[Epistemic status: Processing after a long period of work and recovery, which is not yet over]

Background

Four years ago, I was in university. I was a casual rationalist, having been introduced by HPMOR, been active on rationalist tumblr, and then joined a loosely allied fiction writing community known as Glowfic. Things seemed pretty okay. I had known for a while that I was not neurotypical, having been diagnosed with ADD in high school and also having been in a gifted program.

I was also familiar, casually, with weird things happening to me and people around me. I was active in the hypnosis scene recreationally, and was fascinated by how people transformed under the influence of trance. I am also trans, and thus had experienced a major identity shift from my "cis male" self to a transfeminine identity.

That feminine identity was based on a female roleplay character that I had played as obsessively for several years - not an uncommon occurrence in trans people. She talked to me in my head - not an uncommon occurrence for authors. Eventually I decided I'd be her because she was cooler than my (dysphoric, beaten-down) self. And so we went on in a new identity, changing from our deadname to our new name. There was an attempt at coming out which... did not go well. I'll spare the details. I ended up closeted and under great stress to finish my degree.

I reached out to writing as my source of comfort, as I always had. I poured my hurt out into a newly-turned girl being abused by her vampiric sire. I started getting feelings and emotions from her - a sense of attraction to gothic and old-style clothing, a distinct fondness for lists and checkboxes. It was useful to me to like lists and checkboxes - after all, I was failing my degree from ADD - so I encouraged the persona, using a half-understood concept of Internal Family Systems and my experience with altered states achieved under hypnosis to try and develop the identity.

It worked! And we remain plural to this day, with a dozen or so other identities we've developed over time. We use these identities as different lenses to view the world through, ways of helping us not get too attached to any particular identity. We took the prescription to be a fox and not a hedgehog very seriously to heart. As far as we can tell this is both stable and useful; it's not what this post is about. It's simply necessary background so you can understand the level of weirdness in our life at this time.

So, here we were, trying to succeed at university, feeling like we didn't have enough willpower to manage to apply ourselves to our studies. And we had previous experience with Applying Weird Shit To Get Things Done.

So when we heard about Mastering The Core Teachings of The Buddha (which I will refrain from linking) we were interested. There was supposedly a way to gain better control over your emotions and thoughts that had been theoretically refined for a long period of time and had been studied at least a little by mainstream science! Medication didn't seem to work, so with a can-do attitude we set out to do some brainhacking.

In short, we got got.

The Psychosis

It is somewhat unclear, looking back now four years after my admission to hospital for acute psychosis, whether the meditation practices caused the altered states or whether the altered states caused the meditation practices. Certainly I had experienced many strange things in my life previously that are easily attributed to a schizotypal brain. Even before I picked up a religious bent and started fixating on ritual actions, I was having mood swings and feelings of distrust. What I can say for certain is that the ritual actions gave an excuse for me to experience all kinds of strange things, and as a result I missed many clear and obvious warning signs. So did all my close friends and family, even those I dragged into the ritual actions. Those who were skeptical were shut out; those who were credulous were let in. Towards the end, a few people close to me knew something was wrong; but I personally had considered the option of psychosis, noted that I had its symptoms, and discarded it as funny.

All the insight in the world doesn't help you if you can't act on it.

Eventually, I became so unstable that I had a fit. I lashed out against my family, thinking they were aliens and/or satanic (the religiosity did not discriminate, that late) and I was institutionalized. Fortunately I live in a country with state-sponsored healthcare so this did not ruin me or my family. Very fortunately I did not seriously injure anyone, including myself.

The antipsychotic they tried me on did not work. I had serious mood swings, had delusions that changed by the hour, and a distinct manic energy in my voice and mannerisms. Many of the sounds I made in hospital I cannot reproduce now - the human vocal range has limiters on it normally that the psychosis broke. I wandered, I spun, I laughed. I thought I could time travel. I dropped off the side of a couch about a meter to the floor (lying horizontally) because I thought it was funny and probably wouldn't hurt me. I did the worm spontaneously just because I felt like dancing. I kept my delusions to myself, because I actually believed them and knew that the doctors would keep me for longer if I said that I believed in them. My goal, quite plainly, was to escape the ward via the only mechanism I had - faking getting better convincingly.

