[HN Gopher] The Hair Dryer Incident (2014)
___________________________________________________________________
The Hair Dryer Incident (2014)
Author : bschne
Score : 230 points
Date : 2021-06-17 17:37 UTC (5 hours ago)
(HTM) web link (quotulatiousness.ca)
(TXT) w3m dump (quotulatiousness.ca)
| quwert95 wrote:
| A friend told me a story similar to this where a psychologist
| helped a patient with their taxes and credit card debt, the
| patient was immediately more functional as a result.
|
| The crux of it being that academically this is the "wrong"
| solution because the textbook and journals don't cite it as a
| valid one. But a medical professional's job is to not only treat
| symptoms, but to treat the underlying problems as a person. This
| was the right solution for this particular person. Yes, it
| doesn't scale, but neither does perfect medical care in general.
| There is a difference between "triage" and "care".
| bullen wrote:
| I actually have a triple buffered solution for this on my stove
| and water pump in the summer house (which has dodgy electric
| wiring and home made plumbing):
|
| 1) Manual switch with a light when on.
|
| 2) Timer (runs max 60 minutes, makes some clicking noise when on)
|
| 3) Remote switch that I can turn off with my mobile phone from
| anywhere.
|
| That way if I forget to manually switch things off, I can turn
| the remote switch off and if that fails the stove and pump are
| powered maximum 60 minutes = wont burn the house down or flood it
| too much hopefully.
|
| In a future without insurance this is the only way to have a
| modern life without bringing the pump and stove with you! Xo
|
| By the way I don't think she had OCD, I think everyone else is
| reckless.
| legitster wrote:
| This story is cute, but my concern for calling it a treatment
| method is.. what is stopping the OCD from transferring to a new
| concern?
|
| Surely, it's not about the actual hair dryer. If they suddenly
| get concerned about leaving the heat on or the lamp plugged in
| they will quickly run out of room in the car.
| tonyarkles wrote:
| You're right, but it could be enough of a workaround to help
| this person in the short-term to be able to spend the time
| long-term to better address the problem. For example, if
| they're completely distracted 10 minutes into therapy because
| the hair dryer might be on, it's going to be pretty difficult
| to actually engage.
| kayodelycaon wrote:
| Seems like a good solution to me if that was the only major
| issue.
|
| If the underlying cause becomes an issue again, then maybe look
| at longer term solutions.
|
| I've always had an issue with leaving light switches on. So I
| installed a bunch of home automation stuff. Now my light bulbs
| turn themselves off when I leave the house and a few turn on when
| I return. It's a lot easier than trying to fix the problem of
| forgetting to flip switches before leaving.
| silvestrov wrote:
| Bringing the hair dryer along can be the best road to treating
| the OCD, because you can then do the treatment in small steps.
|
| If people can't go swimming because they are afraid of
| drowning, you don't give them medication and then throw them
| out in the deep end. Instead you let them take as small steps
| into water as possible in a way where they feel in control all
| the time.
| Ensorceled wrote:
| I remember a panel on a news program years ago where the one
| guest was a psychologist who was treating "untreatable" drug
| addicts by getting them "hooked" on running or weightlifting or
| martial arts. They would stop drugs but would instead be doing
| martial arts for hours a day or running 20 miles every morning.
| Then he would start treating the addiction personality and
| causes, but in many cases the patients would just stop coming and
| live three or more hours of every day in the gym.
|
| The other guests were various degrees of horrified.
|
| His patients went from literally living on the street as heroin
| addicts to doing 3 hour gym sessions and holding down a job; and
| his peers thought he shouldn't be allowed to practice.
|
| Recently I was reading a book on ADHD and the author was quite
| adamant that you could only be diagnosed with ADHD if your life
| was worse than "the norm". In this view, if you have symptoms of
| ADHD but can, for instance, hold down a good job then _by
| definition_ you don 't have ADHD. I deleted the book from my
| Audible account.
| fpgaminer wrote:
| > Recently I was reading a book on ADHD and the author was
| quite adamant that you could only be diagnosed with ADHD if
| your life was worse than "the norm". In this view, if you have
| symptoms of ADHD but can, for instance, hold down a good job
| then by definition you don't have ADHD. I deleted the book from
| my Audible account.
|
| IANAP, but that sounds correct to me. I recall the DSM
| requiring negative impact on one's lifestyle as one of the
| criteria for diagnosis of any mental disorder. And even if I'm
| misremembering that, that's what psychiatrists look for in
| practice. They not only query what symptoms you're feeling, but
| also the impact they have on your day to day life.
|
| Which makes total sense. Treatment of any disorder, especially
| mental ones, carries a (sometimes significant) risk. It would
| be unethical to subject someone to that risk for no possible
| benefit.
| handoflixue wrote:
| > It would be unethical to subject someone to that risk for
| no possible benefit.
|
| Let's take two people, say me and Einstein. Let's say
| Einstein has super-severe ADHD and thus performs so poorly
| that he can fairly be compared to me.
|
| Is there really "no possible benefit" to curing that ADHD?
| Keep in mind that the real Einstein discovered relativity,
| and uh... I'm just going to say my contributions to science
| have been a bit less dramatic.
|
| I don't think it's at all unreasonable to posit that there
| are plenty of people who are gifted enough to compensate for
| their mental issues, but they'd still benefit if they could
| fully apply themselves instead of wasting half their talent
| mitigating such issues.
| Baeocystin wrote:
| I agree with your statement. I did not get diagnosed with
| ADD until well in to adulthood, and one of the reasons is
| that I'm intelligent enough to have come up with a crapton
| of workarounds on my own.
|
| I didn't even know they were workarounds that other people
| didn't need. It's just, well, I'm good at problem solving.
|
| But workarounds they were nonetheless. Life was very
| stressful and unsatisfying for a long time, because I
| completely used up everything I had trying to compensate
| for an inherent, undiagnosed deficit. That I was otherwise
| capable enough to (with great difficulty) pull it off
| doesn't make the loss any better.
|
| Within a month of getting a proper diagnosis and
| appropriate treatment, I was getting things done in days
| that I had put off for months or years. If someone were to
| come along and judge that I didn't really have ADD because
| I'd found a way to scrape by, they'd be lucky not to be met
| with a smack upside the head.
| michaelkeenan wrote:
| The same psychiatrist from the hair dryer incident in the
| link has written about this. He's skeptical about ADHD being
| a discrete condition, and generally thinks that if ADHD drugs
| will help you focus, taking them is reasonable whether you're
| diagnosed with ADHD or not:
|
| > Psychiatric guidelines are very clear on this point: only
| give Adderall to people who "genuinely" "have" "ADHD".
|
| > But "ability to concentrate" is a normally distributed
| trait, like IQ. We draw a line at some point on the far left
| of the bell curve and tell the people on the far side that
| they've "got" "the disease" of "ADHD". This isn't just me
| saying this. It's the neurostructural literature, the the
| genetics literature, a bunch of other studies, and the the
| Consensus Conference On ADHD. This doesn't mean ADHD is "just
| laziness" or "isn't biological" - of course it's biological!
| Height is biological! But that doesn't mean the world is
| divided into two natural categories of "healthy people" and
| "people who have Height Deficiency Syndrome". Attention is
| the same way. Some people really do have poor concentration,
| they suffer a lot from it, and it's not their fault. They
| just don't form a discrete population.
|
| > Meanwhile, Adderall works for people whether they "have"
| "ADHD" or not. It may work better for people with ADHD - a
| lot of them report an almost "magical" effect - but it works
| at least a little for most people. There is a vast literature
| trying to disprove this. Its main strategy is to show
| Adderall doesn't enhance cognition in healthy people. Fine.
| But mostly it doesn't enhance cognition in people with ADHD
| either. People aren't using Adderall to get smart, they're
| using it to focus.
|
| From: https://slatestarcodex.com/2017/12/28/adderall-risks-
| much-mo...
| sp332 wrote:
| Sure, and that wouldn't change who gets a diagnosis.
| mlyle wrote:
| > In this view, if you have symptoms of ADHD but can, for
| instance, hold down a good job then by definition you don't
| have ADHD. I deleted the book from my Audible account.
|
| This may overstate the point a little bit. But there's a kernel
| of truth here: if you don't require some degree of significant
| impairment of functioning, a whole lot of criteria for mental
| illness would apply to huge swaths of the population. E.g. this
| is why the diagnostic criteria for ADHD include: "There is
| clear evidence that the symptoms interfere with or reduce the
| quality of social, academic, or occupational functioning."
| thaumasiotes wrote:
| > if you don't require some degree of significant impairment
| of functioning, a whole lot of criteria for mental illness
| would apply to huge swaths of the population. E.g. this is
| why the diagnostic criteria for ADHD include: "There is clear
| evidence that the symptoms interfere with or reduce the
| quality of social, academic, or occupational functioning."
|
| Wouldn't this just tell us that these categories are
| completely meaningless?
