The authorities will claim that psychiatric hospitals are for the benefit of the patients. I'll concede that this is possible in some cases: maybe some people have such dysfunctional home lives, or would otherwise be living on the streets, such that the psych ward is actually a better place for them.
-For most people of my social class, I don't think this is plausible; if the welfare of the crazy person were the primary criterion, almost everyone would be better off with their friends or family, in a familiar environment with people you know. Rather, psych wards make sense as being for the welfare of friends or family who are _sick of putting up with living with a crazy person_. It's a form of responsibility laundering: if there's a designated institution for taking care of crazy people, you can dump your loved ones there to be _someone else's problem_ (at least for a few days), with a clean conscience. Anything bad that happens inside of an institution, isn't anyone fault.
+For most people of my social class, I don't think this is plausible; if the welfare of the crazy person were the primary criterion, almost everyone would be better off with their friends or family, in a familiar environment with people you know.
+
+Rather, psych wards make sense as being for the welfare of friends or family who are _sick of putting up with living with a crazy person_. It's a form of responsibility laundering: if there's a designated institution for taking care of crazy people, you can dump your loved ones there to be _someone else's problem_ (at least for a few days), with a clean conscience, because anything bad that happens inside of an officially sanctioned institution, isn't anyone fault.
It's important not to be misled by the name, psychiatric "hospital". The word _hospital_ gives the impression of a place where medical procedures are performed, like how real hospitals do surgeries and set broken bones. We don't really have _procedures_ to treat mental illness—not ones that are held in high regard these days, anyway.
It's a jail—a place where you lock up undesirable people where they can't impose costs on anyone who isn't being paid to deal with them. And precisely _because_ I was modeling it as a jail, my social performance was a lot better this time around than in 2013.
+[TODO psych ward scenes—
+
+A nice thing about being a free citizen that you don't notice until you've lost it by being kidnapped and thrown in jail, is having a sense of where you are in the world. When visiting an unfamiliar place, I at least know _how_ I got there, how this place _connects_ to everything else in my model of the world: I may not be familiar with this building or these streets, but I know the train or highway that I took to get here from places that I do know—at worst, if I brought my phone, I can pull up Google Maps to see where I am.
+
+In psych jail, this sense of connection is suddenly absent. You don't know what route the ambulance took. You're locked in a building with strangers. There is no Google Maps. You could be anywhere.
+
+...
+
+
+Even things that are more-or-less genuinely intended to be for your benefit, are harder to recognize as such when you're _insane from sleep deprivation_ and rattled from just having been _kidnapped by armed men_.
+
+When being checked in, they confiscate any belongings you have on you. I remember one of the psych ward employees counting the money from my wallet in front of me.
+
+In retrospect, I can appreciate this practice as the system trying to offer evidence of its trustworthiness: they don't just steal your stuff; they _document_ the items they're confiscating, and give it back to you afterwards. (I have in my possession a yellow carbon copy of my "Patient Valuables Record", form A7026, which lists what they took.)
+
+At the time and in context, I wasn't prepared to appreciate it; the employee counting my bills in front of me seemed like an Orwellian ["There are five lights"](/2018/Aug/interlude-xii/) dominance display, intended to undermine my connection to reality—and maybe, I didn't trust that _she_ knew how to count.
+
+...
+
+
+When I tried to complain about the injustice of my confinement to staff, I was once told that I could call "patient's rights". I didn't bother. If the staff weren't going to listen, what was the designated complaint line going to do?
+
+About a year later, Scott Alexander published a _Slate Star Codex_ post, ["Navigating And/Or Avoiding The Inpatient Mental Health System"](https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/), which claimed that patient rights advocates _do_ advocate for patients in opposition to the rest of the system. ("Usually the doctors hate them, which I take as a pretty good sign that they are actually independent and do their job.")
+
+This was _not at all_ obvious from the inside. I'm reminded of an article I once read in the racist[^racist-magazine] magazine _American Renaissance_, [by a public defender complaining about the behavior of his predominantly black clients](https://archive.is/HUkzY):
+
+[^racist]: I think they would prefer that I say _racialist_? But I also think that, when pressed, they would concede that _you know what I mean_.
+
+> If you tell a black man that the evidence is very harmful to his case, he will blame _you_. "You ain't workin' fo' me." "It like you workin' with da State." Every public defender hears this. The more you try to explain the evidence to a black man, the angrier he gets.
