My son is going to arrive in the world Real Soon Now. As such, both my blog and Patreon are on hiatus until April. See you on April Fool’s!
I am an autistic parent, which means I have a relatively high chance of having an autistic child, which means I’ve started thinking about early-intervention treatments for autism. (After all, autism is often diagnosed as early as eighteen months, and I’m not exactly going to have time to do research when I have an infant.)
Many of my friends disapprove of applied behavioral analysis (ABA), one of the most commonly used treatments for autism. I am inclined to be more sympathetic, I think, for several reasons. First, it claims to be the most evidence-based treatment for autism. (As far as I can tell, this is true but complicated; more on that later.) If a treatment is evidence-based I’m always going to take a second look. Second, many of the groups that advocate against ABA support discredited pseudoscience such as facilitated communication, which makes me not trust their judgment very much. Third, I have a natural tendency not to want to admit beliefs that will make my friends mad at me, and “I think this therapy you think is abusive is actually fine” might make people mad at me.
That said, setting those worries aside, I have some concerns about ABA. I welcome opinions from people with more knowledge about ABA.
The evidence is not that great. It’s true that ABA is the most evidence-based autism treatment. As far as I can tell, it gets this status because most autism treatments fall into the category “untested but plausible,” with occasional excursions into the land of “what, no, there is literally no reason to think that would work, the fuck is wrong with you.” (This is a somewhat puzzling state of affairs, because we do spend lots of money funding autism research, and we can’t spend that much money trying to give fruit flies autism.)
This is a fairly representative list of studies of ABA as an autism treatment. Note that no studies follow the children until adulthood. Most have sample sizes of twenty to fifty children. And that’s not even including the really embarrassing stuff: the study of the Early Start Denver Model used parent report for many of its outcome measures even though the parents knew which group their children were in.
I understand that an appropriately blinded randomized controlled trial with a reasonable sample size that follows children to adulthood is really expensive. However, if you’re going to talk about how your treatment is evidence-based, this is the sort of thing that is necessary. The evidence for ABA at this point is less “gold standard” and more “plausible in early, exploratory trials.”
So I feel justified in having other qualms.
Response to adverse event reports. Many autistic adults report that they have PTSD and depression from their experience of ABA. That doesn’t mean that ABA necessarily causes PTSD and depression– perhaps it’s a coincidence, or perhaps they had unusually bad therapists. But I think if lots of people are saying “your therapy gave me depression,” the only ethical thing to do is go “wait, holy shit, we need to study this.”
In my anecdotal experience, I have not seen ABA supporters say this. Instead, I have seen many ABA supporters say that people reporting adverse mental health consequences are pseudoscientists who hate evidence-based medicine, which is not the way you respond to people saying your therapy gave them PTSD.
I have seen some ABA supporters argue that perhaps it causes PTSD and depression among the “high-functioning,” which seems like a really dumb argument. First of all, the whole point of your therapy is that it turns autistic people with high support needs into autistic people with lower support needs; maybe those people have low support needs because your therapy worked. Second, a lot of people with very high support needs can’t communicate in sign, speech, written language, etc., so of course they’re not going to be saying “ABA is terrible and I got depression from it,” even if it gave literally 100% of them depression.
Normalization. I don’t mean to say that faking nonautistic is not a useful skill. It opens more options to autistic people: while many people (including myself) find that faking nonautistic is not worth the cost, I’m not going to impose that on everyone. Many people want to work jobs or have relationships that require them to fake nonautistic, and it’s good to give them that option.
However, in my opinion, it is also not a skill it makes sense to teach people who presently can’t function very well. If a person does not have use of language (whether spoken, written, sign, or through use of AAC), has a severely limited diet that may cause them nutritional deficiencies, regularly experiences meltdowns, self-injures or harms others, or experiences one of the many other severe impairments that can be caused by autism, those need to be the #1 priority. For that matter, if a person is anxious or depressed, has low self-esteem, has executive function issues that mean they can’t meet their goals, or can’t understand nonautistic behavior, then those issues need to be the priority. Only once all of those have been sorted out does it make sense to concentrate on eye contact.
And yet in many ABA programs eye contact is one of the first things worked on, even in autistic children with severe difficulties functioning. It seems to me that this is less about giving autistic people options and more about saying that autistic ways of being are inherently worse than nonautistic ways of being. That is not a therapy I can get behind.
“Effective” is one of those words that depends on your values. Effective for what? Regularly beating your children is a very effective way of making them so scared of you that they instantly and quietly obey; I don’t want to beat my kids in part because I think that’s a terrible fucking goal. And turning autistic children into facsimiles of nonautistic children is also a terrible fucking goal.
Aversives. Fortunately, the use of aversives has been phased out in ABA treatment. In addition to the physical abuse of children (I think it should be fairly obvious why this is objectionable), aversives sometimes included things like taste aversives, which don’t seem that bad to nonautistics. However, as an autistic person, being forced to eat something I have a severe taste aversion to is literal torture. It is wrong to do that to a child.
However, Lovaas’s original randomized controlled trial of ABA for autism did include the use of aversives. How do you know that aversives weren’t the active ingredient? Therefore, this change (which is very positive) makes the evidence base for ABA even more limited.
Prompt dependence. As far as I know, prompt dependence has not been studied in autistic people, and any claims about it should be taken with appropriate grains of salt. But, anecdotally, it is a very common experience among autistic people to find yourself doing things because other people or the environment prompts you to, without actually intending to do it. Sometimes prompt dependence is helpful (I personally use it to get work done). Sometimes it is very unhelpful, as when you find yourself doing something that you don’t want to do or that is even harmful to you.
