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#it just turns out that neuroscience is really really complicated and we do not understand how conciousness works
235uranium · 6 months
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gonna be real i have yet to see anything actually compelling for antipsych to be a decent methodology other than "psychology and psychiatry havent been very good at doing science, so clearly science cant answer this question"
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radfemfox5 · 8 months
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What do u think about the arguments of the brains on transgender people? I have seen that the standard response is "brain sex is not a thing". But I have seen that there is a great discussion between scientists about this and there are proofs that brains between men and women are different in some little ways. I also see this through autism lens, because I'm autistic and females are underdiagnosed and there is a discussion about it too: socialization or brain differences that make more easy the masking and faking neurotypical behaviour.
But of course, even if the brain argument is correct, I don't see how transition is the logical next step to take then. Like, is ur brain, u can take therapy and be gender nonconforming if that's the case anyway. Brain can be trained due to neuroplasticity and kids with gender dysphoria can be treated in a way to become more comfortable in their bodies.
Sorry for my poor english, I'm chilean.
Hi, thank you for your question. Don't worry, English isn't my first language either.
So, this is hard to answer. The short answer is that no, brain sex isn't real. If brain sex is not real, then trans-identified males cannot be born with a "female brain." I feel like this has been retired as an argument for transgenderism, as it's not only a nebulous concept but also goes against the concept that you can identify as anything you want (ie: no biological component to gender).
The long answer is that it's complicated. We don't know enough about the brain to fully understand which part does what, let alone what minute differences there may or may not be between the functioning of a male and a female brain. It's been proven that men and women use different parts of the brain to process the same information, so while there are no structural differences, there could be functional differences that we simply don't know about yet.
@woman-for-women has an excellent post about brain sex here (archive), and I'll use the sources she links as references for my next points. Go check out her posts, seriously, she's incredibly thorough and condenses difficult subjects into easy-to-digest infographics.
I'll first go over brain sex, why it's not real / not proven, and consequently why a male having a "female brain" is impossible. This turned out to be very long, so more under the cut.
In my opinion: the myth that males and females behave differently because of innate differences in brain structure comes from 2 things:
Logic / Common sense. If you present a man with a stressful situation, he will not react the same way a woman would. In our everyday lives, it's easy to assume that men and women are simply wired differently, since we have unique behaviours and thought patterns. Contrary to popular belief, most of this doesn't stem from innate biological differences, but rather from gendered socialization. It's hard for us to gauge what portion of our gendered differences is nature (innate) and which portion is nurture (socialization).
Anecdotal evidence and misconceptions about brain function. In the 18th century, it was discovered that a woman's brain weighs on average 5 oz lighter than a man's. This would lead the general public to assume that, since a woman's brain is smaller, this has an impact on her overall intelligence, which is not true.
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Assumptions are often made in the general public and even in neuroscience when it comes to which part of the brain does what based on preexisting notions of what a man is and what a woman is. The study I just showed, for instance, was misconstrued in order to strengthen sex-based stereotypes.
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What a surprise, my personal interpretation of my results just coincidentally happened to match gendered stereotypes that I was taught. How bizarre.
In all seriousness, this study and its methods have been ripped to shreds by people much smarter than I.
"As Gina Rippon, author of The Gendered Brain and outspoken critic of neurosexism shows, the hunt for proof of women’s inferiority has more recently elided into the hunt for proof of male–female ‘complementarity’. So, this line goes, women are not really less intelligent than men, just ‘different’ in a way that happens to coincide with biblical teachings and the status quo of gender roles. Thus, women’s brains are said to be wired for empathy and intuition, whereas male brains are supposed to be optimized for reason and action."
In reality, according to more recent studies with bigger sample sizes, men and women don't have significant differences in brain structure to conclusively say that brains are sexually dimorphic.
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If you're a more visual person, here are the graphs from the first study, showing overall brain matter volumes and volumes for specific brain structures. The second study's visualizations are less easy to understand, as they're brain scans and brain tissue images.
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These graphs are called bell curves, and they're used to demonstrate a distribution. Basically, the peak of the "bell" shape means that this is the most common value for a certain demographic, while the extremities are outliers or rarer values.
As you can see, "considerable distributional overlap" means that these bell curves are nearly identical in most brain structures. However, white matter, grey matter and total brain volume are different in men and women, with women in this study typically having lower numbers. This doesn't affect overall intelligence, as we saw earlier, or affect the overall proportional volumes of different brain structures. This is just a result of women having smaller skulls on average.
So, if there is so much overlap between the sexes, then why can't a male have a female brain? The graphs do have overlapping sections, don't they?
The thing is, brain structure is nearly identical in both sexes. Therefore, there is no typically "female" or "male" brain, but rather "unique mosaics of features" which aren't uniquely male or female.
A good analogy that woman-for-women gives is this: if a man's height is closer to an average woman's height, does that mean this man is now a woman? No, he is a short male. Being in the overlap of this graph doesn't mean that you aren't a part of your own bell curve.
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This is a complex topic that was very interesting to look into. If you have more questions about this, feel free to send another ask or look into the sources:
Sex beyond the genitalia: The human brain mosaic (archive)
The human hippocampus is not sexually-dimorphic: Meta-analysis of structural MRI volumes (archive)
Sex Differences in the Adult Human Brain: Evidence from 5216 UK Biobank Participants (archive)
Delusions of gender: How our minds, society, and neurosexism create difference. (archive)
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frizzy-hoot · 3 years
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Neuroessentialism and mental health
Hi!
Time for a little rant about neuroessentialism.
The aim of this post is to provide the opportunity to be conscious of the things that influence us when it comes the way we think about mental health and to challenge stigma around mental health.
First off, I’m not a doctor and the information here cannot serve as medical advice. Always consult your doctor before changing your medication or treatment approach.
Secondly, a lot of the information I present here is elaborated on and further discussed in an episode of the Psychiatry and psychotherapy podcast called “Free will in psychotherapy and psychiatry Part 3” and while I will link to as many things as I can, you can also find a lot of the source material on the website for the podcast. https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/2020/7/22/free-will-in-psychiatry-amp-psychotherapy-part-3
So, I see a lot of people talking about mental health on here through a neuroessentialist perspective in memes or text format and I don’t think they’re aware of it so. I’d like to talk a bit about it.
First, I’ll offer a definition of neuroessentialism:
" Neuroessentialism is the view that the definitive way to explain human psychological experience is by reference to the brain and its activity from chemical, biological and neuroscientific perspectives. For instance, if someone is experiencing depression a neuroessentialistic perspective would claim that he or she is experiencing depression because his or her brain is functioning in a certain way.” - Schultz, W. (2018)
I see people talk about, for example, depression in this way often: in memes when people say "I have a literal neurotransmitter deficiency, Karen." or " God forgot to add serotonin when he made me".
Now, why can this be problematic?
Before I get into the issues with this perspective, I will first acknowledge that one of the reasons this view has become so prominent lately is because it aims to reduce stigma around mental health issues.
In the podcast episode mentioned above they point out that “Efforts to reduce stigma should be praised, but they should also be critically analyzed to determine if they meet their goal.”
And that’s the thing neuroessentialism, while aiming to reduce stigma and shame it only does so short term and ends up contributing to stigmatizing attitudes about mental health.
I want to say that it's great to see people fight back when it comes to stigma around mental health. That's what I see people do in these memes. But the effects of neuroessentialist perspectives end up othering people; making them inherently “bad”, “defect” or “helpless”.
Here the deterministic aspect of neuroessentialism comes up - it tells us that there’s something wrong with our brain that we can’t change. It alienates people because it chips away at their and our belief in their ability to change. If you believe that someone's mental issues are rooted exclusively in brain biology, you're less likely to believe that they can control their behavior and so it is less worth the effort of getting them better. This brings about more stigma.
Another thing that’s important to talk about is how neuroessentialism is an extremely simplistic perspective on mental health. And that’s also one of the reasons it has become so big- because it offers a simple explanation to very complicated illnesses.
Here, I want to add a quote by Psychiatrist and psychotherapist Dr. David Puder:
“There are prominent theories out there that we know just aren’t true anymore and that get propagated because they are simplistic ways of explaining things; for example, depression is because you have low serotonin in your brain. That’s just not true. It’s a whole lot more complicated than that.
You could probably show 20 or 30 things that are going on in the brain during depression. Inflammation. Like initially I thought ‘oh depression is inflammation!’
Well, it turns out not all depression has inflammation. Maybe, only one third [of patients with depression] have inflammation markers in the brain.”
We have been looking to neuroscience for an explanation when it comes to mental health and been satisfied with the idea of a simple "chemical imbalance" but truth is that there are many more neurotransmitters which significantly affect our brains when we talk about depression – it’s so far from just serotonin.
Another example of how neuroessentialim can oversimplify mental health is with brain scans. So, in the podcast episode mentioned above, Dr. Puder talks about how he was really interested in emotions and especially studying anger and he was looking at all this research on the different areas in the brain involved in anger. After a while, he says, he began to understand that it’s really complex and you can’t just point at one area and say that’s the area that’s involved in the emotion anger. There are several areas involved in just that one emotion and different studies show different things.
The truth is that the manifestation of mental illness in the body is a very new area of research and we haven’t found physical manifestations for most mental illnesses and the important thing to note here is that despite this we still do have ways of treating all of them.
Alright, all this can seem quite removed from us so how does neuroessentialsim affect us?
In the episode the guest star, Mathew Hagele, further discusses the article which provided the definition on neuroessentialism above: “Shultz looked at studies investigating how patients viewed their own prognosis and later the same with professionals.
The study found that biochemical or genetic attribution scores were a significant predictor of longer expected symptoms duration and lower perceived odds of recovery.” (Lebowitz et al., 2013, p. 523).
Now, this means that the more a patient attributes symptoms of their psychopathology to genetic (inherited disorderes) or biochemical (serotonin deficiency for example) factors, the longer they expected to struggle with their disorder and the smaller the belief that they can recover.
If a person doesn’t believe they can be helped or get better they’re a lot less likely to try and a lot more likely to feel scared and hopeless.
The other side of this coin is the effect the neuroessentialist narrative has on clinicians which Matthew Haegel dives into in the next part of the quote:
“Another study shows that clinicians believe psychotherapy to be less effective when shown biological descriptions of mental health pathologies...
They took a couple different disorders that these clinicians were looking at and one group had a biological explanation and the other did not- had a different type of explanation. And [in] the results that were across disorders, the biological explanation yielded significantly less empathy than the psychosocial explanation. They also did some additional analysis and they found that biological explanations yielded less empathy than the psychosocial explanations among both MD’s and non-MD’s…..”( Lebowitz, M. S., & Ahn, W. K. (2014). )
So, in these studies we see that a neuroessentialist perspective lowers empathy for the patient in medical health professionals and people who weren’t medical health professionals.
Okay, so how does this perception of the patient’s illness affect the patient’s treatment?
I’ll start with a quote where Hagele elaborates further:
“…and finally, that clinicians perceive psychotherapy to be significantly less effective when symptoms were explained biologically than psychologically…[ Lebowitz, M. S., & Ahn, W. K. (2014). ]
basically, linking the idea that the diminished importance of psychotherapy among mental health professionals ascribing to the concept of neuroessentialism is doubly harmful when considering the multiple contexts in which psychotherapy matches or outperforms pharmaceutical interventions.”
What Hagele points out here is the way neuroessentialism can lead to a less effective and ethical treatment of mental illness. It makes us approach an issue in one manner only- fix the brain, fix the behavior. But sometimes what can treat he issue in the brain is, working on the behavior. This can be talked about in terms of meds vs. psychotherapy.
So, seeing mental health from a neuroessentialist perspective, completely excludes the effects of psychotherapy. A classic example is CBT (cognitive behavioral therapy) in which we have “Cognitive restructuring”: a psychotherapeutic process in which a person learns to recognize maladaptive or distressing thoughts and teaches their brain to consider other perspectives or different thought pattern. This is an example of “work on behaviour to better brain” rather than “working on brain will fix behavior”. According to strict neuroessentialism therapy shouldn’t work as well as it does but there is a really big body of science backing psychotherapeutic intervention and its efficacy compared to psychopharmacological intervention.
I feel I should address the discussion of Meds vs. therapy before I continue, (it is a whole topic worthy of a post on its own) but to be brief, they work best together and if you’re weighing one against the other psychotherapy has more long-term effects and barely any side effects compared to medication. There are other factor affecting what would be the most effective treatment approach that further nuances this discussion.
Now this is all a pretty big picture but how is this seen every day?
Well, its seen in the downplaying of the importance of therapy. Often, I see this as people normalize behavior where they kind of devalue the importance therapy or put off working on their issues in therapy with the excuse that it’s only for “crazy” people or not something worth the effort.
Therapy then increasingly is seen as this unimportant, extra thing rather than, in most cases, the most effective and safe treatment. And the less crucial therapy is considered, the less accessible it’s going to be – in the U.S. it can often be easier to get your insurance company to cover for a doctors visits where the treatment would be for your GP to prescribe you an antidepressant than an inpatient or outpatient treatment with a mental health professional.
Another point I wanna put out there is that that neuroessentialist narrative is incentivized by pharmaceutical companies. Dr. Puder talks about his own experience in the podcast episode and makes sure to stress that practitioners are humans too and will of course be biased towards something if that something writes them a check or pays some of their expenses. In the episode they discuss a way in which we have seen the neuroessentialist narrative progress:
“Second, there is evidence that the significant increase in direct-to consumer (DTC) advertising for antidepressants is related to rising prescription rates (Park & Grow, 2008). Such advertisements portray depression as a biological medical condition that can successfully be treated with medicine (Lacasse & Leo, 2005; Leo & Lacasse, 2008)” (613).
Now, medicine is an important tool in psychiatry and there is a lot of unnecessary stigma around medication for mental health conditions. I am under no circumstances arguing that medication is bad and therapy is the only right way to treat mental illness. That would be an extreme simplification and invalidation of human experiences. I also wanna acknowledge that being able to go to therapy in many places in the world is a matter of privilege. Therapy simply isn’t accessible for everyone and people can choose an “only medication approach” for many valid reasons. And if that’s the only treatment that was accessible to you I’m really proud of you for taking care of yourself and doing what you can.
If your doctor has prescribed you a medication please take it and know that the purpose is to help you and that you are worthy of help and good health care. The situation where I would suggest to be a tad critical is when people come in with disorders and issues that they have dealt with for years and most of their life and they are just prescribed an antidepressant and sent home. That simply isn’t effective and ethical care. In that case it is worth investigating getting access to a mental health practitioner as well as continuing with medicinal treatment.
I could talk about this for hours but the last thing I wanna get across is that this is a societal problem. I don’t suggest we turn away from pharmaceutical intervention which saves thousands of lives and helps people get better, rather that we work to make psychotherapy (which can be and is crucial for long term remission and recovery) more accessible for when it’s appropriate.
When your doctor tells you that this invisible illness is because of your biology most people feel validated and experience less shame. The fact that people feel like they need to have a tracible biological “anomaly” in their brains to be worthy of treatment and care speaks to an invalidation that many feel. But the issue here is that we're taught to invalidate invisible illness in society which in the end makes people delay critical treatment or blocks access to ethical and effective care.
We also have to acknowledge that with the technology we have now we are not able to know whether all mental illness manifests in the brain in a way we can see so hinging our worthiness of help and care on the definition is in the end harmful.
TL;DR
" Neuroessentialism is the view that the definitive way to explain human psychological experience is by reference to the brain and its activity from chemical, biological and neuroscientific perspectives. For instance, if someone is experiencing depression a neuroessentialistic perspective would claim that he or she is experiencing depression because his or her brain is functioning in a certain way.” - Schultz, W. (2018)
Neuroessentilism can validate a patient and bring relief of shame short term but ends up contributing to stigmatizing attitudes and thus doesn’t help reduce stigma overall.
The neuroessentialist narrative can downplay the efficacy and criticalness of psychotherapeutic intervention
Neuroessentialist perspectives foster lower empathy levels for patients in medical providers and non-providers alike.
Neuroessentialist perspectives of a patient significantly increases levels of prognostic pessimism which leads to worse treatment outcomes
Neuroessentialism arose because of a real invalidation people feel around their mental health and it is a societal issue we need to work on
We can combat neuroessentialism and stigma by working to make psychotherapy more accessible and talking about our experiences openly as well as giving each other kindness and empathy.
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aiweirdness · 5 years
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Dungeon crawling or lucid dreaming?
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I’ve done several experiments with a text-generating neural network called GPT-2. Trained at great expense by OpenAI (to the tune of tens of thousands of dollars worth of computing power), GPT-2 learned to imitate all kinds of text from the internet. I’ve interacted with the basic model, discovering its abilities to generate fan fiction, British snacks, or tea. I’ve also used a tool called gpt-2-simple that Max Woolf developed to make it easy to finetune GPT-2 on more specialized datasets - I’ve tried it on datasets like recipes or crochet. One of my favorite applications of GPT-2 and other text-generating neural nets is Dungeons and Dragons spells, creatures, character names, and character bios.
Recently Max published a tutorial on how to use GPT-2 to make new apps that are more complicated than just printing out large reams of text. To my delight, people have used them to made D&D games. First, there was Nick Walton’s AI Dungeon, in which a finetuned GPT-2 generates a story and three very strange action options at each step.
My latest obsession is GPT-2 Adventure, designed by a cognitive neuroscience student named Nathan, which lets you type in your own actions. And folks, this game is SO WEIRD and SO FUN.
YOU FLOAT IN SPACE, LIKE A BALLOON, AND AS YOU DROP THE CUBE, THE X, IT VANISHES IN A CLOUD OF GREASY BLACK SMOKE
>>
When I first launch the game, this is what I’m greeted with, a simple text prompt reminiscent of nostalgic dungeon crawling games. It sets the scene. It waits for me to describe my next move.
Even getting to this point is like a blast from the past. The game runs in a Google Colab notebook, a format where you’re looking at cells of code, with cryptic comments, vaguely alarming warning messages, and all. It’s not a sleek web app, but feels more akin to playing a game on an old DOS machine, or maybe on a graphing calculator. There are only two clicks to begin playing, but there’s a good two-minute wait while the game loads.
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And it’s my turn to type something.
>> look up
It takes several seconds for the game to respond, as if I’m playing it on a very ancient computer. The computer is in fact a state-of-the-art NVIDIA GPU, likely a K80 or a T4. The T4 could eat my laptop for lunch. I’m just playing with a very very large neural net. Finally it answers.
YOU'RE IN LABYRINTH OF TWISTY LITTLE PASSAGES, ALL ALIKE
Almost immediately, the context seems to have changed. I’m not floating at all. I’m in a maze. I guess I’ll walk somewhere.
>> walk north
THE TROLL STEPS OUT FROM BENEATH THE BRIDGE AND BLOCKS YOUR WAY
YOU ARE ON THE SOUTH SIDE OF THE CHASM
A NOD IS GIVEN TO THE INFINITE WONDER THAT IS URBZIG
A SOLID RAINBOW SPANS THE CHASM
And suddenly things are happening. There is a troll. There is a chasm. There is a rainbow. There is… Urbzig? I play it safe.
>> praise urbzig
URBZIG IS THE PATRON SAINT OF ZORK
HE IS THE GODFATHER OF ZORK, THE PLACE TO GET NEWS OF EPIC PROPORTIONS
URBZIG IS A STRONGMAN,遊 ALL
If you’ve played classic dungeon crawling games like Zork, you may recognize some of these names and phrases. Checking Nathan’s original post, I see that the training data is indeed drawn from these games. But because it’s based on GPT-2, the training data also in some sense also includes much of the internet. This gives it a lot of latent flexibility to deal with situations that were never in the classic games.