| kdmccormick wrote:
| No. It's a misconception that mental disorders are meant to
| categorize folks by sets of character/personality traits,
| whether or not they negatively impact someone. No, you do
| not have "a bit of OCD" if disorganization simply stresses
| you out.
|
| On the contrary, mental disorders are labels expressely
| intended to inform and enable treatment of distress.
| Disorder and treatment are inextricably linked.
|
| This is all according to how the DSM defines things, of
| course. Others may have opinions on how mental disorders
| _should_ be defined.
| thaumasiotes wrote:
| You're elaborating on how the categories are intended to
| be meaningless, but you're not doing much to claim that
| they are in fact not meaningless.
|
| If someone has low occupational functioning, you could
| call that a disorder. But why would you call it "ADHD"?
| Why would you call it ADHD for some people and OCD for
| other people? Suppose you have two lists of symptoms:
| Attention Deficit Hyperactivity Disorder - Patient
| has an active mind. - Patient has a crummy job.
| Borderline Personality Disorder - Patient rubs me
| the wrong way. - Patient has a crummy job.
|
| And you have several people who display every combination
| of mental activity, mental lethargy, likeability,
| unlikeability, good jobs, and bad jobs. You say everyone
| with a good job has no mental disorder, unlikeable people
| with mental lethargy and a bad job have borderline
| personality disorder, likeable people with mental
| activity and a bad job have ADHD, and unlikeable people
| with mental activity and a bad job have borderline
| personalities _and_ ADHD. Likeable people with mental
| lethargy and a bad job have a disorder as yet unnamed.
|
| What did you learn about the reasons why people with bad
| jobs (your primary diagnostic criterion, after all!) have
| bad jobs?
| lazide wrote:
| That is definitely not how it is defined through - it
| seems to be a straw man?
|
| The criteria is essentially 'you meet these criteria AND
| it causes clear problems with your ability to live your
| life'.
|
| It doesn't mean you have a bad job and X, therefore you
| have ADHD. Rather, you show ADHD traits and they get in
| the way (and cause you distress) in doing a job you
| otherwise would be entirely capable of doing. Or
| consistently fail (and have distress) on social
| environments you'd otherwise be perfectly fine in, etc.
|
| If you don't have a criteria like that, there is no
| useful criteria at all, since practically all medicine is
| oriented towards fixing things that aren't working
| correctly/causing problems.
|
| It's the same type of criteria used for evaluating
| everything from heart disease to stroke to a broken bone.
| Or in other words 'if it ain't broken, then it isn't
| broken.'
| thaumasiotes wrote:
| That is absolutely not how strokes and broken bones are
| diagnosed. If one of your bones breaks, you have a broken
| bone. Whether it hurts, or stops you from doing things
| you'd like to do, is an unrelated question.
| kdmccormick wrote:
| I think you're missing the point. Let me be concrete.
|
| I'm diagnosed with bipolar disorder. Sometimes I feel
| axnious and euphoric, other times depressed and
| lethargic, both at extremes noticably deviant from the
| average person. This has caused all sorts of turbulence
| and distress in my personal and academic life. Being
| diagnosed allowed me access to therapy and prescriptions.
|
| There exist plenty of people who oscillate between
| distinctively high and low moods, but have never found
| themselves in serious distress because of it. Thus, they
| have not been diagnosed with bipolar _disorder_. Whether
| or not they "are bipolar" is a subjective question that
| mainstream psychiatry doesn't seem to have an opinion on.
| thaumasiotes wrote:
| So when you find a person whose highs are higher than
| yours, and whose lows are lower than yours, and whose
| life is better than yours, that person doesn't have
| bipolar disorder, because they're not experiencing
| problems.
|
| Which makes the idea of "bipolar disorder" meaningless.
| That person demonstrates that your problems are not
| caused by bipolar disorder. But the disorder is defined
| by you having problems, even though the problems come
| from somewhere else.
| kdmccormick wrote:
| > whose life is better than yours, that person doesn't
| have bipolar disorder, because they're not experiencing
| problems
|
| Your argument seems to hinge on this idea that a good
| life => no distress, which, if you've interacted with
| anyone diagnosed with a mental disorder, is obviously not
| true.
|
| My life is great. If I didn't take a mood stabilizer,
| it'd probably still be good, but not as good. Regardless,
| my mood swings can negatively affect me and those around
| me.
|
| If one day I reach a point where I can live without meds
| or therapy and reap no negative consequences, then yes,
| it would be fair at that point to say that I no longer
| had bipolar disorder.
|
| > That person demonstrates that your problems are not
| caused by bipolar disorder. But the disorder is defined
| by you having problems, even though the problems come
| from somewhere else.
|
| Bingo. My symptoms (mood swings) + my problems ARE the
| cause my bipolar disorder diagnosis. Until I had
| problems, I had no disorder.
|
| What causes the mood swings, then? Genetics, upbringing,
| life experiences, diet, idk. Nobody knows for sure. It's
| an active area of research, but there is no one known
| cause. For all we know, there may be five independent and
| unrelated risk factors that lead to someone developing
| bipolar disorder.
|
| It's like you get it, but you're still dismissing it for
| some reason. I'm curious what ulterior point you're
| trying to make.
| underwater wrote:
| Someone close to me broke their arm, and had to have it
| pinned. As it healed the bone rotated and shifted
| slightly.
|
| In discussing whether they'd need to try to correct this
| movement via surgery, the doctor very much said "it's a
| problem if it's a problem". When it fully healed the
| person had full use of their arm, so the doctor was
| satisfied with the outcome.
|
| The doctor did also say that different countries had
| different philosophies on what they expected a healed
| bone to look like. In their experience Canadians were
| more likely to be OK with an imperfect solution, but
| Australians were more likely to want the break healed in
| a "like new" condition.
| StavrosK wrote:
| No, why? "Illness" sometimes is about the quantity, not the
| quality. If you enjoy the odd glass of wine once a week,
| you're fine, if you drink every hour of the day, not so
| fine.
| thaumasiotes wrote:
| But that's an orthogonal concern. Two people can easily
| display exactly the same quantity of, shall we say, ADHD-
| like tendencies. If one of them is a success for separate
| reasons, and the other one is a failure for separate
| reasons, why do we want to say that the failure, in
| addition to his other problems, also has ADHD? What do we
| learn from that?
|
| If the success has _a lot more_ ADHD-tendency than the
| failure, how do we defend the idea that the failure has
| ADHD, and the success doesn 't?
| StavrosK wrote:
| It's not about whether the person is "a success" or "a
| failure", it's about whether the person feels that their
| condition is materially impacting their daily life. If I
| feel that my gaming habit is impacting my job because I
| can't resist playing games during work hours, that can be
| classified as a disorder.
|
| It's just shorthand for "this is something we'd like to
| fix".
| adambard wrote:
| The essay [1] from which the hairdryer anecdote is quoted
| has the thesis that categories (in general) are
| instrumental, and don't have much value separated from
| their context.
|
| ADHD is a category of psychiatric diagnosis; psychiatric
| diagnoses exist to address deficiencies in function.
| Separating the one from the other, as you perceive, renders
| it meaningless -- or perhaps, useless. If one happens to
| have some of the traits of ADHD but it doesn't affect their
| life negatively, so what?
|
| [1] https://slatestarcodex.com/2014/11/21/the-categories-
| were-ma...
| pmichaud wrote:
| Do you remember the name of the psychologist or any info I
| might use to look him up?
| thequux wrote:
| Scott Alexander. He used to post on slatestarcodex.com, but
| has since moved to astralcodexten.substack.com .
| gwbas1c wrote:
| > could only be diagnosed with ADHD if your life was worse than
| "the norm"
|
| Because ADHD is a real situation for some people, and for
| others it's a way to legally take class-B stimulants.
|
| Yes, people really do try their friends' ADHD medication, enjoy
| it, and then shop around doctors to find someone who will
| prescribe it. It's called "drug seeking," and doctors do flag
| patients who do it.
|
| This, BTW, is what happens with medical marijuana. There are
| people who really need it, there are people who think they need
| it, and then there are people who who tell everyone but their
| doctor that it's recreational.
| neutronicus wrote:
| I'm ADHD-diagnosed, and god _damn_ do I wish I could just go
| to the store and get Adderall when I feel like I need it
|
| The fact that I have to call someone and get a prescription
| every month just makes it so that I go untreated for months
| at a time (kind of a cruel irony that ADHD treatment is gated
| behind the wherewithal to make a monthly phone call). And
| honestly I think modern life is probably such that most
| people could benefit from 10-20 mg of Adderall.
| TimTheTinker wrote:
| Have you tried a nicotine patch?
|
| Taken for a short period each morning at a low dose (cut an
| 8mg patch into sections) it offers similar stimulant
| effects, but with fewer side-effects. Nicotine patches are
| reportedly less agitating, less addictive, less expensive,
| and more available than Adderall. It also measurably
| improves cognitive ability according to some studies I've
| read online.
