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Your comment seems like a related aside, which I guess you admitted in a follow-up comment? But anyway, it makes me curious what the axiomatic precepts are for trade. The perception of mutual benefit and a shared ability to communicate this fact?

Also OP doesn't clearly distinguish between broader forms of quid pro quo and trade, so I'm just sort of adopting the broadest possible definition I can imagine.

I'm trying to decide to what extent this applies to my lived experience, but finding it difficult to distinguish between maintaining a healthy tranquility and cultivating habitual impassivity. My intuition is that I've had both experiences, but the internal feedback for either is very similar. Both seem to involve putting a functional amount of distance between yourself and your emotional response, and - in my experience - the healthy habit does reinforce itself, just like the negative version. But then, sometimes, I find myself noticing the lack of an emotional response in certain situations where I used to have one. Internally, it's difficult to say whether it's truly absent or simply impotent, but whether through healthy practice or perverse self-denial it's lost its power over me.

Neither seems to stem from a particularly unhealthy cognitive locus. I wouldn't say it's maladaptive, for instance, to watch somebody lose their temper and subsequently decide you'd rather not embody that particular vice. Although it's probably pernicious to foster latent contempt towards anybody who fails to exhibit perfect self-control. So, if the impetus and effects are similar then what are we left with? Because I really do feel like there's a difference, and it's one that feels obvious in hindsight. Unfortunately, "deep down in your secret heart of hearts you'll just know" isn't a very satisfying heuristic and, as I mentioned, it only seems obvious in hindsight.

For anybody who understands this better than I do, the question is: Can you articulate what internal heuristics you're using to ensure that you can practice healthy stoicism without accidentally running over into unhealthy repression?

The latter, although I don't think the gruesome details (beyond that) are really topical. I suspect that oral supplementation of this nature is significantly less effective and, other than a little mechanical discomfort, I don't know why anyone would opt for an oblique approach. The desired bacterial translocation is pretty straight-forward and you can achieve it in a similarly direct manner.

If your desire for details extends beyond mere curiosity, I'll respond to a DM. Just trying to be courteous to other uses.

This is relatable. I'm was diagnosed ASPD as a child, but never had any follow-up treatment or therapy. One noteworthy aspect of my transition into adulthood is the sheer amount of deliberate practice that went into learning how to properly socialize. Standing on the other side of all that effort, I feel that I've become more empathic than half my neurotypical friends and family members, quicker to accurately and elaborately imagine (in a humanizing fashion) another person's perspective. People regard me as eloquent and charming to be around, confident and outgoing, etc. Honestly, it's just a lot of hard work. My tendency is toward seclusion, I'm strongly introverted, and social gatherings of more than, say, three-to-five close friends can easily spike my blood pressure.

When it comes to certain things, I'm definitely having a qualitatively different experience than some of my more neurotypical friends. You brought up lying and that's one good example. I think that a common manifestation of neurodivergence is an obsession with the true shape of things, so that it's easy to become hyperfocused, to a detriment, on distinctions that seem very important to the individual.

That's super useful. Thank-you, I'll definitely follow-up on this. I imagine it would be.

Facile to the extent that it doesn't acknowledge the nuance of withholding judgement. One does not have to pretend at virtue for demanding a higher standard of rigor before committing to one position or another. This is especially true nowadays, when it is quick and cheap to track down the strongest arguments for, or against, any position and exceedingly difficult to thoroughly debunk them; when misinformation is everywhere and having domain specific expertise doesn't protect a source from bias.

The sort of pretention you're describing is contemptible, but - unless I'm misunderstanding something - not for the sake of withholding judgement. I cannot help but feel that, in most of the situations you've described, there is an implication that the authoritative party is not only negligent, but aware of that negligence. This adds an element of deliberate cognitive dissonance to the list of recriminations against such an actor. Together they make a much more convincing reason to despise your hypothetical fence-sitter than their withholding judgement or the presumption that they're posturing.

You seem to have a problem with feigning neutrality as a trendy means of signaling sophistication, but what you've written here reads to me as more of a criticism against ever thinking better of yourself for withholding judgement. Perhaps I'm misreading, but I don't think that was your intention. Assigning a confidence rating to your position is often a difficult evaluation, especially given a contentious topic, and withholding judgement is (probably) often the proper course of action. Shouldn't it should be fine to feel virtuous for withholding judgement when you've honestly judged it to be proper?

Oh, yeah. I should probably amend that. It's basically steroids, antibiotics, anti-inflammatories (whichever flavor you can handle) and a strong recommendation that you increase your fiber intake. I mentioned having been given each of these in roughly equal portions, but then failed to include it as a part of the prognosis.