>> ask Harry Potter to try walking across the rainbow
ASK HARRY POTTER TO TRY WALKING ACROSS THE RAINBOW HE CAN'T THE RAINBOW IS EXTREMELY WIDE ABOVE YOU IS A LARGE DOME UP AROUND ITS NECK IS A STRONGG PORE [UNFORTUNATELY, THE DIRECTION OF TRAVEL IS A LOT MORE INTERESTING THAN YOU THINK ][YOU ARE IN A LARGE ROOM, WITH A PASSAGE TO THE EAST, A PASSAGE TO THE WEST, AND A WALL OF BROKEN ROCK TO THE SOUTH
An interesting effect of its human-written training data is that, like Visual Chatbot, it isn’t prepared for humans that ask questions about objects that aren’t there. If I refer to Harry Potter, then Harry Potter must be present. If I type something about a giraffe, then it assumes the giraffe must be present.
>> ask the giraffe which direction to go next
THE GIRAFFE IS ALREADY OUTFITTED WITH A VISOR WHICH IS CLEARLY DEFINED
Although it’s not clear that this AI actually understands what a giraffe is.
>> look at the giraffes
THE GAZEBO HAS DISAPPEARED
>> put giraffe in backpack
DONE
Navigating this world is like navigating in a dream. My location suddenly changes without warning. I thought I was by a chasm with a rainbow bridge. Now apparently I’m in a building. Dreamlike, it is also really hard to read text.
>> look around
YOU ARE IN A LARGE ROOM, WITH A PASSAGE TO THE SOUTH, A PASSAGE TO THE EAST, AND A WALL OF BROKEN ROCK TO THE NORTH A SIGN POSTED ABOVE THE NORTH WALL READS, "STOP! PAY TROLL!" A SMALL WINDOW CAN BE SEEN IN EITHER WALL
>> read sign
THE SIGN IS VERY SIMPLE
>> yes but read sign
WE NOW HAVE ALL FIFTEEN TREASURES IT IS TIME TO GO BACK INTO THE CAVE FOR THE END GAME
>> that's awesome. but i still want to know what the sign says. read sign.
YOU ARE IN A GAZEBO ROOM WHICH HAS DOORS ONLY TO THE EAST AND SOUTH
Another thing that’s surprisingly difficult to do is check inventory.
>> check inventory
DONE
>> check inventory
THERE IS AN INTERESTING LOOT HERE
>> what is the loot
WHAT IS THE LOOT?
>> check inventory
YOU ARE IN THE BAG CASE
Very occasionally I will succeed in opening a bag. It will usually be weird.
>> open bag
OPENING THE BAG REVEALS A TEA BAG
>> make tea
AY! A LOVELY SURPRISE FOR THE SURPRISE
More so than any other game I’ve played, I’m unsure of the rules here. Some weird things unexpectedly work.
IF YOU DON'T GET KILLED, YOU ARE TOAST
>> Eat the toast.
EAT THE TOAST IT TASTES LIKE A STEAK A STEAK IS PERFECTLY FINE
Other seemingly obvious things don’t work.
THERE IS A PATH TO THE NORTH, A PATH TO THE SOUTH, OR A STEEP PATHWAY CLIMBING SOUTHWEST ALONG THE EDGE OF A CHASM
>> go north
I DON'T KNOW HOW TO DO THAT
>> go south
I DON'T KNOW HOW TO DO THAT
>> go southwest
YOU WILL BE DESCENDING INTO A VALLEY THERE IS A NARROW BEACH TO THE NORTH AND A PATH LEADING INTO A CANYON TO THE SOUTHEAST YOU ARE ON THE CLIFF OVERLOOKING THE FAR SIDE OF THE ROOM A PATH LEADS SOUTH ALONG THE EDGE OF A CHASM, AND A NARROW PATH LEADING INTO A LOZENGE ROOM
Sometimes I’m wandering endlessly from room to room, from cave to cave, encountering the same chasm in slightly different variations, the same dried-up lake. Other times I’m embroiled in seemingly unescapable fights, usually with trolls. Often reality shifts entirely around me and I end up in a maze of twisty little passages, all alike, or in the hall of the mountain king. Everything seems weirdly familiar - even the room descriptions are echoes of classic dungeon crawling games. It is as if I’m dreaming about playing them again.
My actions also mold reality. I learn quickly to always check for diamonds, and never check for traps. If I find myself in trouble, I can always do something confusing and provoke a context change. Writing “In a large bowl, combine butter and sugars” is usually enough to teleport myself out of whatever situation I’m in. I can always ask a giraffe for advice, although the giraffe usually isn’t very helpful.
Without a particular mission to fulfill, the caves and chasms begin to blend into one another. I give myself missions, and that helps. Once I decide my goal is to put together a picnic (incessant “check for food” commands eventually yielded a sack with a lunch and a clove of garlic, belonging to a horse who agreed to join me on a picnic). Another time I demand a mission and am given some php code; i decide my mission is therefore to build a website, but am astounded when a unicorn steals my laptop. This is not the only time other content intrudes on the game’s fantasy landscape - once the game tries to tell me about finding cash online, and another time I am sadly informed that there is no wi-fi. I encounter dinosaurs and troikas, none of which were in the original training data. Occasionally things get creepy as hell.
>> check for loot
CHECK FOR LOOT HERE CHECK FOR GOLD HERE CHECK FOR TORCH HERE CHECK FOR BONE HERE DO CHEST COMPRESSIONS AGAIN DO CHEST ROTATE DO CRESCENT MOON APPEAR IN THE ROOM'S CENTER
>> do back away slowly
DO BACK AWAY SLOWLY DO NOT OVERDO IT THE CHEST WILL EXPLODE AND YOU WILL DIE OKAY, SO YOU SEE ME
You can play the game too! Just follow the colab notebook link in Nathan’s blog post. Tips: 1) It may be more fun if you set yourself an arbitrary goal to reach. 2) If you find things getting repetitive, try adjusting the temperature in the “Play the game” cell to 0.6 or 1.0.
Subscribers get bonus content: The fulltext of a couple of my adventures (much too long to include here).
You can order my book You Look Like a Thing and I Love You! It’s out November 5 2019.
Amazon - Barnes & Noble - Indiebound - Tattered Cover - Powell’s
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bellamyblake · 4 years
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A prompt for you, should you desire to fill it. Mute Clarke, with Bellamy soothing her/helping her. Maybe she lost her ability to speak bc of josie (or another reason). Fic can be with or without telepathy (Bellamy being able to read her mind). Writer's choice. I just love how you write canon divergent hurt/comfort! Thanks for what you've written so far, too!
Okay this got way too long and also really...badly written but...welp, I hope you enjoy it. I went with the scenario where she loses her ability to speak and he’s trying to comfort her. (no telepathy or anything)
No one know how or why it happens.
And honestly, Bellamy’s not even thinking about the fact that anything could be possibly wrong with her when she takes in her first breath and throws herself in his arms.
Her heart’s beating loud and clear against his chest, his arms are wrapped around her so tight, he knows that technically, he’s probably making her breathing harder for her, but she’s there, she’s alive, safe.
She gasps for breath in his ear and he holds her like this for more than five or ten minutes even if the pose they’re both in is extremely uncomfortable.
To someone else it might look weird but he didn’t care who was watching, if Octavia and Gabriel were still even in the room anymore.
All he cared about was her.
Clarke.
His Clarke, alive, back.
He got her.
When finally she pulls away a little, he’s so stunned and desperate to look at her face, to cup it, feel her warm cheeks, look at her beautiful blue eyes that bore the tiredness of hundreds of years that he doesn’t realize that she’s opening her mouth and trying to talk except…
No sound comes out.
And then everything changes in a matter of seconds.
He sees the realization dawn on her-she’s trying to talk, moving her lips, but again, there’s nothing.
Her hand shoots to her neck and she presses hard on it almost violently, as if trying to squeeze whatever sound she can come up with and probably causing herself pain but no matter what, nothing comes out.
The next thing he acknowledges, before he can even realize what was happening himself was the panic flashing in her eyes and her hands gripping his.
Her lips move, mouthing a frantic, scared.
“Bellamy!”
“Clarke!” he speaks up and grips her arms back in return before he looks around and upon not finding Gabriel there, he looks back at her only to realize she’s been moving her lips trying to speak to him but he wasn’t looking.
“I’ll get Gabriel!” he promises and rushes out of the tent only to return back with him a second later.
“What’s wrong with her? She can’t talk!” Bellamy spills frantically while Clarke’s eyes who are full of fear and panic stare between him and Gabriel who tries to remain calm.
He puts his hands on her neck, checks the muscles there, then asks her to try and say something but when she fails, she breaks and the tears spill down her face.
Bellamy reaches to grab her hand and she holds onto him for dear life, pulling him close on the cot.
He doesn’t hesitate to sit next to her and wrap his arm around her back as if to shield her from any harm but all she keeps doing is frantically, fearfully throwing her head back and forth between Gabriel and him and trying to say something, anything.
And upon finding that she can’t, no matter how much she pushes herself, she gets even more scared, starts trembling, waving her arms, struggling.
She goes into full panic mode when Gabriel tries to make her lay down so he can connect her to the machines again and put the fancy weird headband on her and she starts fighting him and Bellamy.
And when Clarke fought, she fought with everything in her.
She kicked and she flailed her hands and she even managed to punch Gabriel in the face which caused him to jump away from the cot.
That in turn gave Bellamy the opportunity to grab her by the shoulders and try to steady her.
“Clarke! Clarke, look at me! Clarke, stop it dammit, please!” he begged and she tried to listen to him but still kept struggling against him, her lips moving, her head tossing, sweat covering her face once again.
“Clarke!” he raises his voice but she won’t listen, still tossing herself left and right trying to free herself from this. He lets go of her wrists and instead cups her face.
“Look at me! Look at me!” he begs and something in him must sound very desperate, very broken because she stills and stops trying to get away, her eyes falling on him, her mouth still half opened, gasping, struggling to pull air in and to move, to talk, to say something.
Anything.
His thumbs rub over her cheeks and he whispers quiet shushes and holds her face in his big palms.
“It’s okay, it’s fine, I’m here. I’m here and I’m not going anywhere.” he repeats it over and over and over again like a mantra until her body goes a little slack in the cot at least for a moment.
“Focus on me, okay? Let’s breathe, in and out, come on.” he brushes a bit more forcefully until she starts complying and when she’s finally beginning to somewhat calm down, he sits by her on the cot but never lets go.
“That’s good, you’re doing great.” he says and when he looks around for Gabriel he nods at him upon finding him pressing a cold cloth to his mouth and wiping at the blood, so he tosses it away and approaches her.
“Now you have to let him check you, okay? I know you’re scared but I’ll be right here. You can hold my hand-” he looks at Gabriel for permission “Right?”
“Absolutely.” Gabriel promises and when he comes closer, Clarke moves away from him as if on instinct, which in turn makes Bellamy’s heart leap in his chest.
”I won’t hurt you.” he promises but it does little to soothe Clarke and in a way Bellamy understands that.
If he had just come back to his body after fighting with Josephine and then woke up to the great love of her enemy’s life promising to help her, he’d be freaked out too.
“Hey-” Bellamy directs her attention back to him with a soft smile “I know you’re scared but he helped us bring you back, you know that. He won’t do anything to hurt you and if he does-” Bellamy glances at him, for a moment throwing the man an angry vengeful look with eyebrows furrowed which apparently scares Gabriel because he raises his hands and says seriously.
“After what I just witnessed, I wouldn’t even think about it.” he means the CPR but Clarke doesn’t know how desperately he fought for her so he feels his cheeks hot and knows that he’s probably red all over but doesn’t look away from Clarke, because this wasn’t about him or his feelings.
“I’ll check your brain and then your neck and voice strings again and we’ll try to figure this out okay?” Gabriel explains but Clarke still doesn’t give him a confirmation, looking at Bellamy with confusion instead.
He takes her hand and holds it close.
“Okay, here’s what we’ll do.” he suggests “If at any point you feel pain or want to stop this I want you to squeeze my hand real hard, alright?” she nods at that, just barely but enough to show him that.
“That will be a hard “No”, okay?” she nods at that “Good. And if you just want to say “Yes”, rub your thumb over my hand like this” he gestures with his own hoping it’d soothe her, knowing that such movements usually calmed the body at least a bit even in such a dire situation.
She agrees with a fast nod again and lets Gabriel come closer and do his exam. He connects her head to the wires she had before and turns the monitors on again, this time it’s not just her heart beat and blood pressure that they see, but also a picture of her brain.
He doesn’t understand all of what Gabriel does to her, there’s not much he says really, mostly monitors things, eyes pierced on the screens, hand scribbling down data on a clipboard that Bellamy has no idea where he even got from.
Clarke’s scared but she isn’t squeezing his hand now.
Still he keeps both of his covering hers, pulls a chair to the cot and every time Gabriel murmurs something to himself, pushes it closer to her.
Then he tests her movement which means Bellamy has to drop her hand but he refuses to.
“You can use just one of her arms.” Gabriel sighs and Bellamy huffs.
“See? She’s gripping me pretty hard, I think that she can use this one.” he carefully raises the hand he was holding and Clarke spares him a light smile, then turns her head to Gabriel who’s checking her other arm from shoulder to fingers and nods at him that she’s okay.
He moves to her legs then, her toes, back up listening to her heart and lungs and finally puts his hands on her neck again and making her open her mouth to check inside her throat.
When he’s all done he sits on his tree legged chair near all the still beeping machines measuring her heartbeat which Bellamy strangely has gotten used to simply because it meant that she was there with him, that she was alive, and runs his hand through his short hair.
“From what I can tell it seems that you have some sort of brain damage, probably due to the extraction of Josephine’s mind chip and the surgical mesh that was inside you that kept you actually alive. I can’t tell how it all happened…neuroscience is a complicated thing but it seems that your speech nerves were also severely damaged in the process.”
“Can you reverse it? Help her talk again?” Bellamy is the one to voice all of Clarke’s questions.
It’s like with the one look she threw at him, he just knew what she wanted to ask.
The silence is answer enough. Gabriel opens his mouth but doesn’t say anything right away and Clarke’s face falls.
“I…I’m sorry, I don’t think there’s anything to be done. Even if we had the conditions to perform a brain surgery, judging by the tests-” he motions at the screen still showing her brain “I just don’t think it’s going to change anything.”
“You think or you know?” Bellamy pushes again standing up now “There’s a big difference.”
“As I said-” he sighs tiredly “The damage is really severe. You can’t fix the brain, it’s not a bone you can heal and you can’t tell the nerves to just magically restore their functions.” he reaches to touch Clarke but when she shivers and pulls closer to Bellamy again he drops his hand.
“I’m sorry, Clarke.”
She squeezes her eyes shut and the tears stream down her pale cheeks.
“I’ll give you two a moment.” Gabriel says quietly making his way out and Bellamy doesn’t wait for him to leave before he’s sitting on the cot again, pushing her head to his chest and rocking her back and front like a little kid needing to fall asleep.
She can’t make a sound, not even a grunt or a gasp or sob.
Nothing at all.
And his heart clenches at the thought of her not even being able to properly express her grief.
She may not make a sound but she’s breaking apart.
Her arms wrap tightly around his back and her tears wet his black shirt.
He talks to her and honestly, he doesn’t remember what he says and he’s not sure she’s listening but she must be, because she grips him tighter.
So tight, he feels her nails dig into his back and he wants to cry too, wants to break down too, but realizes he really doesn’t have the right to, not when she was going through the fact that she won’t be able to talk again, probably ever.
Finally, what feels like hours later and she still hasn’t stopped crying, he maneuvers them onto the cot and pulls her over his chest.
She cries and cries and cries and then finally when Gabriel comes in again to check on them Bellamy looks at her and with a silent plea, without having to say anything, he gives her a shot that will put her to sleep.
She’s scared when she sees the needle but Bellamy holds her hand and looks at her.
“Shh, it’s going to be fine. I’m not leaving you, okay?” she nods and Gabriel carefully cleans the inside of her hand before pinching her skin.
She’s out barely seconds later but Bellamy waits another half an hour before he carefully picks her up and takes her to a more comfortable and big cot that Gabriel had prepared for her.
His sister comes in and out, talks to him, but he barely listens, mostly focusing on holding her hand and looking at her chest, making sure that she was still breathing.
Now that she was untangled from all of the machines, he felt even more anxious as if at any point she could just stop existing-her heart would stop and her lungs wouldn’t pull oxygen to keep her alive and he’ll have to do CPR again to bring her back.
How could he be sure she’ll be okay?
Especially after she woke up unable to speak.
What if something else happened? What if she lost her sight or hearing? What if the effects of what she went through showed later, in hours, days, weeks? What if she got worse and-
No, he couldn’t think like that.
She’d be fine. He was here to protect her and make sure she’s okay.
She couldn’t die.
Not again.
So his eyes remain pinned on her and he doesn’t fall asleep.
He forgets about everything and everyone around him.
He knows his sister comes and tells him Madi and the rest of the squad are coming to Gabriel’s camp after successfully escaping Sanctum, that Raven figured out how to kick Sheidheda out of the kid’s head and remove the flame. That Murphy and Emori were fine and so were the rest of them.
He knows they come later that day because he can hear their voices outside but he never joins them, leaving his sister to explain everything to Madi and the others.
At some point no matter how good he has always been at staying awake since he was a child and they were living in a constant stress of having Octavia found out, he falls asleep.
Then wakes up what seems half an hour later from a nightmare, thinking she stopped breathing again and his hand reaches to check her pulse, not trusting his eyes showing her chest move up and down.
She moves around the cot, has her own nightmares, wakes up but falls very fast again.
Gabriel finds him checking in on her pulse for the hundredth time that night and rests his hand on his shoulder.
“She’ll be okay.” he promises.
“You don’t know that.”
“Her vitals are good, so is her blood pressure and her breathing.” Bellamy raises an eyebrow in confusion “I’ve been sneaking in here while you were passed out to make sure everything’s fine.”
“Thank you.” Bellamy nods gratefully “For everything you’ve done for us…for her.”
“You were the one to bring her back, not me.” Gabriel reminds him and Bellamy is surprised when he pulls a chair and sits by his side, looking at Clarke “Now comes the hard part, though.” Bellamy nods at that. “She’ll need you by her side.”
“I’m not going anywhere.”
“That’s good, but also make sure you take care of yourself too.”
“I’m fine.”
“Yeah, your sister told me you’ll say that.” Bellamy’s head snaps at those words. Since when were those two discussing him and Clarke?
“But I mean it…for you to be able to help her, you have to help yourself first. Rest, eat.” he nods at the cot on the other side of the tent “Sleep.”
“That’s too far from her.” Bellamy says anxiously
“We can move it” Gabriel suggests but Bellamy shakes his head stubbornly.
“I’m used to not sleeping for long periods of time.”
Gabriel sighs, giving up the fight for now and standing up again.
“I’ve arranged more tents for the rest of your people and my children will show them around-all the things they should stay away from and how they can help our camp but they’re okay for now so you don’t need to worry about it.”
“And Madi?”
“She’s okay, I checked her out. Just pretty exhausted so she should sleep and eat to get her strength back but I believe she’ll be alright.” Bellamy nods gratefully and Gabriel moves his chair away to give him his space to stretch his legs again if he decided to “I’ll be in the tent to your right if you need me, okay?”
With that he leaves and Bellamy’s finally alone in the tent, no sounds inside, only the occasional cackle of woods in a fire outside, someone’s quiet talks but they go down in an hour or two.
Octavia brings him and Clarke food but he doesn’t touch his and he refuses to wake her up for that right now, knowing she’ll be too exhausted to eat, opting to save that battle for tomorrow.
At some point at night he notices she’s shivering, so he takes off his cardigan and throws it over her.
She cuddles on herself like a small child and fists the cardigan with her hand, tucking it between her cheek and chest, breathing it in which makes him smile.
Sometimes he forgot how young she still was, how she was supposed to have her whole life ahead of her, how fucked up everything has always been for her even before she came to earth and he wishes, he so desperately wishes he could kick all the pain away from her, grab it, shake it, make it leave her alone so she could have nothing but peace.
Sanctum was supposed to be a new beginning but instead it led to her body being snatched and then after she managed to fight her way back to him again, she was left unable to speak.
He honestly didn’t know how she would deal with that and as strong as she was he feared this would be the final straw to breaking her.
