50 Comments

Does anyone know a good psychologist who could help me get through my issues? I suffer from long-term sexual abstinence. I am looking for the following qualifications: female, 18-25, preferably blond

Expand full comment
Jul 20, 2023Liked by Emil O. W. Kirkegaard

Randolph Nesse also has a book on evolutionary psychiatry btw

https://www.amazon.com/Good-Reasons-Bad-Feelings-Evolutionary/dp/1101985666

Expand full comment

He’s a great guy

Expand full comment

The main issue with this approach is that it's both not clear where you would draw the line, that is it might be tempting to say that virtually all people in WEIRD societies are disordered, due to clearly not trying very hard to optimise in favour of lineage success and often optimising against it. And secondly that when assessing fitness, the wider context matters, that is features of human biology and psychology that are currently not adaptive, might have been within the context of our EEA and its not clear whether it makes sense to call such features disorders, relatedly the most plausible explanation for fertility decline I have heard of is Hansonian status drunkenness, which is a pretty good example of a previously useful set of heuristics going wrong.

"age of partner: for men, fertile females (roughly 15-45), for women, 15+. Strong preferences for outside of these ranges would be disordered" Fecundity is strikingly non uniform across the stated age range, also given a slow life history strategy, low time preference etc. and long term mating pairs, Fisher's reproductive value dwarfs fecundity in evolutionary importance.

Expand full comment

There is a normative dimension to illness that is ineradicable. Thus, we say a broken bone is broken since we have a view of how bones should function. In this regard, there is no distinction at all between mental and physical illness. But this is why the debate is so fraught: to define illness is to define what is normal, and to define norms is to control society.

Expand full comment

Interesting. But norms are not merely arbitrary; it seems as though Nature may select norms over time. Further, it might be possible to ground norms in objective criteria, if we were able to establish the objective reality of morality in a way that placed normative reasoning on a similar footing to, say, mathematics.

Expand full comment

Norms may begin as arbitrary, but the doctrine of absolute chance and evolution, and the strictures of logic which police the boundaries of the possible, and, at last, tradition and reliance interests, will tend to channelize and concentrate the norms that remain norms, and not whims, over time. That's my point.

Expand full comment
Jul 20, 2023·edited Jul 20, 2023Liked by Emil O. W. Kirkegaard

1- I guess this suggesting there is negative correlation between fertility and mental illness. For example we should expext that prevelance of mental disorders are low among sub-saharan people.

2- Ironically it seems users of r/natalism suffering from adhd

60.57 adhdmeme

15.71 adhd

https://subredditstats.com/subreddit-user-overlaps/natalism

Expand full comment
author

Yeah, this approach is not perfect. ADHD does have consistent positive relationships with fertility, so it's certainly adaptive (under positive selection) in the modern welfare environment, but probably wasn't so historically under Malthusian conditions. In this framework, it's unclear how to deal with things that were adaptive, but are no longer, and vice verse. That's what I meant when I talked about this just being a rough outline of this perspective, not a complete model.

Expand full comment

If it's no longer adaptive due to being in a new environment it's just fitness reducing mismatch, but not dysfunctional. I feel like a lot of time could be saved if Emil / Bryan / Scott just actually looked at the work by philosophers of biology on this question, who have made much more headway over several decades. Insofar as you're aiming for an objective, value-free definition, I think you're really trying to get at a selected effects account of dysfunction. The question isn't 'does this trait reduce fitness now' but 'is this trait operating in the way it was selected for'. If yes, it isn't dysfunctional. What counts as dysfunctional needs to be distinguished from cases of mismatch, infection, and tradeoffs. If biologists feel they can fulfill all of their scientific aims by just talking about dysfunction rather than disorder, then once we begin being interested in disorder, arguably we've already granted that non-scientific considerations are relevant, and Scott's considerations will come back into play. I'd propose that disorders are dysfunctions that directly negatively affect the agent, and perhaps mismatches that negatively affect them which we find infeasible to remedy (e.g. white skin in central latitudes isn't disordered because you can just stay in shade or wear sun screen).

A starting point: https://www.journals.uchicago.edu/doi/full/10.1093/bjps/axw021#_i11

Expand full comment

Note that r/natalism is 1/100th the size of r/antinatalism, and one of its biggest overlaps is in fact r/antinatalism (by a factor of 160)

Expand full comment

The DSM is not political, and it's not so psychiatrists can stigmatize people they don't like. It's economic. In the United States, health insurance will only pay for treatment of illness and injury. If something isn't recognized as an illness or injury, health insurance won't pay. Therefore, psychiatrists and Pharma companies that sell psychiatric medications lobby long and hard to get any and every possible mental condition into the DSM as a "mental illness", for profit. That explains why everyone and their uncle is taking amphetamines in 2023, just as they did in 1963, because the psychiatry and pharma lobby were successful in convincing people that ADHD is a common mental illness, with the loosest conceivable diagnostic criteria, and occurs in adults as well as children.

Expand full comment
Jul 22, 2023·edited Jul 22, 2023

I agree with a lot of this, but from a medical point of view, you can’t just point out a set of behaviors and say ”this is a disease.” Diseases are meant to be distinct conditions, with causes and stages of development (etiologies and pathophysiologies). The weakness of psychiatry is that often they struggle to define their diseases as anything besides collections of symptoms. (That doesn’t make Caplan’s critique legitimate though.)