+
+After my psych ward experiences, I deeply empathize with the clients here. In the defense attorney's worldview, he's working to protect his clients' interests, and is frustrated that they don't appreciate that. What the defense attorney doesn't see is that his work only benefits the clients from _within_ the terms set by a system of power that looks arbitrary and unjust to those on the other end of it. From the perspective of a client who doesn't think he did anything particularly wrong (whether or not the law agrees), the defense attorney is _part of the system_.
+
+So I think my intuition was correct to dismiss patient's rights as useless. I'm sure _they_ believe that they're working to protect patients' interests within the system, and would have been frustrated that I didn't appreciate that. But what I wanted was not redress of any particular mistreatment that the system recognized as mistreatment, but to be _let out of psych jail_—and on that count, I'm sure patient's rights would have told me that the evidence was harmful to my case. They weren't working for me.
+
+...
+After I was released and got my belongings back, I couldn't find my Driver License. For a few days, I assumed that one of the psych ward employees had stolen it out of my wallet. I was wrong: actually, there was a separate license-holder compartment inside the wallet. I had forgotten.
-[TODO psych ward—
- * I often have a sense of "where I am" geographically (not just my immediate surroundings, but also knowing how my surroundings relate to the world, what city I'm in; what freeways connect to that city; doesn't exist when kidnapped)
+...
+This was a theme in my thoughts at the time: I was scared that the world was a much less orderly place than I knew. I used to believe the world was "made out of words": that the things people said were mostly true, that the world protrayed in books and maps mostly _was_ the real world. Suddenly, I had been granted a different view of reality, a world of animals in which _words don't matter_.
- * Even things that are for your benefit during the check-in process are hard to appreciate as such—I remember them counting my money in front of me, and feeling like it was an Orwellian exericse to undermine my connection to reality; maybe, I didn't trust that _she_ knew how to count?
+In retrospect, my psychotic vision of a languageless world turned out to be false. Most people really _do_ know how to read.
- * trying to complain to the staff—got told to speak to patient's rights; I didn't even bother, because I didn't think that was real; a later SSC claims that patient's rights is supposed to be adversarial, but that wasn't clear from the inside; I'm reminded of that AmRen article [article by a public defender](https://archive.is/HUkzY); I empathize with the defendant https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/ "Usually the doctors hate them, which I take as a pretty good sign that they are actually independent and do their job"
+I fear that some readers will take this as an admission that the authorities were right, that conventional social reality is right—that I was _just_ crazy, and everything I thought while I was crazy can be costlessly discarded.
+
+I don't think that's right. I _was_ crazy, but _that doesn't mean ordinary social reality is sane_—and it doesn't mean that some of the things I thought I saw from my altered perspective weren't _directionally_ correct, as I can evaluate them from a more standard frame of mind now.
+
+Sometimes, the words written down in official documents really are just lies. I have in my possession an "Involuntary Patient Advisement" form, which claims that I "self presented due to [my] suicidal thoughts". This isn't true. Getting accosted by cops while trying to go into the train station to get back to my apartment is not the same thing as "self presenting"!
+
+I ended up with a "Rights for Individuals in Mental Health Facilities" handbook, which claims that:
+
+> You have the right to refuse medical treatment or treatment with medications (except in an emergency) unless a capacity hearing is held and a hearing officer or a judge finds that you do not have the capacity to consent to or refuse treatment. The advocate or public defender can assist you with this matter.
+
+Naïvely, one might expect that having the right to refuse medication means that when someone tries to give you medication, you can just say that you don't want to take it, and they'll respect that. This did not seem to be true: I was reluctant to take medication, but the behavior of the staff made it clear that they weren't going to take no for an answer, and I folded, _because they were holding me prisoner_.
+
+I remember trying to deceive a staff member, putting on a "show" with magician-like hand flourishes (to which she dutifully pretended to be impressed, as one would to a toddler) before taking the pill—hoping to palm it before swallowing it without her noticing. It didn't work. I swallowed.
+
+Maybe if I had had the presence of mind at the time to read the rights handbook, and point to the specific line where it says, "You have the right to refuse [...] treatment with medications", they would have accepted that? But it seems likely that that would have been punished by a longer stay. A "right" that you get punished for exercising is ... not much of a right?
+
+As it happens, I _now_ think that taking the medication was a good idea. The reason I think this is because when I sought psychiatric help for insomnia in early 2021—intending very dearly not to go insane from sleep deprivation again, very much not wanting to be institutionalized again—the doctor told me that my records from my 2017 institutionalization said they had me on Zyprexa 5mg and Trazadone 50mg. Trazadone!—that was on [Scott Alexander's insomnia page](https://lorienpsych.com/2021/01/02/insomnia/).
