Say Something

One more thing about Ferguson:

Please, please, please, to all of my followers, if nothing else, talk about this. It doesn’t matter if you don’t have anything new to add. It doesn’t matter if you can’t add some unique, insightful angle. Just talk about it. Say that it’s unacceptable. Write that it’s unacceptable. That it’s horrendous.

Maybe you can’t join protests, and maybe you can’t afford to donate, and that is okay. But the least any of us can do is to talk about this. The least we can do is to add our voices, however small or large they may be, to the rest of the voices speaking out against this. The least we can do is to say, out loud, that this is happening, that it’s appalling, and that it has to change.

Doing that matters. Every single person doing that matters.

Say something.

There Will Be No Charges Against Darren Wilson

America doesn’t care about terrorism.

This is terrorism. This is innocent people getting killed for no reason. This is innocent people getting killed and the group that did it lying about the facts of what happened over and over and over and over and over. This is innocent people getting killed and protestors getting tear-gassed and fired upon with rubber bullets when they object to that killing. Innocent people getting killed for no reason and no one going to trial, and the perpetrator making hundreds of thousands of dollars off of the killing.

If the cops in Ferguson really thought they were doing the right thing, they wouldn’t have done everything they could to keep the media from recording what they were doing during the protests, up to and including firing on journalists. They wouldn’t have stopped wearing name tags. They wouldn’t have lied. Repeatedly. About what happened.

We are perfectly fine with terrorism as long as it’s against black people. Perfectly fine with it. So fine with it that if you kill a black kid you don’t even have to go to trial.

All it takes for us to look the other way when terrorism happens is for the terrorists to be wearing badges and uniforms.

Think about that.

Think about that and fucking do something.

http://whoismyrepresentative.com/

https://www.indiegogo.com/projects/ferguson-defense-fund/x/4963453

Reconceptualizing the Placebo Effect

Disclaimer: I read about pain research regularly, but I’m not a doctor/medical professional, and there’s always the chance I’m talking out my own ass. So while perhaps it would be advisable to take the following somewhat with a grain of salt, I will endeavor to make it as accurate and interesting a grain of salt as I am able.

I had a conversation with a friend a while ago about pain. I was talking about the idea that your brain can create pain independent of any actual physical damage to your body. You can hook a person up to a device and tell them it will be, say, running a current through them that is proportionate to how far a dial is turned, and they will report a pain experience proportionate to how far the dial is turned, even when the device does not actually do anything.

Her response to this was, “Oh, yeah, the placebo effect!”

This threw me, because she was absolutely right, but I hadn’t thought about that phenomenon in terms of the the placebo effect in quite some time.

When I think about the placebo effect, I think of it the same way that I think about a computer bug. It’s a mistake, a glitch, an error in the way the system was written. It’s as though the system works in a particular way – that is, it is designed to produce pain in response to physical damage – and the placebo effect is the phenomenon where every now and then the system gets fucked up and overwritten by what we think is actually happening.

That way of thinking about the placebo effect is wrong. It took having this conversation for me to realize that. The placebo effect isn’t a bug in the sense that I was thinking about it. For the most part, it’s a feature. The placebo effect happens as a result of the fact that your brain always, without exception, takes context into account when making a decision about whether or not to create an experience of pain. The fact that it sometimes gets this wrong isn’t because of some random glitch in the system, it’s an inescapable byproduct of how the system fundamentally works. In some sense, every physical experience you have is the placebo effect.

What I mean by that is that every physical experience you have is modulated by context that has nothing to do with what is actually happening to you physically, and everything to do with the associations you have with what is happening to you physically, with contextual cues, et cetera. That isn’t a separate phenomenon, it isn’t something that happens sometimes, it is a basic, core part of how every physical sensation happens (or doesn’t).

Fun example fact: if you prick the finger of a dancer and then of a violinist, there’s a pretty good chance the same prick will hurt more for the violinist. Their finger is more important to their wellbeing, and so the context of the prick is that it represents a greater threat to the violinist, and thus there is a greater impulse to avoid it, and thus the brain will create a correspondingly greater experience of pain¹.