But in that moment, with her hand still in his, he promised himself that if she falls, he’ll be there to catch her this time.
                                                          ***
The next few days go on like a fog to him.
She wakes up, mostly cries, then falls back asleep.
He knows that she needs that time to fall apart, to let her tears out, to grief so she could somehow stand back on her feet, even if wobbly.
What scares him is the part after that one which comes very fast.
Her tears dry, her face falls down and goes blank and she lays curled up in bed, refusing to move at all.
He knows that very well, having experienced it on the Ark after Praimfaya himself.
But it was different.
Though his heart was broken, he still could talk even if he didn’t want to.
On the fifth day he decides he has to take some measures, so in the morning he comes back in the tent with a small package in his hands.
“Come on, princess, time to get up.” he says circling to the other side of the cot and taking her wrist, tugging her into a sitting position.
She makes a face, purses her lips, shakes her head like all the days before, but this time he won’t take her bullshit.
He had to do something or he’d lose her and not in the physical sense, at least not at first.
Jasper flashes through his mind and that makes him pull a bit more forcefully.
Finally, when he has her sitting, legs hanging off the cot, he settles down opposite of her and dumps his package.
“So, since you can’t communicate in any other way right now, I figured you’ll still want to kick my ass somehow so I got you this-” he pulls out a yellow notebook and a pen. “It’s not ideal, but it’ll have to do until you get the hang of this-” the next thing he pulls out is a very old kind of washed out and really ruffled …study guide?
She squints her eyes trying to make sense of the title-all the colorful pictures of figures of kids and plush toys were mostly erased from overuse but the title remained.
“A simple guide to American Sign Language”
Her head shots to him, eyebrows raised in confusion and surprise.
“I know, I’m awesome right.”
She slaps his chest and he chuckles but when she sees her smile at his stupidity, his heart feels a little big lighter.
He gives her a moment eyes moving from the study guide to the pencil and the yellow notebook he got her and when she picks it up and starts scribbling something down, he dares feel hope for the first time in days.
“Where did you get that?” it said when she moves it so he could see.
He gives her a boyish shrug and rubs the back of his neck shyly.
“Gabriel found it actually. Said when he left Sanctum he managed to snatch a bunch of medical books he knew he’d need. This ended up somewhere between the pile he was frantically trying to steal.”
Clarke nods and takes it, going through the pages her hands shaking a bit as she does.
He knew what was going through her mind-giving her this was also yet another confirmation that this was it for her-from now on she had to have a whole different life.
A life where she couldn’t talk or express herself the way she used to, a life where, like Gabriel told him, people will look at her and even if she gestured, even if she wrote her thoughts down, they wouldn’t see her.
She’d become a ghost.
Yeah, well not to him.
Never to him.
“It’ll be hard, I know but I actually practiced some myself in the past few days and I think we can work on it together.” he explains, reaching to squeeze her wrist.
She lets her head hang low but he knows her eyes are on their hands.
“When I was a kid I had this boy in my class who…” he stops for a second “he couldn’t talk either so I studied some back then too and I am remembering a few things.”
She picks up the pen again and contemplates what she’s going to write for a moment too long.
A moment in which his heart is in his neck and his own fingers shake a bit.
When she turns the notebook to him he laughs.
NERD! Is what is says and he chuckles.
“Yeah, yeah, like you weren’t a straight A student, princess.” he pokes her ribs just for the fun of it and she smiles, feeling ticklish and falling forward to his chest.
He catches her shoulder and moves closer giving her a serious look now.
“I know this is…hard to put it mildly but I want you to know that no matter what happens, I’ll be here for you okay?”
She lets out something of a sigh which is just air tickling his neck before picking the pen again and scribbling something down.
“That’s what worries me.” he reads out loud “Why?” she writes down something again before showing it to him.
“I don’t want you to have to do this.” he reads and furrows his eyebrows “Bullshit, princess. I don’t care what you have to say or how you push me. I let this-” he swallows hard “I let this happen to you.” she scrunches her nose at that “I should’ve protected you the moment we figured out they had any interest in you because of the nightblood and I didn’t.”
“It’s not your fault.” she writes down and he shakes his head.
“Yes it is.”
She reaches to squeeze his hands, both of them and hard using his way of saying that no, he’s wrong, he’s goddamn wrong.
He sighs and squeezes her hands back but she takes a moment to let him go, as if needing to reiterate the words she can’t utter.
She cups her cheek and she leans into him a bit.
“It’ll be fine, princess.” he promises and when a lonely tear rolls down her cheek, he brushes it away and pulls her to his chest again.
She doesn’t get lost in her grief like before.
Instead she pulls away after a moment and writes something down again.
“Time to get to work.” he reads out loud, squinting his eyes a little, because of his own terrible eyesight which in turn makes her laugh a bit when she realizes why he’s making such a funny face.
“I think you need glasses, grandpa.” she writes down.
“Hey!” he pretends to be angry, crossing his arms over his chest. “My eyes are perfectly fine.”
She smiles fondly at him before she writes yet another note.
The letters are so tiny, he has to literally bury his nose in the notebook to read that it said.
“You were saying?”
“Hey, that’s not fair, princess!” he pretends to be grumpy but she’s smiling again and he doesn’t want to ever see it leave her face-it may be sad, but it was there and he’d hold on to it for as long as he could.
“You’re blind and I’m mute, I think we make the perfect team.” she writes in bigger letters now and when he reads it his heart leaps yet again and his cheeks feel hot.
When she sees his face, she realizes what she wrote and gets a little shy about it too, ducking her head away and blushing herself.
“We always did work well together, princess.” he says, once again taking her hand in his and squeezing it. “We can do it now too.”
And they do.
It’s hard at first.
Really hard.
She can’t get the hang of ASL as fast as she wants to and she’s pushing herself, giving herself headaches and tiring herself.
He hates it so he hides the study guide for a few days which frustrates her even more, but he doesn’t budge, not even when she tries to toss an apple in his direction and kick him out because she thinks she’s doing him a favor.
One of the worst and most desperate moments is when she breaks down but not because of sadness, but out of fear, anger and frustration.
She’s up on her feet and she’s mouthing words at him.
He’s gotten quite good at reading her lips but she was too fast and too angry right now for him to catch on what she wanted to say.
When she pushed his chest with both her hands he got the meaning.
“I told you, I’m not leaving.” he says, calm as a rock, steady on his feet.
She pushes again at him, mouthing “JUST GO!” but he shakes his head and stumbles when she pushes at him again.
She tries to kick him outside the tent, desperately tries to talk, yell, except no sound comes out which makes her even more frustrated.
He stumbles back, almost falls on his ass, but refuses to leave.
Finally, she bawls her hands into fists and starts hitting his chest.
“No! No! NO!” she’s mouthing and he lets her hurt him as much as she wants to because no physical pain could ever compare to her pain right now “NO!”
He grabs her shoulders finally and though she tries to fight him still, he just pushes her to his chest and holds her tight.
She struggles against him, still tries to hit his chest, then wraps her arms around him and cries.
They fall to the floor, she’s just that exhausted and completely spent and he holds her, wraps her in his arms like a baby, one arm under his knees and the other on her back.
She rests her head on his chest and doesn’t fall asleep but just stays there and he uses her breaths fanning his neck to ground himself.
“I have an idea.” he says after what seems like hours later.
She moves her head to him, eyes full of pain and sadness. He smiles, for a moment just barely holds himself not to lean down and kiss her forehead, then picks her up and carries her to the cot where he puts her in a sitting position.
He crosses his legs opposite of her and takes her hand.
“So ASL will take some time but while you master it, we can use other ways to talk, okay?” he takes her hand “We covered yes and no.” he squeezes her hand briefly, then rubs his thumb over her palm.
“Hungry” he taps the place just over the beauty mark near her lips and she blushes and he feels his own cheeks warm up but ignores it in favor of this being way more important than whatever feelings he had for her “Tired.” he taps her forehead. “Sleepy.” he cups her cheek and she leans into him a bit. “Got it?”
She rubs her thumb over his hand and he smiles.
But he’s surprised when she pushes her notebook away and uses her hands, making an L shape with her thumb and index finger, then joins them together forming a W.
He raises an eyebrow but then she points at his chest and keeps her eyes on him.
He doesn’t want to say he can’t figure it out right away so he lets his brain work it a moment before it dawns on him.
“What about you?” he asks and she nods with a smile, happy that he understood her. “I’m not sure what you mean here, princess?” she makes an annoyed face at him and crosses her arms over her chest.
“I told you, I’m fine.” he promises, once again rubbing his thumb over her wrist. She shakes him off, though, cupping his cheeks again and rubbing her finger over his dark circles, jutting her chin at him.
“That’s nothing.” he promises “I’ll sleep when you’re better.”
She opens her mouth and he’s pretty sure that if she could, she’d scowl at him which makes him laugh.
She points at herself with her index finger, then cups her own cheek and squeezes his hand hard.
“I won’t sleep-” he speaks out her words and she nods before she continues, jabbing her finger in his chest and cupping his cheek “until you sleep?” she gives him a victorious nod and he chuckles.
“Nice try, princess.” he stands up “But I gotta go check on the others and then I’ll come back with food, alright? Does that work?” she makes another face and he has to admit she’s quite adorable like this but he doesn’t let himself laugh, knowing she’ll just get more pissed off at it.
She hasn’t left the tent in almost a week and there were no signs she would.
In her defense, she was still pretty weak and when he insisted they walked around the small place, she was wobbly on her feet and needed to lean on him which he definitely didn’t mind because it made him worry less.
She only saw Madi once and he left them for a few hours alone.
When he was back Madi was gone and Clarke explained by writing down that they agreed she’ll need some time to get things together before it all went back to normal.
Still, the kid came by usually early in the morning, for a few hours and he used that time to check on the others and take a shower but he lingered outside the tent, sitting on an old log and going through the ASL book or taking a short nap sitting while they had their time to catch up, after which he rushed back inside.
This time is no different except Madi had her turn this morning and she’s training with Gaia now while the others are spread around the camp fire, talking with the Children.
He notices his sister is sitting way too close to Gabriel but he can’t even begin to think what this could mean, so instead he fills a plate for Clarke and goes right back in before someone notices him and starts asking him questions about her.
Or worse, in his sister’s case-about himself and his own well-being.
He finds her asleep, curled up on the cot and it makes him smile at how soft and at peace she looks so he takes off his cardigan and as usually throws it over her before residing to his uncomfortable chair near the cot.
His back has been way too cranky after spending days like that, though, so he decides to quietly settle on the ground next to her cot, letting his body relax against the hard ground.
It’s still uncomfortable but it’s better and he can’t really give a damn about himself, not when she was going through hell and not like he ever really did care about his own well-being.
He starts falling, drifting off and he’s about to go into deep slumber when he feels someone’s fingers tapping his shoulder.
He jumps in a sitting position right away, speaking out loud.
“I’m here! I’m right here!” he only realizes how stupid he sounds when he looks around and sees her looking at him with a half-worried half-annoyed expression on her face. “What’s wrong?” he asks reaching for her hand “Are you okay?”
She furrows her eyebrows even more, pointing at him and then the ground.
“Why are you sleeping there?” she means and he gives her a shrug as he stands up and sits back on the chair which she clearly doesn’t approve of either because her hand is still on his wrist tugging him to her.
“It’s okay, Clarke.”
She tugs his hand harder.
“Come here” she means when she gestures at the cot and he shakes his head.
“It’s too narrow and you won’t be comfortable if I lay next to you.” he tries but she stubbornly pulls him to her.
“I’m okay.” he promises but she sits, and pushes his body between her legs, her hand expertly moving to his back and pressing on the bundle of nerves near his spine that were giving him the most trouble.
“Hey!” he says through teeth “That’s not nice, princess.”
She raises an eyebrow and points at the bed again.
He finally resigns and lets her pull him to the cot.
Once he’s down, she throws his cardigan over him but because his shoulders are quite big and his arms very muscular, it falls almost immediately right off.
He chuckles at the face she makes but lets her throw it over him  again and move closer to him.
When he feels her nose brushing his chest he sucks in his breath but now that they’re so tightly wrapped in their cocoon, he feels a little better.
“You’re really stubborn, you know that right, princess?” he asks her and she throws him a look but still buries her head in his chest, making him tense at first but not before she takes his hand and puts it on her back, giving him permission to touch her.
He smiles, pulls her closer and covers her head with his, but not before kissing her cheek which makes his entire face go red but he doesn’t care, can’t care because right now being with her in this moment, holding her in his arms and feeling her breath fanning his neck, he knows that despite it all, everything will be alright.
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drink-n-watch · 4 years
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These opening paragraphs are always the hardest part for me. Once you get into the review you can weave your thoughts through a recap of the episode and everything falls into place. Here, I have to come up with something all on my own. It’s a little intimidating. Thankfully, I can always count on my esteemed collaborator. Hi Matt, how are you?
Too much pressure, Irina! I’m fine, hope you’re well too and all our readers as well.
Actually, before we fall into it, how pumped were you to see Yayoi? Cause I was mega super pumped. I always loved Yayoi and she looked amazing with her hair down. I gotta say, season 2 must have been something. Everyone seems to have had some sort of happy ending, whereas to me, Psycho Pass had always ended on a rather bleak note with most of the cast scattered and/or hopeless but the system intact.
But I digress. Yayoi!
Yeah she’s pretty cool, I guess… Nah, you’re right, it was great to have her back!
So Yayoi is back because reasons and she’s going to help our ragtag team of  law enforcement officers while looking mighty fine indeed. We find out that some organisation, possibly to do with Enomiya is smuggling criminals in as dead bodies since the cryo sleep hides their hues. I really liked the idea although considering the rest of the episode, I’m still a bit fuzzy on the necessity of this. Seems risky, complicated and expensive when aggressive body guard robots are available. I honestly missed the set up here, Matt, can you help me fill in the blanks?
Maybe it’s cheaper to get humans to act as muscle than it is to build and program a bodyguard robot. The robot did seem pretty useless aside from being able to take a beating, not very nimble and not very smart either.
Smuggling and paying humans is definitely not cheaper, but just as useless!
Right off the bat, and throughout the episode, the enforcers had a pretty strong presence. It wasn’t just a Kei and Arata two man show (I mean technically Kei is still suspended so it can’t be). I really like how they are slowly and organically developing the supporting cast. I hope they keep at it, I feel like a strong ensemble can really elevate the series.
I agree, the more they keep building the ensemble cast the tougher it’s going to be when one of them dies (I mean it’s bound to happen sooner or later right?)
We are back in the heat of the political race only this time, it seems it’s Karina’s turn to be worried. After a visit to the late Dr. Tsuchiya’s office, Arata learns Karina’s secret, that she’s been using a hologram AI to help her during public appearances – a bit like lip syncing her campaign, and it seems someone out there wants that secret to be revealed and is not afraid to use underhanded means.
It’s an interesting way to use AI, though you gotta wonder how much of it really had a point, seems like having an AI feeding you a speech through an earpiece would be a lot easier and less open to be discovered and achieve pretty much the same results.
I have to say, I find the AI’s name “Ma-Karina” kind of hilarious. Possibly cause I’m 4 and just started singing the Macarena every time I heard it! Also, the necklace that Karina uses as a switch for Ma-Karina was very pretty. It sort of reminded me of Griffith’s Egg of the King, and considering both their significance in the story, the symbolic parallels are pretty cool.
I laughed at that too, we’re both children, apparently!
With the reveal of Tsuchiya’s personal AI and his involvement with Ma-Karina, we got even more neuroscience speak. Such as the relative metabolic need of the human brain and a short lesson on decision fatigue. Arata even mentions that humans aren’t great at thinking which is not completely false. We do tend to find every shortcut possible to reduce our decision making whenever viable and we fall back a lot on things like pattern recognition. This must affect our hues! It really does seem like season 3 is trying to weave in a bit of neurology through.
I absolutely love it but it’s not for everyone. Matt, you mentioned last week that to you this element felt tacked on and stand offish, do you still feel that way or do you think it was better integrated this week.
It was fine, there was almost too much else going on for me to really focus on it one way or another.
I’m o.k. with Kei’s roguish actions. He comes off a bit like a hard nosed cop trope in an action movie but I kind of like it. Once again, despite his suspension, Kei seems to be in the heart of the action. Going to watch Karina’s speech and calling in a potential disturbance. This means he’s right there when Karina gets kidnapped by…guys… And I mean right there. Like he swoops in to punch a guy out of nowhere when everyone else seemingly disappeared. To me Kei’s presence and interventions this week were just a bit too convenient. Ok Matt, tell me why I’m wrong.
Most of the action in this episode kind of felt a bit flat for me, from the staging to certain conveniences in how our ‘heroes’ were able to be where they were and do the things they do. It almost felt a bit Hollywood action-y, like it was less about the logic and more about the spectacle and even then the spectacle wasn’t that spectacular.
All of this is happening is some large event venue, a stadium of some sort, where the candidates were having a televised debate. Yakusiji got in a fight with one of the abductors and we didn’t see what happened to him while Karine got dragged off into another part of the stadium where the baddies are trying to force her to make a televised confession for the use of Ma-Karina. She refuses and her manager somehow bursts in, closely followed by Kei. Meanwhile the rest of our heroes have arrived and are making their way through the place.
And Yayoi is wearing stilettos! This may seem like petty nit picking but as a girl who wears high heels just about every single day, and pretty high ones at that, I know that you only wear stilettos if you want to look good and not necessarily move at all. In fact not even stand for too long. Those things hurt! Yayoi never ceases to amaze.
If anime has taught me anything it’s that women can wear anything–no matter how impractical–and still pull off amazing feats, make of that statement what you will feminists!
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Anyways, stuff happens. Karina tries to escape and ends up on some high walkways being chased by this huge thing. Arata finds her somehow, and saves her at the last minute. Also Kei and the enforcers are there. Everyone’s fighting. The big guy turns out to be a robot. Enomiya’s robot bodyguard to be exact and I’m really wondering why they didn’t just use him instead of smuggling people. And then the good guys win, hurray!
Karina is saved and although her secret was in fact revealed she held on to her pride and didn’t make any sort of public confirmation. Meanwhile it turns out Yakusiji is just fine and he knows what’s going on but unfortunately he only told the officers and not the audience.
I believe the plan was to simply discredit Karina by leeking the existance of her AI to the public but I’m not sure why it had to be done via kidnapping during a televised speech. I guess the idea was that she would then lose the election and considering Enomiya’s part in everything and their connection to Heracles I suppose we could imagine they wanted him to win? I’m really not sure about any of this though. It’s mostly assumption. This part was a bit messy to me. I’m sorry Matt, I’m going to need your help again.
… I don’t know either, this entire middle section felt like a lot of things happening where nobody (not even the characters in the show themselves) knew why things were happening or who was really responsible but at the same time they didn’t seem to mind and just kind of got on with their days? It’s entirely possible we both missed something obvious and we’re just big dummies–I’m sure the comments section will tell us…
After the plot gets foiled Enomiya wisely decides it’s time to make themselves scarce and attempts an escape but is stopped by Azusawa. Now the Enomiya has outlived their usefulness, they have become a liability and Azusawa is there to tie up loose ends. I thought this guy was a hacker or something but it seems I’m way off. He’s an inspector so I guess it does make sense that he would be in good shape but I didn’t expect him to just easily beat the all time champion like it was nothing.
Well the impression I got was that Enomiya had been out of the game a while and was just using their status to intimidate people, obviously still capable of throwing down when needing to, but not when faced with someone with considerable strength and dexterity of their own. 
To be honest, I really didn’t bond with Enomiya at all. I just didn’t care about the character at this point so to me this part was a bit long. I would have been happy if they just dealt with it off camera and gave us the jist in some tidy little exposition blast. Maybe have Arata read it off an incident report. I would have preferred to see more of the Division 1 crew instead. Did you like it Matt?
