I used to have pretty emphatic opinions about which media was high quality and which wasn’t, and rarely hesitated to make them known. I’ve since renounced not only voicing such opinions, but having them in the first place, and have cultivated acute embarrassment over a past me who would do my friends the kindness of informing them that that movie they liked was terrible. (Though it was meant as “good-natured ribbing”, many social groups read this behavior as “dickish”, and the line between those two is often fine enough to be invisible.)
In tandem I’ve developed an envy of those pure souls whose love for things was never poisoned by a critic’s disapproval or a particularly cutting internet comment, either because it was proof of the earnestness that I as a Cynical Worldly Adult lacked, or because it meant they were too busy caring about things that actually mattered to get caught up in squabbles over what was essentially fashion.
Occasionally I revisit things from the height of my snobbery period, expecting to be disappointed, but instead I’m almost always shocked by how good it still is. The mindset I had when I developed those tastes wasn’t exactly admirable–it often felt competitive and even mildly paranoid–but it did the job of pushing me away from lower effort pop art and toward things that I believe were genuinely richer and more complex. In itself I’m not sure how virtuous that is, but these were the things I had in my life before I had access to medication or satisfying relationships or autonomy, and in addition to being useful for directly modulating my emotional states, they gave me something to connect to when everyone I knew was a replicant.
Snobbery gets a bad rap because it seems to exist for the sole purpose of weaponizing taste, and I’m not sure what proportion of snobs actually are in that game, but there’s some idealized version of snobbery that’s mostly about incentivizing people to like things that are better for them and spend less time on junk. Unfortunately, it’s hard not to cause offense if implemented at the individual level, and I’m generally down on directly insulting your friends. If only there were some sort of institution that everyone in your social sphere went through in their formative years which exposed them to important culture…
Facts about my life and mental properties. Answers given off-the-cuff and intoxicated, so likely to be disavowed by the me of two weeks in the future.
K: What would be the best thing about being in a cult?
T: I guess you would never have to decide what to wear. Or who to have sex with.
K: Maybe I can help advise you on who to have sex with. Are you hoping to get any particular value from having sex?
T: What value do people usually get from having sex? Like, what are my options?
K: I think your options are broader than the mere value people usually get.
T: Ok, I’m hoping for spiritual revelation.
K: Have you ever tried religion?
T: Does atheist Buddhism count?
K: Did you get any spiritual revelations?
T: No. I was mostly that because my best friend in middle school was an atheist Buddhist. We did weird things together and it was one of the weird things.
K: Why do you want a spiritual revelation?
T: Sounds fun, doesn’t happen every day. People who have them often change their whole lives afterwards. It’s like another thing that’s telling you what to do.
K: Why don’t you want to decide what to do?
T: There are often many options and they often have many pros and cons and it’s very unclear how to weight them, so I end up spending a lot of time on spreadsheets, which is maybe not that functional.
K: Who would you be most happy if someone told you to have sex with?
T: Of all living people, maybe the actor who plays Cesare Borgia in Borgia (not the Showtime show The Borgias). For people I know, I should optimize for least likely to spontaneously have sex with. So I have, ok, gee, I really don’t want this on my blog profile. [censored]
K: Why do you spontaneously have sex with people?
T: I guess it only happens if they initiate it. In a way, sex is sort of a low risk activity.
K: Wow, what else do you do?
T: I mean, it’s safer than [censored]. And even if it’s not stellar sex, it’s a decent way to pass the time.
K: What characteristic is most likely to lead to stellar sex?
T: The person being good at sex. Also, [censored]
K: What makes a person good at sex?
T: It’s sort of mysterious. I feel like I’m not very good at paying attention during sex to the things going on. I can tell you things that make people bad at sex though. For instance, biting other people’s genitals. Also, not responding to other people’s indications that they are in pain because you have bitten their genitals.
K: Lots of great sex advice here.
T: Better than Cosmo.
One skill that’s really great to have is not being a nineteen year old boy.
K: Does your mother know you’re gay? [More accurately bi — ed]
T: I think she suspects very strongly. I think she once said out of the blue, “You know, it’s ok if you’re gay.”
K: What is the most annoying thing about other people that is also true of you?
T: I think it’s really annoying when I’m depressed and people are obnoxiously having fun.
K: If all of your superficial characteristics were changed, what short set of instructions would let a person pick you out from the crowd?
T: The person standing awkwardly and not talking to anyone.
K: From a Rationalist crowd?
T: I’d be talking about stimulants or executive function rather than AI risk.
K: Why do you talk about those things instead of AI risk?
T: Because I don’t know enough about AI not to make a fool of myself, and obviously talking endlessly about your special interest is how you signal friendliness.
K: Who is a person you admire for their behavior other than sexiness? Why?
T: Miyazaki made the best anime films ever, and also some of the best films ever period, and also just seems like a great guy. Like, he’s nice to his subordinates. And he has cool glasses.
K: If you had to have a mental health problem you don’t already have, which one would you want?