|
| I'm almost 40 years old, and I have ADHD-inattentive. For
| two weeks I've been using sections of nicotine patches -
| about 1/4 of an 8mg patch for an hour each morning, and I
| have never found it more easy to be focused and productive.
|
| Just be careful to not use too much, especially if you've
| never been a recreational nicotine user. I've had several
| nights when it's been difficult to sleep -- which has been
| a signal that I need to decrease the morning dose.
|
| (I'm not a doctor, this is not medical advice)
| Zababa wrote:
| > Because ADHD is a real situation for some people, and for
| others it's a way to legally take class-B stimulants.
|
| In some cases it's really clear, in some others it isn't. A
| few of my friends did better than me in school, and they had
| access to Ritalin. They were pretty good student while I was
| a problem child. I never really explored the option during
| school as I didn't really know how it worked and what ADHD
| was. I tried it later in life and it helped with work.
| Ritalin probably would have helped me during school. But was
| it because of some "real" ADHD? Was it because it's a
| stimulant and it helps anyone? Was my ADHD more or less real
| than them? I know that for them Rilatin and ADHD was a part
| of their identity, so maybe they convinced themselves they
| couldn't work without it? I don't think there's any good and
| objective way to measure that. Should I feel guilt when I
| take Ritalin now? I can function without it, but they can
| too. It's just far from optimal.
| dantheman wrote:
| Let people take whatever medicine they want.
| kaibee wrote:
| So like, in theory, yes, but in practice, now everyone has
| to take Adderall just to be able to keep up with their
| coworkers.
| dantheman wrote:
| Not at all, there's more work than can possibly be done.
| It's not a sports competition - everyone can win.
| sneak wrote:
| It's straightforward/trivial to excel over coworkers
| (even those on stimulants) at most jobs.
|
| Regardless, this idea that one needs to "keep up", as if
| work were a competitive footrace, is something you have
| invented.
| caslon wrote:
| Seems like the free market at work to me.
| Zababa wrote:
| Would you apply the same reasoning to caffeine and
| nicotine? Should we ban both? You're also seeing the
| world as a competition between people ("keep up with
| their coworkers") but I believe most people are actually
| trying to make a living (no need to take adderall if you
| are already satisfied with what you have).
| hinkley wrote:
| Doctors are really good at cognitive dissonance. I think it's a
| professional hazard of having to compartmentalize.
|
| Those same doctors are probably perfectly fine with handing out
| methadone prescriptions to addicts.
| frickenhamster wrote:
| Crabs in the bucket
| spicybright wrote:
| This is very much paralleled with non-techies solving techie
| problems eloquently.
|
| A few weeks ago there was a story in a company where the
| financial department used pretty old computers that didn't run
| anyone else's software. They were the only ones that could use
| it.
|
| When asked, they said they were tired of the programmers mucking
| around with their machines so they just didn't use anything they
| knew.
|
| A knee jerk techie solution would probably be password login
| systems with someone holding the "keys" to it. Maybe some kind of
| other procedures. Or just do the above!
| superjan wrote:
| While reading, I was thinking about telling her to get rid of the
| hairdryer, but bringing it with you is way smarter. If there was
| no hairdryer to worry about the mind would likely search for
| something new to obsess over.
| lainga wrote:
| A bit like a lightning rod. The OCD is going to fixate on
| something... give it a target you can control
| tyleo wrote:
| This is a great story. I know its not related but I can't help
| but feel a sort of analogy to engineering work: the tension
| between idealism and pragmatism.
|
| At a previous company our build times for a game client were
| around 5 minutes or so. Our tools team had planned some work to
| get this down but it kept getting pushed out. The tools weren't
| part of the client so I'm not sure they know how bad this was.
| Anyways, one of the tools engineers rigged up a solution in a day
| or so that got this down to a minute. Unfortunately it wasn't the
| nice, perfect, planned solution that kept getting pushed out so
| they were reprimanded by some manager. Fortunately, more were on
| the side of the engineer than the manager. To my knowledge they
| never did end up implementing the planned solution.
| Ma8ee wrote:
| Imagine if the nice perfectly planned solution would have
| gotten the build time down to 5 seconds and been done next
| month, but it now never would be implemented because 1 minute
| was considered good enough.
| phkahler wrote:
| >> but it now never would be implemented because 1 minute was
| considered good enough.
|
| By definition it's good enough. The only thing being lost is
| the stroking of some ego. Our whole world seems to be built
| with "good enough" and I do find that frustrating at times.
| People are imperfect and have finite time, so I understand.
| Evolution seems to think we're good enough for now.
| milesvp wrote:
| I'm a big fan of these kinds of improvements. They can be a bit
| dangerous politically though. 5 minutes might be something the
| manager can get traction to implement a fix to get it below 1
| minute build times. At 1 minute the manager may never be able
| to make a political argument to improve.
|
| This may also be why the manager chastised the person fixing
| this. Such a drastic improvement can completely undermine any
| efforts to make even bigger fixes, as well as make the manager
| look foolish that they couldn't make these improvements
| already.
|
| I tend to believe the perfect is the enemy of good, but I've
| certainly worked in some orgs where I might take an improvement
| like this to the main champion of the problem first and ask if
| it's a useful solution. I might even be willing to shelf the
| solution if I can be convinced it's not in the long term best
| interest of the org. If I'm not, though, I'd likely become a
| champion of this short term pain relief knowing that things may
| not ever have much chance to get much better.
| ChrisMarshallNY wrote:
| It's totally related. There's the old urban myth about the
| "NASA Pen,"[0] which is a favorite of tech people (It isn't
| actually true, but it's a great story).
|
| I have a similar apocryphal story that I use in design. I write
| about it here[1].
|
| _> For many years, I have heard stories about some architect -
| they never say who - that once designed an office park
| /university campus/government center, etc., and deliberately
| did not add any paved walkways. Instead, it is said he had the
| buildings completely surrounded by lawns. After a year, he came
| back, and paved the areas of these lawns worn thin by people
| taking the most effective routes around the buildings. He did
| this because he decided at the start of the project, he'd never
| be able to account for human nature, and it was his goal to
| serve the folks using the campus as best as he could. The users
| of his system would let him know, organically, how to "tune" it
| so it can best serve them._
|
| Also, anyone that is familiar with the Granny Weatherwax
| character, by Sir Terry Pratchett, may remember that she
| practiced what was termed "Headology." That was sort of
| "practical" psychology, and it involved things like giving
| headless ghosts pumpkins, so they would stop moaning (actually,
| it was another character that did that -from _I Shall Wear
| Midnight_ [2], but it was definitely Granny's "Headology").
|
| [0] https://www.scientificamerican.com/article/fact-or-
| fiction-n...
|
| [1] https://littlegreenviper.com/miscellany/the-road-most-
| travel...
|
| [2]
| https://www.studynovels.com/Page/Story?bookId=27327&pageNo=6...
| ortusdux wrote:
| I believe it was the podcast 99% invisible that had an
| episode about urban planners driving around after a heavy
| snow and documenting unofficial paths for later development.
| nexuist wrote:
| There's a subreddit for this: /r/DesirePath
| ChrisMarshallNY wrote:
| Cool! Thanks for that!
| gricardo99 wrote:
| Engineering is filled with "hacks" and workarounds, where the
| root cause isn't fully understood, if at all. I feel that if, as
| a profession, there was immense pressure to instead find only
| root causes to address issues, we'd still be working out the
| kinks with punch-card systems.
| tonyarkles wrote:
| Yeah, it's a really tough balance to strike. I've worked with
| teams and systems where they were fully happy to apply a hack
| and move on and it worked great for them. I've also worked with
| teams who had a terribly bad culture of throwing shit at the
| wall to see what sticks for fixing weird errors and in the
| process making problems worse without actually fixing the
| problem.
|
| Using good judgment to figure out when a hard RCA is necessary
| and when it's not is _key_ to making forward progress without
| constantly shooting yourself (or your teammates) in the foot.
| ElViajero wrote:
| Many are missing the point, this is a story about transgender
| rights, not about psychologist knowledge.
|
| The original article, linked in the post, starts with:
|
| "I've made this argument before and gotten a reply something like
| this:
|
| Transgender is a psychiatric disorder. When people have
| psychiatric disorders, certainly it's right to sympathize and
| feel sorry for them and want to help them. But the way we try to
| help them is by treating their disorder, not by indulging them in
| their delusion."
|
| And then goes to explain the "Hair Dryer Incident" as a counter
| point.
| nexuist wrote:
| Oh wow, this is very cool added context. Unfortunate that the
| linked article doesn't include it, although the story works out
| of context as well.
| dahart wrote:
| I saw you were downvoted, and went and read the rest of the
| post to read the transgender argument. It's a great read, the
| longer article is well worth perusing. I upvoted you for that.
