The search for the perfect grandma

Optimising our folk psychology

A thought experiment: You are a benevolent but non-omnipotent God. 

Adversarial forces - demonic powers, budget cuts, a crappy UI, whatever - are holding you back from fully shaping the world to your whim. Your power is limited to specific, niche interventions, whose positive leverage you are keen to maximise. 

You’re aware that the humans in your world are really struggling. Specifically, they’re having a hard time with a thing they’re currently calling Mental Health.

Right now you’ve got the chance to do something very positive. A window has opened, and your limited power is enabling you to do exactly one thing: you have a chance to wholesale re-design how your humanoid subjects talk about this phenomenon. You don’t have the resources (let’s call them G-Bucks) to suddenly give them therapy or medicine that works better. What you can do is a wholesale overhaul of the words these people use to describe their Mental Health, the conceptual categories with which they perceive the world around them. A semantic refurb, if you will.

What new words do you give them? 

How much of the current verbal morasse do you keep? Are your humans still gonna be talking about how their serotonin deficiency and dopamine addiction made them waste their teenage years playing of League of Legends? Or how their ADHD and high-functioning autism made them antagonise their teachers and peers? Or maybe about how the breakup happened because their avoidant attachment style triggered their girlfriend’s daddy issues, or because your climate anxiety rubbed up against her generational trauma? Which of these terms are accurate? Which of them are useful? Are the accurate ones the useful ones? 

The Culture produces these new terminologies tirelessly. Sometimes they filter down from the practice of psychotherapists. Attached permanently added a new item to the pedestrian inventory of first-Hinge date questions. Bessel van der Kolk’s The Body Keeps the Score hard-carried the term “trauma” into the collective arsenal of This-Is-Why-I’m-Sad explanations. 

Sometimes, these terminologies are consciously constructed in perceived opposition to psychotherapeutic establishments. Once Twice Thrice Tarnished author Johann Hari wrote Lost Connections with the precise goal of slaying the folk psychology chimera that depression is caused by a chemical imbalance of low serotonin. Hari does what every other pop psychology author does: light the Google Scholar beacon of Gondor, amass an onslaught of papers that support your case into a compelling - and ideally, adversarial - narrative that makes your conclusions appear overwhelming, obvious, and the triumphant victory of truth-at-last over some variety of Establishment. 

I don’t know what vocabulary is best, but surely these vocabularies do matter. Consider the new mother struck lame after the birth of a child, for whom post-partum depression offers a lifeline path to self-forgiveness as well as a pharmaceutical roadmap. Consider the schizophrenic Jehovah’s Witness, ostensibly possessed by the devil. Consider yet again the 14 year old girl, struggling with schoolwork and bullying, watching 20-second-confessionals documenting how a $500 Taylor Swift concert “altered my brain chemistry / cured my depression”. 

What are you doing gonna do about it, big guy? 

II.

‘There is something that causes me the greatest difficulty, and continues to do so without relief: unspeakably more depends on what things are called than on what they are.’

• Nietszche, The Gay Science

I like framing this as a choice between two grandmothers. 

I’ll explain. A couple years ago, I was travelling in the West Bank - nothing crazy, just normal tourism. I stayed at hostels there, and as always you get the privilege of meeting some great characters on the way. 

Of these characters, perhaps the best was a young 20-something American - let’s call him Kyleb - I met while staying in Nablus, a town in northern Palestine notable for its hearty Kunefeh and close proximity to a population of half of the world’s remaining Samaritans.

Kyleb, whom I can only describe as the chillest dweeb I’ve ever met, was from West Virginia, and had escaped his “shithole” hick hometown to study Hebrew and Arabic at the University of Jerusalem. Hilariously, he was of neither Jewish nor Muslim ancestry - his parents were white Appalachian evangelicals on the paternal side, and Nepalese Hindus on the other. I guess rural West Virginia really is just that bad. 

This guy told several great stories, the best of which concerned a time his grandma brought him back some mad honey after a trip to Nepal.

