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Does anyone have thoughts about avoiding failure modes of this sort?

Meredith from Status451 here. I've been through a few psychotic episodes of my own, often with paranoid features, for reasons wholly unrelated to anything being discussed at the object-level here; they're unpleasant enough, both while they're going on and while cleaning up the mess afterward, that I have strong incentives to figure out how to avoid these kinds of failure modes! The patterns I've noticed are, of course, only from my own experience, but maybe relating them will be helpful.

  • Instrumental scrupulousness is a fantastic tool. By "instrumental scrupulousness" I simply mean pointing my scrupulousness at trying to make sure I'm not doing something I can't undo. More or less what you describe in your edit, honestly. As for how much is too much, you absolutely don't want to paralyse yourself into inaction through constantly second-guessing yourself. Real artists ship, after all!
  • Living someplace with good mental health care has been super crucial for me. In my case that's Belgium. I've only had to commit myself once, but it saved my life and was, bizarrely, one of the most autonomy-respecting experiences I've ever had. The US healthcare system is caught in a horrifically large principal-agent problem, and I don't know if it can extricate itself. Yeeting myself to another continent was literally the path of least resistance for me to find adequate, trustworthy care.
  • Secrecy is overrated and most things are nothingburgers. I've learned to identify certain thought patterns -- catastrophisation, for example -- as maladaptive, and while it'll probably always be a work in progress, the worst thing that actually does happen is usually far less awful than I imagined.

The "quit trying so hard and just do it" approach that you and nostalgebraist are gesturing at pays rent, IMO. Christian's and Avi's advice about cultivating stable and rewarding friendships and family relationships also comports with my experience.