|
| The article's thesis, though, is about how humans get stuck
| categorizing things, in ways that get canonized, and then have
| a hard time understanding that there are different legitimate
| ways to categorize. Transgender was just one example, the Hair
| Dryer incident another, and among them the whale-fish, and
| Israel vs Palestine. I love the way he framed transgender
| rights, and the Napoleon example is hilarious, but I wouldn't
| say the story is primarily about trans rights rather than
| psychologist knowledge. If anything, it's specifically showing
| some of the reasons why DSM 5 is so dramatically different from
| DSM 4, right?
| cowboysauce wrote:
| I've read most of Scott's blog posts and he rarely mentions OCD
| and when he does it tends to be "this is what I think people with
| OCD experience" and not "this is what my patients have told me"
| which leads me to believe that he is not an expert in OCD.
|
| I have OCD and it's ruined my life in ways that are hard to
| articulate. Which is why I can point out two good reasons why
| what's being described might not be a good idea. First, giving
| into compulsions just legitimizes them and reinforces the
| patterns that are central to OCD and can ultimately make things
| worse. Secondly, OCD has a habit of changing how it manifests.
| Sure, maybe the woman is no longer bothered by the hairdryer, but
| what happens when it becomes changes to worrying if the oven is
| on? She'll be right back where she started.
|
| I doubt that the anecdote actually happened as described. It's
| way too contrived, simplistic and borders on "Psychiatrists hate
| her! Cure your OCD with this one simple trick!". Realistically,
| OCD is incredibly insidious and if it were that simple to cure
| then nobody would have OCD. What's described is, at best, a
| short-term fix and half the psychiatrists likely knew that such
| things rarely stick.
|
| I've had the same thing happen to me more times than I can count.
| I think I found the silver bullet, a way to permanently defeat my
| obsessive thoughts. If I'm lucky then it'll last a week before my
| OCD comes back in full force. But the truth is that you cannot
| directly fight OCD, it's like squeezing dough. When you clamp
| down in one spot, it just squirts out somewhere else. There's a
| quote that I think describes it perfectly "To hate me is to give
| me breath, to fight me is to give me strength". Fighting OCD or
| giving into its demands is just falling into its traps. You only
| truly win when you reach a point where you don't respond to it.
| meowface wrote:
| I've suffered from symptoms of OCD on and off, and, personally,
| I totally believe this anecdote and think it's a great parable.
|
| I think the world is probably split into pro- and anti-hair
| dryerism, both among people who do and don't have OCD.
|
| >First, giving into compulsions just legitimizes them and
| reinforces the patterns that are central to OCD and can
| ultimately make things worse.
|
| Of course, but that's the whole crux of this story: "She'd seen
| countless psychiatrists, psychologists, and counselors, she'd
| done all sorts of therapy, she'd taken every medication in the
| book, and none of them had helped." It's paved over for
| conciseness, but I think it's implied that what you said is
| definitely not news to the patient.
|
| _Of course_ the first, second, third, and fifteenth thing you
| should and must try is what you say. I 'm sure Scott would
| agree. This was a Hail Mary when every attempt to do that so
| far failed.
|
| To give another example: I think ECT is terrible. But if
| nothing else has remotely helped someone with severe depression
| over a very long period of time and they hate every waking
| moment and are close to suicide? Throw that brain in a Tesla
| coil, I say. Another facet of hair dryerism would be stances on
| body identity integrity disorder. I won't write at length, but
| I think anyone can guess my position on it.
|
| >Secondly, OCD has a habit of changing how it manifests.
|
| Yes, this was my first thought, but I think that's also part of
| this parable, too. It likely will manifest in other ways for
| the patient, but this is a simple hack that actually helped
| resolve one immediate issue that was causing her a lot of
| difficulties at that time.
|
| Some of the other issues will probably cause less severe of a
| life impact. There's a decent chance some won't, since it could
| be something thing like an oven, but the point is that this was
| one method to immediately address one pressing problem that was
| heavily affecting her life. Obviously you wouldn't just say
| "okay, you're fine now" and tell her to never come back; this
| would just be a stopgap while the patient is further treated.
|
| On the topic of OCD, one thing that surprisingly helped me a
| lot and continues to help me came from what I believe was a
| random reddit or perhaps HN comment I happened to stumble
| across a few years ago. It was a short sentence from someone
| quoting their psychiatrist - essentially a suggestion of a
| different way of mentally framing things. It actually was "one
| weird trick" that really did immediately work in my case.
|
| I think it was the precise phrasing of it that helped me, so I
| don't want to try to roughly paraphrase it from memory, but it
| definitely made it clear that while OCD is certainly a
| neurological problem, psychological techniques can help guide
| your neurology, like the proverbial elephant rider prodding the
| elephant a bit in one direction or another. Hopefully something
| like that, or perhaps something entirely different, will help
| this patient so they don't need to take their hairdryer with
| them anymore.
| cowboysauce wrote:
| Despite my initial comment, I'm pro-hairdryer. If it works
| when nothing else does, then do it. I'm even pro-hairdryer in
| the sense that it could be used as a stop gap until the
| patient learns more effective ways to manage their OCD.
|
| I think what bothers me about is that Scott doesn't mention
| that there are legitimate drawbacks to the solution in the
| story. It's a nice "thinking outside of the box" story but to
| use it as an excuse to be smug and very much "I'm better than
| the rest of these psychiatrists who don't actually want to
| help you" is distasteful.
| meowface wrote:
| I didn't see it as a way to be smug or seem better. It
| seemed like his colleagues were split in half, as he said,
| and he happened to be on one side, and both sides felt like
| the other side was being ridiculous.
| fpgaminer wrote:
| I think what you wrote perfectly describes the correct approach
| to mental health _in general_. Not just OCD, but also many
| other mental disorders like anxiety, and just emotions in
| general. Trying to ignore or repress our thoughts and emotions
| just serve to "give [them] strength". It's a life lesson I wish
| a lot more people knew.
|
| [NOTE: This thought got me going on a random train of thought
| below, not really directed at the person or comment I'm
| replying to above. Sorry for the slight tangent...]
|
| I've recently started taking on a unique viewpoint of my own
| psychology. It's more of an interesting way to think of one's
| mind than an actual theory on the mechanisms of the brain. But
| basically I started thinking of my mind in terms of the classic
| conscious/subconscious split, but thinking of the subconscious
| as less like a ... primitive/instinctive part of myself and
| more like a separate system with its own thoughts and desires.
| Kind of like how we imagine the body to be conceptually a
| separate entity from our minds. Though they're quite
| intertwined, its easy to imagine that we could transplant our
| mind into a different body and still be ourselves. I imagine
| that I could transplant my consciousness into a different brain
| and still be _me_, but with a different subconscious. That
| sounds strange, because we're so used to the idea of the
| subconscious being a part of our us, but hopefully it makes
| more sense momentarily.
|
| The point of viewing the subconscious like this is then one can
| say that, like the body, if you don't take care of your
| subconscious's needs and desires, if you don't give it space to
| be heard, it will lash out. Trying to repress one's emotions,
| anxieties, OCDness, etc, you're making your subconscious
| unhealthy in the same way that you can make your body unhealthy
| by not eating healthy, not working out, or ignoring pain.
| Emotions are the way our subconscious tells us its in pain or
| in need.
|
| More importantly, this allows a subjective _detachment_ from
| one's emotions and anxieties. To view them objectively. Whereas
| it's really easy to feel anxious and then believe that that
| anxiety is _part_ of yourself. That you, yourself, are anxious.
| But viewing the subconscious as a separate system that must be
| managed like the body allows one to feel anxiety and
| acknowledge that it isn't _you_, yourself, that are anxious.
| It's your brain that's anxious. And it's a signal that you need
| to do X, Y, and Z to take care of your brain. Much like one
| would rest when your body is telling you it's hurt.
|
| Again, this is more of a way of viewing the brain, rather than
| a psychological theory with any basis in reality. It's
| definitely very derivative of archaic psychology theories like
| Freud's theories and bicameralism. But I find it helpful none
| the less. The most important component, and something I think a
| lot of people with mental disorders have trouble grasping, is
| that this idea that one's identity is not tied to their
| disorder. I'm lucky in that I've experienced what my brain is
| like without anxiety and found out that I'm still the exact
| same person, just minus anxiety. I know prior to that
| experience I probably would have said that _I'm_ an anxious
| person, as if it were some fundamental part of my personality.
| So that experience has better enabled me to make clearer
| divisions between self and the flaws of the substrate my
| conscious mind is running on.
|
| N.B. I'm just sharing a (hopefully) interesting viewpoint. This
| isn't "do this one weird trick and you won't have a mental
| disorder anymore!" kind of thing. Anyone who suspects a mental
| disorder, no matter how small, should seek guidance from a
| medical professional. Seriously. There's no shame in any of it,
| and treatments are better today than they've ever been. My
| little pet theory above is, again, just something I found
| interesting in the way I view my own psychology.