It’s time again to review Lorimer Moseley’s snake bite story^2,3, because it’s such a perfect illustration of this idea:

Lorimer was hiking with some friends one day and felt a mild twinge on his leg, thought nothing of it, and ended up in a hospital having been bitten by an incredibly poisonous snake. One of the effects of snake venom is that it locks nociceptors into an activated position, so the amount of danger signals sent to the brain would have been massive, and yet when those signals got to the brain, the brain had no historical context to indicate such signals were dangerous, and so did not create a correspondingly massive pain experience. In fact, it created almost no sensory experience at all. As a result, Lorimer nearly died. About six months later, however, Lorimer was hiking again and experienced a sudden, massive pain on his leg in the same place as before, and very nearly ended up taking a trip to the hospital until one of his friends took a glance at the leg and discovered that it was only a tiny scratch from a twig.

In both of those cases, the system failed. When the trigger was a snake bite, the brain did not produce a sensory experience that felt anything like a snake bite. Later, when the trigger was only a twig, the brain interpreted it, mistakenly, as incredibly dangerous, presumably because it then had the context of the near-fatal snakebite informing the sensory interpretation.

So why does this matter? It matters because this model makes it possible to better understand what’s going on with the placebo effect and how the phenomenon of pain being modulated by context can be applied to solving pain problems.

In Lorimer’s story, we have an illustration of both sides of the coin: not having an experience of pain when it would have made more sense to have one, and having an experience of pain when it would have made more sense not to.

Here’s one of the ways I apply this model of thinking: what does it mean when someone says acupuncture cured their chronic pain, given that we know acupuncture performs no better than sham acupuncture in studies⁴?

The interesting thing to note here is that both the pain and the cessation of pain could have nothing to do with damage to the body. I.e. it is possible to experience chronic pain that is not a result of physical damage, and it is also possible to stop experiencing pain regardless of whether or not any physical damage has actually been fixed. All that needs to change is what your brain thinks of what is going on.

So what happens if your brain thought something was wrong when nothing actually was, and then for whatever complex, chaotic, emergent reasons thought that acupuncture had fixed it?

Well, acupuncture would have, quite literally, cured your pain.

I want to be very clear here that this does not mean I’m advocating acupuncture as a treatment. Given the right context, just about any experience you could imagine, if it hits your brain at just the right time and angle, has some chance of convincing your brain everything is fine. The fact that acupuncture may possibly do this does not meaningfully distinguish it from homeopathy, prayer, or exorcism.

But I do think it’s an idea worth thinking about. Anything that changes the context in which your brain processes physical experiences has the potential to change the nature of those experiences, e.g. to make things hurt or not hurt. Anything at all. Because our brains are generally very good at evaluating context effectively, we don’t notice how powerful this influence is, but it’s always there and it has significant implications for thinking about pain and the placebo effect⁵.

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¹ Explain Pain (2013)

² Video of him telling the story

³ Original post where I wrote this summary of the story

⁴  Though both sham acupuncture and regular acupuncture to slightly outperform nothing at all, which has led to some fascinating hypotheses about why that may be the case.

⁵ A good example of these implications are some of the studies that have shown that educating pain patients about pain actually reduces their experiences of pain.

Adulting

I’ve been contemplating a cross-country move lately, mostly due to finances being tight. It’s a big decision, and I’m not 100% decided on it yet, but over the past week or so I’ve been leaning heavily in the direction of making the move. Today and yesterday, though, I started leaning a bit the other way again.

I’m still not sure what I’m going to decide, but I realized something this morning: thinking about changing my mind again to staying here didn’t feel like that big a deal. Neither does the idea of doing a move.

I mean, it will be a lot of work. But I know I can do it because I’ve done it a few times before and I’m not particularly worried about it.