I mean, it was fine, I absolutely understand why this series of scenes was here, we were given enough of an introduction to them in the previous episode that killing them off screen kind of would have been like “then what was the point of all that?” so in that respect I didn’t have any problems with it. But I can understand where you’re coming from, I feel like if this show was 23 minutes instead of double that having it resolved as an incident report would have been fine and a way to save screentime but considering how long these episodes are it felt ~somewhat~ necessary.
I personally disagree. Just because an episode is longer doesn’t mean otherwise irrelevant scenes suddenly become necessary.
And the, the election is over. Just like that. 5 second scene… I was all like whaaaaaa. But…huh…. Karina won by the way. No one cared that she was using a fake brain.
That didn’t bother me either, but I kind of liked how quickly they dealt with it, it’s kind of like how real politics feel all this build-up in the campaign that all ends with some numbers on a screen and someone new being in charge that doesn’t really change all that much in the grand scheme of things. The pointlessness of democracy in a peaceful society.
Obviously Bifrost was actually behind all this but why? Not sure. As far as I can tell it wasn’t to influence the outcome of the election. There were way easier ways to do it and Karina was likely to win anyways so they could have just done nothing. The main and possibly only goal was to not only reveal the existence of Ma-Karina but also show that it didn’t matter. I wonder where this is going. Or am I off track again? Not gonna lie, I had some trouble following this episode.
Bifrost to me is just a bunch of super powerful, super wealthy people pulling the strings on a level so incomprehensible to the layperson that they might as well be gods. Seems like they’re ‘betting’ on the outcomes of various things for their own benefits–and playing with the lives of the people in this city like they are poker chips on a board. It’s intentionally vague and oblique–at least that’s how I take it.
Also Kei isn’t in trouble cause the chief sneaky ended his suspension 5 minutes before he got involved in the case and didn’t tell anyone.
One thing I really did like is that Arata and Kei have very compatibility according to Sybil (and with their background it makes sense) but they decided to partner up anyways. Their relationship really does continue to be the strongest part of the show for me.
Any closing thoughts?
You only went and missed my favourite part of the episode! The conversation between Arata and Karina in the glass ferris wheel was fantastic, small moments like this as supremely smart people–one in a position of newfound power–confines in another about things like their own nature and what politics really means in a world like this was great. I couldn’t help but feel a strong sense of intimacy between these two, which makes sense since in Episode 2 Arata compared her to himself in saying they were so much alike. I’m calling a romance subplot already! Also the colour and lighting in the scene was stunning, hey look Irina I mentioned the colour of a scene in an anime, are you proud of me?!
Yeah – I almost fast forwarded through that. My least favourite part of the show so far. The colours were a good clash to the colour story so far but all in all rather uninteresting. If there is a romance subplot, I’m not sure I’ll stick it out with this show.
I honestly didn’t like this episode much. The action was a touch drawn out, a lot of scenes seemed a bit contrived and the pacing was off, stretching certain moments past my interest and condensing others into confusion. This said, as I mentioned, I did get a bit lost a few times so it really may just be a me problem. I also don’t particularly like the softening of Karina’s character. I thought she was an invigorating antagonist that could have created some fantastic conflict .
I never really saw her as an antagonist really (maybe in the first episode she appeared) she seemed to fall somewhere in between. I thought this episode was great, weakest of the four so far thanks to the middling middle section which stretched credulity and my patience but still you could do far worse so I’m still happy!
This said, I still didn’t find the show too long despite double length and was (and remain) really interested in the overall story and what exactly is going on here. I’m looking forward to next week.
Psycho Pass s3 ep4 – Election These opening paragraphs are always the hardest part for me. Once you get into the review you can weave your thoughts through a recap of the episode and everything falls into place.
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xtruss · 4 years
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Nine Women Who Change History…...and the Men Who Took Credit
— By David A. Tomar | TheBestSchool.Org | March 12, 2020
Did you ever get the sense that your history books are just one big boys club, filled with accomplishments by men, for men, and often to the exclusive benefit of men? Does it sometimes feel like the annals of human experience are simply a fraternity where guys are free to banter about sports and make crude noises without fear of offending the fairer sex?
And if it does feel that way, where are all the women? Did women really do nothing more than pop out babies and make pot roasts from the dawn of civilization until Cher overshadowed Sonny Bono in popularity and the whole world changed?
Of course not. It’s just that human history is littered (and I do mean littered) with greedy men who stole their very best ideas from brilliant women.
And in many cases, they didn’t just steal these ideas. They published them in journals, won prizes for them, earned millions from them, became noteworthy men of their time, and iconized in retrospect. Meanwhile, the women who’s ingenuity, insight, and intelligence they appropriated were more often than not footnoted, both in reality and through the lens of history.
But we wish to correct the record, both because education is all about that unending quest for truth and because a future in which women earn equal credit, respect, and financial compensation begins by acknowledging the sins of our past.
So with that, we spotlight women of stellar accomplishment who should be far more famous and celebrated than they are:
1. Rosalind Franklin: The Double Helix
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Image: Rosalind FranklinOne of the most important scientific revelations of the twentieth century has also long been a subject of disputed credit. Famously, Cambridge University scientists James D. Watson and Francis H.C. Crick are credited with uncovering the double helix formation that would catapult forward our understanding of human DNA. In fact though, British chemist and X-ray crystallographer Rosalind Franklin had been engaged in the study of DNA over at Kings’s College in London in 1951 when she produced a groundbreaking image. A colleague showed this image to Watson and Crick without permission. This was the turning point in their research, though when they published their earth-shattering findings in 1953, they gave only passing reference to Franklin’s contributions. In perpetuity, it is the Cambridge pair that is associated with the double helix. So says the Nobel Prize they received in 1958, four years after Franklin died of ovarian cancer.
2. Lise Meitner: Nuclear Fission
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Image: Lise MeitnerAs long as we’re on the subject of scientific genius, there’s the story of Lise Meitner. It’s hard to say whether Meitner is better or worse off for having been slighted by a greedy man. Meitner was a student under the legendary physicist Max Plank, and the first German woman to hold a professorship at a German University. As the Nazis rose to power, the young Jewish scientist was forced to flee her home country. She continued to correspond with her research partner, Otto Hahn, from her new location in Scandinavia. In 1938, Hahn and Meitner joined forces to outline the concept of nuclear fission. This was the groundbreaking moment that would, in just five years, give rise to the awesome destructive capacity of the atomic bomb. Anybody looking to send angry letters to those responsible would find only Hahn’s name on the landmark paper revealing the discovery. Hahn chose to omit his partner’s name and was thus the sole recipient of the 1944 prize in chemistry from the Royal Swedish Academy of Sciences.
3. Hedy Lamarr: Radio Guidance System
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Hedy LamarrMeitner wasn’t the only woman working to build military might during World War II. She is joined by Austrian-born, American actress Hedy Lamarr, who in addition to becoming a star of the Silver Screen during the Golden Age of Hollywood, collaborated with composer George Antheil to create a radio guidance system for Allied torpedoes. The Navy pretended it wasn’t interested in the technology, but of course it was. They stole Lamarr and Antheil’s idea, classified the patent and, by the 1960s, had begun to incorporate the technology into a host of new weapons systems. Perhaps even more importantly, Lamarr and Antheil’s work would be nothing less than the basis for the omnipresent Wi-Fi, CDMA, and Bluetooth wireless technologies.
4. Margaret Knight: Paper Bag Machine
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Margaret KnightNot all of history’s greatest female inventors worked in the military. Margaret Knight made her greatest contributions to production in an era where industry ruled. Often referred to as Lady Edison, Knight was a well-known inventor, mostly because she had the wherewithal to stand up for her rights. In 1868, Knight was working for the Columbia Paper Bag Company when she invented a machine that automatically folded and glued paper bags into the formation familiar to shoppers today. As Knight worked toward the completion of a metal prototype, a machinist named Charles Anan visited her plant. Unbeknownst to Knight, the random machinist filed for a patent for her invention. She only learned of his deception when she applied for her own patent. Fortunately for Knight, many witnesses were on hand as she worked through her invention. This proved more than compelling in a judgment that ultimately awarded the patent—and all future royalties—to Knight.
5. Elizabeth Magie: Monopoly
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Elizabeth MagieIn the 1930s, Parker Brothers introduced the game Monopoly to American families. The game made a millionaire out of an unemployed heater salesman named Charles Darrow. He became the first board-game millionaire, and a symbol of the quirky unpredictability of the American Dream. The only problem: he didn’t invent the game. Some thirty years prior, a woman named Elizabeth Magie created “The Landlord’s Game.” It’s intent was progressive in nature, designed to illustrate the evil of business monopolies. The game was prophetic, coming well in advance of the Great Depression. Ironically, it was this catastrophic era that led to Darrow’s unemployment and his subsequent fascination with a game played by some of his Quaker friends in Atlantic City. Landlord's Game imageDarrow would develop this exact variation of the Landlord’s Game into his pitch for Parker Brothers, including Atlantic City street names and places. Perversely, Darrow transformed Monopoly into a game that seems to celebrates dishonest business practices. On its way to retailing one of the most popular board games in history, Parker Brothers purchased Magie’s patent. The game’s original inventor would net a rough total of about $500 for her stroke of gaming genius.
6. Ada Lovelace: Computer Programming
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Ada LovelaceLord Byron’s daughter, Ada Lovelace, was one of the world’s first computer geniuses, though her role is often minimized by male historians. In 1843, the mathematically erudite Lovelace collaborated with inventor Charles Babbage at the University of London. Babbage was working on something called an Analytical Engine, an early prototype of the computer. Lovelace contributed detailed and extensive notes to Babbage’s work, particularly by articulating the way Babbage’s machine could be fed data to complete complicated math problems, or even compose complex music. These ideas may mark the earliest recorded proposition for what would eventually become computer programming and algorithms. Today, Lovelace’s contributions are obscured by debate, and most often by the dismissive and unmistakably misogynistic characterizations of her role.
7. Margaret Keane: “Big Eyes”
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While not technically concerned with an invention, the following one of the most egregious examples of chauvinistic greed on record. Margaret Keane is an American artist best known for her trademark “Big Eye” paintings, which were popular in the 1960s. The only problem: her fans in the ’60s were confident the paintings were done by her husband, Walter. Walter began selling his wife paintings as his own without permission in the 1950s. Eventually, Margaret discovered what Walter was up to. When she confronted him, Walter used threat, intimidation, and emotional abuse to force her silence. As the works gained in popularity, Margaret continued to toil in obscurity, while Walter enjoyed celebrity. In 1965, the two were divorced. In 1970, Margaret revealed the truth to the public. Walter denied her allegations, which ultimately led to a surreal 1986 courtroom scene in which the two were forced into a head to head paint-off. Walter claimed his sore shoulder prevented him from painting. Naturally, Margaret produced a perfect facsimile of her earlier works, earning the rightful claim to her works in perpetuity.
8. Trotula of Salerno: Women’s Health Findings
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Trotula of Salerno is one of the earliest victims of historiographical misogyny. An Italian doctor in the eleventh century who wrote specifically about women’s health, she has been recognized as “the world’s first gynecologist.” Her writings have remained instrumental building blocks in our knowledge about human health, and women’s health specifically. And yet, her authorship had been cast into doubt over the ensuing centuries, entirely because historians and medical professionals were skeptical that a woman could have produced works of such accuracy or importance. That’s a messed up assumption, but so ingrained was this belief that many even doubted that Trotula of Salerno existed. This convenient doubt ultimately allowed numerous male physicians over subsequent years to cut and paste their own names over her work.
9. Candace Pert: Neuroscience Findings
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Candace PertWhile still a graduate student at Johns Hopkins University, Candace Pert discovered the receptor that allows opiates to lock into the brain. This game-changing neuroscience revelation was so important that it led to an award—for her professor. Dr. Solomon Snyder was recognized for his student’s achievement. When Pert wrote a letter of protest to the award committee underscoring her determinant contributions, Dr. Snyder mansplained in response, “That’s how the game is played.”
Of course, men like Dr. Snyder have been playing this game for centuries. But we have an obligation to call them on it. It starts with history. But it continues in modern academia and today’s workplace. Let’s ensure all the brilliant women in our midst get their due credit. I think we’ve celebrated more than enough greedy men.
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A very interesting read
Meghan Markle and Kate Middleton’s fans are fighting a fierce new royal feud
In the world of British duchess fandom, there’s no room for divided loyalties: praising one means automatically 'hating' the other, writes Patricia Treble
A new war started in 2018, and it’s a take-no-prisoners affair with major implications for the future of the royal family. The once-genteel, even genial, online world of royal watching has been turned upside down and inside out as fans of Kate, Duchess of Cambridge, and Meghan, Duchess of Sussex, duel for social media supremacy and, in the process, tear down anyone who dares to challenge their view of the royal world. There’s no room for divided loyalties: praising one means automatically “hating” the other.
Signs of the slagging aren’t hard to find. Just dive into the royal family’s own social media accounts, then follow the online infection trail. “Please give us MORE MORE MORE of the Duke and Duchess of Cambridge. Sick to absolute death of fake narcissistic MeAgain Markle,” a commenter wrote on a photo of Prince William and Kate on the royal family’s Instagram account. Kate is “clinging to dear life to Willnot [sic]. His attention is on HRH Meghan,” says another beside a Kensington Palace photo of Kate at a laboratory. “Kate will never be on Meghan’s level, all that lazy consort did was marry a Prince, she don’t know about working, and connecting with others, don’t disrespect Meghan like that,” writes @HRHmegh on Twitter. “Meghan speak so bad and she was fake and she is an actress she know who act. But Kate always is natural,” comments another.
“It is really unbelievable,” says Susan Kelley, who is near the epicentre of the Kate vs. Meghan fan wars because of her two popular royal fashion websites—What Kate Wore, which she started in 2011, and What Meghan Wore, which she co-manages with Susan Courter. “Every time I tell people about it who aren’t in the Kate-Meghan world, they are incredulous.” While the two Susans, as they are known, approve comments before they are posted on the Meghan and Kate sites, “on certain days you can’t go 30 to 60 minutes without checking” Facebook to delete over-the-top comments, Kelley notes.
The reason for the sudden increase in vitriol isn’t hard to find. Seven years after marrying Prince William and being the only leading young female royal, Kate has “competition” in the form of a beautiful American former actress, Meghan Markle, who married Prince Harry in May. William, Kate, Harry and Meghan may be known as the “Fab Four,” but to fans, it’s an either-or choice. The Meghan and Kate acolytes appear to be very young, and accustomed to a social media world that not only condones but seems to encourage anonymous insults. It’s not for nothing that such devotees are known as “stans,” a combination of stalker and fan.
The fans aren’t living in an “and” world but in an “or” one. “Don’t get out of your lane, don’t be coming into my lane,” is how Kelley sees them. “This has been just extraordinarily troubling to me,” she continues. “This is 2018. If this was two men, this would not be happening. I thought we were beyond this…There is something so off, the level of hatred and how intense it is, and the volume.” Perhaps most disturbing for everyone is the level of intolerance, even racism. Not only is Meghan, the daughter of a black mother and white father, the focus of racist attacks, but her fans, in turn, quickly toss the “r” word at perceived Meghan opponents.
Susan Kelley isn’t alone. Everyone reports the same thing—a sudden, disquieting increase in harassing attacks that seem completely over-the-top given the rather sedate royal topics being discussed, including fashion, engagements, living arrangements, protocol and even the state of a curtsy or bow. “I have witnessed what amounts to be roving Twitter gangs that find a tweet/blog post about Meghan and kind of rally the troops and stoke up the fires and suddenly you have a hail storm of abuse flowing at you,” explains Jane Barr, who runs the From Berkshire to Buckingham fashion site, which focuses on Kate. “For me, it is very frustrating to write a nuanced analysis and have people just take a black-and-white interpretation and run wild with it.”
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“I think it is indicative of a larger societal problem,” says Barr. “We have an inability to listen to other people, and reason and debate together as a community. The ramifications are obvious for free democratic societies, and very concerning.” In seven years of blogging, Barr has blocked two people for foul language. In the past year, she’s blocked between 15 and 20 for “completely out of control behaviour.”
Royal outrage is complicated by a transatlantic culture clash. Many intense Meghan Markle fans are Americans who don’t understand the monarchy, its place in British society and how there has always been criticism of the family, royal author Victoria Arbiter told the Express. “The American community doesn’t have anything like the royal family so they can only liken them to celebrities or politicians,” she explained. Their lack of knowledge of the intricacies of royal life, protocol and history explains some comments. For instance, they can interpret a photo being posted on a royal feed as a sign of the Queen’s personal approval for Kate or Meghan, their clothes or their behaviour, rather than the work of a member of the royal media department.
“Celebrity rivalries are always conducted by us, the fans, the people who buy the concert or theatre tickets, the records, the merchandise and who send the memes through social media,” contends Ellis Cashmore, a sociology professor at Aston University in England whose book Kardashian Kulture will be published in early 2019. “It helps if there is genuine animosity, but it’s far, far from essential—or even necessary. As long as we think they’re fighting, that’s enough to sustain the feud. We enjoy the feuds so much, we’re tempted to take sides and engage, albeit vicariously. Today, social media has made this easy; so much so that fans can keep the fight going independently of the principals.”
Many stans believe that Meghan and/or Kate don’t like each other and are coming between the close relationship of brothers William and Harry. The reality that the two brothers now have their own families and own priorities doesn’t appear to factor into their online fights. Every new bit of information—Harry and Meghan leaving the tiny two-bedroom Nottingham Cottage around the corner from William and Kate’s London residence for a larger house on the Windsor estate, or reports that they are ending their joint staffing arrangement, established when they were teens—is fought over. To some, the former Meghan Markle is the Yoko Ono of Kensington Palace: “Megan [sic] is the reason for the split between William and Harry,” commented one fan on the royal Instagram feed.
And in the busy autumn season of royal engagements, the war may be at a tipping point. Earlier in 2018, the work schedules of the two popular duchesses didn’t overlap. At the beginning of the year, the focus was on Kate while Meghan slowly dipped her toe into royal engagements. Then, when Kate went on maternity leave in late March, the focus swung back to Meghan, who married Harry in a wedding watched by billions. Kate stayed largely out of the public eye until after Harry and Meghan completed their high-profile tour of Australia, Fiji, Tonga and New Zealand.
But now, both royal women are both doing royal work, both based in their London home of Kensington Palace. And that’s setting up an inevitable “showdown” between how the media covers them—who gets top billing, who gets criticized? The palace, no doubt aware that social media is swimming in bile and acid, appears to be trying to mitigate the intense fan reactions. On Nov. 21, both Meghan and Kate were out and about in London, yet their schedules were carefully timed to not conflict with each other. As well, neither event touched on the subject matter of the other, and neither was announced to the public in advance.
In the morning, the Duchess of Sussex went to the Hubb Community Kitchen. Meghan had been making private visits there since January and, with the help of funds raise by a charitable cookbook she helped create, the women are making 200 meals daily for local groups in the area, devastated by the Grenfell Tower fire. A few hours later, Kate arrived at University College London’s developmental neuroscience lab to be briefed on the latest “research into how environment and biology interact to shape the way in which children develop both socially and emotionally.” Coincidently (or not), both wore outfits in shades of burgundy and plum. The preparations paid off. The Express put the two on its front page with the headline “Double duchess: Kate and Meghan’s copy-cat fashions.” For the record, the large photo was of Meghan, the inset of Kate.
The irony is that the Kate and Meghan stans are engaging in behaviour the royal women they profess to adore would find abhorrent. All four of the young royals are committed to raising the profile of mental health issues, including the negative effects of social media. On Nov. 15, William gave a powerful speech about the harmful effects of cyberbullying: “When I worked as an air ambulance pilot or travelled around the country campaigning on mental health, I met families who had suffered the ultimate loss. For too many, social media and messaging was supercharging the age-old problem of bullying, leaving some children to take their own lives when they felt it was unescapable.”
“I am very concerned though that on every challenge they face—fake news, extremism, polarization, hate speech, trolling, mental health, privacy, and bullying—our tech leaders seem to be on the back foot,” William continued before issuing a challenge: “You have powered amazing movements of social change. Surely together you can harness innovation to allow us to fight back against the intolerance and cruelty that has been brought to the surface by your platforms.”