I am concerned that many forms of ABA, by rewarding specific behaviors in response to prompts, would increase prompt dependence in autistic children. It would certainly not teach the essential life skill of noticing that you’re doing something because you’re being prompted to do so and being able to do something else.
Amount of time spent in therapy. ABA often involves twenty to forty hours a week of therapy. This seems to me to be an excessive workload for a toddler, particularly when you consider that therapy is stressful and requires a lot of energy, so the remaining hours are unlikely to be high-quality hours. When does the child get to play? I don’t just mean this as a “play is fun and it is mean to deprive developmentally disabled children of the opportunity to play.” The current scientific consensus is that play improves social skills and executive function. (See, for instance, this report from the American Academy of Pediatrics.) Those are exactly the things autistic children are impaired in. Without strong evidence of efficacy, it seems ill-advised to give children so much therapy that their play time is limited.
Behaviorism. Unlike many autism advocates, I do think that there’s an appropriate role for behaviorism as one component of therapy for mental disorders. However, pure behaviorism has been rejected in most areas of psychology. Patients with mood disorders and personality disorders receive therapy with both a cognitive and a behavioral element (and often with other elements, such as mindfulness). Experts no longer advise not comforting crying infants for fear that it would incentivize the child to cry; indeed, comforting crying infants is often recommended as a way to build attachment. Many people are concerned that extrinsic rewards of the sort promoted by behaviorists may decrease intrinsic motivation and ultimately lead to lower performance. We understand the importance of social learning and attachment in children’s psychology.
And yet here we are treating autism with pure Skinnerian behaviorism. I have no doubt that pure Skinnerian behaviorism is effective for some things– it works quite well for phobias– but I would be really really surprised if it were the correct treatment for a complex condition like autism. Teaching children to say “hi, what’s your name?” in response to someone saying “hi” is not actually teaching any useful social cognition. There is, in fact, a difference between people and chatbots.
I don’t know what my ideal autism early-intervention program would look like. Certainly it would be customized to the child. Maybe there’d be a big play component. Maybe there’d be work on building attachment between the child and caregivers. Maybe there’d be age-appropriate cognitive therapy (despite the difficulties in providing cognitive therapy to children without language). Maybe children could play at a play group with both autistic children and neurotypical children who have been taught how to play with autistic children, so they could build social skills in an easier environment. (The neurotypical children seem like they ought to be easier to teach than the autistic children, anyway, since they’re the ones without social impairments.) Maybe there would be a lot of occupational therapy to help with motor skills, feeding, speech, sensory sensitivities, and other common areas of impairment. Maybe children would be taught to identify their needs and self-advocate. It is hard to know without more study. But I feel like pure behaviorism is not it.
[I have literally no qualifications to have an opinion on this and everyone should take it with many grains of salt.]
If I ran the world, there are two things I would do to make research on human beings more representative and have higher sample sizes.
First, there are lots of cases where there are multiple treatments for a particular condition, but there isn’t any really solid evidence about which one is the best. (Autism treatment, of course, is an example close to my heart, as is antidepressants.) Right now, people are prescribed a variety of treatments, but the data is pretty much useless, because maybe doctors who have rich patients favor Treatment X and doctors who have poor patients favor Treatment Y and then it’s no surprise that people who get Treatment X fare better.
Instead, we should use this as an opportunity to run a randomized controlled trial! If you’re depressed, your doctor should press a button and get a random SSRI to prescribe you. There would be no extra burden on the patient, because you could use the information about effectiveness and side effects that should be in the patient’s medical records anyway. Result: enormous sample sizes with plenty of real-world validity.
Research should of course be consensual, so the patient can opt out and rely on their doctor’s clinical judgment. I think this should require signing a consent form that says “I UNDERSTAND that there is no clear evidence that one treatment is better than another. I UNDERSTAND that my doctor’s clinical judgment may be influenced by many factors, including but not limited to advertising from pharmaceutical companies.”
This would be easiest, of course, to do in a country that, unlike the US, has a national health system. But I think it would be possible in the US as well.
Second, we would recognize that participating in human-subject research is a necessary part of contributing to society, the same way that jury duty is; everyone has to participate in creating science that benefits everyone. Researchers with an academic affiliation, or who are sponsored by a researcher with an academic affiliation, have the right to pull a random sample of people from the voters’ or drivers’ rolls. If they wanted to research a subpopulation of people, they could send out questionnaires (with an online option, because we are in the 21st century here); only the people who are eligible for the study need show up at the study site.
People would have a right to refuse to participate in any studies with an actual risk, such as drug trials, weight loss studies, or studies which involve sensitive issues like violence or stigmatized traits. However, certain studies would be certified by the institutional review board as minimal risk: for example, spending an hour talking with an interviewer about household chore division or filling out a new personality instrument or having your blood pressure taken before and after you watch a video about puppies. IRBs are currently absurdly strict about ethics, so I expect they will not certify anything as minimal risk unless it is actually minimal.
Once again, the result is studies with large, random sample sizes and a complete end to psychology actually being the discipline of Introduction to Psych Student Studies.
My gracious employer, Wild-Animal Suffering Research, is doing its end-of-year fundraiser.
What is Wild-Animal Suffering Research?
We research wild-animal suffering. (See, there is an advantage to clear names, despite the apparent opinions of all the EA organizations named something like Center for Effective Future of Open Global Action Priorities Research Institute.) Our goal is to understand wild-animal suffering, build a community of wild-animal-welfare researchers and advocates, and hopefully eventually discover cost-effective tractable interventions into wild-animal suffering.
