Fighting the allure of depressive realism

post by aaq · 2019-02-10T16:46:21.371Z · LW · GW · 2 comments

Epistemic tragic backstory: Personal.

Earlier this week, on my first post on this site under this account, shminux commented to the value of cognitive-behavioral therapy [LW(p) · GW(p)] to get out of what I called "depression philosophising".

I was worried about trying it. One claim of CBT is that depressed people are negatively biased and by correcting their thinking errors they are gradually brought to being both happier and more accurate about the world around them.

However this may not actually be the case. The phenomenon known as "depressive realism" suggests that the ordinary person might be positively biased and that depressed people might need to correct their "errors" by forming less accurate, but happier patterns of cognition. Sort of like a really, really weak Nozick machine.

Now, this question doesn't actually undermine CBT itself that much. A movement from (depressed, inaccurate) to (not depressed, accurate) is pretty much as good, in terms of what any anti-depression therapy is trying to do, as one from (depressed, accurate) to (not depressed, inaccurate).

But if it's the latter, our least convenient likely world [LW · GW], we face the classic question: "Should we optimize more for epistemic or instrumental rationality?" This was a hurdle I had to get over before I could convince myself to use CBT. I had a few false starts, but eventually came up with some good convincing arguments that even if this is the case CBT is well worth it.

I decided to treat it as a decision on the margin, remembering my Econ 101. That turned out to be such an obviously right fit to the problem that I felt ridiculous for not having thought of it instantly. The tradeoff of a small amount of epistemic rationality (= losing the benefit of depressive realism) for a high chance of a moderate, potentially large amount of instrumental rationality (= all the time, energy, and general life pleasure I get from treating my depression) is one almost any sane person should make.

After that I also realized that there was an argument from symmetry here. Would I advise someone looking to improve their epistemic rationality to become depressed? Of course not. We have all of these tools already to improve our epistemics - the wisdom of crowds, prediction markets, good old fashioned education and reaching out to experts on whatever topics seem pertinent. But you will very likely lose at least some of the energy and motivation to pursue these much better strategies if you take the nuclear option first. Even people as already successful as Rob Wiblin think this is a good idea. The costs far, far outweigh the benefits.

Then we move to the specific case: Would I advise someone who is already using CBT successfully to treat their depression who wants to improve their epistemic rationality to stop using it and slip back into depression? Again, no, for all the reasons above.

And that general -> specific move makes me realize: These arguments are more about depression in general, not CBT in particular. While my fear started from thinking about starting CBT specifically, that's not where it actually was. It was in losing the benefits of depressive realism.

I was never scared about starting therapy. I was scared of losing part of my identity.

Throughout my life I've felt keenly aware that most people seem happy for no good reason. That they make decisions without having good evidence for why they do it. And I felt that I had to serve as some sort of counterbalance to that, that I had to be the person to bring everyone back down to reality. That was part of who I was. But those two things don't go hand in hand nearly as much as I've been telling myself. You can be happy most of the time, and you can also be aware of the human tendencies to overestimate and adjust accordingly in yourself. Life doesn't have to be this zero sum game where only the sad are wise and only the wise know enough to be sad.

I remembered a post by Natália Mendonça [LW · GW]. I remembered that I had a whole community of people I could turn to for advice about when I was overestimating my chances on anything large enough to be worth more than 2 or 3 minutes of thought. I remembered that letting myself be depressed so I could be more realistic is making the classic mistake of trying to change human nature itself, rather than trying to change the environment to suit imperfect human nature. And, going off of that, I remembered that humans don’t owe society anything. We were here first.

I had let my desire to think accurately in every single domain in my life overpower me, and ironically cause me to think very inaccurately about the nature of my mental illness.

So I picked up a pen, and I printed out some ABC forms, and I got to work.

2 comments

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comment by Pattern · 2019-02-12T02:04:18.548Z · LW(p) · GW(p)

Good luck!

(Btw. the title made me think a) of the claim that gratitude journaling works and b) made me wonder if CBT is associated with that practice.)

Replies from: aaq
comment by aaq · 2019-02-12T20:52:23.239Z · LW(p) · GW(p)

Thanks! :)

I think the approach is different for me, but maybe other person leverage gratitude as a way to fight their negative thoughts closer to the way you imply.