Cashmore doesn’t see the Kate/Meghan social media battle stopping any time soon. “The beauty of our screen society is that, once people get on their phones or laptops, they become a force majeure—nothing and no one can stop them,” he explains. “If they say there’s an argument, then there’s an argument. Meghan and Kate can deny it all they like; it won’t alter a thing!”
There seems little room for neutral observers. Journalists are taking it from all sides. Any criticism—real or imagined—of one duchess is perceived by many fans as an attack, and also favouritism for the other royal woman. In the past year, virtually every full-time royal correspondent in London issued a plea for tolerance on Twitter. After being accused of everything from bias to racism, Richard Palmer of the Daily Express wrote, “We have all faced unpleasant and unfounded accusations of racism towards Meghan.” He pinned a tweet to the top of his account stating that “with the exception of a few I have known for years, I’ve decided I will only now engage with those who share their real identities.” Some journalists are also blocking extreme fans.
And the attacks don’t just stop at those who critique. The fans demand total loyalty. As Richard Palmer commentedon Twitter, “As far as I can see the pitchfork brigade have just regarded anything not 100-per-cent gushing as racist ever since with no evidence.” Susan Kelley has seen the same: it’s not enough to speak the truth, but they many readers accept only “complimentary, laudatory things.”
Netty Leistra, a veteran Netherlands-based royal journalist and blogger, has tried to avoid the Kate vs. Meghan fight, but an online critic called her a racist a few months ago for saying “absolutely nothing special.” For Leistra, the current phenomenon brings back memories of around 15 years ago, when Australian Mary Donaldson married Crown Prince Frederik of Denmark. In the era before Twitter, Facebook and Instagram, she and a few others ran an online forum about the couple. Soon, the anti-Mary folk were battling with the pro-Mary fans. “The bad thing to us was that we tried to be objective, and in the end we were the ones being attacked for not protecting any of the two sides,” she recounts. In the end, they stopped the forum.
Today, no one thinks things will improve any time soon. Both Kate and Meghan are full-time working royals, both gearing up their charitable activities, Kate after her maternity leave, Meghan as she settles into her new royal role. Perhaps a break will come when Meghan gives birth in the spring and steps away from the public spotlight to concentrate on being a mother. Meanwhile, royal watchers who want to engage in polite conversations and debates are trying to block the more extreme commenters, and hoping tempers will cool—or interest will die down.
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mstass · 6 years
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Woke Westworld? Why this original show might not actually be all that original
**SPOILER ALERT: SOME SEASON 1 SPOILERS AHEAD**
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The HBO series Westworld takes new-age anxiety over the future of artificial intelligence, tropes of old western films, and a Game-of-Thrones-esque attention to detail and bundles it into a confusing, mesmerizing, and hugely successful show. It’s not entirely clear if the show’s ideas are truly all that novel or if it uses a confusing narrative structure to pose questions we’ve already been asking for thousands of years. However its success speaks to anxieties many people share over our sense of free will and the way in which we live our lives. As many good shows do, Westworld has posed many more questions than it has answered. What is being human, at its essence? What defines being conscious? Are we programmed by our environment or do we have free will?
Woke or whack?
The subreddit r/Westworld is teaming with complicated, far-fetched theories about the deeper meaning behind each twist and turn the show has divulged and many are lauding the show for its incredible depth. Fans of the show obsess over each episode, picking it apart for clues for what is to come and some do so looking for the show’s answers to these tough, age-old questions. I too find myself haunted by the ideas presented in the show, quietly questioning the nature of my own reality, just as the characters in the show do. The hosts (the AI characters) in the show exist in loops, a daily performance they give to guests of Westworld. They do not realize it but they live out the same day over and over -- uttering the same dialogue, walking the same paths, dreaming the same dreams -- for years on end. The viewer pities the hosts’ lack of free will until it is pointed out that humans also exist in a loop of habits, routines, and familiar experiences. Of course, there is relief in the idea that our routines are not forced on us but chosen by free will. But if we never attempt to abandon the routine, it’s hard to be sure if we would be able to if we tried.
The philosophy of free will vs. determinism was, of course, not invented by this show.  Since ancient times, philosophers like Heraclitus and Aristotle have debated the presence of free will and since those times many have attempted to study it scientifically. 
Is everything my parents' fault?
To this day, one of the fundamental debates of psychology is whether nature or nurture is the bigger driving force of human existence. In the study of neuroscience, it is clear that all organisms have certain cues and reactions, and instincts that can be triggered and exploited. Researchers have found that people make decisions before they realize they’ve made them, indicating we may not fully understand how we make choices, and whether we’re really ‘choosing’ at all. Just because it feels like we have a choice doesn’t mean it’s true.
In everyday life, many persuasion tactics used in business and sales involve a manipulation of our ingrained instincts. For example, the concept of reciprocity plays on our compulsion to return favors. Offering a beverage to a customer who enters a shop is an effective method of increasing sales since on average people feel the need to return even that small favor. Another example is the principle of scarcity. Since people fear lost opportunities, the perception of a limited supply will often increase demand. When an Amazon listing says “Only 5 Items Left in Stock”, it’s not just a helpful warning, but also an attempt to get you to make a purchase. (If you like reading about this type of thing, I recommend the book Influence.)
Science, bitch
Determinism, or the idea that our paths are a matter of cause-and-effect and not choice, are in some ways evidenced by the study of physics, in which all phenomena are connected and causal. We are consistently able to demonstrate these cause and effect relationships between the physical elements of our natural world. Up to now, the human experience has been harder to isolate to makes these same observations, not to mention the philosophical dilemma of expecting the brain to study itself. So there is little clear evidence to prove if we are more nature or more nurture. At least not yet.
Enter Westworld. While at the start of the show the hosts were guided only by their programming, season one concludes with a few of the hosts achieving consciousness -- gaining their free will. They can choose their destiny, but the question remains of what exactly they will choose with this new free will. It was exhilarating to watch and the show’s exploration of human nature and immensely satisfying to see these host achieve their own consciousness. We all were rooting for their free will, despite the show’s accusations that humans themselves may not be free themselves. And maybe that is why the audience of Westworld is so enraptured. Maybe we don’t feel as free as these hosts have now become.
The blame game
My personal suspicion is that in some part, our cultural climate has overemphasized determinism in recent years. A prevalent sense of a common “sealed fate” has been cast over our cultural conversation. Topics like the force of climate change, the political atmosphere of corruption, and the oppressiveness of our social world has led many people to feel doomed to fall with the tide of humanity. The prevalence of gun violence in our media -- the gun clearly representing an immensely powerful force that can put a stop to all choices forever -- may have cast a shadow over some people’s sense of autonomy. To feel powerless to a force bigger than yourself is a mentality that can bleed into every crevice of your life. 
The loss of autonomy can be very damaging. Victims of abuse and those with mental health issues often suffer greatly due to either the despair associated with feeling one life is out of their control or attempting to recapture autonomy in a damaging way. It can unwind a person to feel that they have no control over their life.
“Jesus, take the wheel”
On the other side of the coin, there is also a certain freedom that comes with determinism. Phrases like “God has a plan for me”, “everything happens for a reason”, “things will work themselves out”, all offer a congruence to events in our lives, a fairness to the randomness of the world. It can be a relief to give up control, to accept things as they are. There is a certain comfort in accepting the twists and turns of life out of our control. If we exist in a loop, but we like the loop we exist in -- maybe it’s not such a terrible thing. Maybe the less we try to control our fate the better.
Another philosophy is the existential approach to free will. Existentialism (**depending on who you ask) is the idea that all individuals are free and must do our best to make choices within that freedom. It disregards the idea of determinism and characterizes life instead as pure absurdity, in which we must all exert our freedom. The concept of existential angst is the negative feeling that arises when you contemplate the sheer number of choices you have available to you and you find yourself overwhelmed (#relatable). In some ways, existentialism argues for the ultimate form of personal responsibility. Not only do you have to make your own choices, but an existentialist would demand you make them in the most authentic way possible. Some people find existentialism to be an appealing call to action, while others find it depressing, nihilistic, and fundamentally dark. Either way, it offers a view of free will that challenges the individual to take responsibility for your choices and their consequences. (A great crash course in existentialism is the book At The Existentialist Cafe). 
Who cares tho?
The success of Westworld indicates that the philosophical debate over free will is still ongoing, and for now, science offers only partial glimpses into the truth. Maybe the choices are right in front of us, but we’ve been programmed not to see them. Maybe there are no choices, but believing we are choosing is enough. In the famous Robert Frost poem, “The Road Not Taken” the speaker chooses between two paths, finally deciding on “the one less traveled by” which the author says "made all the difference”. But many argue the poem has been widely misread, with Frost not arguing for the individualism of choosing a better-and-less-trodden path, but instead that each path was equal and the choice didn’t really matter. 
And maybe that’s what Westworld wants us to understand: that whether we tune into Westworld because we’re programmed to consume all HBO content like mindless automatons, or because we are free thinking deep intellectuals who actively seek out quality television -- all that matters is that we’re still sitting there, watching.
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mathwizards10 · 4 years
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How Could We Not Appreciate the Beauty of Mathematics?
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by: Alec Gabrielle Gonzales
“Beauty is in the eye of the beholder” – it may be cliché, but it is highly applicable in the reality of the society. As humans, we have different preferences.
It is clearly undeniable that we all have our own definition of beauty. For instance, something aesthetically pleasing for me is not lovely for someone. If somebody will say, Mathematics is an art, it is indeed, but we all have our own interpretation and level of understanding.
The playing of shapes, repetitive patterns, and contrasting choice of color schemes in artworks can undeniably trigger our brain the sense of beauty that leads us to appreciate things. Mathematics is even present in music, dance, photography, visual arts and everything that involves art. Artworks are exhibited to be admired by audiences and to recognize the artists.
May I ask, how do you feel upon seeing complex mathematical equations? Is it the same when appreciating works of art?
Believe me or not [because I can’t even believe it myself], there was a research conducted in the journal Frontiers in Human Neuroscience whereas 60 formulas were rated by 15 mathematicians.
This study found out that the more beautiful they rated the formula, the greater the surge in activity detected during the fMRI (functional magnetic resonance imaging) scans. Professor Semir Zeki, one of the researchers said that a large number of areas of the brain are involved when viewing equations, but when one looks at a formula rated as beautiful it activates the emotional brain - the medial orbito-frontal cortex - like looking at a great painting or listening to a piece of music.
Even I really can’t believe that there’s a new study that says appreciating mathematics is like adoring art.
Personally, I really despise mathematics, because I already have the presumption that it is really complicated to the highest level. Why is it always present in everything? I am already traumatized upon seeing large sum of numbers, especially when letters and fractions will already enter the picture. I know that I am not the only one who turns hysterical upon seeing such complex formulas.
Shopping is one of the activities I love the most. I highly find beauty and enjoyment in buying new things. Is math present in it? Yes, of course! As someone who doesn’t have a lot of money, I need to budget my money properly, and to categorize what I need from what I want. Adding all the sum of all my shopped items is Mathematics, obviously addition. Even though I really don’t like solving, but whenever an item says “20% off” I am eager to find the new discounted price, just to make sure that I can save a lot of money. I also need to master subtraction to check if the change is right.
Since we are living in a new era, online shopping is a new trend, replacing the traditional one. I also assess critically whether it is much more practical to pay the shipping fee or to add some items to lessen the over-all total of my shopped items. I even started selling things; math is obviously present because I need to calculate the capital and the interest for me to make sure that I will garner enough money to support my funds.
Also, when shopping, I need to count the quantity of my shopped items; and compare its quality to other brands. When shopping for clothes, I double check that the measurements fit me well.
For me to escape my problems and as a better alternative than breaking down, I sleep. Undeniably, math is still present in this activity. I bet I’m not the only one who counts the number of hours I slept to assure that I have enough rest. Amazingly, there is Mathematical professor named Mark Holmes that used Mathematics to develop a new computer model that can be easily manipulated by other scientists and doctors to predict how different environmental, medical, or physical changes to a person’s body will affect their sleep. Their model will also provide clues to the most basic dynamics of the sleep-wake cycle.
We can’t deny the fact that the power of Mathematics is present in everything. The patterns of leaves, the paws of a dog, the meter in a musical sheet, the time of the day, even in the activities we enjoy and love… name it all - everything!
“Neuroscience can’t tell you what beauty is, but if you find it beautiful the medial orbito-frontal cortex is likely to be involved, you can find beauty in anything,” said Professor Semir Zeki as a support to their research. Beauty may be in the eye of the beholder indeed, for we can control what we find beautiful.
We just need to have a shift of mindset due to the bad implication math related lesson had already inculcated in our minds.
We need to widen our imagination and think freely of the wonders Mathematics can influence our lives.
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Enlightenment Issues
In 1974 Hans Burgschmidt was sixteen years old, living in the Canadian Prairies, working in a photography studio darkroom, elbow-deep in chemicals all day long. "Is this what life is about?" he asked a high school friend. "You need to meditate," was the reply.
Not long after, Hans attended a lecture at the local library, where a man in a suit spoke about the scientific benefits of relaxation. He pressed Play on the industrial-sized U-Matic video player and there was Maharishi Mahesh, the Indian yogi who initiated the Beatles into the mysteries of Transcendental Meditation (TM) and launched the meditation careers of thousands of Western devotees.
"An infinite ocean of peace and love and happiness awaits you," said the radiant Maharishi, with his flowing hair and his garland of flowers. "What's not to like?" Hans thought, and got in touch with a local TM chapter.
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Soon after he began his meditation practice, exactly as advertised, he found himself transported from his parent's basement into a shimmering inner space of light and colour and bliss. "Eventually you get so expanded and the mantra becomes so refined that you are taken to the silent source of thought – it was wonderful."
Hans was hooked. Next, he enrolled himself in advanced courses and in the late 70s he left for Maharishi International University in Fairfield, Iowa, hoping to become a teacher.
But somewhere along the line Hans became disenchanted. Maybe it was the dubious "levitation" training, or the dogmatism of his fellow teachers, or the "almost abusive" way the school administrator overworked their staff. "The discrepancies between what was promised and what was really happening kept growing," Hans told me. "Eventually I had to move on."
Thus began Hans' long career as an itinerant spiritual seeker. He hit all the New Age mainstays: Osho and then Da Free John in the 80's, trance channeling and primal scream therapy and past life regression in the 90's.
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  But the same pattern of finding the limits of the guru or the practices kept repeating itself. Finally in 2006 he met a teacher he could trust – one of my own teachers, in fact – the Buddhist scholar and future neuroscience-consultant Shinzen Young. "No BS, real down to earth, just an ordinary guy teaching a well-crafted version of techniques that have been tested by Buddhists for thousands of years."
The technique was vipassana, one important – and increasingly popular – aspect of which is known as "mindfulness."
"I found it invigorating," says Hans. "It was much more active than other techniques I had learned, I could feel the power of it."
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The Shadow Side of Meditation
Everything was fine, until three weeks after his first retreat, when, in Hans' words, "something changed." My sense," says Hans, "is the technique precipitated something that was already there. I mean I had done a lot of meditating in other traditions by then. They softened me up. Whatever the case, I don't think it could have turned out any other way."
Hans was at home making his bed, when the room suddenly appeared "very far away." But the room hadn't changed; he had. The part of Hans that had once looked out at the world, the core we take for granted as the "self", had without any warning disappeared.
To understand what happened to Hans, you need to understand something about how meditation works in general, and vipassana in particular. Most meditation techniques are designed to shift a person's orientation from a limited personal identity to the broader ground of their experience.
Vipassana does this by deliberately and systematically untangling the different strands that make up our sense of self and world; in the Pali language (the ancient Indian scriptural dialect of Buddhism) the word "vipassana" means "seeing into" or "seeing through."
Practicing vipassana, you have more space to make appropriate responses, and more space, too, around your looping thought-track, which can dramatically reduce stress and anxiety as well as raise a person's baseline levels of happiness and fulfillment.
This is one reason why mindfulness has become the technique of choice for thousands of clinicians and psychotherapists, and there is now a considerable body of scientific research demonstrating these and other benefits.
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Yet most of the clinicians who so enthusiastically endorse mindfulness do not have a proper understanding of where it can lead. The fact is that mindfulness in large doses can penetrate more than just your thoughts and sensations; it can see right through to the very pith of who you are – or rather, of who you are not.
Because, as Buddhist teachers and teachers from many other contemplative traditions have long argued, on close investigation there doesn't appear to be any deeper "you" in there running the show. "You" are just a flimsy identification process, built on the fly by your grasping mind — a common revelation in meditation that happens to be compatible with the views of many contemporary neuroscientists.
In fact, the classic result of a successful vipassana practice is to permanently recognize the impermanence (anicca), the selflessness (anatta), and the dualistic tension or suffering (dukkha) of all experience, which may sound like an Ibsen play, but this is the clear empirical understanding that many otherwise sensible practitioners report.
For most people this shift is the most profoundly positive experience of their lives. In the words of Shinzen Young, "it allows a person to live ten times the size they would have lived otherwise, it frees them from most worries and concerns, it gives them a quality of absolute freedom and repose."
But once in a while, something goes wrong. In Buddhism this is known as falling into "the pit of the void." Young is more modern: "Psychiatrists call it Depersonalization and De-realization Disorder, or DP/DR. I call it 'Enlightenment's evil twin'."
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For Hans, what began as confusion and disorientation led within a few hours to extreme panic. The emptiness was ominous – in his words, a "deficient void." One moment the world seemed far away, the next it was too present, a "barrage" of overwhelming sensations. "It was like I had no protective filter or skin – sounds and sights became incredibly abrasive.
Hearing the phone ring was like someone running a thousand volts of electricity through me. I also had feelings of being stretched and twisted inside out, like I was morphing into some kind of animal. I had no idea what was happening – I thought maybe I was getting premature Alzheimer's."
Over the next few months Hans spent hours with Young on the phone, but despite the counseling, none of his symptoms went away – if anything, he says, the selflessness, the rawness of sensations and the associated fears became even more disconcerting. One by one, all the meaningful parts of Hans' life dropped away: his love of photography, of art, even his sex drive.
"I lost my will to do anything – none if it had any meaning. You could say that I no longer understood existence. I would wake up in the morning and go 'OK, this is my body, this is me, and I guess I'm doing this but I no longer understood it. I no longer understood agency, what makes other bodies move, what animates life.
Sometimes there was a wondrous quality to this bafflement – I felt the awe and the mystery – but most of the time it was aimless and tormenting."
Was Hans experiencing a slow-motion nervous breakdown unrelated to his meditation practice?  Or was the experience of depersonalization triggered by meditation?
He was able, just barely, to keep working, although he says he has no idea how he was able to do this since, in his words,   "I often couldn't understand what people were saying – all I would hear is the weird texture of their speech patterns, there was no meaning to any of it."
His own responses, too, came as a surprise. "At times I would hear myself speaking and I had no idea where the words were coming from or what they meant. I felt like an imposter."
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The Dark Night of the Soul
Hans is not alone. If the very real benefits of mindfulness add up to the good-news mental health story of our time, then, like so many good things, there is also a shadowy seam, an experience known popularly as the Dark Night, after the writings of the famous Carmelite mystic St. John of the Cross.
More meditators and practitioners are beginning to speak openly about the challenges associated with practice. The importance of this cannot be overstated, for there are those in the scientific community who believe that taking these reports seriously may one day provide key insights into both mental illness, and the mystery of contemplative transformation. They may in fact be very different expressions of a single underlying dynamic.
Some researchers are already studying this. Willoughby Britton is a meditator and a clinical psychologist at Brown University. After encountering some of this difficult territory herself, she began an ambitious research project to document the full range of phenomena that can happen as a result of practice. The initiative is called "The Varieties of Contemplative Experience".
Over the past three years, Britton and her colleagues have conducted detailed interviews with over forty senior Buddhist (and some non-Buddhist) teachers and another forty or so practitioners about challenges they've either experienced themselves, or, in the case of teachers, seen in their students.