| cosmojg wrote:
| What you're describing lines up well with recent research[1]
| on multi-agent models of mind. You might be interested in
| internal double crux[2] and internal family systems[3] more
| generally. These are techniques for managing mental health
| very similar that which you describe, and they build
| primarily upon the idea that the mind is best treated as a
| collaboration among multiple subagents.
|
| [1] https://www.lesswrong.com/posts/i9xyZBS3qzA8nFXNQ/book-
| summa...
|
| [2] https://www.lesswrong.com/posts/mQmx4kQQtHeBip9ZC/interna
| l-d...
|
| [3] https://www.lesswrong.com/posts/5gfqG3Xcopscta3st/buildin
| g-u...
| caethan wrote:
| Scott _has_ OCD. Search for "obsessive compulsive disorder"
| here: https://slatestarcodex.com/2014/04/11/going-loopy/
| cowboysauce wrote:
| That's strange. My impression came from his article about the
| Chamber of Guf where he talks about pure OCD, but it sounds
| like he's only read about it and never actually met someone
| with it.
|
| I wonder if the disconnect is in taking the story in an
| idealistic way vs a practical way. Like sure, if you had
| someone for whom that works utterly when nothing else works
| then yeah, do that. But I don't think that's a realistic
| scenario.
| fleekonpoint wrote:
| "To hate me is to give me breath, to fight me is to give me
| strength"
|
| I've been listening to the self-esteem meditations on headspace
| and this is the same thing that they are recommending. I am
| amazed at how effective it has been.
| sunshineforever wrote:
| The idea that the entire psychiatric community wouldn't be
| completely on the side of the author is one of the reasons that I
| have such little faith in their field.
|
| The reason being is that the underlying condition could always be
| worked on after first taking the small, practical steps to
| dramatically reduce the impact of the problem.
|
| I have personally experienced situations like this and it was so
| frustrating until I realised that I had to take personal
| responsibility, because help wasn't coming from within the
| system.
| kayodelycaon wrote:
| I've had the same problems with regular doctors and medical
| issues. A lot of my problems turned out to be a milk allergy.
| hallway_monitor wrote:
| In my experience most doctors are pretty useless trying to
| solve a difficult problem. I had my daughter's colon biopsied
| before someone suggested using a hypoallergenic formula.
| dr_orpheus wrote:
| Variation from doctor to doctor is also wild the reactions
| you get out of people. Our daughter had a dairy allergy and
| we had observed after cutting it out her getting better.
| Our original pediatrician basically had the attitude of
| "well since you self-diagnosed this and it wasn't
| officially by me I'm going to largely ignore it and proceed
| as normal."
|
| We switched pediatricians and the difference was amazing.
| The response was "I have listed to all that you have said
| and I agree with your assessment that she has an issue with
| dairy. Here are some options for her diet going forward".
| The difference between fighting a battle to feel heard
| versus feeling like someone is on your team solving a
| problem is incredible.
| rebuilder wrote:
| Doctor 1: "Kids have all kinds of stomach problems all
| the time. The parents always say it's dairy or gluten.
| The parents don't know anything, so I'm going to ignore
| them."
|
| Doctor 2: "Kids have all kinds of stomach problems all
| the time. The parents always say it's dairy or gluten.
| This is probably going to go away on its own, but the
| parents will keep insisting I do some thing until it
| does. I will tell them they are on the right track and
| send them off. "
|
| Doctors have to play a whole metagame beyond just trying
| to figure out what might be causing the symptoms their
| patients are presenting with.
| nitrogen wrote:
| _Doctors have to play a whole metagame_
|
| I _really_ detest this idea that blatant manipulation is
| necessary from people we are supposed to be able trust.
| How about this instead, where the doctor provides
| information and a plan of action instead of manipulation:
|
| Doctor 3: "Stomach problems are common, they may or may
| not be caused by the most popular triggers, and they
| might go away on their own by coincidence. Here's the
| decision tree we can follow, which will let us know if we
| need to do more..."
| verall wrote:
| Plenty of doctors do explain all of this, but people hear
| what they want: did the doc affirm or contest my theory?
| Did they "do anything"? (recommend surgery, prescription,
| diet, etc)
| paulcole wrote:
| > In my experience most doctors are pretty useless trying
| to solve a difficult problem
|
| This applies to nearly every profession. Most people are
| average at their jobs and most people aren't that great at
| consistently solving the harder (or hardest) problems their
| job presents.
|
| It's as true for doctors as it is software developers or
| truck drivers or teachers.
| phkahler wrote:
| That's why they should do triage. If they can't figure
| out the problem, at least be able to refer a person to
| someone they think can. If they're not willing to do that
| then they're probably more interested in their own
| practice (can make more money by fumbling around) than
| helping patients.
|
| I have a great deal of respect for someone who says "I
| can't help you, but that person over there can" and turns
| out to be right. I'd gladly try them again with a
| different problem.
| [deleted]
| ineptech wrote:
| Doctors are just tech support for the human body. They listen
| to your complaint and offer up their best guess diagnosis
| based on what's helped previous customers with the same
| symptoms, but they have limited information on the system
| they support, the documentation is spotty and sometimes
| contradictory, there's a ton of bugs, and they have no
| escalation path because the engineer who designed the system
| quit ages ago and left no contact info.
| __turbobrew__ wrote:
| I have been misdiagnosed so many times for health issues, I
| feel like doctors need to specialize within domains and
| they are only allowed to practice within that domain. So
| much advice given out by general practitioners is useless
| and only treats symptoms of health conditions. It literally
| took me 4 years to figure out a health issue as a bounced
| from doctor to doctor as they all scratched their head.
| Some doctors even made incorrect diagnoses which lead to
| treatment which was actively harmful to my condition, it
| would have been better to not see those doctors at all
| since they set back my recovery by months.
|
| We dont let electrical engineers build bridges so why do we
| give doctors so much freedom in their practice?
| kyleee wrote:
| Hilarious and often quite truthful
| teucris wrote:
| Except that the small steps that seem innocuous actually turn
| into dramatic problems in the case of OCD.
| TuringTest wrote:
| But if you dramatically improve the patient's life _right
| now_ , it will probably be a lot easier to treat the
| underlying problem, without the added worries of stress and a
| failing career.
| rootusrootus wrote:
| The impact isn't the same, but I've been guilty of doing
| exactly the same thing with software bugs. "Sure, we could just
| do this little workaround and get you back up and running, but
| there's a _reason_ for this and we would be better off in the
| long run investing in a real fix. "
|
| I do have a limit, at least, after which I'll go for the quick
| fix and then try to follow up with a broader investigation.
| Depends on how severe the issue is, too.
| loloquwowndueo wrote:
| People are not software :)
| hawkesnest wrote:
| I heard/read a similar mental "hack" about folks who fear leaving
| things "on" when travelling. Take pictures with your phone of all
| the things just before you leave. They'd be easily available,
| verifiable evidence that the stove is off, all the doors are
| closed/locked, furnace set, water shut off, and so on.
| op00to wrote:
| The pictures don't work with all ocd. Often times I would worry
| that I did the thing that couldn't happen (open door, whatever)
| AFTER the picture. So I'd videotape the situation and myself
| walking away. It got silly. I really hate this condition.
| teucris wrote:
| Just recently went through my phone and spent an hour
| deleting all the photos I took of appliances, etc. I had
| taken during the height of my OCD. It must have been hundreds
| of pictures.
| op00to wrote:
| I had to upgrade to a bigger cloud tier. lol. So insane!
| csteubs wrote:
| FWIW, this is also great advice from an insurance point of
| view. I went on a 3 month trip and took pictures of all the
| appliances before leaving--mostly for peace of mind, but also
| because the building was fairly old and had a history of
| leaking pipes, faulty outlets, etc.
|
| Sure enough, a month into the trip and my downstairs neighbor
| has his bathroom ceiling fall in due to a leaky drain pipe in
| my shower. I had photo proof that the water wasn't on or
| leaking and the building's insurance policy ended up renovating
| both of our bathrooms. Came back to a brand new rainfall shower
| and granite countertops.
| rootusrootus wrote:
| That's cheaper than my solution, which was to make the status
| of the door locks, garage doors, furnace, etc, all verifiable
| via home automation. And with backups for some of them, like
| auto-closing garage doors. I used to have a problem where I'd
| get a half mile from home and have to turn around and verify
| the garage doors were in fact closed. Never once did I return
| to find them open. But now I can just pull it up on the phone.
|
| Pictures is a cheaper way of accomplishing that, not a bad
| idea.
| PaulDavisThe1st wrote:
| level 2 of that game, tho':
|
| "Is the list I made to know what to take pictures of complete?
| Did I really take pictures of everything? What about that thing
| I'm not remembering right now and wasn't on the list but I'm
| pretty sure I didn't turn it off, either ..."