I’d not heard of mad honey before but it’s basically the product of bees that feed on a particular type of rhododendron native to Nepal and some parts of Turkey. Mad honey contains grayanotoxins, which can cause hallucinogenic effects as well as euphoria, dizziness and nausea. Like pretty much 90% of naturally occurring psychotropics, it’s traditional use is apparently as an aphrodisiac.

One afternoon, Kyleb decided the time had come and ate several spoonfuls of the prodigal honey whilst at home with his grandma. The problem: he chose the wrong grandma. Inexplicably, Kyleb took the mad honey while chilling with his white evangelical Christian grandma, not his here’s-a-powerful-drug-for-you-to-try-honey Nepalese grandma. 

If you want to know what mad honey feels like, there’s a couple reddit confessionals you’re welcome to google and read. People online describe it as ranging anywhere from weed to opiates to nutmeg overdoses (yeah you can do that too). For Kyleb, in any case, the mad honey made him feel super not great. He described it as deeply confusing, nauseating, and extremely physically uncomfortable - like hosting a hive of bees in his bowels. 

And so when he sought solace from said grandma, she came to the (for her, ontologically sound) conclusion that he was possessed by demons. She did the noble thing: an impromptu DIY exorcism, which in Kyleb’s retelling of the story involved repeated slaps on the face and “leave him alone you devil!” 

Clearly, there’s a lot on the line if people use the wrong concepts, like “demonic possession”, in place of the right ones, like “oh that’s just the honey, dear”. Which grandma would you rather have tripsit you whilst you bear the pain of mad honey? Obviously we’d all rather go for the Nepalese grandma, the one who knows wtf is up.

Ok so maybe that’s our solution: to describe our suffering, we should be using whichever terminology our Nepalese grandma - ie, the relevant domain expert - is using. We use the words that accurately describe the ground truth cause of the pain: “you are feeling bad because you ate mad honey, dear”. 

This opens up the immediate question: who is the Nepalese grandma of mental anguish? Is it science? The Buddha? Gary Vee? Which scientists, which priests?  Is it someone who talks about dysfunctional hedonic reward, or lack of a social circle? 

The simplest option - that our preferred grandma is neuroscience, and the ground truth cause of suffering is in the brain - makes it sound like what we’re aiming for is eliminative materialism. The basic position of eliminative materialism (propounded by power couple Paul and Patricia Churchland) is that the folk psychological terms we use to describe our mental states are conceptually impoverished. As neuroscience advances, words like “belief” and “desire” will and should be replaced with fine-grained descriptions of the actual material processes underlying what we previously and erroneously described as mental phenomena. 

I’m a tentative fan of this suggestion - surely emotional dictionaries informed by physiology are helpful, even just on a low-level like “nicotine increases my heart rate and blood pressure so that’s why I feel bad when I smoke a cigarette first thing in the morning”. It seems reasonable to expect that getting more and more detailed mappings of emotions to physical processes could help us understand ourselves. 

One problem, of course, is that emotions may not always reduce neatly to specific physical configurations. I’m going to avoid the metaphysical rabbit-hole here, but even within neuroscience there’s a school of thought that the physical creation of emotions is a context-dependent, whole-brain computation. There’s evidence that individual interoceptive phenomena are rendered emotional by context, and no description of neuron activity in a particular region of the brain makes sense outside of wider recent phenomenological history. 

Furthermore, mapping emotions to underlying physiology requires us to interoceptively apprehend those emotions with a consistency and accuracy that is surely beyond many of us. Can I consistently feel the difference between increased amygdala activation (fear) and the heightened nucleus accumbens activity (anticipated reward)? Maybe what we want is Neuralinks giving us this information immediately but, alas, you’re not a god that can accelerate tech for your human underlings.

So it seems our Nepalese grandma is also going to have to foreground phenomenology, and talk to Kyleb about the cause of his unease in experiential as well as materialist terminology. Would this world, in which therapy-speak is the lingua franca of emotional discussion, be an improvement? 