My experience with corticosteroids was hit-or-miss, and I had severe, acute depression as a side-effect (I have never experienced anything like depression before or after, so it was pretty blatant). In any case, I don't really see steroids as being much better, since AFAIK, pretty much everyone relapses w/ steroids as well, and then they have to be adjusted.
 

EDIT: I'm not specifically trying to be overly pessimistic/fatalist here, it's just that I've had a very bad time w/ traditional approaches to treatment for IBD. Take everything I say with a grain of salt, obviously. I think that people should do whatever they can to feel better.


I'll update the post, and thank-you for the reply.

I've had gastrointestinal issues all my life. They started when I was a newborn; doctors diagnosed me as 'withholding', which is a polite way of implying that somebody is causing their own indigestion by refusing to take a shit. My distraught parents consulted several doctors who reaffirmed the original 'diagnosis' and finally resorted to administering enemas after other approaches had failed.

Presumably driven to innovation, half-mad with pain, sometime during my toilet training I arrived at a hack solution on my own. Rather than sitting on the toilet, I adopted an improvised 'squatting' posture with my feet planted on the seat, which my mother affectionately christened 'The Spider-Man pose'. I had no way of knowing at the time, of course, that a good chunk of the modern world does their business in a similar-if-somewhat-less-elevated position.

The new posture was a winner in the sense that I could actually move stool. Unfortunately, it did fuck all for my chronic constipation and extreme pain. So my adolescence was full of grueling, agonizing bowel movements that persisted into my teens. For me, it was ordinary to go six or seven days without shitting and then spend a tortured 2-3 hours in the bathroom, passing a frankly terrifying amount of stool in a single sitting and then recuperating for several hours afterwards. This sounds like a gross exaggeration: Let me assure you it is nothing of the sort.

Things proceeded without much fanfare in this fashion for years. I saw several doctors during high school and they amended the consensus diagnosis from Withholding to 'Irritable Bowel Syndrome', the less-glamorous-but-equally-nebulous baby sibling of IBD (Irritable Bowel Disease). I was prescribed laxatives, antibiotics and steroids in approximately equal portions on the whim of the prescribing physician. I was directed to the food pyramid and instructed to adjust my intake towards more fiber and grains.

None of this helped and my condition worsened. It wasn't until after I had graduated high school that things became truly intolerable. By this time I had developed a bad case of hemorrhoids, was occasionally shitting blood, and suffering from chronic abdominal pain and persistent fatigue. My parents trucked me around to several specialists (gastroenterologists), each of whom reaffirmed that I had IBS. I had two colonoscopies, both of which were inconclusive because my body wouldn't properly flush even when I was following the cleansing instructions zealously (I imagine they weren't written with people who only shit bi-weekly in mind).

It was about this time I started to get seriously desperate. All my life I'd been pretty athletic, but I was running out of energy to do anything and that worried me. I broke out the laptop and started digging, trying to keep my wits about me but willing to try more-or-less anything for which I could imagine a plausible mechanism. At this point I had moved out of my parents house and was poorer than most readers here will be able to properly envision, so I didn't have access to a doctor. The only lever I had was my lifestyle, so I adjusted my diet and tried several supplements (the promising few I could afford). After running the gamut, I hit a bit of good luck.

On a hunch, after reading Gary Taubes' Good Calories Bad Calories, I started pulling grains out of my diet: The effects were immediate and powerful. My energy levels returned to nearly normal and, for the first time in my twenty-something years of life, my bowel movements got a little easier. I remember running downstairs, tears streaming down my face, to tell my roommate that I had figured it out: I was allergic to gluten.

My initial conclusion was, of course, embarrassingly wrong. Removing wheat had been a good first step, but it wasn't a cure. My symptoms had been consistent (and consistently worsening) my entire life, but now they came and went, seemingly at the whims of a capricious god, with no rhyme or reason whatsoever. Anybody reading this who knows anything about the reward systems of the brain is going to understand immediately how this engendered in me a sudden, insatiable interest in anything nutrition or gut-health related.

The rabbit hole deepens...

Over the course of much experimentation and several years worth of research I had developed a tenuous control over my condition. The flare-ups and remissions were at least explicable if not fully predictable, and I had become convinced that I was suffering from Ulcerative Colitis (a form of IBD which is really a fancy way of saying Colon Bad: Causes Unclear). Along the way I'd developed a cynical distrust of medical practices (especially in the US and especially where the gut is concerned) as I learned how little is truly known about the human microbiome and how large a role it plays in our health.

Then I had the worst flare-up of my life. I had no energy. I couldn't get off the couch, and I was losing copious amounts of blood to the toilet. I lost something like 20lbs and if it weren't for the generosity of my roommates helping to take care of me, I have no idea what I would've done.