| bigmattystyles wrote:
| I have, at times, pretty bad OCD - If this works and it keeps
| working, I'm happy for the person. In my experience though, OCD
| will find something else. The point about the other psychiatrist
| saying it's absurd is probably because they know, it will about
| having left her garage door open next. OCD is horrible, and
| nothing like what most people think; if you want to see the
| horrors many with the affliction deal with, head over to
| reddit.com/r/ocd
| CalChris wrote:
| The Gordian Knot theory of psychiatry.
| dr_orpheus wrote:
| I agree that its a great solution and in a way it is consistent
| with any other long term medical condition so I don't understand
| the outrage.
|
| You can try and try and try to treat the underlying medical
| condition. But at some point if it doesn't work you stop trying
| to treat the underlying medical condition and instead treat
| symptoms to make the patients quality of life as good as you can
| while living with the issue.
| mindvirus wrote:
| Hah, my first instinct was "just set up a baby monitor". I can
| totally see not thinking of the even more obvious solution.
| tempestn wrote:
| Similarly my thought was, "Just sell the hairdryer and deal
| with damp hair - it's not worth it!"
| Hamuko wrote:
| I think a similar case I read somewhere was a case where someone
| was having trouble showering because they had body image issues
| and they didn't want to see their naked body in the shower.
| Therapist had a simple solution: "Try showering without lights
| on."
| jmkd wrote:
| A brilliant little story with a lovely glimpse as to where
| scrappy solutions might come from to many kinds of problem.
| teucris wrote:
| Having lived through OCD and come out the other side, I
| completely understand why the solution was considered bad.
|
| Sure, this solves the particular obsession. But the issue is that
| OCD is never satisfied. You develop rituals like this and they
| work for a while, giving your brain that little dopamine boost
| every time you look at the hairdryer in your car. But that dose
| diminishes over time, and soon taking the hairdryer with you
| isn't enough. You need to do something more to feel okay about
| the obsession. This is why OCD sufferers find themselves doing
| something over and over.
|
| Sustainable solutions address the anxiety (most often meds) or
| build up the person's tolerance for uncertainty (exposure
| response prevention). It was only a combination of these
| approaches that helped me overcome my illness.
| spaetzleesser wrote:
| Don't let the perfect be the enemy of the good. It may not be
| the final solution but it improves the life of the person.
|
| I would have more sympathy with the other doctors if they
| actually had a solution for OCD but they don't. So somebody who
| has no fix for the problem is criticizing someone who fixes a
| part of the problem.
| choeger wrote:
| Did you consider that the OCD could get worse due to the
| negative effects of the OCD, e.g., bad performance in the job
| or problems with the patient's relationships to friends and
| family? If such a feedback loop exists, breaking it _can_ be
| part of the cure, no?
| teucris wrote:
| Breaking the cycle is important, no doubt. The issue I take
| is the quote makes it seem like all they had to do was carry
| the hair dryer with them. There's so much more that needs to
| be done.
| phkahler wrote:
| It's critical to find any intervention that works for a
| debilitating problem. If the hairdryer person lost their job
| because of it, they may not be able to continue ANY treatment
| and that might be the end of them.
|
| The first goals in DBT therapy are to stop behaviors that may
| interfere with therapy or kill the patient. Seems like a good
| approach to me.
|
| On a related note, I knew someone who had some very self-
| destructive ways of dealing with her stressful life and
| associated problems. She held down a good professional job at
| <big company> and most people didn't know about her issues. She
| found a psychologist that she liked (and I didn't) and after
| somewhere between 1 and 2 years she ended up dead. You've got
| to stop self-destructive life-interfering problems any way you
| can.
|
| When a person might be bleeding to death, the first step is to
| stop the bleeding even if by tourniquet. You can do surgery to
| fix things later, but not if the patient is dead. Priorities
| are a thing.
| teucris wrote:
| No argument here. I just don't think the other medical
| professionals are given a fair shake in the original quote.
| tnorthcutt wrote:
| _She'd seen countless psychiatrists, psychologists, and
| counselors, she'd done all sorts of therapy, she'd taken
| every medication in the book, and none of them had helped._
|
| Sounds like everything else had been given a fair shake to
| me.
| teucris wrote:
| This is the part that irked me:
|
| > And approximately half the psychiatrists at my hospital
| thought this was absolutely scandalous, and This Is Not
| How One Treats Obsessive Compulsive Disorder
| stordoff wrote:
| Also having OCD, I can see how this would be helpful though.
| You can fall into a stable position where you're doing enough
| to keep the OCD at bay (taking the hairdryer with you) without
| it being something that interferes with your life. I don't
| think it's an _ideal_ long-term solution, as the OCD can latch
| onto something else, but as a starting point for ERP (leaving
| the hairdryer at home on shorter trips) or if other solutions
| have been tried and failed, I can see it being useful.
| teucris wrote:
| Sure, but the quote seems to deride the other medical
| professionals involved. They were likely not idiots: they
| were likely thinking longer term.
| phkahler wrote:
| They are idiots. And also probably very smart people.
| Sounds like they have their own issues to work on :-O
| betwixthewires wrote:
| Well, you can call it a stopgap. As long as they're not saying
| "cured! It's over for you now." I think it is great. Why does
| the patient have to live through the debilitating symptom while
| the causes are worked on? Perhaps a part of the treatment then
| is getting the patient to leave the dryer at home on weekends,
| maybe initially curled up on the coffee table, then in the
| bathroom, etc. while they go to the grocery store or for a jog.
| It could be a very good first step.
|
| I have a compulsive problem that developed due to an anxious
| situation I was in. I was taking a nap on the couch, I smelled
| burning and assumed it was someone in my neighborhood grilling,
| which was common. I woke up to an apartment filled with smoke,
| my place was on fire. It was small, I was able to get out the
| front door (which is where the fire was) and call the fire
| department, they came and put it out, minimal damage, no loss
| of life. But still, since then, if I smelled wood burning, even
| though I know it's probably someone grilling or with a fire in
| the fireplace I go outside and look around just to be sure. It
| is irrational and I know while I'm doing it. What helped me was
| living in a place where some neighbor or other burns wood
| almost daily. I still get a tinge of "but what if that's not
| what it is this time" every time I smell it, but I don't
| compulsively check anymore.
|
| Also for a lot of people these mental illnesses cannot be
| cured, only managed. I'd think finding simple solutions to
| reduce compulsive anxiety are more sustainable than long term
| drug use.
| teucris wrote:
| When monitored, sure. The approach I would guess an OCD
| specialist would use (I'm not one, so this is only a guess)
| is to have the patient dry their hair, leave the bathroom,
| and wait as long as they can bear without checking to make
| sure they turned it off. Then, some time later, have them do
| it again, and try to wait longer. Repeat until they can go to
| work without worrying. Letting them take the hairdryer with
| them until they can do without it seems like a good addition
| to ensure they can get through the rest of the day.
| aspyct wrote:
| I personally have problems with doors, and stuff that should be
| locked. I can never be sure I locked properly.
|
| Totally did backtrack unreasonable distances just to check if I
| had closed the door.
|
| It's all fine when it's my door. Worst case scenario, I get
| robbed.
|
| However it's more of a problem when it's someone else's door.
| Worst case scenario, they get robbed, and that's a different
| story. Or pets get out...
|
| Obviously I can't take the door on my front seat... So my
| solution is to take a picture of me trying to open the door, a
| kind of proof that it's closed.
|
| And, would you know it, it works! When I get anxious, I pull out
| my phone and look at the pictures.
|
| It's getting better, actually. I believe I'm fixing it slowly.
| Good riddance!
| robotresearcher wrote:
| There's a very helpful method for being confident that you did
| something right, and while it may not be enough for people with
| compulsive disorders, it's great for many situations:
|
| https://en.wikipedia.org/wiki/Pointing_and_calling
|
| I think it works by recruiting more of your body & brain to the
| task of attending to something.
|
| Maybe the anxious could video themselves doing it, and watch it
| back later.
| dasyatidprime wrote:
| I've had a lot of success with this for things like closing
| doors and taking medication, as my memory gradually wanders
| off into the misty lagoon. Especially the "as needed but at
| most once every 24 hours" kinds of medication that can't be
| handled with a pill organizer--with the timing information
| included in the call. Point to the bottle (or if out of
| range, hold the pill up, or otherwise physically emphasize
| the object), say "Taking a symptomstoppidine on Thursday
| morning" or such.
| [deleted]
| bentcorner wrote:
| I kind of hit a similar problem: My parents let me stay at
| their house while they were on vacation and I was traveling
| through their city, as long as I locked up and set their alarm
| when I left.
|
| Me, being unused to how their alarm worked, was unsure if I set
| it.
|
| I set the alarm, locked the door, hear it beep, waited outside
| until it stopped beeping, then I thought to myself "was the
| alarm _really_ on? ". I unlocked the door, opened it, setting
| off the alarm, which I turned off with my code.