“You never get to the point where you think “I am the adult”, but you do get to the point where you think “I’ve dealt with this before.” The older you get, the higher and higher the percentage is of things you’ve already been through. Have you ever changed a tire? Had a flat tire? Someday, you might, and the next time it happens, you’ll know what to do, since you’ve already done it.”

– Tumblr Post

It feels like a personal growth moment.

Disambiguating Trust

I’ve been having a recurring thought lately about the idea of trusting people.

More specifically, I’ve been thinking about the idea of asking “Do you trust this person?”. It’s a very simple question and the more I think about it an incredibly oversimplistic one.

In my experience, asking whether or not you trust someone is generally about whether or not you trust their intentions. The answer to that question is yes if they want good things for you and generally try to do right by you. The thing is, in an enormous number of situations knowing that isn’t enough.

The set of people whom I trust to have good intentions toward me is much larger than the set of people I would trust with confidential information about me, for example. It’s not just about trusting intentions, it’s about trusting abilities as well.

For example, if a company I’m applying to asks me to fill out a form and email it back to them, and that form includes personally identifying information such as my Social Security number, address, date of birth, etc., I may be able to trust that they don’t intend to give my information to anyone else, but I can’t trust that they have any idea what precautions are important to prevent anyone else from getting it. Asking someone to send that kind of information over email is a dead giveaway that you have no idea which forms of communication are reliably secure and which aren’t. It means I can’t trust you with my personal information even if I can trust your intentions.

I find that in many situations “What can I trust this person about?” is a better question than “Can I trust this person?”. The set of people I know who I am comfortable discussing my gender with, for example, is much smaller than the set of people who I think would be okay with and supportive of it in a general way. Positive intentions are great, but they are not the only thing I need to trust someone with that information. I also need to trust people to judge accurately who I would be comfortable having that information shared with and who I wouldn’t. I need to be able to trust them to understand it well enough that I wouldn’t have to spend long conversations with them dealing with microaggressions.

I made a post last year about a situation that is another good example of this principle (paraphrased somewhat for conciseness):

A friend of mine volunteered to have every-other-weekly get-togethers to offer support. I, however, was apprehensive that by needing that support that often, I was going to be too heavy a friend.

When I expressed that fear, she responded by telling me that this wasn’t something she had decided to do blindly. She had considered, in making the offer, that the worst-case scenario was that it would consist of nothing but giving me support every single time we did it. She had considered that, and decided that doing that every-other-weekly would be handleable for her.

I can’t think of a better example of what it means to be a mature adult than this. To be sufficiently aware of, first, the fact that that kind of worst-case-scenario assessment is important to make when offering this kind of support, and, second, to be sufficiently aware of how many spoons that commitment may cost you to make an accurate assessment of whether or not that worst-case scenario would be a manageable commitment to make.

It’s so much easier to trust someone who says they can offer you something when you feel like you can trust that person to know whether or not they are offering something that they are genuinely capable of following through on.

As mentioned in that post, this also speaks to the importance of being able to self-assess with respect to things like this. It was not, in the above situation, my trust in my friend’s good intentions toward me that made me trust them more after we had that conversation. My trust in their good intentions toward me was pretty much the same after as before. It was the trust I had that they would and could think about and accurately predict not just whether or not they wanted to help, but also whether or not they were capable of offering to help that they wanted to be able to offer.

One last example, because I think it fleshes out the point well: I trust different of my friends to have accurate knowledge about different things, and to be more or less skeptical about what they think they know. If a biologist friend of mine tells me “Did you hear they found the gene responsible for X disease?”, I assume that really happened whereas with another friend of mine, I might think it’s more likely they read some massively oversimplifying article in a magazine somewhere.

Trust is fiddly. Whether or not I trust someone is too simple a question to be very useful in many situations. Some people I trust in certain specific ways, and other people I trust in certain other specific ways. Some people I trust about different things in different degrees. So much of the time, the difference isn’t about trusting intentions, but trusting things like knowledge and capability. It’s not about whether I trust a person, it’s about what I trust them about.