Still, through this, I was able to semi-lucidly explain my condition via text to my girlfriends. I was able to keep to the ward's rules, more or less. Hearing the other psychotic patients cry or scream from the locked portion of the ward overcame me with sympathy at one point, so I rushed in: after this incident I was seriously asked by a doctor if I thought I was Jesus. (I said no, though I had unrelatedly hallucinated being crucified.) It was hard to focus and control my behavior, but I somehow stumbled along. I consented to being treated with lithium on the basis that I had been struck by lightning, therefore a material used in batteries would clearly help. Eventually I faked semi-stability for long enough that the doctors released me.

Naturally the instant I left the hospital and met my family again they knew that there was something wrong. I had manic and paranoid symptoms still. I wasn't okay; I was just faking being okay. And after a few days the illusion broke. I was sent back to hospital, where I had a breakdown on my re-entrance interview and confessed everything.

They tried me on a different antipsychotic, and that one worked. Gradually my symptoms faded away. I resolved that I would take nothing from the experience - that there was no spiritual lesson to be learned here, nothing of religious significance. I was unwell. The "messages" I had received, the religiosity, the manic fits - all of it was just a product of my fevered brain.

Recovery and Moving Forwards

I've stuck to that, since; but there's still some things that I've learned from this. Foremost, that reality is that, which, when you stop believing in it, doesn't go away. Even when I was hallucinating, I couldn't hallucinate my way out of my material circumstances (being locked in a ward with doctors and a bunch of other loonies like me). Even when I was delusional, I couldn't create evidence from nothing. I could leap incredibly far from a single suggestion - the doctor's nose looks a little weird in their mask, therefore he is an alien! - but there was nothing stable about it. When the antipsychotics started to work, mundane reality inevitably won out.

The road back after that wasn't easy either. I was still on lithium, which is incredibly emotionally deadening and destroyed my libido. It took years for me to be taken off it and to recover to the point where I could function in daily life. In the early days after being released from hospital I would sleep, write for one hour, text a little with my girlfriends about the writing, eat, and go to the bathroom, and that was everything I could do. Gradually, life and color returned.

One of the things I have learned from that recovery process is that improvement comes in bursts, and compounds. I gained the ability to write (and nothing else.) Then the ability to write and handle a little social activity. Then I felt comfortable enough to sleep in my own room again. (I had associated it with going crazy and moved to a different room in my family's house.) Then the lithium dosage was scaled back, and I gained some ability to care again. My libido became strong enough to support occasional intimacy with my girlfriends again. Each time, there was a sense of a new normal being reached, something that would normally be only a high point becoming everyday. And as the recovery progressed, those high points became closer together, as I became more able to actively self-modify. I incorporated elements of the therapy I had been unwillingly subjected to in hospital, mainly to do with compassion for oneself - a quality that I think is under-spoken to in rationalist circles, which emphasize heroic responsibility strongly. (Or at least did back in 2019, some work has been done since.) I learned to take slack seriously.

Somehow, though, I still had not actually learned the lesson. While trying to recover my sexuality, I became involved with a cult based on an imagined hypersexual transhumanist future/heaven. I had gotten got again.

I met some lovely people there, but I also sacrificed some of my sanity to do it; I genuinely believed in the proposed heaven for a while, and changed my behavior to suit. Eventually, the cult's founder proved unstable, so I left with one of their lieutenants who I'd fallen in love with. That actually turned out fine, as well; we left the cult together and gradually shed our old belief in it over a period of another couple years, before finally coming to a resolution to discard them entirely a few months before this writing.

What helped? Meeting another rationalist who took their craft seriously and cared about the truth. With someone else there to catch my errors, progress was much faster. I was encouraged to read the Sequences again on a date with them, and found myself wincing hard several times. I haven't finished my reread: I really should finish it. In fact, I'm going to schedule that right now. (Okay, done that.)

Having someone else there to check you - someone you ideally don't know well, who isn't involved intimately in your drama, who isn't compelled to care about you and soft-pedal things - matters a lot. That kind of relationship can be hard to find, because as soon as you trust someone to do it you've lost some objectivity. But I think that working together with other rationalists can get things done more effectively than any individual working alone. Sanity is unbounded alone; with a sane anchor you trust, you're less likely to make grievous errors because everything has to pass both of your bullshit detectors.