|
| Goto 10
|
| This repeated a few times until some larger alarm somewhere
| else in the house started blaring loudly that could probably be
| heard across the neighborhood. So I disabled it one more time,
| and just left it well enough alone since I couldn't get out of
| the loop without some other way of verifying things.
| Johnny555 wrote:
| I used to work with someone who had that same problem with door
| locks, he'd sometimes leave work to make sure he locked his
| door. This was well before the days of ubiquitous web based
| home security cameras, but he rigged up a video camera and a
| video capture card on his PC to take a picture of the door (and
| door lock) and post it on a web page every minute. So he could
| easily check to verify that the door was closed and locked.
|
| Nowadays, maybe an electronic lock would be an easier solution,
| though I'm not sure that would satisfy the urge to be sure it
| was locked, would he trust it?
| underwater wrote:
| I don't see why he wouldn't trust it. The OCD seems to be an
| anxiety triggered by the uncertainty of his memory, rather
| than paranoia.
| spaetzleesser wrote:
| That's correct. My girlfriend has issues with locks and
| stoves. She doesn't trust herself but if I tell her it's
| all good she has peace.
| rootusrootus wrote:
| Can't speak for anyone else, but for me the electronic lock
| was enough. At least after I'd used it a few times and got a
| feel for how reliable the indication was.
| DanHulton wrote:
| Similarly, I used to get anxious about if I'd turned off the
| lights, locked the door, made sure the oven was off, etc at
| night. So now I count one number for each "thing" I do, and I
| know that I need to count up to 5 to "prove" I did it. Then,
| later in bed, I know I checked the front door because I know I
| counted to 5.
|
| You'd expect this would transfer to the "well, are you sure you
| counted", but I'm never actually anxious about that. I think it
| works similarly to mnemonics, where the simple act of making a
| mnemonic for something makes it memorable, and it doesn't
| matter if it's a good mnemonic or not. In this case, I have
| "proof" I have done the things that make me anxious, and it
| doesn't matter if it's "good" proof or not, I just don't feel
| the anxiety.
| function_seven wrote:
| This is kinda funny, because I've had the opposite outcome.
| Well, "ish", because my situation isn't directly comparable.
|
| When I'd leave the house in the morning, there were always
| five things I needed to have with me: Wallet, phone, badge,
| glasses, and smokes.
|
| Once a month or so I'd get to work and realize I had left one
| of these at home. It was a tragedy to be caught an hour from
| home without my phone or glasses. It was annoying to be
| without my wallet, cigarettes, or badge.
|
| So I decided to regiment this. Wallet always in the front
| right pocket, badge always clipped to belt, phone in left
| back pocket, cigs in front left pocket, and glasses in my
| backpack. I would pat each location and say out loud,
| "wallet, badge, phone, smokes, ... glasses".
|
| It didn't work. I quickly just went through the motion of
| patting and saying without _actually verifying_ the fucking
| things were there. The first time I forgot an item was a mini
| existential crisis. ( "If I can't account for these simple
| EDC items when I'm trying to, what hope is there?")
|
| WFH has solved the badge issue. ApplePay mitigates the wallet
| issue. Glasses are still forgotten sometimes, but my eyesight
| isn't _that_ bad when I 'm out and about (it was only
| terrible to be without glasses when I worked at a computer in
| an office). So I guess the situation just solved itself.
|
| I only need to confirm my e-cig is with me. Everything else
| is either I remembered it or "oh well". And if I quit that,
| then I'm free :)
| alliao wrote:
| I do this counting thing subconsciously with the stuff I'm
| carrying from "scene" to "scene" of my life. And it show. If
| you suddenly throw me an extra thing to carry, I'll forget
| something I should've had with me. It's hilarious really for
| everyone else.
| malka wrote:
| I am totally gonna use your solution. Thanks. This has been a
| huge problem for me as well.
| aspyct wrote:
| Good luck :)
| Pick-A-Hill2019 wrote:
| I make a mark on the back of my hand in ball-point and _ONLY_
| rub it off when the job is done. Eq (using your example) if I
| knew I had to lock a door on the way out I would write either
| an 'L'(ocked) or a D(oor) on the back of my hand.
|
| Because I stick to the 'mental rules' of only rubbing it off
| once the task is completed, if I'm uncertain if I've done the
| thing / task I can look down to my hand to see if that mark is
| still there or not. If it is - U-Turn time!
|
| It Works pretty well (as always, mileage may vary) even for
| multiple things if needed although the random letters/marks on
| the back of your hand can make people curious but if it does I
| simply say - It's a list of stuff I need to do.
| dragontamer wrote:
| I keep a pocket notebook.
|
| Field Notes has been my favorite, though I'm experimenting
| with different brands. Pentel Kerry is my pencil.
|
| https://fieldnotesbrand.com/products/original-kraft
|
| https://www.jetpens.com/blog/pentel-sharp-kerry-a-cool-
| mecha...
|
| Field Notes 3.5" x 5.5" notebooks are the size of a folded
| index card with only a few pages in them. So they comfortably
| fit in my pocket. Staple bound is relatively weak, but their
| relatively cheap price means that you can just keep buying
| them as they wear out (moving your legs / walking / etc. etc.
| slowly weakens the paper and tears it apart).
|
| Realistically speaking, a Field Notes 3.5 x 5.5 is well
| balanced: I seem to run out of space roughly as the staple
| binding wears out. (I know people don't want to "waste paper"
| but.... I haven't found a good strategy for that. The small
| size and "disposable" nature of these Field Note books are
| superior in my experience)
|
| Pentel Kerry is a "shrinking" pencil. It has a small size
| when its stored, but when you pull the cap off and put it on
| the back, it "grows" slightly and has a better balance for
| writing. Its a very slight effect, but the "smaller stored
| size" makes for a nifty pocket-pencil.
|
| ---------
|
| > I make a mark on the back of my hand in ball-point and ONLY
| rub it off when the job is done. Eq (using your example) if I
| knew I had to lock a door on the way out I would write either
| an 'L'(ocked) or a D(oor) on the back of my hand.
|
| Never erase in your pocket notebook (despite using a pencil).
| Just add more information later: cross out old information
| with new dates, if you're out of space write down a page-
| number where you can see more information on a particular
| subject.
| aspyct wrote:
| Oh that's pretty cool!
| larsiusprime wrote:
| I have a weirder version of this problem that's less
| debilitating but annoys people who live with me -- if I pass by
| a door I will automatically lock it with no memory of having
| done so, even seconds after. Like kleptomania but for locking
| doors. If I'm within five feet of a door it's as if a magic
| force emanates from my body to lock it as far as my own
| awareness is concerned.
|
| One of my roommates in college was carrying in groceries, put
| his keys down on the counter, and went out to get a second
| load. I was reading a book, passed the door, locked it, and
| walked upstairs, completely oblivious, stranding my roommate
| outside.
|
| They referred to this as "getting Larsed out" from then on.
| cperciva wrote:
| My version of this is turning lights on. I enter a room and
| immediately turn the lights on, but I'm neither aware of
| turning them on nor aware of them _being_ on, so I don 't
| turn them off when I leave.
|
| Drives me wife crazy.
| Baeocystin wrote:
| I had a family member who had the same drive, and after one
| too many times of me getting locked out while I'm bringing in
| things from the car, the New Rule(tm) was that if I'm
| actively using the door, it is stopped fully open, and the
| Habitual Locker is not allowed to touch it without coming
| outside to help carry things in, no exceptions.
|
| It actually worked out quite well!
| JadeNB wrote:
| I started reading and thought "why not just ..."--and you did!
|
| Since this _is_ Hacker News, I 'm surprised that you haven't
| come up with some more elaborate system, e.g., properly locking
| the door closes a circuit, and you can check the status of the
| circuit remotely.
| SamBam wrote:
| I don't worry too much about whether I left the door locked
| or unlocked, but suck a system would _produce_ anxiety in me,
| because I could never be sure if there wasn 't some circuit
| malfunction and it wasn't showing me a false positive or
| negative.
|
| My wife and I had the exact same response to the baby
| wearables or gadgets that promised to tell us if our baby was
| still breathing up in her crib. We _weren 't_ worried about
| that, so the notion of _adding_ something that would almost-
| certainly be a flaky indicator seemed guaranteed to increase
| anxiety.
| aspyct wrote:
| Spot on, mate!
| aspyct wrote:
| Ahah, I absolutely did! And sibling commenter SamBam got it
| exactly right :D
| betwixthewires wrote:
| Is I was reading the first few sentences, my thought was "why
| don't they just take the hair dryer with them?" And then I start
| thinking "well, maybe that's just an outward indicator of the
| illness and that it would manifest in other ways, maybe they have
| to treat the underlying whatever, these guys are experts after
| all if the solution was so simple..."
|
| Then that's exactly what happened. Maybe there are underlying
| problems. But maybe, and this is a stretch, medicine treats
| symptoms and not causes. And maybe those problems don't really
| matter to the people who suffer when something simple can make
| their lives work for them.