+
+I worry, again, that some readers will take this as vindication that the authorities were right: they forced me to take drugs, and now that I'm sane and have a little more information, I agree that the drugs were a good idea. Why, the contemptuous normie reader asks, does this not demonstrate that they were right to force me, when I was crazy and therefore couldn't make decisions for myself?
+
+Because submission to authority isn't the same thing as sanity. In the psych ward in February 2017, I _knew_ that I needed sleep. If someone I trusted to have my best interests at heart had _told me_, "This is 50mg Trazadone; I strongly recommend you take it, because it will help you sleep; I also have this Trazadone fact sheet you can read if you want more information," I probably would have taken it.
+
+A system that actually had my best interests at heart would not have _kidnapped me and locked me in a building with strangers_, which is _not a good environment for getting rest_.
+
+Serious antipsychotic medication is scary stuff. When I was institutionalized in 2013, I had tardive dyskensia—an involuntary lip-smacking compulsion—from the Haldol that they gave me. Tardive dyskensia can be permanent in some cases.
+
+I do not think I had good reason to trust the system given the information I had at the time.
+
+...
+
+Scott Alexander's post on navigating the inpatient mental health system says that doctors will sometimes threaten to have a patient committed involuntarily, if they don't agree to sign a form committing themselves "voluntarily".
+
+"This sounds super Orwellian, but it really is done with the patient's best interest at heart," Alexander says. As a local response within the system, I'm sure it is—at least, I'm sure Alexander believes what he wrote. But I would argue that timelessly and in the long run, _destroying the concept_ of "voluntary" is not actually in the interests of the victims of coercion.
+
+ * Another "gem" from _Slate Star_ on the inpatient system: "don't contradict evidence against you, don't accuse other people of lying, just downplay whatever you can downplay, admit to what the doctors already believe, and make it sound like things have gotten better" !!!—similarly, "take the damn drugs"
+
+...
* First facility—separate rooms with beds for men and women; me tapping at the walls trying to teach; pacing, thinking I was one of the most important people in the world
+
* Taken to a separate facility; _very_ lucky to get my own room
- * paper claims that I "self presented due to your suicidal thoughts"; this isn't true; getting stopped by the cops while trying to
+...
- * "Now memories are blurred, and their faces are obscured"
+ * ("Now memories are blurred, and their faces are obscured")
* racist/sexist intuitions: avoid the gaze of males; males physically smaller than me are OK
* a moment of solidarity with a black male smaller than me?
* beliefs about evolutionary psychology (make friends, avoid enemies) very salient
* black woman named "Tone" asked what we had for breakfast
* black man saying something about his mother, I explained that his mother probably did love him, he got angry, and I hid behind my door
* doing better than in 2013 precisely because I was modeling the place as a prison
- * wanted to avoid taking medication, put on a magician-like "show" to nurse to try to trick her, it didn't work
- * I ended up with a booklet that claims I have the right to refuse medication, but this isn't actually true in practice
+ * trying to demonstrate that I was a trustworthy agent
+
+...
+
* asking Anna on the phone whether I was a political prisoner "Really?" "Really really?" followups (if I were a political prisoner; she might not be able to say so)
+
+...
+
* mother visited, mother was cranky, Michael Vassar visited; Michael said that rape doesn't really happen in this kind of facility, and I believed him; I handed him papers (which I thought was necessary to escape the powers that be)
+ * my reports were not reliable; I thought Vassar pretended to be a doctor; I thought one of the other inmates had a security code
* vision of needing to pull the fire alarm?
+
+...
+
* other males pacing the way I pace
- * my reports were not reliable; I thought Vassar pretended to be a doctor; I thought one of the other inmates had a security code
- * trope-awareness of being a psych patient; distrustful of other psych patient; thought I could subtly leave clues that I was a Jesus-analogue (as a Jewish male with long hair) to discourage people from murdering me (because the Christianity meme says you're not supposed to do that); I told people that my father was coming to pick me up at the end of my 72-hour (== 3 days) evaluation period, but that it wasn't fair that I couldn't rescue everyone. (I'm proud of this one.)
- * my father actually did pick me up three days later!
+
+...
+
+I was a very genre-savvy psych prisoner. I was distrustful of the other inmates, and distrustful of the authorities, but in different ways; the optimal strategy to protect myself against each was different.