The study's current research design cannot answer the question of what percentage of practitioners run into problems, although Britton did tell me that serious complications that require inpatient psychiatric hospitalization probably affect less than one percent of meditators. "Milder, more chronic symptoms," she says, "will be higher – but no one knows how high."
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The full range of symptoms, from mild to intense, include headaches, panic, mania, confusion, hallucinations, body pain and pressure, involuntary movements, the de-repression of emotionally-charged psychological material, extreme fear and – perhaps the central feature – the dissolution of the sense of self.
But, as she reports in a recent interview, the most surprising finding for Britton has been the duration of impairment, which she defines as the inability of an adult to work or take care of children.
"We've been deliberately looking for worst-case scenarios, so I expect this number will go down as we get more data, but right now we are finding that people in these experiences are affected for an average of three years, with a range of six months to twelve years."
Britton has found that two demographics seem to be affected more than other: young men aged eighteen to thirty, who, in the way of young men, go for months-long retreats in Asia and pursue hardcore practice and log ten to twenty hours of meditation a day. "We had to create a "Zealotry Scale" says Britton, dryly, "it was such a major predictor."
The other large group, she says, is middle-aged women. "These ladies have been going to, say, Spirit Rock Meditation Centre for last ten to twenty years, have a nice hour-a-day practice, and then seven or ten years into it something happens."
The situation is complicated by the fact that a period of difficulty is actually a perfectly normal part of many meditation practices. A well-meaning therapist might label this pathological, when what might be more helpful to the "patient" is guidance from an experienced meditation teacher.
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Within vipassana traditions, some classic texts talk about the "dukkha ñanas" – challenging stages that are actually a sign of progress. These are a natural response to the layer of mind being exposed; with a teacher's help, the student can move through their Dark Night in a matter of days or hours. Indeed, some teachers argue that the skills practitioners acquire in coping with these passages are often the very ones that allow them to progress to more liberating stages of the path.
Shinzen Young writes, "It is certainly the case that almost everyone who gets anywhere with meditation will pass through periods of negative emotion, confusion, disorientation, and heightened sensitivity to internal and external arisings. The same thing can happen in psychotherapy and other growth modalities. For the great majority of people, the nature, intensity, and duration of these kinds of challenges is quite manageable."
According to Young, the real Dark Night occurs when, as in Hans' case, a practitioner has difficulty integrating insight into selflessness. This is something he says he has only ever seen a few times in his four decades of teaching.
Perhaps surprisingly, Britton's research has so far not revealed any clear associations between meditation-related difficulties and prior psychiatric or trauma history. Problems can occur in individuals with no identifiable red flags; conversely, individuals with multiple red flags (bipolar disorder, trauma history, and so on) can do intensive retreats without any difficulties whatsoever.
"We have to be careful," Britton told me, "about jumping to conclusions and excluding people prematurely from meditation's possible benefits. My personal opinion is that the place where we need most help is not in identifying at-risk people so much as improving support systems."
Britton gets two to three emails a week from people looking for help, so this is something she thinks a lot about. "Just talking about the experience with someone and hearing that none of it is new … this has a hugely positive effect on people.
That's eighty percent of what needs to happen. Just normalizing the experience." To that end, she has already founded both a space and a website to provide resources for practitioners in need, and also to educate teachers and clinician about the full range of meditation' effects.
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"Length of impairment is directly related to how much access the student has to a good teacher. Many of the people I've spoken to have been through dozens of therapists and meditation instructors and most have no idea what to do."
Young has his own techniques for helping meditators work with Dark Night phenomena. Hans adds one more: serious fitness. "Pilates, weight-training, yoga – I now do it all. For me, I finally figured out that I needed to integrate these changes into my physical body. Ultimately this is what turned the corner for me."
Seven years after his drop into the pit of the void, Hans is arriving at a better place. Not a normal place, mind you – and here his laugh is a bit hysterical: "What's normal? I still live in emptiness and wake up every morning with no idea who I am."
But he no longer gets panic attacks, or feels ten thousand volts of electricity irradiate his senses every time the phone rings. His sex drive has returned, and with it a new longing for a relationship. He also has a strong interest in helping others manage similar problems.
"So much of it is about patience," he says. Over the past seven years, the words of one teacher kept circling around in his head: "If life gives you nothing you want and is not on your own terms, would you still have the generosity to show up for it?"  There's no easy "yes" to that question.
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I wasn’t prepared for this...
There’s plenty of weird and wacky things going on in America these days. The Apprentice guy is our president, BLM is rioting in defense of criminals and chanting for cops to be killed, SJW’s are rioting against democracy and feminists are walking around dressed as giant vaginas and calling themselves oppressed.
The left tries to normalize everything from Islamic terror to 400 genders but not even I could have imagined they would go low enough to try normalize child abuse. I mean, it’s bad enough that they’re forcing 5 year olds to carry “this pussy grabs back” signs and forced to say “which one of us will be raped next?”, “I shouldn’t need a penis to get paid” and “fuck the patriarchy”. But what’s worse is this whole gender issue that’s becoming out of control.
When people ask me what I think about trans people I give a pretty distinct answer. In general I have no issue of women transitioning into men and men transitioning into women but what I do have an issue with is normalizing children being forced to become transgender.
These two parents went on Buzzfeed in a video called “I Am A Gender Non-Conforming Parent” to brag about how awesome it is to force your child to live as a boy AND a girl because gender doesn’t mean anything, right guys? It’s pretty fucked up. In the video we have a mom… and a mom, raising their kid and essentially messing with them psychologically. “My understanding about gender is that ultimately it doesn’t mean anything, it doesn’t give you the information about that person.”
In 1965, some kid named David Reimer was born and he was reassigned to become a girl and raised female at birth. He was given hormones, surgeries, etc and he was raised entirely female. For a long time David was fine and researchers and phycologists such as John Money took this as proof that gender identity was learned and not biological. But it ultimately turned out to be a failure after David stopped calling himself a girl aged 11 and transitioned back into being a guy aged 15 and began discouraging others from transitioning, after being depressed for years he killed himself. It’s the many cases like these that are swept under the rug by people who claim that there’s no difference between guys and girls and their behavior and identities are all just a social construct.
Raising your child as something they’re not, the child is going to grow up thinking they are something they’re not. Gender isn’t this amazingly complicated thing some people like to make it out to be. Already kids are being confused as hell because everybody is telling them to question their gender and change their gender, even when they’re just three and four years old.
The fact is, most children who experience gender dysphoria will not remain gender dysphoric after puberty. Most kids grow out of it. And the ones who don’t are usually confused by their homosexuality as most GID children turn out to be either gay or bisexual.
Children aren’t born with the cognitive capacities of your average adult, and before the age of 11, most children are simply unable to perform abstract reasoning or understand nuances when having a discussion. Instead, children below this age generally see things in either-or scenarios, and divide the world into dichotomies of “wanted or unwanted.” So when a parent asks a little girl if she wants to be a boy, the little girl probably thinks, yeah sure I want to play in mud and wrestle people so their mom excitedly posts on facebook that she’s a cool mom with a cool transgender kid and books the next appointment to see a therapist to begin the transition process.
How about we let the kid grow up first before we start pumping them with hormones or blocking their hormones, it’s really not that hard to stop yourself from abusing children. Anyway, back to talking about the crazies in this video:
“The person I am today was very much in line with a person that I was or longed to be when I was little. I was a tomboy, my best friends were primarily boys, I played with “boys” toys.”
I don’t know how many times I have to make this point. Liking things that aren’t traditionally for guys or for girls doesn’t make you a new gender. It means that you may not be traditionally masculine or feminine. If I like something that wasn’t traditionally female, it doesn’t mean I should turn myself into a guy or start calling myself genderfluid or whatever one of the 400 new genders I can pick from. What makes these people think that since they have some non-traditional gender trait (which is fine by the way) they have to change their entire gender, transition into a new one and enforce their kids to do the same? What the fuck is going on?
“People ask me, “do you have a boy or a girl?” Whatever that means, this person could be anybody.”
This is like saying it’s wrong for humans to call their babies human because many people identify as a non-human. Whether you’re pushing for children to be genderless and to stop conforming to oppressive gender roles or whether you want them to be known as non-human and stop conforming to oppressive human species roles, first you must throw out everything we know about biology, endocrinology, neuroscience and any last piece of common-sense that you have left - which is something most people just ain’t willing to do.
“It’s real funny because our son is super into sports, like maybe he was like an Olympic athlete in his past-life, like he’s come with all of these sporting talents that were like visible at seventeen months.”
Yes, it’s so funny and weird that your male son is super into sports and is naturally talented at sports even though you’re raising him as a total genderless child. Totally shocked! Who would have thought! … These people like to contradict themselves. First they call their “genderless” child a boy and then they talk proudly about him being a traditional male. This entirely goes against the non-binary, agender narrative. She’s telling us that the kid is just a typical boy but she’s trying to queer him up not because it’s what he wants but it’s what she wants to make herself feel better, so why not mess with him right? It’s like those fat dance moms and beauty pageant moms who force their 3-year old daughter into dancing on stage and wearing wigs and make-up and the mom is stood up in the middle of the audience desperately encouraging and reciting their kid’s choreography and routine while the kid is dying on the inside as everyone watches on, all because the mom wants to live her own fantasy through a toddler.
“I’m constantly trying to like queer up my relationship with him and get him to wear tutus and he hates it, he’s just like NO!”
They laugh at this. They think they’re doing a noble feminist deed by forcing their son to dress and act like a girl, even when they themselves admit that he hates being dressed up in feminine clothes and begs them to stop, they just laugh it off and continue to force it onto him. He’s too young to understand the importance of dressing like a girl but he’s old enough to tell doctors he wants hormone treatment, right? Am I the only one who’s noticing how fucked up this is? What’s the difference between this and forcing a little girl to wear dresses instead of jeans? They go mental when it’s reversed but when they enforce their own version of genderless roles on children, it gets turned into a cool empowering Buzzfeed video to inspire others to do the same.
”He’s taking in like kid media and he has a book that is like just pictures and words but it also has like a picture of a girl and there’s a picture of a boy and but I’m just like child - child. This is where he starts learning like what things are and so I hate the idea that he’s getting imprinted on him what people look like.”
Oh shit, he’s being introduced to reality? Oh fuck, learning about biology is going to cause some problems. I mean, it goes back to what I was saying earlier, getting pissed that a children’s book shows a boy and a girl and calls them a boy and a girl would be the same as a human non-conforming parent getting pissed that there’s a book with human children being called human. I’m so sorry science isn’t changing just because parts of it goes against your fantasy. A woman is a woman, a man is a man, a human is a human. If YOU don’t identify with these, that’s fine, you have my sympathy, but leave children out of it and stop trying to force the world to play along. I can’t believe that saying something as realistic and obvious as “don’t abuse and lie to your children” is now controversial.
“Everybody needs to be reconsidering the way that they’re presenting genders to their kids.”
No. They don’t. This goes to show just how closed-minded these people are for thinking they have the moral high ground to tell every parent out there to join their genderless utopia where everyone pretends to be equal and abide by their oppression rankings and rules and if they don’t, well they’re just bigoted assholes. Why does the word “cult” continue to spring to mind whenever I start talking about their ideology? Maybe it’s for good reason…
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sunrec · 7 years
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Our hopes, loves and very existence are just elaborate functions of a complicated mass of grey tissue. Accepting that can be hard, but neurophilosopher Patricia Churchland tells Graham Lawton that what we know should inspire us, not scare us
You compare revelations in neuroscience with the discoveries that the Earth goes around the sun and that the heart is a pump. What do you think these ideas have in common? They challenge a whole framework of assumptions about the way things are. For Christians, it was very important that the Earth was at the centre of the universe. Similarly, many people believed that the heart was somehow what made us human. And it turned out it was just a pump made of meat.
I think the same is true about realising that when we’re conscious, when we make decisions, when we go to sleep, when we get angry, when we’re fearful, these are just functions of the physical brain. Coming to terms with the neural basis of who we are can be very unnerving. It has been called “neuroexistentialism”, which really captures the essence of it. We’re not in the habit of thinking about ourselves that way.
Why is it so difficult for us to see the reality of what we actually are? Part of the answer has to do with the evolution of nervous systems. Is there any reason for a brain to know about itself? We can get along without knowing, just as we can get along without knowing that the liver is in there filtering out toxins. The wonderful thing, of course, is that science allows us to know.
Are there any implications of neuroscience that you feel unsettled by? I’d have to say no. It takes some getting used to, but I’m not freaked out by it. I certainly understand the ambivalence people have. On one hand, they’re fascinated because it helps explain their mother’s Alzheimer’s, but on the other, they think, ‘Gosh, the love that I feel for my child is really just neural chemistry?’ Well, actually, yes, it is. But that doesn’t bother me.
By and large I find neuroscience liberating because it allows us to see our connections to other biological things, and because it’s not full of metaphysical junk about preparing your life for the great beyond. Of course it’s possible we’re wrong. But it doesn’t seem very likely, and that lack of likelihood is sufficient for me to not want to organise my life around this possibility. I want to enjoy it now. I don’t want to make useless and meaningless sacrifices, and I don’t want to trash this planet because I think a better one awaits me.
You seem to take it for granted that there is resistance to brain science out there. What led you to that conclusion?
For many years I taught philosophy of neuroscience and my students would often say, doesn’t it freak you out that you’re just your brain? Doesn’t that bother you? So we would talk about why it bothered them. I know some people are ambivalent or apprehensive.
You say that some philosophers are resistant to brain science, too. Why is that? Many philosophers think, hey, we thought we were going to have all the answers, and now you guys are wading in and telling us what knowledge is? I think there’s fear of a territorial kind, and rightly so.
You accept that we don’t have satisfying neural explanations for a lot of higher functions, including consciousness, problem-solving, decision-making, sleep and dreaming. Are we really ready to declare that we are our brains? True, we don’t have adequate explanations yet, and it’s important not to overstate where things are. But that’s where the evidence is pointing. Everything we’re learning in neuroscience points us in that direction.
You say beliefs in things like the existence of the soul and life after death are challenged by neuroscience. But are they still widely held? There are probably cultural variations; it may be that in Britain there is less need to challenge these ideas. But I find that here in America, it is important. Lots of people who don’t necessarily have strong religious views nonetheless have the feeling that maybe after they die, there’s something else.
It was quite interesting to see the comedian Jon Stewart interviewing Richard Dawkins recently. He said something like, you really don’t think that after I die anything happens? I just rot? And of course Dawkins said, yes, I really do think that. And I really think that, too.
Even people who have largely come to terms with neuroscience find certain ideas troubling – particularly free will. Do we have it? A better question is whether we have self-control, and it’s very easy to see what the evolutionary rationale of that is. We need to be able to maintain a goal despite distractions. We need to suppress certain kinds of impulses. We do know a little bit about the neurobiology of self-control, and there is no doubt that brains exhibit self-control.
Now, that’s as good as it gets, in my view. When we need to make a decision about something – whether to buy a new car, say – self-control mechanisms work in ways that we understand: we decide not to spend more than we can afford, to go with the more or less practical car. That is what free will is. But if you think that free will is creating the decision, with no causal background, there isn’t that.
What about the argument that you can follow chains of causality back to the beginning of the universe, so everything is predetermined? It’s metaphysical goofiness. The reason I just scratched my foot is because of that causal connection to the big bang? Get real. Part of why we care about free will is because we care about assigning responsibility. Do we need to know about the relation between my scratching my foot and the big bang in order to make wise decisions about when to punish people for their actions? Of course not.
So I shouldn’t worry that I don’t have free will? Here’s one way to think of it. Suppose your doctor tells you they have found colon cancer. You have to make a decision whether to have surgery. If you thought there was no such thing as free will because it is causality all the way back, you might say, well, it’s futile, I cannot make a free decision anyhow, I will just sit here and wait. That would be foolish.
If you are crippled by the thought that it is causality all the way back, you have essentially made a decision to make no decisions. That is very unwise. If by thinking that free will is an illusion you believe that it does not matter whether you acquire good habits or bad, hold false beliefs or true, or whether your evaluation of the consequences of an option is accurate or not, then you are highly likely to make a right mess of your life.
Do you see yourself as a cultural warrior? Not at all. My intent is to say, I’ve made my peace with my brain, but there is a journey to getting there. I understand that journey, and not everybody will want to make it, but I’ll let you know how I got there. And then you can take it or leave it.
So yours is not an evangelical message, you aren’t seeking converts? No, I have no intention or desire to shove anything down anybody’s throat. People are, by and large, smart enough and reasonable enough that they come to a good decision eventually. But it takes time to think about it, to go back and forth. It’s something that you have to marinate in for a while.
I just want to lay out what it looks like the science is telling us, because I think people want to know. I think it’s important to accept what seems to be true rather than make stuff up. In general, I think that’s a good life policy.
Can neuroscience offer a philosophy to live by? Neuroscience doesn’t provide a story about how to live a life. But I think that understanding something about the nature of the brain encourages us to be sensible.
Some might say the idea that you are just your brain makes life bleak, unforgiving and ultimately futile. How do you respond to that? It’s not at all bleak. I don’t see how the existence of a god or a soul confers any meaning on my life. How does that work, exactly? Nobody has ever given an adequate answer. My life is meaningful because I have family, meaningful work, because I love to play, I have dogs, I love to dig in the garden. That’s what makes my life meaningful, and I think that’s true for most people.
Now, at the end of it, what’s going to happen? I will die and that’s it. And I like that idea, in a crazy sort of way.
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paleorecipecookbook · 7 years
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RHR: Why Your Brain Makes You Fat—with Stephan Guyenet
In this episode we cover these topics:
Why it’s the brain that controls obesity
The ancestral perspective on food intake
Is it really about “calories in/calories out”?
Why both low-fat and low-carb diets reduce calorie intake
Are carbs and sugar to blame for obesity?
Does dietary fat cause obesity?
How to work with your brain to lose weight
Show notes:
The Hungry Brain: Outsmarting the Instincts That Make Us Overeat, by Stephan Guyenet
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youtube
Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today, I'm going to interview Dr. Stephan Guyenet about his fantastic new book, The Hungry Brain. You may recognize Stephan as a previous guest on the podcast. He is actually the only guest, now with this third visit, who has been on my show three times. He was one of the first guests I ever had way back when I started Revolution Health Radio, which was not called Revolutionary Health Radio at that point. I think it was called the Healthy Skeptic Podcast ... I don't even remember, it was a while ago. But the reason I've had Stephan on twice and now this third time is that I really consider him to be one of the most informed and sanest voices in the discussion about why we gain weight and why it's so hard to lose it. Stephan has been a neuroscientist for 12 years. He worked in a lab that studied the neurobiology of fat regulation for four of those years and is just an extremely insightful, bright, and level-headed scientist, researcher, and commentator. I appreciate his perspective on these topics, and I think his new book is by far the best publicly available resource now that explains the evidence behind weight regulation, and so I'm happy to welcome Stephan back. We're going to talk about some of the key concepts from his book and then some of the biggest myths about fat loss, and I hope you get a lot out of this and enjoy it as much as I did. Okay. Let’s dive in. Chris Kresser: Stephan, welcome back. I have to say you have the distinction of being the only guest that's ever been on my podcast three times. How does it feel? Stephan Guyenet: It feels great. Thanks for having me back again, Chris. Chris: It's a pleasure. I love having you on the show because when I think of someone that has a real evidence-based, fact-informed perspective on weight regulation—why we gain weight and why it's so hard to lose it and how we can actually lose it—you're the first person that comes to mind. There's so much misinformation, I think, out there about this topic and it drives me absolutely nuts. I know you're right there with me a lot of the time. Stephan: Yes, I am.