Conclusions

  1. Just because your weirdness has not bitten you yet does not mean that you will not be gotten got.
  2. You can be gotten got for years of your life here. Take it seriously.
  3. Care about your mental health. Preserve your slack. Schedule maintenance or your body and mind will schedule it for you.
  4. It can be very easy to miss lessons if you are not looking for them. Get someone else to check your work. Someone you don't already talk to all the time.
  5. When you improve, it'll come in bursts. Don't get discouraged by all the practice you have to put in; you will eventually see a breakthrough.
  6. It helps a lot to have people who care about you who will help you through serious problems. Get some.
  7. If you think you could have a mental illness, it is generally sane to talk to a doctor about it.
  8. If you don't take actions based on the state of your evidence, your evidence is no good to you.
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[-]dxu269

You have my (mostly abstract, fortunately/unfortunately) sympathies for what you went through, and I’m glad for you that you sound to be doing better than you were.

Having said that: my (rough) sense, from reading this post, is that you’ve got a bunch of “stuff” going on, some of it plausibly still unsorted, and that that stuff is mixed together in a way that I feel is unhelpful. For example, the things included at the beginning of the post as “necessary background” don’t feel to me entirely separate from what you later describe occurring; they mostly feel like an eclectic, esoteric mixture of mental practices—some of which I have no issue with!—stirred together into a hodgepodge of things that, taken together, may or may not have had a contribution to your later psychosis—and the fact that it is hard to tell is, to my mind, a sort of meta-level sign for concern.

Of course, I acknowledge that you have better introspective access to your own mind than I do, and so when you say those things are separable, safe, and stable, I do put a substantial amount of credence on you being right about that. It just doesn’t feel that way to me, on reading. (Nor do I intend to try and make you explain or justify anything, obviously. It’s your life.)

On the whole, however, reading this post mostly reinforced my impression that the rationalist memeplex seems to disproportionately attract the walking wounded, psychologically speaking—which wouldn’t be as big a deal if it weren’t currently very unclear to me which direction the causality runs. I say this, even as a (relatively) big fan of the rationalist project as a whole.

I always thought that this impression I had that the rationalist memeplex was an attractor for people like that was simply survivorship bias on people reporting their experience. This impression was quite reinforced by the mental health figures on the SSC surveys once the usual confounders were controlled for.

Very interesting account, and admirably self-aware! (Though some work on the latter front remains, it seems to me.)

One thing did jump out at me. Your “rationalist origin story” has you reading the Sequences at the end (and this having a salutary effect on your understanding), and HPMOR and glowfic at the beginning (and this having… well, we can’t confidently conclude what effect, but the implication is not encouraging).

This seems to suggest that (as I have long held) one fruitful opportunity for improvement, for many “rationalists” (by which is meant: the sort of people who hang out with the sort of people who read Less Wrong and/or live in a certain cluster of Bay Area group houses), would be to… read the Sequences.

To be clear, I had already read the Sequences long before I did any of the many crazy things I ended up doing. However, I absolutely agree that going back to them is important. One read is insufficient to actually grok the material, as best as I can tell. You have to actually practice the skills - which I did not do. The sequences were cool, but implementing them in my life didn't happen.

As someone who doesn't want to go insane, I find it useful to read accounts of people going insane (especially from people who passed through madness and out the other side).

For people who are curious and want to read a more detailed account of someone's psychotic break, what delusions felt like for them from the inside, the misadventures they had during it, and the lessons they took from it, Peter Welch wrote about his here: https://www.stilldrinking.org/the-episode-part-1

This story is the pivotal narrative turning point that it’s easy to blame for me being the person I am instead of someone else. The summer of my twentieth year on the planet obliterated every measure of good, evil, truth, beauty, reality, and fantasy I’d had before and makes everything that’s happened since seem banal. It’s the reason I will never believe in anything again, the reason I play music, and the reason the Acadia Hospital nursing staff thinks I’m a crackhead. There are probably three or four dozen people that won’t talk to me to this day because of these events, and I am an local legend in Bar Harbor, Maine.