This went on for about six months until I decided that I would try getting on the formerly useless Medical Carousel again. As it happened, I was able to afford a specialist this time around. They set me up for a colonoscopy and, since I was practically starved already, the results were conclusive this time around: I had Ulcerative Colitis. One of my friends had to explain to the nurse who gave me the news when I came around that - no - she hadn't upset me, and that I was just excited to be proven right.

The feeling was elation followed by anti-climax; they'd confirmed what I'd already known. Ulcerative Colitis is more of a syndrome than a disease, which is to say that it's a constellation of symptoms that we frequently see together: It says nothing whatsoever about the underlying mechanism.

What nobody ever tells you about these gut conditions is that they are basically a very slow, unattractive death sentence with a lot of discomfort to look forward to in the interim. The prognosis is something like this: many rounds of consistent steroids, antibiotics and NSAIDS (whichever you don't react to, if any) to hopefully induce periods of remission followed by unexplained flare-ups until your intestines finally give out, at which point your options are death-by-sepsis or surgically removing them in favor of an ostomy-bag.

Having plunged deep into the available literature, I was resolved to fight the inevitable. By this time, however, I had already tried every fanatical lifestyle change that seemed likely to help. Perhaps you will think less of me for this, but having pored over hundreds of medical journals and listening to specialists discuss what little we know of the gut (which - in its own way - is rather a lot), I have concluded that antibiotics ought to be the very last line of defense, ranked up there with chemotherapy in terms of how much damage they do for the benefit of alleviating your symptoms. At least with chemotherapy, you hope to reduce/remove the underlying problem - antibiotics for an IBD flare-up is really more of a band-aid solution.

 Anyway, I was desperate to try something with a little more promise and a little less side-effect. Enter FMTs: It was vexing to discover that here in the United States, FMTs (Fecal Matter Transplants) are an approved treatment to repopulate the gut biome post-chemo, but otherwise unsanctioned; it is apparently a sanctioned treatment for IBD in at least a few other countries. It seemed promising albeit gross. Honestly, most of the pushback seemed to stem from this singular fact: it's basically disgusting. Having neither the money nor the requisite knowledge to make the arrangements, I discarded flying to another country as an option.

You know what they say about desperate people... (please don't try this at home I guess)

I'll attempt to skip the gory details here, but I arranged to perform a homebrew FMT, utilizing a cough-donation-cough from a generous friend of mine who was a stellar specimen of gut health. At the time, he was in the military which meant that he'd recently been screened for all the relevant parasites. In any case, I'd done my homework thoroughly enough to feel confident that I wasn't going to get myself killed.

The results were immediate. My energy levels came back from all-time-low to better-than-ever, and (sorry) my bowel movements were easy and picturesque for the first time in my life. I stopped bleeding. For those who are curious, there were some unexpected side-effects. Namely, during the subsequent two weeks everything smelt like my friend's poo (this was apparently an internal thing, nobody else could smell it - WEIRD) and I had sudden, serious carb-cravings; I'd been low-carb for years and this was very noticeable.

It's been 4-5 years since then and my condition - while not always perfect - hasn't been nearly that bad since. I occasionally have flare-ups but they tend to resolve themselves and my diet/lifestyle seems to be holding my condition in check approximately 95% of the time. That being said, things seem to be slowly worsening over time and I wonder what I'll do the next time around. I've got no delusions about being cured, since IBD seems to have some sort of underlying genetic component and we're still pretty foggy on the mechanism.

The whole thing has soured me considerably on the medical mainstream though, and I'm somebody who is staunchly against hokey bullshit like homeopathic remedies. I suspect there's truth in the nuance here. It's not as though the scientific method is a bunch of shit, but there's a lot more that goes into medicine than simple, on-the-ground experimentation. Individual practitioners are experiencing information overwhelm to an extent that was formerly unimaginable and we all know that there are Incentive Structure Issues around drug research and manufacturing.

I don't know what the moral of the story is. Perhaps that it's an odd time to be alive. I felt compelled to share my story after reading, but I will admit that - looking it over - I feel pretty exposed. Nonetheless, if there's a place to share this, it would be here.

I wish every single one of you the best of luck. It seems like we may need it.

This is incorrect. The example only assumes that your only consideration was your spouse's view of how much you care about their experience. It makes no assumptions about what your spouse actually cares about.

Your claim, that for the majority of women that behavior isn't attractive, is just superfluous editorializing and I support Baisius's attempt to pressure you into more constructive discourse.

Does anybody know if there have been any sleep-deprivation studies that attempt to control for belief effects? I'm think about this sort of thing. The knock-on ramifications in either direction seem like they could be potentially significant. Among other things, belief effects could help to explain the swaths of contradictory studies around this topic.

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