhere else (emotionally) to love me.