We’ve only been around since June, but so far we’ve written a research agenda, released two cool review papers, given talks about the importance of wild-animal suffering and about human appropriation of net primary productivity, and subsidized a lot of writing on this very blog about wild-animal suffering.
What are you going to do with the money?
Most importantly, if we hit our goals, I am going to get a raise and to go to more conferences.
My coworkers Persis Eskander and Georgia Ray are not only going to get a raise, they’re going to get to work more hours, which means that we will produce more of the cool papers you have come to expect from us. There are some great papers in the pipeline, guys. I know, I get to read them.
We are a tiny organization– our whole room for more funding is only $160,000. Even a relatively small donor can have a really big effect.
Okay, so, raises, conferences, and more hours. What is all that going to actually accomplish?
We’re going to get a bunch of useful things that it is helpful for charities to have, such as “a strategic plan” and “an evaluation plan.” We’re going to summarize the evidence about the capacity of wild animals to suffer, the quality of wild-animal lives, possible interventions into wild-animal suffering, and how human activities affect wild animals. We’re going to make connections with academia, effective altruism, animal activism, and people with an interest in wild-animal suffering in the hopes of building an anti-wild-animal suffering community. By the end of the year, we should know more about what we should be doing and have more of the tools available to actually do it.
What are your philosophical commitments about wild-animal suffering?
Wild-Animal Suffering Research has employees with very different values and has no official position on complex and uncertain issues like population ethics, whether wild-animal lives are worth living, habitat destruction, etc. (We do all think that animals matter morally, at least a little bit, because otherwise we’d be working a different job.) Since the movement is in such an early stage, people who are concerned about wild animals can work together to improve our state of knowledge and the strength of the pro-wild-animal community, even if our values mean we will come to different conclusions in the end.
But I heard there were no tractable interventions into wild-animal suffering!
We don’t actually know that. The argument for donating to WASR is that, even though it’s possible that we’re going to finish up our research in five or ten years and go “nope, there’s nothing we can do,” if there are trillions of suffering beings and no one has even checked if there’s something we can do about it, then probably someone should check.
If you are persuaded, please donate!
[DISCLAIMER: Wanting to increase the chance that my child has a particular trait does not mean that I would not love, respect, accept, and approve of a child without that trait, and if you think that is impossible I am somewhat worried about your mindset when you avoid teratogens. I have read Selfish Reasons to Have More Kids and think increasing children’s altruism is positive in expectation even given the book’s arguments.]
[COMMENTING NOTE: While opinions from non-effective-altruists are welcome, comments along the lines of “have you considered not being an effective altruist?” will be deleted.]
I’ve been reading about increasing the chance that your children are altruistic. It seems like two things that increase the chance are modeling altruism yourself and giving the child opportunities to engage in altruism in an age-appropriate way.
I would like to increase the chance that my son is an effective altruist, which means that modeling ineffective altruism is kind of pointless. The behavior I want to model and to offer opportunities for is thinking about how to do the most good and doing it, not doing something for signaling value and warm fuzzies. But the forms of altruistic behavior my husband and I engage in look like going to work (him) and typing on a computer keyboard (me), neither of which models altruistic behavior specifically. And children, particularly before adolescence, generally have a limited ability to earn to give or fill talent gaps in important organizations .
Things I have thought of so far include:
- Political involvement in effective causes (protests, phonebanking, canvassing, letter-writing).
- Discussing effective altruism in front of my child.
- Running an age-appropriate Giving Game once a year so he gets experience in charity selection.
- Offering opportunities for my child to write or speak about effective altruist ideas (maybe he can guest-post on my blog).
- Trick-or-treating for UNICEF (or AMF?).
- Eating a lacto vegetarian diet and explaining why (in an age-appropriate way, I don’t plan to show my toddler factory farming videos).
- Explicitly connecting things I and my husband do to effective altruism (I do research to help wild animals; Topher works as a programmer so he can donate to charity).
- Explicitly connecting things my child does to effective altruism (learning reading, writing, math, and natural and social science will help you improve the world in the future).
Does anyone else have suggestions?
Game Changer: A Memoir of Disruptive Love: A memoir by Franklin Veaux, author of More than Two, about his marriage to an obligate monogamous person while being obligate poly. If you are like “wow, that seems like an incredibly horrible idea,” you are far more sensible than anyone in this book, who universally seem to be under the impression that this situation can be managed by coming up with a bunch of rules about Franklin’s dates with other people. (No “I love you”s! No sleeping in their bed! His wife for years gives him, a grown man, a curfew.) Naturally this entire situation is very painful for Franklin, his wife, and all of Franklin’s other partners. Somehow this relationship, which in any sensible world would have ended after the third date, managed to stay together for eighteen years. Eighteen years! That is definitely an impressive feat of endurance if nothing else.
Trauma Stewardship: An Everyday Guide To Caring for Self While Caring for Others: I really wanted to like this book. I think the concept of “trauma stewardship” is really interesting and important: the author reframes trauma exposure responses (the mental health consequences often faced by people who help others– whether people or animals– cope with highly traumatic situations) as trauma stewardship, the entire conversation about how we come to do the work, how we’re affected by it, and how we make sense of it. I think it’s a really interesting move to understand helpers’ relationship to trauma as stewardship, as taking a valuable thing which has been entrusted to us and which we have responsibility for but which ultimately does not belong to us. Unfortunately, I have a limited tolerance for woo, and after the sixth or seventh comment about the wisdom of Native Americans I checked out. So it did not really live up to its potential from my perspective.