| acuozzo wrote:
| Hacks like this often work wonders.
|
| Reducing the burden of OCD is necessary to get in the frame of
| mind required to make breaking cycles a habit.
|
| Taking a daily photo of the stove dials with my iPhone helped
| break the cycle for me and was the first step I took on my long
| road of (successful!) recovery.
| teucris wrote:
| That's awesome! It's funny because taking pictures was one of
| the major compulsions I had to break.
| swayvil wrote:
| If she suffered from an obsessive compulsion to review her case-
| notes in her head all waking hours, which made her into a better
| lawyer, we'd never even hear of this.
|
| Other useful forms of this "insanity" may be seen in engineers,
| scientists, writers...
|
| So UTILITY is definitely already the basis for any further
| judgment or antidote. We can say that.
|
| So taking the hairdryer with you is already entirely appropriate.
|
| An ideal of sanity is not our aim here. Never was. Never should
| be (unless that's your own personal thing).
| [deleted]
| [deleted]
| Fleetfantasy wrote:
| As an OCD haver of over 20 years, I find these suggestions to be
| pretty wonderful. In some of cases, these conditions can't be
| fixed by therapy, and/or the drugs don't work. Therapy is
| fantastic, but sometimes these things can be the difference
| between getting out of bed in the morning & not.
|
| Finding these solutions can be absolute bliss - technology for
| 'hands-off' switching off things is one for me. As with
| everything it's a balance, but if something small helps in a big
| way, that's a win for me!
| insickness wrote:
| This story sounds like it should be posted in the subreddit "and
| everyone clapped." Any therapist worth their salt would consider
| both practical solutions as well as treatment of the underlying
| cause. If your depression were triggered by job loss, they'd urge
| you to look for another job as well as figure out how to
| prevent/treat the depression itself. I'm skeptical that the other
| psychiatrists thought the practical portion of this treatment was
| scandalous.
|
| The only reason the other psychiatrists may have objected to his
| 'treatment' is if the psychiatrist who recommended this solution
| considered the problem solved after just applying the practical
| solution. The OCD is likely to find another way into this
| person's life, whether it's checking lights or the stove or
| something else. It's a pathology and pathologies don't typically
| resolve themselves by making a minor life change.
| jetrink wrote:
| The writer is a well-known and well-liked psychiatrist/blogger
| who does not have a reputation for lying.
|
| 1. https://en.wikipedia.org/wiki/Slate_Star_Codex
| MarkusWandel wrote:
| Seriously, I wasn't even through the second paragraph before I
| thought the same thing - just take the thing with you. It doesn't
| try to solve the OCD, but it solves the problem.
|
| Nobody in my household has OCD, but we had a garage door that
| sometimes, unpredictably, would decide that there was an
| obstruction at the very bottom, and go back up. Did you really,
| really watch it go all the way down before driving off? Did you?
|
| Engineer's solution rather than psychiatrist's - simply rig
| something that lets you check over the internet _and_ close the
| door (but not open it!) if necessary. I 've since debugged the
| garage door too.
| ortusdux wrote:
| I've been looking at circuit breaker level power monitors, and
| one of uses that seems interesting is the ability to see if
| your oven is drawing power. Some systems allow you to enable
| geofencing and trigger a push notification if your phone leaves
| the home wifi range wile the oven is on.
| stordoff wrote:
| > Engineer's solution rather than psychiatrist's - simply rig
| something that lets you check over the internet and close the
| door (but not open it!) if necessary.
|
| Wouldn't necessarily work for OCD, as the obsession can easily
| morph into "Did the sensor fail?" I can see it being helpful
| though.
| lstamour wrote:
| Live feed camera with a timestamp turned on then? :) Could
| double as a security cam for the car when it's in the
| garage...
|
| The real fun one is if you need to stare at the latch as
| well, just in case it looked closed, but wasn't...
|
| That said, this particular story has been repeated a bunch,
| or at least I've heard it before but I can't quite remember
| where. I'd be interested if anyone's found a proper source
| for it, but not quite interested enough to go hunting myself.
| :)
| zestyping wrote:
| Same here. The solution was immediately obvious. I'm amazed
| that she actually got as far as talking to a psychiatrist,
| unless I suppose she was so ashamed of the problem that she had
| never told anyone about it before.
| kleinsch wrote:
| I think a lot of smart home gadgets are stupid, but we had to
| get a new garage door opener and all the decent ones are smart.
| It's amazing. My opener sends me a notif on my phone if it's
| been open for 10 mins and I can close it remotely.
| Forge36 wrote:
| I had a gather like that, for like half an hour the sun would
| shine on the sensor and it wouldn't close. Fixed with a toilet
| paper role over the sensor to avoid the glare. In my current
| house I have homeassistant and a sensor so I can check if it's
| closed/auto close after ~10 minutes (I'd set it to 5 but that
| was too aggressive).
|
| Haven't worried since
| MarkusWandel wrote:
| In my case the rails were misadjusted so the door would
| contact the frame before it was all the way down. The
| friction would sometimes, just sometimes, trigger the
| overtorque sensor, but only when the door was about an inch
| or two from the bottom. Fixed by adjusting the rails.
| tibbydudeza wrote:
| In my case it is my remote garage doors.
|
| Sometimes worry that I did not press the button on the remote to
| close them when I left home so I would drive pass my home again
| after dropping off the kids at school.
|
| Fortunately distance to school/home/freeway to work is within a
| few minutes of each other.
|
| Later installed an IP camera - told the wife it was for home
| security and not monitoring the garage doors.
| [deleted]
| P4u1 wrote:
| That's amazing. Before I finished reading the article I thought
| one solution could be to throw the hair dryer away, and just use
| a towel or something(not ideal but beats being miserable I
| guess). But taking the hair dryer with her was way better.
| ngvrnd wrote:
| SSC FTW
| OscarCunningham wrote:
| > If one day I open up my own psychiatric practice, I am half-
| seriously considering using a picture of a hair dryer as the
| logo, just to let everyone know where I stand on this issue.
|
| He didn't, as it turns out. https://lorienpsych.com/
| frereubu wrote:
| This reminds me of the British Psychiatrist R.D. Laing who had a
| kind of "open house" for people with mental health issues in the
| late 60s / early 70s, where they could go and live untreatead
| except as they wished. (There were obvious limits to this, such
| as violent people not being admitted). One person came to stay
| and wouldn't talk to anyone, spending the vast majority of his
| time in his room, and becoming very irritated if anyone spoke to
| him. He became more and more withdrawn and stopped eating, and
| the psychiatric team were very concerned about his wellbeing as
| his weight dropped. One morning he came down from his room,
| smiling, and asked for a large breakfast. It turned out that he
| had been trying to count up to one million and back to zero and
| every time someone spoke to him he'd lose count. Once he'd
| managed to do it the spell was broken and he was essentially
| "cured". There are obvious ethical concerns about his treatment,
| and I often wonder whether he just lapsed back into some other
| compulsion, but it does make me wonder a great deal about the
| lack of individual attention and creative thinking about
| treatments for for patients with mental health issues that the
| hairdryer incident points to.
|
| Found the story: https://www.madinamerica.com/2013/11/living-one-
| r-d-laings-p...
| willcipriano wrote:
| I had a weird tick as a kid where anytime someone said something
| to me I had to mentally adjust the length of the statement so the
| number of words was divisible by 5.
|
| So for example if you said "Are you going to school today?" I'd
| add "my good friend, Will" in my mind.
|
| It drove me nuts, but I was unable to stop. Then one day it just
| went away. Still have no idea what that was but it plagued most
| of my childhood. I remember when I noticed that I didn't have to
| do that anymore and it was probably the happiest I felt prior to
| my daughters birth.
|
| Never told anyone about it before this comment. It's a strange
| thing to try and explain to someone.
| spicybright wrote:
| Have you considered writing children's books? :) /s
|
| It's so interesting how many weird states our brains can get
| into like that.
|
| Congrats on kicking the habit though!
| robocat wrote:
| Have you had any benefits? For example, has it made you much
| more accepting of the mental quirks of other people?
|
| I really appreciate your disclosure of something so intimate,
| because it brings a sense of wonder into my world, and it
| reminds me we never really know what is going on in the minds
| of our friends (let alone my own mind!). Thank you.
| anonymousDan wrote:
| Wow, it's actually amazing to me that this is the first time
| you have articulated this to anyone - thanks for sharing!
| zentiggr wrote:
| I've had a habit for my entire adult life, of sorting the
| letters of words alphabetically in my head. The longer the word
| the better.
|
| It's even better when the sorted letters turn out to make any
| sort of repetitive pattern.
|
| And I count stairs, unless I specifically override the internal
| voice and say "1", "1", "1", "1,".... to myself.
| Zababa wrote:
| I used to count stairs when I was younger too, and remember
| that most of them had between 16 and 18 steps for a floor.
___________________________________________________________________
(page generated 2021-06-17 23:00 UTC)