Flow 🧘⛩️👁️

This is the most annoying part of consciousness debates for me. The constant interchanging use of 'consciousness' to mean either the substrate or the presence of phenomenal qualia (of course there are more definitions as well). There needs to be at least two clearly defined terms and a lot of mindfulness when one is slipping into the other definition. So many conversations I have with people they don't seem to realised when they've strayed, or they can't even understand the difference. My preference would be don't call the substrate 'consciousness', find another word.

Question for psychiatrists. Where in the depression treatment algorithm would you place psychedelics? Is this kind of like cannabis being roughly the 86th best treatment for glaucoma? It has a very mild effect but you would never actually prescribe it because there are so many better options. This is an honest question.

The truth about therapy therapists need to learn how to weather storms of negative feeling coming directly at them from miserable people, how to keep their self-esteem when being relentlessly devalued, how to recognize and deal with the grain of truth in patients’ complaints about them, how to handle their traumatic internal responses to searing accounts of trauma, how to bear ugly and personally alien feelings in themselves, how to tolerate uncertainty, how to set boundaries with people who feel wounded by reasonable limits, how to maintain an unnatural level of secret keeping, how to find hope when clients fill the office with their despair, how to manage anxieties that a patient may die by suicide, and other emotionally taxing lessons. -Nancy McWilliams

A special shout-out, not to joy but rather the specific feeling of getting your joy back after it had been lost. The greatest feeling in the world

the more I meditate the more baseline goes up and the body is sensitive to random things. putting headphones on within 2hrs of showering creates some moisture in ear which hurts, every food leads to a diff feeling later, dozens of things like this, but also things are great

Depression occurs at moments of identity dissolution. The issue is that we've taken the thing where you outgrow your old self and don't yet have a new one, and we've labeled it as purely a disorder to be treated, rather than also a transition to be navigated.

Here I'm going to explain the problem with treatment approaches that in some form endorse the idea that thoughts are meaningless or should be ignored (CBT, ACT, ERP). Let's say a patient has a thought of stabbing their newborn baby. It terrifies or disgusts them. They fear that this thought means they're going to actually harm their child, or they're going crazy and need to be locked up, or just that they're in fact a very bad person. We call it an "intrusive" thought because that's how it's experienced. Something "not me" is attacking "me". But where else could this thought be coming from except from "me"? But the patient doesn't really want to hurt their baby, so this thought is nonsensical and therefore meaningless, right? Or at least just ignore it, right? This is what CBT, ACT, and ERP tell us. And at first glance, this seems like a good way to think about it. In fact, some people are able to take a degree of comfort from the idea their thoughts are meaningless and they sometimes find their symptoms do lessen a bit: "Oh good, I'm actually not a bad or dangerous person." So what's so bad about this? If it helps, it helps, right? The problem is that the patient does continue to suffer in some form. Maybe the symptoms persist at a mild or moderate level. Maybe they come back later. Maybe they have intrusive thoughts about other things. Maybe they become depressed. Etc etc etc. Why do they continue to suffer? Because the thoughts actually do have meaning. Just because a thought isn't literally true, doesn't mean it's not symbolically true. Or carrying meaning in some form. Intrusive thoughts are parts of ourselves that we can't integrate into our conscious understanding of ourself, but it's still us and it comes back to haunt us in symbolic form and will continue to do so until we integrate it. So what could thoughts of harming a newborn baby mean? Here's a patient who maybe can't tolerate their own aggressive feelings towards people they also love. So no matter how much we present evidence that they'll not physically harm their child, this completely misses the mark of the true source of their suffering. We can't just treat the fever and ignore the underlying infection.

You have to name him the last thing you ate