The Myth of Sex Addiction: I really, really wanted to like this book. And to be fair some of its arguments are effective. Probably the most effective argument in the book is a case study of a college student and evangelical Christian who identified as a sex addict because he felt like he couldn’t control his masturbation no matter what he did and it was causing him serious distress. He masturbated twice a month. That, I think, is the best argument I’ve ever heard that some cases of sex addiction are best treated with sex positivity and destigmatization, not attempting to get the patient to reduce their masturbation to zero times a month.
I also find it plausible that the diagnosis of sex addiction is, as it were, gynecentric. That is, “sex addiction” doesn’t just pathologize unusual but harmless behavior such as BDSM; it pathologizes behavior that, for whatever cultural or biological reason, is far more common in men than in women (a desire for anonymous sex, enjoying sex outside of a relationship context, seeing sex workers, daily masturbation to pornography).
Unfortunately, The Myth of Sex Addiction itself has an addiction to gee-whiz clickbait-headline thirty-undergraduates-from-an-Intro-Psych-class this-is-never-going-to-replicate psychology studies. It tells us that these studies are Just How Men Are, because of Biology and Evolution, without ever doing any sort of cross-cultural analysis or acknowledging that its sample is WEIRD. It repeatedly cites the SurveyFail guy, who years later has still not managed to work out that women don’t jerk off to fade-to-black romance novels.
The Myth of Sex Addiction very confidently claims that women don’t have fetishes. I think this is a bizarrely confident claim to make after you’ve spent five pages mustering the evidence that women are less likely to masturbate and to approve of porn and non-PIV sex. Maybe they do have fetishes and they just have no idea? Also, the definition of fetish is actually androcentric. My research suggests that men don’t have fetishes, because while it is very common for women to dream of being ravished by a cowboy, almost no men dream of being ravished by a cowgirl. In fact, the entire genre of cowgirl-ravishment books appears to be aimed at lesbians.
As always when I read books about mental illness that don’t come from a social-model perspective, I think the social model would make this guy’s life so much easier. Yes, it is possible for the same mental trait to be an illness if it causes you distress or difficulty functioning, and a quirk if it doesn’t. The fact that I don’t experience any negative consequences from my hypersexuality doesn’t mean anything one way or the other about whether it’s a mental illness; it just means that my environment accommodates me.
Utopia for Realists: I am honestly pretty surprised by this book, because I didn’t expect anyone to be so slavish in following Silicon Valley political orthodoxy. Guaranteed basic income, shorter work weeks, randomistas in foreign aid, open borders… it honestly surprised me that there wasn’t a chapter on fixing the housing crisis by building more houses. Anyway, it was all pretty boring for me, because I live here and am already familiar with the arguments for and against a guaranteed basic income and open borders, but if you are curious what Your New Tech Overlords think about things there are really far worse books you can read.
The Joy of Gay Sex: A evocation of gay male life circa 2009 cleverly disguised as a sex advice book. The sex advice itself is mostly not very interesting, assuming you have some idea of the mechanics of anal sex. The little essays about HIV, chosen families, monogamy, and all the other details of gay life build up a rich tapestry that really helps you intuitively understand what it’s like to be a (certain kind of) gay man. The sections on the Internet were particularly interesting to me, because they were written pre-Grindr; the gay Internet as described in the book is both recognizable and distinctly less convenient than the present Internet. My one complaint is the underrepresentation of the gay and bisexual men of my acquaintance (where are the furries? where are the anime nerds?) but I suppose that they don’t really hang out at gay bars so perhaps the author never had a chance to meet them.
Crazy Like Us: The Globalization of the American Psyche: I am leery of giving a positive review of this book, because it is written by a journalist, and it is very possible the author is misunderstanding all the research because he doesn’t have a background in the field. Perhaps Scott Alexander or Sarah Constantin or someone could fact-check it for me.
Until it is fact-checked by someone I trust on psychiatry, my tentative opinion is that this book is very plausible. Essentially, the thesis is that certain things (trauma, mental distress, psychosis) are universal, but we tend to express symptoms of those things depending on what’s floating in the cultural “symptom pool.” A psychotic person who grows up in America will think the CIA is mind-controlling them; a psychotic person who grows up in a developing country will think demons are talking to them. A person in severe emotional distress in the United States may be anorexic or self-harm; a person in severe emotional distress in Indonesia may commit a mass assault. (Caveats: it does occasionally happen that people pick up symptoms that aren’t usual for their culture; anorexia is probably not caused by the “thin ideal”, and in fact one of the strongest pieces of evidence for anorexia as a culture-bound syndrome is the existence of societies with a thin ideal and very very low rate of anorexia.) When a syndrome only exists in another culture, it is called a “culture-bound syndrome.” When a syndrome only exists in the Anglosphere, it is called “how people work.” Because the DSM is seen as authoritative, we export our local symptom pool around the world.
I am personally interested in the prospect of cultivating the symptom pool to reduce distress in mentally ill people. Through careful messaging, could we remove harmful symptoms like anorexia, somatization which results in chronic pain, and running amok and replace them with less harmful expressions of distress like snapping a rubber band against your wrist or cutting off your hair? I imagine how much future schizophrenics could be helped by a hundred million dollars directed towards PSAs about people who have a positive relationship with their voices and representation of people with nice voices in popular culture. Sadly, the book does not explore this concept.
The last chapter was annoying. While it established that pharmaceutical companies increased the rate of antidepressant prescription in Japan by raising awareness of depression, it did not provide any evidence that this actually increased the rate of emotional distress in Japan. Would one assume from the Viagra marketing campaign that before Viagra no one had ever had erectile dysfunction?