+
+I feared violence from the other inmates. I thought I could subtly leave clues that (as a Jewish male with long hair), I was an incarnation of Jesus, which would discourage them from attacking me (because many of them would have already been programmed by Christianity meme to believe that killing Jesus was the worst sin). I told people that my father was coming to pick me up at the end of my three-day evaluation period, but that it wasn't fair that I couldn't rescue everyone. (I'm proud of this one, even though I no longer agree with the threat model.) My father actually did pick me up in three days.
]
-----
-/2017/Mar/fresh-princess/
+[TODO Vassar
+ * 22–23 February —
+ * he asks for my phone number
+ * I messed up by revealing secret info to Michael (I can say _that_ I messed up a secret, without revealing what the secret was)
+ * Michael says that he can easily keep committments; "I'm not being sloppy and accidentally defecting against the generalized optimization for secrecy, I'm actively at war with it."
+ * 28 February "Re: You're really bad at communicating!", nonprofit suggestion
+ * "I really think that fill documentation of your experience would be maximum leverage for your time"— my reply, "Too narcissitic!" (oops!)
+ * Between my checking and brokerage account, I have ~$97K to play with
-[28 February, I email Blanchard/Bailey/Hsu/Lawrence]
-
-[emailed Gunni on 26 Feb (still haven't gotten that inteview, 5 years later?!)]
+7 March—
+> As I recall, at the time, I was thinking that people may know far less or far more than I might have previously assumed by taking their verbal behavior literally with respect to what I think words mean: people have to gently test each other before really being able to speak the horrible truth that might break someone's self-narrative (thereby destroying their current personality and driving them insane, or provoking violence). I thought that you and Anna might be representatives of the "next level" of scientists guarding the human utility function by trying to produce epistemic technology within our totalitarian-state simulation world, and that I was "waking up" into that level by decoding messages (e.g., from the Mike Judge films that you recommended) and inferring things that most humans couldn't.
+reply—
+> What you were thinking is about right I think. But we still know that animals sleep.
[another happy price offer to Yudkowsky on 2 March
> That makes sense. Sorry for being boring; I'm kind of going through a "Having a nervous breakdown, suddenly understanding all the things Michael has been trying to tell me for eight years that I didn't understand at the time, and subsequently panicking and running around yelling at everyone because I'm terrified of the rationalist community degenerating into just another arbitrary Bay Area humanist cult when we were supposed to be the Second Scientific Revolution" phase of my intellectual development. Hopefully this is not too socially-disruptive! Michael said he thinks I'm doing good work??
]
+]
+
+[28 February, I email Blanchard/Bailey/Hsu/Lawrence]
+
+/2017/Mar/fresh-princess/
+
+[emailed Gunni on 26 Feb (still haven't gotten that inteview, 5 years later?!)]
+
+
[Blanchard Tweets my blog "again" on 3 March]
-7 March—
-> As I recall, at the time, I was thinking that people may know far less or far more than I might have previously assumed by taking their verbal behavior literally with respect to what I think words mean: people have to gently test each other before really being able to speak the horrible truth that might break someone's self-narrative (thereby destroying their current personality and driving them insane, or provoking violence). I thought that you and Anna might be representatives of the "next level" of scientists guarding the human utility function by trying to produce epistemic technology within our totalitarian-state simulation world, and that I was "waking up" into that level by decoding messages (e.g., from the Mike Judge films that you recommended) and inferring things that most humans couldn't.
-reply—
-> What you were thinking is about right I think. But we still know that animals sleep.
12 March—
> You can tell that recent life events have made me more worried than I used to be about unFriendly/unaligned possibly-AI-assisted institutions being a threat to humane values long before an actual AI takeoff in however many decades
+
+-------
+
+On 12 March 2017, I made a Facebook post trying to explain my new outlook:
+
+> The core of the update is that it turns out to be surprisingly useful to model the world as being made out of three things: people (who can be friends, enemies, or strangers), evolved social-control mechanisms (which use people as components as well as trains, pieces of paper, credit cards, web forms, &c.), and rocks. Instead of taking the things that people say about the evolved social-control mechanisms literally with respect to what _you_ think the words mean, you should constantly be making predictions (preferably predictions that you can get feedback about on the timescale of seconds or minutes) about what will happen if you interact with the social-control mechanisms in a particular way, and then noticing if the predictions come true or not. It turns out that non-nerds—you know, those people we disdain for being stupid or sexist or voting for Donald Trump or whatever your favorite excuse is—already knew this; they just didn't tell you because they were—correctly—modeling you as a component in the evolved social-control mechanisms rather than as a person.
+
+-----
+
+
I met Jessica in March
projects / Ultimately_Untrue_Thought.git / blobdiff