T: For a really long time I had an obsession with Cotard’s syndrome, but mostly because it was really horrifying. But, despite my fear of psychosis, it seems like mania might be fun.
K: What is a thing that humans do that you think should receive less stigma?
T: Not greeting people.
K: What is a thing that should receive more stigma?
T: Greeting people? Generally being loud.
K: If you had to run a cult, what would it be like?
T: I would most likely get a bunch of sub-leaders and delegate all of my power amongst them.
K: It sounds like you don’t like power.
T: I like the power to delegate.
K: Have you considered being a pet? Pets don’t have to make decisions ever, except things like which way to pace around the table, plus you can sit on people’s keyboards and such.
T: There was arguably a time when I was a pet. To the point of wearing cat ears.
K: Tell me more.
T: I guess my relationship nickname was ‘kitten’ and I had cat ears I wore sometimes. And sometimes I would meow at my partner. And also I would ask if I could haz things.
K: How do you feel about memes?
T: I feel like if I didn’t like memes I wouldn’t spend as much time as I do on Tumblr.
K: If you learned that someone really liked you, why would you guess that was?
T: Probably because I had appropriate special interests.
K: How did you acquire your special interests?
T: I guess I got interested in executive function because I thought [censored] was autistic, and then I read some autistic blogs that talked about executive function and I thought “Wow, this is what is missing from my life!” And I think then I got interested in stimulants because I like taking them.
K: How does Scott Alexander in person differ from what you expected?
T: I think I had heard people describe how he is, so not that much. I suppose he may be more soft-spoken than I would have expected.
K: Do you have a list of characteristics you want a person in a relationship with you to have?
T: More than twenty-two years old is good, intelligent is also good, not a jerk is pretty good… some really high bars here. Also I guess funny is fairly important.
T: The thing that mentally ill people have is humor, and if we didn’t have that, life would not be very good.
K: Do we not also have cheesecake?
T: Yes, but not all of the time.
K: Do you think people should talk more or less about their mental illnesses in public?
T: It depends how they talk about it. I’m tired of people who got depressed once writing long think pieces about how they understand everything about depression now. I think for people with very serious mental illnesses, it would be good if they talked more about them.
K: What is a surprising fact about you, from the perspective of a person who has had a substantive discussion with you about five times?
T: I don’t actually know that I have any surprising characteristics in that case.
K: A contradiction–that’s pretty surprising.
T: Is it more surprising that I once considered doing sex work, or that I once decided that sex work isn’t for me?
K: This is like one of those probability puzzles. The latter requires the former, so is less probable. With regard to the latter, huh, why?
T: Two reasons. I prefer not having sex with people who I wouldn’t choose to have sex with. Also, transactional sort of stuff feels weird. I worked as a nanny for two years, and even getting a check from them felt weird. Oh, I guess the fact that I was a nanny for two years is sort of surprising.
K: What is the most surprising thing you have learned about me?
T: Probably the vulva rock… it’s not even surprising, it’s just… man, it’s not like something you wouldn’t do, it’s just… [censored]
K: If you don’t like kissing people, what do you do if you want to hook up with them or something?
T: I write them a strongly worded letter. I mean, often I do kiss them, and I’m not really opposed to it, I’m just not terribly enthusiastic about it, relative to other things. I mean, often in sexual contexts all you have to do is signal acquiescence and most of your work is done for you.
K: Would you like sex?
T: I wouldn’t like to put any effort into pursuing it.
K: Are you selfish? Defined as too interested in your own welfare compared to that of others, such that others should disapprove.
T: It’s possible that I don’t have enough experience being around other people where there is something at stake to make a judgment.
K: Of the arts and media stuff that the world has produced, which parts do you especially enjoy?
T: Miyazaki obviously. Bergman. And I guess working to 80s music.
K: What kind?
T: I just have a compilation of 80s music that was made by electropop bands from 2008.
K: If you had perfect control over what you looked like, what would you look like, or who would you look like?
T: Moderately tall and elven and androgynous.
K: What fraction of the population do you think would have that answer?
T: A sizable one. Probably everyone who didn’t want a more gender-typical presentation.
K: What color would your hair be?
K: Why don’t you want a gender-typical presentation?
T: Well, I really like menswear, and you can’t really effectively wear menswear with female morphology. And also looking feminine feels conspicuous or something. Also it’s really bad for sports.
K: Would you rather be male?
T: Probably weakly.
K: What else should I ask you?
T: “Are you tired and need to go to bed?”
K: Are you tired and need to go to bed?
T: Why yes.
K: Why do you think that is?
T: Probably because I drank half a bottle of wine and I got about six hours of sleep and probably it’s pretty late also.
K: Do you think AI is really dangerous?
T: I think I am not informed enough to comment. But I’m betting AI will not destroy all value. But it’s good that MIRI exists and they should keep doing whatever it is that they’re doing.