Evolution’s Rainbow: Diversity, Gender, and Sexuality in Nature and People: I agree with the main thesis of this book: I think that sexism, homophobia, and other oppression-related cognitive biases affect how we interpret biological data and lead to inaccurate conclusions. I appreciated Joan Roughgarden pointing out that commonly used terms like “female mimic” and “cuckoldry” can lead scientists to assume one explanation has to be true (that the animal is pretending to be female, that the female is passing off offspring from an extra-pair copulation as the male’s) when they haven’t collected the data to justify the assumption.
Some of her criticisms seem quite valid to me. For example, it does seem implausible that if humans can tell apart with the naked eye females and female mimic males of a species with sharp eyesight, then the male (who has an evolutionary reason to be good at telling these things apart) does not. Perhaps the female mimic male assists the male somehow: helping him defend his territory or allowing him to signal that he won’t attack the female. It also seems implausible that male seabirds never notice extra-pair copulations occurring in public, and thus we should look for alternate explanations in which the female having extra-pair copulations improves the male’s reproductive success somehow. Maybe extra-pair copulations reduce the risk of another male committing infanticide if the female’s partner dies.
However, I think Roughgarden has a bad habit of presenting her interpretations as settled science, when in reality they’re just interpretations. We would have to do a lot more detailed ecological work to decide whether her conclusions are accurate. And every time she says “this interpretation has an unfortunate oppressive implication” as an argument against a particular interpretation of the data, I want to cringe. That is not what science is supposed to do. You can’t decide the truth by saying what’s most convenient to your ideology.
Roughgarden writes mostly about the potential adaptive benefits of genetic diversity in humans, which makes me really curious about her opinions about the adaptive benefits of neurodiversity in humans. I agree with her hypothesis that many genetic impairments would not be as common as they are if the genes didn’t pose some fitness benefit, the way that people who are heterozygous for sickle-cell anemia genes are protected against malaria. However, she once again fails to consider alternate hypotheses. Many genetic impairments, for example, are very common in Ashkenazi Jews, who have a relatively small effective population size and thus are particularly susceptible to genetic drift. There is no reason to suppose that those impairments have an adaptive benefit.
[this review talks about rape]
Unscrewed: Women, Sex, Power, and How to Stop Letting the System Screw Us All: Probably my least favorite of Jaclyn Friedman’s books so far. I mean, anticapitalism aside, she’s right about everything. Reproductive justice does need to include not just the right to contraception and abortion but the right to start a family, have adequate perinatal care, and not be shackled to the bed while giving birth. Sex work stigma does harm women who aren’t sex workers and combating it is a vital part of sex-positive activism. The de facto legalization of rape of Native American women on reservations is horrifying. While level of vaginal arousal is completely uncorrelated with level of self-reported arousal, reporting this as “women don’t know what they want, are all secretly bisexuals who like fucking bonobos” both is sexist and misrepresents the science. While there are personal decisions that affect sex-negative cisheteropatriarcy, like volunteering for a rape crisis center or choosing not to be an asshole to people whose sex lives you disapprove of, whether or not you flash their boobs and say “wooooo!” is not one of them, either on a “this is empowering!” or a “this is objectifying!” level.
I continue to highly recommend Yes Means Yes, and maybe if any of those statements is surprising to you consider checking out Unscrewed.
I was very annoyed at the chapter on masculinity. Jaclyn Friedman is, in fact, a decent person who comes to the correct conclusion that male gender norms both hurt men and cause men to hurt others and that both aspects should be recognized. But goddamn does she feel like she needs to signal that she is still a Woke Feminist who engages in Fashionable Misandry. Is it really necessary to make fun of men who internalize oppositionally sexist norms to the point that they can’t buy female-branded products? Do you have to put in that paragraph about how the harm male gender roles cause to women ought to be enough to get men to be feminists, but okay if we have to we can talk about the harm it causes to men? Notably, Friedman does not do that in the chapter on how sex work stigma hurts non-sex-workers, which I can’t help but figure is related to the fact that Friedman is a woman and is not a sex worker.
[the next book is about dieting]
Health at Every Size: The Surprising Truth About Your Weight: I realize that no one knows why weight set points are going up, but I wish there had been more discussion of various hypotheses. Instead, the author basically goes with “dieting causes weight set points to rise!”, which is one plausible hypothesis but also seems really convenient for the book about how you should stop dieting.
The advice for practicing Health at Every Size is as follows:
- Stop hating yourself and your body. Find supportive people who won’t talk about how you need to lose weight. Practice reframing your negative thoughts about your body, food, and exercise.
- Eat delicious food. Pay attention when you eat. Eat when hungry; stop when full. If you find yourself eating to manage an emotion, use a different self-care technique while practicing self-compassion (it is perfectly natural to use food to manage your emotions if you don’t have another way to do so).
- Integrate movement into your daily life. Eat a variety of food, mostly plants, almost all unprocessed food, 100% food you enjoy. Get enough sleep. Manage your stress.
- If you have a hard time with the food advice in #3: learn to cook, check out community-supported agriculture programs, eat in a peaceful and loving environment, slow down, and pay attention to presentation.
The Nursing Mother’s Companion: Look, in six months I will tell you which of these breastfeeding books I liked the best. This one has individual survival guides for various stages of breastfeeding, covering concerns such as mastitis and nursing strikes that occur at various ages, which seems very useful and a clear improvement on how scattered they are in many nursing books.
Precious Little Sleep: The Complete Baby Sleep Guide for Modern Parents: Highly recommended; evidence-based and extraordinarily complete. I appreciate that the author characterizes both “cry-it-out” and “no-cry” methods of sleep parenting as right for some parents and some babies; this seems to me to be consistent with the research. (No, cry-it-out will not ruin your attachment with your baby, nor will no-cry methods prevent your child from developing independence.)