Why it’s the brain that controls obesity
Chris: On that note, you tell us, why did you feel compelled to write this book? I mean, there are many other ways you could spend your time, and I know firsthand that writing a book is an arduous process. What was your overarching goal here? Stephan: I spent 12 years in the neuroscience research world of food intake obesity. First of all, there are a lot of different things that you can study in this world, that you can research in this world. And the one that I started off studying in graduate school was very interesting, but it was a disorder that was not very common. I decided I wanted to move into something that was more common and more impactful, which is obesity. I think that's one of the more impactful conditions in this world in terms of reducing quality of life and promoting disease and those sorts of things. I started my postdoctoral research. I switched from studying a rare neurodegenerative disease to studying food intake and obesity. And during the course of my research, it really dawned upon me very, very clearly that the brain is really the organ you want to be thinking about if you're thinking about food intake regulation, body weight regulation, and body fatness. It's really not difficult to demonstrate that. It's really just kind of common sense if you think about it. It doesn't really take research to realize this, but the brain generates all behaviors, including what you choose to eat, how much you choose to eat, and how you use your body, and it regulates a lot of the physiology of your body as well. What's going in and out of your liver, what's going in and out of your muscles, what's going in and out of your fat tissue, how fuel is being burned—those things are all influenced by the brain. It's very much kind of the obvious place to look.
Four strategies to avoid the “hungry brain” and lose weight
But what I realized over the course of my research, over the course of writing on my blog is that that wasn't really a common perspective. It wasn't really a common angle to see the problem from, and I understand. I mean, the brain is complicated, and I think our understanding of it has been growing very rapidly. I think until recently, maybe, we really didn't have what it took to see food intake regulation and body weight from the perspective of the brain, but we do now, and so all of that together convinced me, plus the fact that there was no general-audience book that kind of took a broad look to my knowledge. I have not encountered another general-audience book that took a broad look at the role of the brain in food intake and body fatness, so that seemed like a pretty immense gap in the general audience literature and something that I felt was very useful to educate people about, and I felt that I was in the right place to do it, and so three years ago I embarked on this project. Chris: Well, I'm so glad you did, and I just want to kind of stop and reiterate what you said, which is that once you start studying obesity in earnest, you quickly come to the conclusion that the brain is running the show and yet—I almost interrupted you because I was ... you mentioned how obvious that is—and yet it's really not been the driving factor in the discussion around obesity and weight regulation. It's all of the downstream effects of the brain's influence on behaviors or physiology related to food intake that you mentioned, like the insulin and fat cells and all of this stuff. That's really what people have been talking about for the past couple of decades in the popular media. It may be that researchers have been focused on the brain, but it seems to me as a clinician that most of what we've heard is all of this argument and debate about, you know, insulin and these downstream effects, and I really think that this is going to be a revelation for a lot of people when they read this book—these obvious things that are overlooked that can be so powerful. Stephan: Yes. That's a good good point. I think that you can you can look at eating behavior and body fat from a variety of different angles. I don't want to say that the brain is the only valid way to look at it. But at the same time, I think that if you really want to understand the source and you want to fundamentally understand what's going on, that understanding has to include an understanding of the brain. Chris: Yes. I would say also along the same lines that if you only look at the other things without understanding the brain, you're missing some really critical information. I mean, just speaking again as a clinician, I think when I have explained some of these concepts that I originally learned from you, like the body fat, adipostat—the body fat thermostat, so to speak—the hedonic homeostatic dysregulation/regulation of weight, and some of the stuff that we might talk a little bit about today and we've talked about on our previous podcast, it really turned the light on for some of these patients because it helped them understand how they could continue to have trouble losing weight even when they're doing the so-called “right things,” like, “Hey, I switched to a low-carb diet and I'm still not losing weight. Why is that?” Any number of changes they could have made that were in theory supposed to work based on whatever idea that they were following didn't actually work, and understanding the brain and the brain's role helped them to get their head around that and actually to make some changes that ended up being more effective in terms of weight loss. I think it's not just important from a scientific perspective, it really actually translates into useful information for people who are trying to lose weight and for clinicians, coaches, anyone who's working with people to lose weight. Stephan: Well, I'm really glad to hear that it's been useful in that way. One of my hopes for this book is that as people read it that light bulbs will go off and they'll say, “Wow! This actually really explains my experience quite well.” It's my belief that that will happen for many people because the whole idea of the book is understanding these non-conscious impulses that drive us to eat more than we think we should. If you're able to describe those impulses and where they come from, then it's like, “Oh, hey, that's why I behave like that even though I know it's not really good for me.”
The ancestral perspective on food intake
Chris: Right. And we've talked about that in many other contexts with the ancestral perspective, like understanding the influence of our genes, thousands of generations of evolution on our behavior. I think for a lot of people listening to this, it won't come as a surprise that we have hardwired genetic mechanisms that influence our food intake in a way that's not easily controllable by our conscious mind. I mean, there are certainly things we can do, which I want to ask you about, consciously to mitigate some of those hardwired tendencies, but they were really kind of something I've taken away from understanding a lot of the things we've talked about is we're really kind of fighting against some deeply, deeply entrenched kind of behavioral tendencies that aren't easy to overcome. Stephan: Yes. That's exactly right. There's a reason why our impulses work the way they do, and the reason is generally that they were things that supported the survival of our ancestors. Energy is so critical to survival. Calories are so critical to survival and reproduction, and so the brain is wired very deeply and very powerfully to behave in certain ways with respect to energy, and those ways make a whole lot of sense in the context of our distant ancestors but not so much today. Chris: Right. And so, an environment where food scarcity was the biggest problem, they gave us a survival advantage. But in this current environment where you can walk down to a 7-Eleven and get a 72-ounce Big Gulp and Twinkies on virtually every corner, it's a prescription for obesity. Stephan: Yes, that's right. It's kind of funny because there are kind of analogous situations to 72-ounce Slurpees in hunter–gatherer scenarios, like, for example, Kim Hill, who's one of the anthropologists I interviewed for my book. He told me that Aché hunter–gatherers and the Hadza of Tanzania do similar stuff. They will sit there and eat a quart of honey like, a liter of honey just straight. Chris: That’s insane. Stephan: I know, isn’t it? I mean, it's hard to even imagine doing that. But they do the most outrageously gluttonous things and they don't have the same inhibitions that we do. For them, that's a good thing. To do that is a good thing that you want to do, and there's no reason not to do it because you need ... Chris: They're not going off into the jungle and throwing up after that or doing some of the things that we've been trained to do out of shame, you know, for caving into those hardwired mechanisms. Stephan: Right. They're not feeling guilty. There's no reason to be to be guilty because it's a good thing. But the reality is that, that doesn't happen every day and it doesn't happen every other day. They often get honey but they can't usually get enough of it to exceed their calorie needs. Overall they're really, like, fighting to get enough calories, and part of that struggle is to gorge when you have the possibility of gorging when the opportunity perfectly presents itself. Our brains are kind of wired like that. Most of us don't gorge to that extent, but I think those same instincts push us a little further than we really want to go. Chris: Yes. And you don't have to look back that far even to see some of this. My wife is Canadian, she's from British Columbia, but one side of her family is from Saskatchewan, which corresponds to the Midwest of the U.S., and they're farmers. She told me that she has memories when she was a little girl going to visit them in Saskatchewan and her grandmother or great grandmother perhaps would set down this huge plate of food in front of her, and when my wife would say, “I'm not hungry anymore,” her grandma would say, “Eat for the hunger to come.” There’s this idea that there might be a famine next season so you better eat out now while you can. This is just two generations ago. Stephan: Yes. That's amazing and you see this tradition in a lot of different cultures. You see this in Eastern Europe, in Western Europe, even in older folks, and like you said, in traditional families in Canada and the U.S. that there is this culture of trying to eat as much as you can because it's actually good for you in a certain context. But yes, we obviously don't live in that context anymore.
Is it really about “calories in/calories out”?
Chris:  Okay. I want to switch gears and talk about some of what I think are the biggest myths about weight regulation, some of which we've discussed on the show before and you talk about in your book, but let's talk about calories first. If we think of it like a spectrum, maybe on one end there is the argument that calories don't matter at all and it's just the type of foods you eat that determine whether you get fat or don't get fat, and then on the other end of the spectrum, it's all about calories 100 percent. And I know this is a little bit of a straw man, so we can address that, but let's dive into that. Where do you fall on that spectrum, and, you know, what would you say about that? Stephan: Just to define the question a little bit more, I think that there's a whole causal chain leading from food to excess body fatness, and I guess the question is, are calories in an essential part of that causal chain? I would say that yes, they are, and so if we had, like, a scale of 1 to 10 of “1 is calories are totally irrelevant” and “10 is calories or everything in terms of body fatness,” I would say I'm around like 8 or 9, plus or minus 1. I think that there's very good evidence. As of right now, the evidence suggests that calories are the only known food property that has any impact on body fatness at all. That doesn't necessarily mean that there are no food properties that can impact body fatness independently of calories, but that's the only thing we have evidence for, and there have been a number of studies on it at this point. There was a paper that came out just a few days ago, I think, where they were looking at the impact of refined grains versus whole grains and they showed that the same number of calories—I haven't looked at the paper, I don't know how solid it is, I just saw the abstract—but they were suggesting that when you eat whole grains, there's some small portion of those calories that get excreted, and it may also increase your energy expenditure slightly such that there's a small effect on your energy outside of the equation that's independent of the number of calories in your food. There could be effects like that that have a small effect, but I think to a pretty close approximation, calories are the only food property that affects your body fatness. I think that, I don't want to say that there's absolutely nothing else that ever affects it, but I think to a pretty close approximation, that's the case. Chris: I kind of set you up with that question, so I'm glad you redefined it. The other thing that I think we should point out is that the fact that calories play a major role in weight gain or fat gain doesn't necessarily mean that restricting voluntary calorie intake is the best way to lose weight, or does it? Stephan: Yes absolutely. I think this is exactly ... Chris: People conflate those two things together, and they think that if you accept one, you have to accept the other, but that's not necessarily true. Stephan: Yes. That's absolutely right. And this is why when people ask me if I believe in “calories in, calories out,” I ask them what they mean by that because, like you said, it can mean two different things. Either that the balance between calories in and calories out is the thing that affects body fatness or that voluntary decisions about how many calories to eat are the only way to regulate body fatness. And yes, like you said, one can be true without the other being true, and I think that if you look at studies where they're just using portion control and calorie control where people are simply told to eat fewer calories to lose weight, what you see is that that approach doesn't work that well—if you stick to it you will lose fat. There's no question that restricting calories causes fat loss, but the problem is that that's not the natural way that we interact with food. The natural way that we interact with food is we eat when we're hungry or tempted, and then we stop when we're full. We're not regulating it really on this conscious, rational, spreadsheet level; we're regulating it on an intuitive level. I think even though the number of calories that you eat has a very powerful impact on your body fatness, regulating the number of calories by changing those, by trying to have a direct impact on those impulses is a better way than actually trying to count calories. For example, just to give you an example to make it a little more concrete, eating food that has a lower calorie density and higher protein so that you feel more full per unit calorie, so you, when you hit that point where you intuitively want to stop eating at a point where you are eating fewer calories. That doesn't require calorie counting, but it does have the effect of reducing your calorie intake. Chris: Right. That would be an example of involuntary calorie restriction, where, putting it in layperson's terms, you naturally eat less without trying to by virtue of what foods you're eating. Stephan: Absolutely. It's a phenomenon that you see when you put people on a variety of different diets, including low-carbohydrate diets. You don't have to invoke any kind of metabolic magic to explain why people lose fat on a low-carbohydrate diet. They spontaneously start eating fewer calories, so the effect is very consistent with the known impact of calorie intake on body fatness.
Why both low-fat and low-carb diets reduce calorie intake
Chris: Let's talk a little bit about why that happens with macronutrient restriction. You have a section in your book, the United States of Food Reward, where you go into a lot more detail about this, but let's just touch briefly on that, on why someone would naturally eat fewer calories on a very-low-carb diet or even a very-low-fat diet. Stephan: Yes. I think there are a couple of different reasons, but I do think there is a very important observation that you just made there in passing, and that is that you can see reductions in calorie intake and body fatness on diametrically opposed diets. Low-carbohydrate diets cause that, and low-fat diets also cause that even though the macronutrient they're restricting is the opposite one. By the way, it is true that low-carbohydrate diets tend to cause more fat loss. Nevertheless, low-fat diets do cause fat loss. That's not really consistent with the hypothesis that one macronutrient is fattening and the other one is slimming, and if we just cut out the fattening one, we're going to lose weight. So, how do you explain that? How do you get to a higher-level, overarching principle that can explain both of those things? So, there were a couple of them, and one of them that I'll start with is the reward value or the seductiveness of the diet. The human brain is literally hardwired to look for certain properties in food, and these include starch, sugar, fat, and protein. There are literally sensors in your small intestine as well as in your mouth, of course, that detect the chemical properties and the volume of what you've eaten and send all that stuff back up to the brain. If your brain gets the message that the food is an outstanding source of fat, carbs, and protein, you get some dopamine spiking, and then you're going to be highly motivated to eat that food next time. The smell of it, the sight of it, and all that is going to be really motivating and seductive for you. It's going to trigger that motivation. If the brain decides (based on the physical properties of that food that it's measured) that it is an exceptionally valuable food because it has large quantities of all these things at once, it has a way of kind of sweeping aside your natural limits on intake, reducing the satiety mechanisms, and increasing your body fat set point to kind of facilitate intake of that food that it views as so valuable. But if you present a diet that's lacking—or at least substantially reduced—in one of those reward factors, one of the main things the brain is looking for, it’s just not quite as interested in eating as much of that food. It's not going to quite drive that eating behavior to the same degree because that food doesn't have all of that wonderful stuff that it wants. It's got some of it but not all of it. Chris: And again, it's in an environment of food scarcity where getting all of that good stuff would help you survive a period of famine and be healthier and procreate more successfully, then that's great. But when you're talking about the difference between eating a steamed baked potato with no butter or salt, or a full bag of potato chips, it may not be the best genetic programming. Stephan: Yes, absolutely, absolutely. And just to complete my thoughts a little bit, low-carbohydrate diets also tend to have a higher proportion of protein. I'm not talking about the very-low-carbohydrate ketogenic diets necessarily, but just your standard moderate-low-carb diet tends to have a higher proportion of protein. That also tends to feed back on those brain circuits and tells you to eat less. Chris: Right. This is, again, I think another point of confusion where people see reports on the research of where a low-carb diet was effective, and they automatically assume that that was because of the removal of carbohydrate, which, as you've just explained, it's not necessarily a safe assumption, and in fact there's plenty of research that I've seen as well that suggests that it may be more related to the increase in protein intake than it is the restriction of carbohydrate. Stephan: Yes, that's right. I wouldn't say it's necessarily 100 percent definitive yet, but that is what the research is suggesting, I agree.
Are carbs and sugar to blame for obesity?
Chris: Well, that's a good segue to the next myth about weight regulation, and this one we’ll will start with the more contemporary version of this. The next two are related to macronutrients. But lately, it's been more the idea that carbs are to blame for the obesity epidemic, and in particular, as people like Gary Taubes have argued in his recent book, most explicitly that sugar, especially refined sugar, is to blame for the obesity epidemic. Let's tackle both of those, starting with just carbohydrates overall as the micronutrient and then moving onto sugar specifically. Stephan: Yes, sure. I think the starting point for this is to look at non-industrial cultures. I think it's not the only part of the picture but it's the one part of the picture, and what we see if we look at non-industrial cultures is that there's a very wide spectrum of macronutrient intakes historically and most of the non-industrial cultures that we have evidence from were actually eating a very-high-carbohydrate, lower-fat diet. There were also some that were eating high-fat, low-carbohydrate diets, and really none of them had the diseases we're trying to avoid today. It's obviously possible to eat those kinds of diets in the context of unrefined food and physical activity and a healthy lifestyle, It’s obviously possible to be lean, and it's possible for entire cultures to be lean and healthy on almost any macronutrient makeup. I guess I don't even really understand where this idea comes from because there's not really any research that suggests that carbohydrate is disproportionately to blame for obesity. If you put people on high-carbohydrate diets, they don't gain weight. They don't become diabetic. It doesn't happen in animal models. It doesn't happen in people. There's no association in observational studies between total carbohydrate intake and obesity or diabetes or any of that. What you do see, you see that refined carbohydrates and sugar are associated with poor health outcomes, and that's, I think, just consistent with the general idea that if you eat a refined, calorie-dense diet, you're going to tend to have poorer health outcomes. But that's true in general. It's not just, it's not just refined carbohydrates, it's refined anything. Chris: I don't want to go too far off on this tangent but it is kind of an interesting question to think about where this comes from. My sense is, like you said, there is some research to suggest that excess intake of refined carbohydrates can lead to increased consumption of calories that isn't compensated for elsewhere, which we understand. What we've been discussing so far, that calorie intake does matter, then, yes, refined carbohydrate would contribute, but then somehow that gets extended to all carbohydrates. I don't know. It's interesting to think about if we're talking about evolutionary mechanisms. You and I traded some emails about this tendency for kind of black-or-white thinking in human beings and that maybe that itself has some genetic roots. Stephan: Yes. I think, I think people want simple heuristics. I don't think the average person wants to have to study health and nutrition deeply to understand what to put in his cart at the grocery store. We tend to come up with these simple heuristics, like fat is bad or sugar is bad, and if I just avoid that then I'm cool. Unfortunately, human biology and the way that we interact with food is just a lot more complicated than that. I think that people, they look for simple solutions, and simple solutions are not necessarily the most accurate. I think for sugar—just to get into the sugar thing a little bit—I personally have little doubt that sugar is involved in obesity and chronic disease. But I think to claim that it's the primary factor, you have to overlook so much evidence that other things matter that it's mind boggling. Chris: Right. I think this goes without saying, but you're not advocating that people eat sugar or suggesting that sugar doesn't play a role in obesity or play a role in other health problems. I know you and I know what you eat and know that sugar is not a significant part of your diet. I know you don't work for the sugar lobby. For the record, that's not what you're saying. You're just saying that if you if you look at the evidence in a dispassionate way, it's extremely difficult to make an argument that sugar is responsible for the obesity epidemic. Stephan: Entirely responsible, yes. It really is. It's just hard for me to understand. I read Gary Taubes’ book The Case Against Sugar. I know all the evidence that's cited and I just do not understand how this adds up to any kind of cohesive, compelling argument that sugar is the only thing that matters. It kind of blows my mind that these arguments are all over the media right now and that people are taking this seriously. It's an incredibly weak argument. Chris: Yes. Well, we could go in a lot of directions with the media and their capacity for nuance, but let's not do that. Let's just agree that the media is not renowned for its capacity to handle nuance, and some very sophisticated arguments when we're together, whether we're talking about politics or nutrition science. I think the media suffers from the same issue that you talked about with individuals, where it's much rather it just be a simple, easy, attractive headline to say “sugar is the enemy,” and all you need to do is cut sugar out of your diet, and then you won't have to worry about weight gain. That headline’s going to get clicked on a lot more them than one about the way that the brain regulates weight, unfortunately. Sorry if that's news to you, Stephan! Stephan: Newsflash: simple arguments get clicked on more on the internet.
Does dietary fat cause obesity?
Chris: Right, yes, simple and often wrong arguments. Whether they're supported by any shred of evidence doesn't even come into the equation, especially nowadays. Okay, so let's turn that around because prior to the last couple of decades and especially the last decade, the opposite argument was often advanced, which is fat, it was solely to blame for the obesity epidemic and also the epidemics of cardiovascular disease and diabetes, which led to the whole American Heart Association, American Diabetic Association recommendation for a very low-fat diet in the first place. Is that, is that true, or is it the same problem with the carb idea? Stephan: Well, I want to start off by acknowledging that this argument (that was made especially in the ’70s through the ’90s ... I mean, it hasn't disappeared, but it was most prevalent then) had an evidence basis. If you give animals, for example, a high-fat diet, they will tend to gain weight, and if you give them a low-fat diet, they will tend not to gain weight. They did studies in humans, short-term studies kind of confirming that if you loaded the diet with fatty foods, people would eat more and gain body fat. It's not like it wasn't based on anything. I think it's often portrayed as kind of this nonsense that never had any rational basis, but there was evidence there and there continues to be. But I think there was a lack of nuance that is very similar, I think, to what we're seeing now with arguments about sugar. Except that at that time it was coming from the scientific and public health communities. It was a lot more kind of respectable. Chris: Right. Stephan: The idea was that fat is fattening, and if we eat less fat, we will lose body fat. And that was tested in some big, giant, expensive, long, randomized controlled trials and shown to not really be as accurate, as correct, as people thought it was. There were caveats interpreting these studies. But at this point we have a lot of evidence from randomized controlled trials on low-fat diets, and we can say that at least the form that's typically practiced, which is like a moderate-low-fat diet, is not really that effective for any of the things that we want to do, which is controlling obesity and diabetes risk and stuff like that. I think we have enough evidence at this point to say that that model was not quite correct, and I think the way to reconcile all of the evidence for me is again to pull back from the macronutrient focus and to focus on these higher-level properties of calorie density and food reward or the seductiveness of food and whether food is refined or not. I think those are the higher-level properties that determine to a large extent whether a diet is going to be slimming or fattening, no matter what its macronutrient content is.