Generally amphetamine helps with OCD-spectrum symptoms (an advantage to which relatively few mental healthcare providers avail their patients), but it has an unfortunate tendency to encourage skin picking and other “body focused repetitive disorders” for some people. It turns out I’m one of those people, so I asked my psychiatrist what he recommended.
Before I reveal his suggestion, I feel the need to go off on a particular tangent. You see, I could spend all the hours of the day studying psychiatry – delving into its history, poring over its arcane trivia, hypothesizing, cooking up experiments. But I can hardly imagine a more loathsome fate than that of becoming a clinical psychiatrist, because what could sap the excitement and joy from a subject as quickly or thoroughly as the Hippocratic oath? A profession which advertises a prohibition against risk-taking as its central tenet is one that values stability over progress, bureaucracy over creativity. And when your field’s knowledge base is as underdeveloped as psychiatry’s is, you can’t really afford stagnation.
So he suggested Lexapro, an SSRI. Boring. I floated the idea of trying a tricyclic antidepressant instead. TCAs comprised the second generation of antidepressants, following the MAOIs, and were in use from the 1960s until the institution of our Great SSRI Overlords in the 90s. The folk wisdom in psychiatric circles is that there’s a negative correlation between an antidepressant’s age and its efficacy, but rather inconveniently a positive one with its deadliness, and it was decided that providing depressed patients with a potential means to commit suicide wasn’t very sensible. Now the TCAs and MAOIs were left to gather dust in the backrooms of pharmacies as second- and third-line options for treatment-resistant depression, while all the doctors went and swore fealty to their new master, fluoxetine. Yet still they knew, in their heart of hearts, that the ways of old truly possessed superior efficacy and diminished sexual and metabolic side effects.
I selected clomipramine on the basis of its reputation for OCD and its position as number three on the official SSC list of things you should try instead of whatever your doctor recommends. It’s supposed to be milder than its parent, imipramine, but the lowest dose commercially available (at 25 mg per capsule) is still subjectively pretty striking. The most immediately noticeable effect was on my sleep, as it woke me the first couple of nights after four dreamless hours, and the next couple after six. Despite this, I felt not only well but happy, a rare occurrence first thing in the morning even with adequate sleep. I concluded that the loss of the REM-heavy tail end of my sleep was likely due to the well-known fact that serotonergic drugs inhibit REM, a sleep stage that is generally disordered in the clinically depressed, and which incidentally has various theories attached to it implicating it in depression’s pathogenesis. On several occasions I fell asleep before taking my nightly dose, and on all of these I slept for exceptionally long periods of time and had exceptionally vivid and memorable dreams – “rebound REM”.
The other very robust effect was a reduction in hyperactivity and impulsivity, possibly larger than with stimulant treatment. When I was much younger I was able to read for many hours on end, and I lost this ability sometime in adolescence. I could force myself to read while on amphetamine, with frequent endogenous and exogenous interrupts. But clomipramine seems to allow me to get completely absorbed into things, rather than having to refocus my ever-errant attention back on them continually, making extended reading sessions not only possible but enjoyable. And I suspect that this quality of absorption is related to my subjective sense of the world having more “color” and “meaning”, and possibly to the fact that my initial impression of this drug was that it felt like a very low dose of MDMA. The dark side of absorption is that I have had a couple of panic attacks in the last month, one understandably after fainting for the first time ever, the other somewhat less so after a plausible but still overblown serotonin syndrome scare, both of which resulted in unnecessary (and unusual) usage of emergency medical services.
Apart from those few isolated incidents, background anxiety has been down, and my frustration threshold has raised significantly. More surprisingly, I’ve found that unpleasant sensory sensitivities are mitigated to the extent of allowing me to work to music for the first time ever, and to wear my hair down without constant aggravated fiddling to prevent it from touching my skin or pulling at my scalp. And my improved mood has caused my sociability to soar from Emily Dickinson levels to near-JD Salinger heights.
The least noticeable effect was on the very thing I requested the drug for, skin-picking, but considering all the incidental benefits, I can’t muster up too much disappointment. I’ve been on it a month, and overall I’d say I’m pretty sold on clomipramine. Having heard from a lot of people put on SSRIs or SNRIs who weren’t sure whether or when their drugs did something, I can wholeheartedly recommend clomipramine as a drug that definitely does something, even if it’s not the thing you expected or necessarily wanted. But all those little surprises are what make psychopharmacology so fun, aren’t they?
Find more nuggets of pharmacological knowledge on clomipramine and the TCAs here.
Update: It looks like I failed to mention this before, but clomipramine is an anticholinergic. Acetylcholine is a rather important neurotransmitter that does things like initiate REM sleep (I’m unsure of whether clomipramine’s anticholinergic effect is great enough to make a noticeable dent here), and chronic antagonism tends to impair learning and memory, and could be associated with dementia. I suppose one could try pairing a cholinesterase inhibitor with it, but racetams are more common, and I’ve started taking a noopept/choline complex now and again that seems to perk me up.