Newborn sleep is generally all over the place and there’s not much point to sleep training before the child is about two to four months old. Use lots of soothing techniques and try not to let your newborn stay awake too long, lest they get overtired; it’s also a good idea to establish a bedtime routine you can build on when the child is older.
People who aren’t newborns have sleep associations. Your sleep association might be the sound of white noise, reading a bit, having a cup of tea or warm milk, your blanket, or your partner on the other side of the bed. If your sleep association isn’t present, you’ll often have a hard time falling asleep. Unlike adults, babies wake up all the time in the night, so they need their sleep associations to fall asleep every time they wake up. If your baby’s sleep association is thirty minutes of being bounced on an exercise ball, then nobody is going to get a lot of sleep. It’s even worse if you, like many parents, rock your baby to sleep and then leave them in the crib. Imagine how you’d feel if you fell asleep in your bedroom, full of your sleep associations, and then suddenly woke up in a crib. You’d probably cry too.
Useful soothing tools to help babies sleep include white noise, swaddling, pacifiers, baby swings, and managing your child’s schedule so they consistently sleep at the same times each day, when they are neither not sleepy nor overtired. These should mostly be phased out by six months; white noise can be used throughout the first year, and schedule management is useful throughout life.
The easiest time to teach a baby to sleep on their own is when they are two to four months old. The second easiest time is right now; it gets harder the older the baby is. Start with bedtime; set yourself up for success by choosing a bedtime when the child is tired but not overtired, going through a quiet and soothing bedtime routine, and making the room be very very dark.
“No-cry” methods (a misnomer; they usually involve some crying) include:
- Providing lots of soothing in ways you can live with that don’t involve you waking up all the time
- Experimenting with seeing if the child will fall asleep on their own if you leave them alone in their crib for ten or twenty minutes.
- Soothing your child fully to sleep using whatever method works best for you, then waking them a little when you put them in bed.
- Gradually weaning your child from whatever you’re doing that helps them fall asleep.
The “cry-it-out” method is basically just leaving your kid in a safe and comfortable place to sleep and then not returning until they fall asleep. The author recommends full extinction (not checking on the child) as a quicker and more effective method, although parents often prefer checking on the child at regular intervals as it seems more loving.
The book also covers night waking, night eating, weaning your child from sleep soothing techniques, common causes of sleep setbacks both medical and nonmedical, and sleep in older children. It’s good. Check it out.
Your Orgasmic Pregnancy: Little Sex Secrets Every Hot Mama Should Know: A pamphlet’s worth of information stretched out into a book through lots and lots of padding, most of it entirely unrelated to sex (did you know that doing prenatal yoga is good for you?). There is some misinformation: the book claims that masochism is entirely off-limits during pregnancy, when in reality many forms of masochism are perfectly safe. It would be really useful if they had spent less time trying to pitch me on prenatal yoga and more time talking to kink-aware obstreticians to provide an actually useful resource. That said, the list of pregnancy sex positions is genuinely useful, and they had several pretty cool ideas for pregnancy-themed roleplay.
Siblings Without Rivalry: How To Help Your Children Live Together So You Can Live Too: The correct techniques for dealing with sibling rivalry are surprisingly similar to the correct techniques for metamour management. Acknowledge and accept that your partners might have negative feelings about each other, and don’t try to tell them their feelings are wrong or bad. Don’t compare your partners, saying that one is more romantic and the other is funnier. Make it clear that you love each of your partners as unique people with whom you have a unique relationship, and you do not have a hierarchy. Spread your time among them based on your needs (and, in the case of partners, the seriousness of your relationship– presumably it is relatively rare to have a secondary relationship with one’s offspring). If they start arguing with each other, listen to both sides respectfully but don’t get in the middle; leave them to resolve it themselves. However, one advantage of partners is that they are adults and can be generally trusted not to hit each other on the head with a toy truck, while children have no such guarantee.
Instead of dismissing a child’s negative feelings about a sibling, acknowledge the feelings:
- Put the child’s feelings into words (“you’re furious!”).
- Express what the child might wish (“sometimes you want your sibling to go away”).
- Help children channel their feelings into creative or expressive outlets (e.g. art).
- Stop hurtful behavior. Show how angry feelings can be expressed safely. Don’t attack the attacker.
Alternatives to comparing children:
- Acknowledge what you see or feel (“you put away your blocks and your truck. It’s a pleasure to look at this room”) without favorably comparing the child to another child.
- Describe the problem (“you didn’t do your homework”) without unfavorably comparing the child to another child.
Instead of worrying about treating children equally:
- Focus on each child’s individual needs (e.g. give more food to a child that is very hungry).
- Show children how they’re loved uniquely (“in the whole wide world there’s no one else like you’).
- Give time based on the child’s needs (“your sister needs help with tying her shoes right now”).
- Acknowledge the abilities of disabled children.
When one child bullies another:
- Don’t focus on the aggressor. Attend to the injured party.
- Don’t put one child in the role of “bully”. Acknowledge their ability to be kind and control themselves and correct others or the child themself when they describe the child as a bully.
- Don’t put one child in the role of “victim”. Show them how to stand up for themself (“I bet you can make an even scarier face back) and correct others or the child themself when they characterize the child as weak or helpless.
When children are fighting:
- Acknowledge the children’s anger towards each other.
- Listen to all sides with respect.
- Show appreciation for the difficulty of the problem.
- Express faith in the children’s ability to solve the problem.
- Leave the room.
- If the children appear to be hurting each other, describe the situation, set your limit, and separate the children.