Thanks for this. Not only is it interesting, it’s also quite relevant to me. I’m not psychotic, more something like depressed, but I’m wondering whether I’m going mad, and I guess it’s good to know it’s possible to be both a LW-style rationalist and quite mentally ill. And most importantly it’s great to know it’s ‘normal’ or ‘okay’ to be in rationalist circles and yet engage in self-deception regarding one’s psychological state for years.

On the other hand, a bit curious how your life is going in general, and what kind of consequences it has: I’m terribly worried my own issues will prevent me for being ‘successful’ in life (whatever that means).

I guess it’s good to know it’s possible to be both a LW-style rationalist and quite mentally ill.

Not commenting on distributions here, but it sure as fuck is possible. 

Well, I knew it was very much compatible with ADHD, ASD, and a few others. I guess what I meant is closer to "Good to know it’s possible to both be a massive rationality and self-help nerd ; and never use any of that to think more clearly and escape destructive thought patterns ; and yet it’s still okay"

I object to the phrasing that you "got got" by Mastering the Core Teachings. That book is riddled with radiation warnings and, as far as I can tell, is entirely good faith.

You did not "get got." You took the demon core out of storage, placed it into the lower sphere, placed the top sphere above it, held them apart with a screwdriver, then flinched.

The LessWrong Review runs every year to select the posts that have most stood the test of time. This post is not yet eligible for review, but will be at the end of 2024. The top fifty or so posts are featured prominently on the site throughout the year.

Hopefully, the review is better than karma at judging enduring value. If we have accurate prediction markets on the review results, maybe we can have better incentives on LessWrong today. Will this post make the top fifty?

Personal perspective: psychotic experience truly is an enigma wrapped inside of a riddle. So much complexity involved that rookies would have no idea what was actually going on (even the insiders would largely be unaware of whatever ground truth might exist).

Interestingly, perhaps my clearest memory from that time was thinking that I was playing my most rational strategy to cope with my life as it was. My life was not making sense and escape seemed the best way out.

From the perspective of today that might seem an odd take, though given what I know now it actually was not an entirely bad strategy at all-- perhaps my optimal strategy. How could that possibly be true? It turns out that my family has coped with dominant Alzheimer's disease for centuries and this was never made clear to me when growing up. This was of interest because the parent with the dementia risk waited an especially long time to start a family. From what I understand this parent would have been cognitively comprised even while I was a teenager and this parent went onto developing profoundly severe Alzheimer's dementia. There is really no way that a parent with such hidden cognitive impairment could realistically be a competent parent to teenagers.

This was the view of our closest family. They were extremely surprised at the near complete absence of judgment demonstrated by my parent in the role of a caregiver. The family had stayed back on the farm hours and hours away on a plane and we wound up in a big city where everyone works around the clock. The rural relatives were absolutely shocked at the level of child abuse that they witnessed in our city life ways. I was equally surprised at their perspective because from what I could tell it was not so much abuse as largely normal modern urban behavior.

There are just so many layers and layers of this. People who somehow think that this can be neatly described have no understanding. It is quantum physics -- it is beyond linear description. So of course, the parent with the centuries history of dominant Alzheimer's became a respected member of the psychiatric treatment community. Thus, the power balance was clearly stacked against me. When you become embedded into the power structure you are uniquely positioned to create your own self-serving narrative.

Of course it also turns out that there was an underlying genetic risk for me that involved mental illness, though this risk was actually highly dependent upon environmental circumstances. Once I became aware of the nature of this genetic risk, I simply chose those environments that were non-triggering. No problems for me from there on out. Unfortunately, this knowledge has largely not spread to others with this genotype. There must be a world of hurt out there as people constantly reenact my trauma when it could simply be avoided by choosing the correct life path. Strangely, others in the family also have this genotype yet have never had an acute episode; this has meant that they have never fully incorporated the understanding of the genotype into their life. Ergo, while they have never acquired the crazy label they have made the problem into a chronic condition that was never recognized. For me, actually having to deal with it has allowed me to move on with my life.  

And on and on. The storyline is essentially endless; I am sure that there are many many layers that I have not even imagined yet.