Homosexual sex may be pointless (although this is unclear) and maladaptive, but so is a lot of stuff that people do. Like riding horses for fun or downhill skiing.

People live in cultures and societies, and it is difficult to interpret their behavior in terms of some kind of individual fitness. Someone might be driven to become a monk by mental disorder, but you can’t say becoming a monk itself is a disease especially in a society where that is considered an acceptable choice. (You could say it is a societal disease, if you want (although you would have to prove monks are bad for society as a whole), but that isn’t medicine anymore, and really it is just a metaphor.)

Personally I think the primary problem with Caplan is that he is just playing a game with words. He is taking a certain definition of the word ”preference” from a theory in economics and inappropriately bringing it over to psychology in general and then he thinks he has ”discovered” something about psychology.

Expand full comment

If riding horses for fun or downhill skiing were as evolutionarily maladaptive as exclusive homosexuality, then they absolutely would be considered mental illnesses by every normal person. Equating these with exclusive homosexuality is incredibly dishonest. If virtually none of group X had children, then normal people would consider them diseased/screwed up in some way.

Expand full comment

They would not be considered illnesses by me , since the element of not wanting them, the element of victimhood, and the element of treatment are all.missing.

Expand full comment
Aug 8, 2023·edited Aug 8, 2023

I wasn’t equating them with anything, I was exaggerating to make a point, which is that one needs more than the idea that a behavior is maladaptive to call it a mental illness or the symptom of a mental illness. Not only does this misunderstand what an illness/disease is supposed to be, but it requires one to claim that all kinds of behaviors indicate mental illness.

In a society where fertility is low, suddenly nearly everyone is mentally ill. Men who think having a child would be inconvenient are probably a larger group than exclusive homosexuals, but it is really hard to argue they are ”mentally ill” In the DSM sense.

Expand full comment

I don't think Scott really disagrees with any of this. Apart from utility of officially specifying homosexuality as an disorder maybe.

Expand full comment

I think this part is the weakest in the text:

"The more broad category of diseases is disorders, which as the word suggests, is some kind of deviation from order, or how the body is supposed to work. Supposed here meaning that the body works in the way evolution designed it to solve the problems it faces."

As you said previously, evolution is dumb, it doesn't design anything with any particular goal. Any function or design is a post-hoc rationalization. Sure, it makes intuitive sense that the heart's function is to pump, but evolution itself is not a safe vantage point for establishing what these functions are. Deciding these functions — deciding what the norms are — remains essential, and this text doesn't make a strong case that evolution is enough to guide this decision.

Expand full comment

Some species have been around in the same habitat for millions of years and have hardly changed for much of that because they are already basically perfectly adapted. Under such conditions, you can substantially equate evolutionary pressures with purpose. With humans, though, our environment has changed over and over again, and, each time, evolution starts re-optimising us, but precisely that re-optimisation leads humans to change their environment, introducing a whole new set of pressures. Under such circumstances, it becomes impossible to equate evolutionary pressures with purpose. Are we adapted for the neolithic? the bronze age? the iron age? feudalism? capitalism?

The answer is, to some extent, all of them, but also none of them. And it's worse than that because human societies are internally complex. Is it adaptive to be be highly aggressive? Well, if you're a soldier, probably yes, if a tenant farmer, probably not. Measured by effect on fertility, high aggression was once (usually) adaptive, then it became (usually) unadaptive, and now its seems to be becoming more adaptive again. It's hard enough, with humans, to say what the appendix or wisdom teeth are 'for', let alone different instincts in the brain.

Expand full comment

Heck, I seem to remember an old Scott post where he admitted that various mental illnesses correlated with each other, and that this can be used to tell whether something is a real mental illness. He also admitted being trans correlated with mental illness, but stopped short of drawing the obvious conclusion.

Expand full comment

Do you have a link, or remember anything else about the post that would help me locate it using a search engine?

Expand full comment

Unfortunately, not of the top of my head.

Expand full comment

“One might even speculate that women evolved to provide non-vaginal sex for situations where they do not want pregnancy to occur but still want to acquire some other benefit from a man, or to build towards future partnership.”

Or when she is already pregnant and wants to keep her mate around. (Or to signal that she will be willing to do this when the time comes.)

“Family members: healthy = non-close family members, close family members = disordered”

Given outbreeding depression, might we make healthy relatedness an Aristotelian mean like age, where extreme close relation is very disordered, like extreme youth (under 15), and extreme distant relation is somewhat disordered, like extreme age (over 45)?

Expand full comment

What evidence is there of outbreeding depression in human beings?

Expand full comment

Great piece !

Expand full comment

This was a long and complex way to say “physiognomy is real.”

Expand full comment

I would have put neuroscience in between biology and psychology. As it is that seems like a much larger jump in abstraction than the others.

Expand full comment

Why should something be.regarded as a disorder in the medical sense, if the "sufferer" doesn't want treatment , and the psychiatrist has nothing effective to offer anyway? It's not enough to say that an evolutionary maladaptation is automatically a disorder.

Expand full comment

Disorders and low fertility aren’t the same thing, and it isn’t enough to use fertility decrements or relationships with other disorders to show a trait is disordered.

I don't mean to imply that this isn't an interesting perspective, or that this wasn't a worthwhile post, Emil. However, reasoning like this implies conclusions I strongly doubt you endorse: https://thingstoread.substack.com/p/disorder-is-not-merely-depressed

Expand full comment