- For recurring or serious problems, you may wish to hold a parent-guided family meeting, in which you hear all sides and their rebuttals, brainstorm solutions as a family, and pick a solution everyone can live with.
Infant Massage: A very annoying amount of this book is devoted to the fallacious argument that cuddling babies is very important for their mental and physical health and therefore you should devote fifteen minutes a day to a massage. To be clear, cuddling babies is very important to their mental and physical health; a baby deprived of cuddles may get sick, have lifelong developmental disabilities, or even die. That is why parents and alloparents feel a natural, instinctive desire to cuddle babies. Outside of very exceptional circumstances– a Romanian orphanage under Ceausescu, a neonatal intensive care unit, or strictly following the advice of a quack parenting book that thinks you should avoid cuddling your child so you can tame their innate sinfulness or avoid rewarding negative behavior– you will instinctively give your baby enough cuddles that they develop properly.
(Note that most neonatal intensive care units practice “kangaroo care,” in which the baby regularly spends skin-to-skin time with the parents, and if your NICU does not you should absolutely throw a fit until they start practicing the standard of care.)
But on the other hand massage is a nice thing to do with your baby, and I have no objection to the instructions, including chapters on adjusting your infant massage for premature babies, babies with special needs, and toddlers. Might be useful for parents who want to try massaging their babies.
Fire From Heaven: The first book in Mary Renault’s the Alexander Trilogy, focusing on Alexander’s early life. Much less enjoyable than the Persian Boy, because she keeps interrupting all the gay romance with this boring “battles” stuff. Why are there battles in my book about Alexander the Great? That is definitely not what I am reading the series for. However, the Persian Boy is sadly light on Ptolemy (Alexander’s half-brother and future ruler of Egypt, not the astronomer), who is an absolute delight. And Bagoas is not exactly what one would call a “reliable narrator” about Hephaiston, which means that Fire From Heaven is the only book in the Alexander Trilogy with any amount of Hephaiston content at all, which is tragic, because Hephaiston is the best.
Mary Renault outdoes herself with the extremely euphemistic sex scenes in this one; I actually had to flip back and reread a few pages before I worked out that “some time later a mother fox walked by with her cubs” was Alexander and Hephaiston losing their virginity to each other.
An Apprentice to Elves: I read this series because it provides me with gay Vikings telepathically bonded to wolves. This book is not, in fact, about the gay Viking telepathically bonded to a wolf; it is about his daughter Alfgyfa who is apprenticed to the svartalfar (the elves of the title). I mean, it is a fine book, but I have expectations and they were not met. I did appreciate Fargrimr, who is probably one of my favorite trans male characters in fiction, and his complete incomprehension about why the not!Romans kept calling him a girl. “Uh, I’m obviously a man, have you ever seen a woman be a jarl?” In general, from a worldbuilding perspective, I appreciate a society that has culturally accepted roles for LGBT+ people that are weird. (“Oh, sure, you can be gay, as long as you telepathically bond with a wolf first. Oh, sure, you can be a trans guy as long as you dad needs an heir, but if you have six brothers you’re shit out of luck.”) It just feels more realistic than societies which are completely perfect and accepting and everyone talks like they have a Tumblr.
A Civil Contract: I regret the decade and a half of my life I wasted not reading Georgette Heyer. If you’re the sort of person who has worn out your copy of Pride and Prejudice and mourns that there is only so much Austen in the world, you should pick up this book. The protagonist Adam is in love with Julia, a beautiful but very silly woman. His father dies and he discovers his father has run up enormous gambling debts; the only way to preserve his family fortune is to marry Jenny, a heiress, who is plain and practical and sensible. Naturally he falls in love with Jenny and then takes five chapters to work out that he’s in love with her. It contains all the Austen goodness: a gently mocking and ironic narrative, absolutely ridiculous mothers and fathers, and a truly delightful snarky little sister. Also, at one point there is Serious Dramatic Tension about whether one guy’s investments are going to pay off. It’s great. Highly recommended.
Station Eleven: An excellent post-apocalyptic novel, in which 99% of humanity dies of a pandemic. The protagonists are a traveling theater/music troupe who visit post-apocalyptic settlements and perform Shakespeare and symphonies for them, because (as the slogan on their wagons reads) “survival is insufficient.” Unlike most post-apocalyptic novels I’ve read, the plot does not derail halfway through to be about some group of survivors fighting a war with some other group of survivors. It is consistently about rebuilding civilization all the way through. I never once had to skip past a loving three-page description of someone’s gun. I think this is an excellent decision on the part of the author and more post-apocalyptic novels should follow her example.
When I reached the end of the book I discovered this was actually Literature, because there were discussion questions in the back. In retrospect, this makes sense of the otherwise puzzling decision to devote multiple chapters to a pre-apocalypse boring middle-aged actor having affairs. However, as chapters about boring actors having affairs go, it was fairly tolerable and the rest of the book was very enjoyable.
Uptown Local and Other Interventions: A short story collection by Diane Duane. I particularly enjoyed The Fix (in which Duane actually manages to pull off starting a story with a dream sequence) and Uptown Local (set in the Young Wizards verse; even for the Young Wizards universe, has a particularly high level of the spirit of Secular Solstice). A good book to read if you’re a Duane fan.
The Door Into Fire: I thought it was just a Young Wizards thing that the villain is entropy, but apparently Diane Duane’s grudge against entropy shows up in all her books. Since she used to write for Scooby Doo, does this mean that there’s a long-lost episode where Freddie unmasks the villain and reveals that he is the second law of thermodynamics?