There’s two big problems with this. The first is obvious: which therapy-speak are we going for? Different psychotherapies - all of which posit different root causes of psychic suffering - all seem succeed. So success can’t really be our criterion for ground truth. Are all of them true? maybe, but just true for different people. 

There’s another, subtler problem with the therapy-speak utopia though, and it concerns the effect that the prevalence of awareness about mental health problems might have on the prevalence of those problems themselves. Boomers make this point fondly and sagaciously - “kids are depressed cos they won’t stop talking about depression” - but there’s some meat to it. Scott Alexander is particularly fond of pointing out that diagnoses of multiple personality disorder exploded once doctors started looking for it.

If this is true, the therapy-speak utopia would come at the steep price of universally raising everyone’s priors on things, like OCD or multiple personality disorder, which are super bad to have. It would be like subtly suggesting to everyone that they might have eaten mad honey, which might be helpful to those who genuinely had, but could be calamitous to those who hadn’t but amplified their generally weird noisy bowel-signals into agonising stomach distress. 

There’s an even broader point beyond this. The literal ground truth cause of emotions likely isn’t even something that most humans - perhaps any human - can understand. Perhaps a Superintelligence could tell me the exact reason why I feel rubbish today, but it might be delivered in tongues. I wouldn’t want the exact reason, I’d want some approximation of the truth conducive to my own feeble ape-brained understanding. An unemployed Fine Arts grad doesn’t need the 12-hour lecture series on the labour market to start applying for jobs. 

Likewise, a world in which everyone can meaningfully understand hypothalamic overactivation in the context of threat processing is one in which the diversity of human brainpower and comprehension has radically shrunk around an area several standard deviations away from the current median. Words-for-emotions exist to facilitate meaningful introspection at a level comprehensible to the individuals experiencing them.

Finally, words-for-emotions have an important interpersonal role to play: they help us negotiate relationships, address grievances and make demands. 

Ok, so maybe even a God shouldn’t just unilaterally fashion the new emotions dictionary. It just won’t suit the infinite diversity of human experience, it won’t adapt to the variety of human levels of understanding and the diverse interpersonal needs of language. We need some kind of decentralised solution. What we want is to create conditions in which benign dictionaries outcompete the unhelpful ones. The new question then, is not which grandma for all of humanity? but how can everyone get the right grandma for them?

III.

‘The truth will set you free. But not until it is finished with you.’ 

• David Foster Wallace, Infinite Jest

What is it that causes new emotion dictionaries to be authored and catch on anyway?

Sometimes, it’s just for insidious motives: profit, fame - think cults and scientology. Sometimes an earnest understanding to apprehend the true cause of suffering. Think the Buddha, or the post-Nam science of PTSD. Sometimes, too, it’s a way to make political and interpersonal claims: climate anxiety, “triggers”. Sometimes it’s a mixture of all the above: SSRIs, etc. 

This kind of thing is natural and important. It can help you reach out to a friend for help; it can help you successfully cash in a life-saving insurance claim. But the pressure to develop emotion dictionaries which help you make demands can warp these words. The insurance need for neat diagnostic categories retcons people’s own phenomenology into more clearly cut boxes than they were ever intended to. Critically, processes are set in motion which amplify trends towards self-victimisation. 

Consider the way that transgender people need to wheedle doctors to get the medical care they want. Often, the gates to transition are opened only by threats of depression or suicidal ideation . This has warped trans discourse to accentuate the true suffering of gender dysphoria. I’m not denying for a second that it certainly can be true suffering, but the spotlight is all negative, and the terminology which gains currency is of a high negative valence.

So the benevolent God shouldn’t ditch the old emotions dictionary. Really, you want a perfect marketplace/ecosystem (choose metaphors according to your political leanings) of competing terminologies. The real key is to fashion a better criterion for success than “go viral” or “make insurance companies cough up money”. We’re less interested in giving everyone the right grandma than we are in 1) providing a diverse enough supply of grandmas to satisfy everyone’s diverse needs; and 2) empowering individuals to pick the right grandma for the right problem.