Mostly a fairly bland and forgettable epic fantasy novel, although I appreciated the detail that everyone is bisexual and polyamorous and this is just totally normal. I was bracing myself when a jealousy plotline happened, but it honestly felt like it was written by someone who actually understands how polyamory works and that in a poly context jealousy reflects underlying relationship problems and unmet needs, not the fact that you are in Twoo Wuv.
Warning for people considering starting the series: the last book has literally been delayed longer than I’ve been alive.
A review paper I wrote about methods for assessing wild-animal suffering. Critics have raved that it is “surprisingly interesting.”
Screwtape in San Francisco, a Screwtape Letters fanfic. Updates on Mondays until I run out of things to say and/or go on parental leave.
Ever said to yourself “I wish I had a version of Thing of Things, but without the book posts, link posts, cursing, sex jokes, and culture war stuff?” I have started crossposting on Less Wrong 2.0 and that is precisely what is available there! You can also entertain yourself by trying to catch the comments from LW’s resident troll, who really seems to dislike me specifically, before they’re deleted.
The Republican case for donating to Roy Moore’s opponent. Honestly, if Roy Moore were fictional, I would be like “oh, come on, no one is that pointlessly, dickishly evil.”
How to be a socialist without being an apologist for the atrocities of communist regimes. “If your revolutionary movement keeps producing mountains of skulls, it is important to consider whether the problem may be with you rather than the people who were turned into the mountain of skulls.” [CW: picture of a Khmer Rouge mass grave.]
Why we need to get better at critiquing mental health diagnosis. A good list of fallacious arguments; I particularly like the observation that “mental illness” is a broad category and things that are definitely true of schizophrenia may not be true of erectile dysfunction.
Study suggests autistic social impairment may be caused in part by neurotypicals disliking autistic people for no reason. Might fail to replicate, of course, but it definitely fits my biases.
One ordinary week of the heroin crisis. [CW: even more depressing than that description makes it sound]
Against neglectedness. Not sure if I agree, but an interesting contrarian argument to effective altruist conventional wisdom.
New research paper argues that animal welfare reforms reduce the number of animals in factory farms. [CW: pictures of factory farming.]
Fascinating article which argues that dehumanization is not actually the cause of acts of great cruelty.
Just Plain Neat
Judge Alsup, “the judge who codes”, is an old nerd who codes in BASIC (!) and judges Silicon Valley IP cases. I am pretty sure he is now my favorite.
A pill to make exercise obsolete (h/t Sniffnoy).
Secret blog post about depression exists over on Patreon for $3/up subscribers.
It is very annoying that the English language does not distinguish between free speech the ethical value and free speech the legal right. I feel like many conversations would be far clearer and more sensible if different words were used for these two things.
For one thing, while most people who value free speech as a matter of ethics support the legal right to free speech, the converse is not true. I can believe deep in my heart of hearts that some speech ought to be censored– that the people who speak it ought to be punished in various ways up to and including being punched in their stupid fucking faces– without thinking that it would be a good idea to give the US government the power to censor that speech.
The reason is that I cannot give the US government the narrowly tailored Power To Censor Only Speech Ozy Doesn’t Like. I can only give them the power to censor speech that is generally unpopular. The one thing everything currently censored by the US government has in common is that it is wildly unpopular, whether for good reasons (saying false and malicious things about people, shouting at an angry torch-wielding mob mob that God requires you to burn witches) or bad ones (drawn child porn).
Of course, much speech I do think should happen is very unpopular (such as pro-vegan activism) and much speech I think shouldn’t happen is very popular (such as saying cruel things about trans people).
So legal free speech is in the interest of all groups who want to say unpopular things. You get weird fucking allies in free speech defense: for example, a recent ACLU case’s defendants included PETA (message: “go vegan”), an abortion provider (message: “abortion pills available cheaply, quickly and privately”), the ACLU itself (message: the text of the First Amendment), and Milo Yiannopoulous (message: “everyone hates me! buy my book”). These groups have nothing in common with each other except that lots of people would like them to shut up and go away. But a legal precedent that protects any one of them would protect all four.
I am always puzzled that centrists are generally more fervent defenders of the legal right to freedom of speech than leftists are. It seems to me there ought to be a whole bunch of centrists going “wait, you mean we can silence the alt-right, the Nazis, the communists, Black Lives Matter, and PETA all at once?”
Some people argue that, in reality, it is possible to put up a fence on the slippery slope. The typical example is Germany, which bans Holocaust denial and displaying Nazi symbols. Of course, Germany has recently passed a law fining social networks who don’t delete “blatantly illegal” content within 24 hours, which may include censorship of statements like “we shouldn’t shield Muslims from criticism.” So I’m not sure that they’re doing a great job on that “only censor some of the unpopular opinions” thing.
However, this argument does not apply to any forms of censorship which are not being done by the government. When you advocate for or against legal free speech, you are only affecting the behavior of one entity, which has defined powers and acts based on precedent. But the conscientiousness of my behavior does not have any consistent effect on the behavior of my political opponents. While it may occasionally happen that people justify their anti-ethical-value-of-free-speech behavior with “but my opponents did it first!”, if their opponents were very conscientious about the ethical value of free speech those people would probably just decide that the ethical value of free speech was an Enemy Thing and people who support it are evil. So it goes.
That doesn’t mean that one should not support the ethical value of free speech. I myself support it. You just have to make arguments for it based on the value of people being able to speak freely, not porting over arguments from the legal right to free speech where they don’t belong. And even if you don’t value free speech ethically– which many people don’t!– if you have ideas that are outside the Overton window it is within your best interest to protect the legal right to free speech. For that reason, you should not use the government as an instrument of censorship, and should instead use boycotts, protests, discrimination, harassment, etc. as tools.