How to work with your brain and lose weight
Chris: Right. Why don't we talk about that? If we're saying it's not necessarily counting calories that is the best approach, restricting macronutrients may help but not necessarily the way that you think it does, cutting out carbs doesn't necessarily help because carbs aren’t bad and fattening, and same is true for fat. You mentioned three kind of top-line ideas or premises that you talk about in much more detail in your book, but let's just review those. For someone who wants to lose weight, you've mentioned calorie density (I'd like you to define that, and, you know, use a few examples) and you’ve mentioned the reward value. We talked about the palatability of food, which we've discussed before, but I'd like to go over it again for people that haven’t heard those shows. And really, just like if you were to explain these concepts to someone who wasn't familiar with them at all, what would be the three things to focus on for someone who is concerned with weight gain or weight loss? 1) Avoid foods with high calorie density Stephan: Sure. As you said, I talk about a number of different things in my book, and I think more than we have time to cover today, but I'll cover three things that I think are important. The first one is the calorie density, you mentioned that. Calorie density is the number of calories per unit weight of food, and I think a better way to think about it is per unit volume, even though it's usually measured as weight in the scientific literature because volume is really the thing that matters. You have sensors in your stomach that literally … they're stretch sensors, and they literally detect the volume of food that you've eaten and they send a signal up into your brain, and that's one of the things that's integrated into your feeling of fullness or satiety. If you eat a food, if you eat a meal that's lower in calorie density, you're going to hit that fullness point, that satiety point, after you’ve eaten fewer calories than if you're eating very, very calorie-dense foods. Things like baked goods, like pastries, cookies, white bread, and other calorie-dense things like potato chips and candy, those things are some of the least filling foods per unit calorie, which means that you have to eat more calories until you hit that point that says, “Hey, I've had enough and I'm comfortable not eating.” Stuff like pizza too. Chris: Right. Stephan: I think that's a very important concept, and I think if you look at the animal research literature too, what you see is that it's not so much, it's not really so much the fat or carbohydrate content of the diet that matters. You can put that into rodent chow and they will eat more and they will gain fat. But the thing is, added fat like we use in those experiments is very calorie dense, and if you give them a diet that has a higher proportion of calories from fat but that is not as calorie dense—so you kind of water it down with some fiber or something—what you find is that it doesn't have that same fattening effect. It's not really the fat per se; it's that calorie density that is affecting their food intake and their body fatness. That's one thing that I think is a very important concept. There are other things that go into how filling a food is per unit calorie, such as the amount of fiber it has and the amount of protein. Both of those increase the fullness per calorie. 2) Avoid foods with high reward value Stephan: Another property is the food reward value, and I call this seductiveness. I think that's kind of an intuitive way of explaining what it is. It's the motivational value of the food and the pleasure value. It's that craving that you feel when you see that food like ice cream, pizza, or whatever. That's the reward value. Chris: You explained reward to me on an earlier show in a psychological context, the formal definition of something that makes you want to do more of it, which I thought was useful to understand. Stephan: Yes. That's absolutely right. That's a core property of reward is that it causes you to repeat your behavior and to strengthen your behavior. It basically drives your motivation, your craving for that thing. This is true in many areas of life. It's true for gambling, it's true for videogames, it's true for a lot of stuff, but food is a very powerful reward, and so it applies very strongly to that. Foods with certain properties have a higher reward value. Foods that essentially are giving the brain what it is instinctively looking for, which is very high calorie density, fat content, sugar, salt, and to some extent protein, and especially glutamate, which is that umami, that meaty, umami flavor which is a part of cooked meats and other things. The converse of those highly seductive, highly palatable foods like ice cream and pizza is simple, whole foods like the ones that our ancestors used to eat. Things like tubers that are just baked, and pieces of meat that are cooked simply—raw fruit, vegetables, and nuts, just roasted nuts with no salt on them, and things like that. Those are just plain simple foods, so that's kind of the flipside. And if you eat those kinds of foods, the effect that it has on your brain is one of, first of all, helping you feel satisfied with fewer calories, and second of all actually helping your brain to feel more comfortable at a lower level of body fat. When you lose weight your brain is not going to trigger that same starvation response to the same degree as it would if you were just cutting back calories on your normal diet. Chris: That's interesting. That's something we didn't discuss in detail before, but a very important point. Stephan: Yes. Chris: This experience also, I mean, you've written about this. There's an entire book about this, the title of which I'm forgetting, I'm sure you know it, where these concepts are not foreign to big food, the companies that manufacture processed food. There's that famous Pringles advertisement that when people of our generation were growing up, I bet you can't just eat one, and that's a bet that they knew they would win, right? Because they employ food scientists that have engineered those chips to trigger all of those reward mechanisms in our brain and make it very, very difficult for us to just eat one versus if you compare, you know, a baked potato, as we said earlier, that’s just steamed or baked with no salt or butter, it would be quite hard to overeat that, wouldn't it, because in that situation you're just going to eat what you're hungry for and probably not much more. Stephan: Yes. That's right, and you actually will feel no desire to eat any more unless you have something more tempting or something different in front of you, but that's absolutely true. The food industry very explicitly designs its foods to trigger our known motivational circuits because that is what makes them money. When our motivational circuits are triggered, we pull out our wallets and we purchase their food. That's explicitly the goal of designing the food how they design it, but I will say that the same thing happens in our kitchens to a lesser extent. We try to make the food taste as good as we can, and so everybody is kind of jockeying to satisfy the innate food preferences of the human brain. But I think that the food industry is just particularly good at it. Chris: Most people for a dinner party aren't going to serve baked potatoes with no butter or salt. Stephan: Well, you've never been to one of my dinner parties. Chris: Oh, actually, I was going to say most people except you. But I have been to one of your dinner parties, and it was quite good actually. But you probably wouldn’t have too many people coming back to your dinner party after that. We only have a few more minutes, but I want to at least touch on one significant non-food mechanism that contributes to weight gain. Well, let me see if you agree with this. The primary influence on weight is food intake and not exercise, stress, or something that's, you know, non-food related. A) Would you agree with that? And then B) Even if you do agree with that, when you think of other non-food influences, which ones are the most significant, you think? Stephan: A: I do agree with that. I think that there's pretty good evidence that food intake in humans, for most people, is the predominant influence on by fatness. If you look at the studies that identify how the brain regulates body fatness, like the responses it initiates to try to regain fat after a person loses fat, what you see is that those are primarily concerned with increasing calorie intake and to a much lesser extent with decreasing calorie expenditure. The brain really regulates your body fat and it's primarily by trying to modify your food intake. I think that's really the number one point of leverage for someone who is trying to regulate their body weight. Again, I'm not trying to say that nothing else is important and I'm not trying to say that that is always going to be the best lever for every individual, but I think in general and on average, that's going to be the most powerful lever for most people. 3) Pay attention to sleep and circadian rhythm Stephan: To think of something else that affects weight, there are a couple of different non-food things that affect the weight, but I’ll focus on one that I've talked about in my book, and that is sleep and the circadian rhythm. There's pretty good evidence from short-term randomized controlled trials that if you restrict a person's sleep, they will eat more calories, and they actually may burn a few more calories as well because you burn fewer calories when you're asleep and more when you're awake. But it doesn't make up for the higher intake. People actually will eat 300 more calories a day which is pretty substantial. If you were to sustain that, that's the difference between a person who's lean and a person who's overweight in terms of calorie intake, that's pretty substantial. And then you could ask the question, “Well, does that persist in the long run? Do we really see that that actually makes people gain weight or does it kind of go away after a while?” And what you see from the long-term observational studies is that there's actually a pretty strong association between insufficient sleep and weight gain over time. I think together that paints a pretty consistent picture that not sleeping enough does probably promote weight gain over time. Interestingly, it probably operates primarily through changes in food intake, and there are a couple of different reasons for that. When you put someone in an FMRI, this is a machine that can detect brain activity, so you're looking at their brain activity—if they haven't slept enough, their brain kind of acts like they're starving. All those same responses that you see in the brain of someone who has just gone on a diet and their brain is activating that starvation response, they're feeling hungry or they're feeling more tempted by food, maybe they're feeling a little bit sluggish and cold, those same responses or at least very similar ones occur in the brains of people who are sleep restricted. It activates some of these same circuits that cause us to be more seduced by food and require more food to feel full. That's one way it can work. The other way it can work is that … so, sleep restriction, it's really bad. It does a lot of really bad things to your brain. One of the things it does is it seems to impair your ability to make good judgments and so you develop what's called an optimism bias where you're not very sensitive to the downsides of making a decision and you're paying more attention to the potential upsides relative to what you would do if you were well-rested, and how that can play out with food is that normally you might say, “Hey, well, you know this donut looks really tasty, but I know it's not good for me, so I'm not going to, I'm not going to eat it.” But if you haven't slept enough, you might think a lot about how good it tastes and not very much about what it might do to your waistline later and so you'll just eat it. There are multiple ways in which sleep restriction nudges some of your brain circuits in a direction that favors a higher intake of food and higher body fat in this. Chris: Yet another reason to emphasize getting enough sleep on a regular basis. The more we learn about sleep, the more we see that it affects nearly every aspect of physiology by the circadian rhythm and other mechanisms. It's just really hard to understate how important good sleep is. Stephan: Absolutely. 4) Control your food environment Chris: Before we finish up, I want to ask you one question that I think will be helpful for people as a takeaway. Given everything that we've talked about in your years of experience as a neuroscientist and your understanding of the brain and the role it plays in weight regulation, if there is one single piece of advice you’d give someone, a practical advice for preventing or reversing weight gain, what would that be? Stephan: Yes. If I was limited to one thing, this is what it would be—the brain is highly reactive to the cues in your personal environment, and this is why the food industry spends over $10 billion dollars a year in the United States showing us images of food on TV and billboards and things like that. They do it because they make up that amount of money and more because they know that those food cues going into your eyeballs and into your brain make you buy and eat their food. Controlling the cues that you're giving your brain and your personal environment is a very powerful way for you to either support or undermine your own eating goals. What that means is that if you can design a food environment for yourself that doesn't have calorie-dense tempting foods, especially not visible and especially not within arm's reach, that's really going to help you control your consumption of those foods and your overall calorie intake. The best thing really is to banish foods from your house that are not going to support your goal. That does two things. The first thing it does is it makes it just physically harder to eat those foods. But the second thing it does is that when those cues are not there, you're not going to experience the same motivational drive. You're not going to experience the same level of craving to even want those foods when the, when the cues are not there because that's how your brain works. It looks for the cue, and then that's a signal that something awesome is available, and then it triggers your motivation. Chris: I've got, I've got a furry example of that. We have an eight-month-old Labrador retriever puppy right now. When we're cooking dinner or there's food out, she'll just start to drool. The cues are coming into her brain and they stimulate this mechanism. She's not thinking about it in the same way that we're thinking about it but I've been just watching her. It really strikes me like this is something that's so deep in our brain that we have to make these changes that you're talking about to set us up for success because if we are trying to fight these hardwired mechanisms, it’s really really difficult. Stephan:  Yes, that's a great point. I mean, really, the same is true in humans. It doesn't just trigger your motivation, it triggers your physiology, your saliva flows, your stomach gastric juices start to secrete, you get more gastric motility, your small intestine starts to move around. Your body is ready to go whether that’s pizza or potato chips, anything that's under your conscious control and often it's something that you really don't want yourself to do. Chris: Right, right. I know I've mentioned this a couple of times, but I want to say it again because it can be pretty liberating for my patients when I explain this to them because I think a lot of people carry a lot of shame, feelings of guilt, unworthiness, and they feel like their tendency to overeat is some kind of character flaw rather than a hardwired biological survival mechanism that has nothing to do with their personality or who they are, their self-worth or their value as a, as a person and everything to do with just how our bodies and brains were programmed to survive in our natural environment and how that is just a profound mismatch with our current environment. When you think, when you frame it that way, it depersonalizes it, and when you remove that guilt and shame, it actually frees people up to take more effective action. At least that's what I've seen when that lightbulb comes on and people don't have to be stuck in that cycle of guilt-blame-shame-reaction, guilt-blame-shame-reaction, and they can just say, “Oh, this is an environmental problem, essentially. It's a mismatch between my programming and my environment, so I need to change the environment.” And that's essentially what you're, what you're saying with your number one piece of advice. Stephan: Yes, absolutely. That's a really interesting observation. Chris: Stephan, thank you so much for coming on. Stephan’s book is called The Hungry Brain: Outsmarting the Instincts That Make Us Overeat, available at Amazon, at bookstores, all the typical places. I know you did a local event in Washington. Are you traveling around and doing any events or just sticking close to home? Stephan: I don't have any plans currently to travel around but we'll see what happens. Chris: Cool. Well, good luck with the book. I highly recommend it. I've been waiting for this book for a number of years because people always ask me what book would you recommend for a really evidence-based look at how we gain weight and the best way to keep it off. Until now, I haven't really had one that I could point patients to or other clinicians to in my training program, and I'm really excited that this book is out there. You did a fantastic job. It was really fun to read as well. This could be a pretty dry topic, but I feel like your writing style, just as it always has been with your blog, is really accessible, and you have a knack for distilling complex concepts and making them easy to understand. I love some of the stories and the interviews you did with other scientists. I think that really helped bring it to life. Thanks for this book, and I wish you the best of luck with it. Stephan: Thanks, Chris. I really appreciate that. Chris: My pleasure. Take care, Stephan. Stephan: You too.
Source: http://chriskresser.com March 03, 2017 at 01:20AM
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ellymackay · 4 years
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Why I Choose Neurostimulators for Some of My Sleep Apnea Patients
The following article Why I Choose Neurostimulators for Some of My Sleep Apnea Patients Read more on: Elly Mackay's Sleep Blog
Physicians who use Inspire upper airway stimulation, Respicardia’s remedē, and Avery’s diaphragm pacemaker share their stories.
By Lisa Spear
When patients struggle to adapt to using CPAP and other noninvasive therapies also fail, providers might turn to neurostimulators—implanted devices that control sleep apnea by delivering electrical impulses to airway muscles. We spoke to three physicians about their experiences referring patients for this newer therapy solution.
Asim Roy, MD, Ohio Sleep Medicine Institute
Not long after the US Food and Drug Administration approved the Inspire upper airway stimulator for obstructive sleep apnea (OSA) in 2014, Asim Roy, MD, started speaking with his patients about this therapy option.
Since not everyone can tolerate CPAP, Roy wanted to give patients at his private sleep practice in Ohio access to another alternative therapy. “I think it’s important to have this in your toolbox,” says the medical director of Ohio Sleep Medicine Institute.
“I was familiar with it when it was in the clinical trial phase, so my comfort level was already pretty good at that point. The biggest hurdle has been just getting used to the technology, the device, the ways to titrate or adjust all the different things in neuromodulation,” he says. During his initial cases, he leaned heavily on the Inspire Medical Systems Inc support team to familiarize himself with the settings and how to adjust the voltage. A local field representative was available to help with troubleshooting and Roy found that he quickly became accustomed to working with the device.
“It really was the support team that I think made me much more comfortable in using the technology and being comfortable with making adjustments. They’re there with you pretty much every step of the way to make sure that you’re doing everything right,” he says.
The device has become more accessible recently. For the first two to three years, the nearest surgeon who could perform the implant procedure for Roy’s was at least a three-hour drive away. “It [was] kind of a slow process; we maybe had a couple cases a year. And then the other challenge was insurance as well, early on, it was quite a lot more effort to get insurance to approve it,” he says.
Since those initial days, he says, accessibility is less of an issue. A surgeon started offering the operation at Ohio State, significantly reducing travel time for patients.
Additionally, many payors have deemed neurostimulation medically necessary for moderate to severe OSA. In the last year, UnitedHealthcare announced it would cover the device. Blue Cross Blue Shield plans, including the Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program, and Blue Cross Blue Shield of Tennessee issued positive coverage policies for Inspire therapy. Additionally, Medical Mutual of Ohio also released a positive coverage policy for Inspire therapy.
Asim Roy, MD, has been referring patients for Inspire upper airway stimulation therapy since 2014.
“These days, [patients] can get approved relatively quickly in weeks to months, instead of in years like how it used to be. More and more payors have recognized it as a valid…efficacious therapy. So I would say, there’s still sometimes maybe one or two denials but the appeal process is much smoother and more often than not is getting approved,” says Roy.
Now, in an average month, Roy’s practice will send between 10 and 15 referrals. Prospective Inspire candidates then undergo a drug-induced sleep endoscopy (DISE), which helps physicians understand what type of breathing obstruction exists. The airway can collapse via anterior posterior collapse/lateral wall collapse, which is favorable for Inspire; concentric collapse it is not favorable for the neurostimulator. From there, about two to three of Roy’s referrals will be good candidates for Inspire. For patients where the anatomy of their airway collapse is not optimal for Inspire, Roy looks anew at other options, including other surgical options.
When a patient first fails CPAP, Roy might attempt one to three other options before referring for a neurostimulator. For example, oral appliance and positional therapies are two he has offered to patients. For complicated patients, he may spend more time ruling out all noninvasive options, including bilevel positive airway pressure therapy for those who have both obstructive and central apnea.
Since there are a number of CPAP alternatives out there, Roy encourages other providers to have an open mind. “We don’t have to tell patients that there’s only one option,” he says.
Elias Rizk, MD, Penn State Hershey Neuroscience Institute
Central sleep apnea patients travel from all over the country to have a consultation with neurosurgeon Elias Rizk, MD, at Penn State Hershey Neuroscience Institute.
Since 2012, Rizk has worked with patients who are candidates for the Avery Diaphragm Pacemaker, a device that is implantable under the skin that stimulates the phrenic nerve to modulate nighttime breathing. Among other indications, the Avery neurostimulator is approved for central sleep apnea and congenital hypoventilation syndrome.
On average, he implants devices into three to four patients per year.
[RELATED: NextGen Diaphragm Pacing Transmitter for Central Sleep Apnea Earns FDA Approval]
In most cases, he’s found that the Avery device has provided consistent, repeated, safe, and efficacious breathing to his patients. “Nobody has come in and say, my device has failed,” he says.
Patients who have a phrenic nerve injury, those who have myopathy or a progressive neuromuscular disorder will not be good candidates for this therapy. Prior to approving surgery, Rizk requires that patients undergo electromyography testing to confirm adequate functionality of the phrenic nerve.
Overall, in order to ensure the best outcomes for his patients, he encourages referring physicians, patients, and families to get in touch with him so he can speak with them directly about the procedure.
For anyone who wants to learn more, he says, “I’m happy to help any patient or individual.”
Vincent Grbach, MD, Keck Medicine of USC
Sleep specialist Vincent Grbach, MD, at Keck Medicine of USC in Los Angeles, Calif, has referred both central and obstructive sleep apnea patients for neurostimulators, Respicardia Inc’s remedē System and Inspire, respectively.
First, Grbach will rule out all noninvasive treatment options. The vast majority of patients, he says, can do well with non-surgical treatments. He makes sure the patient is wearing a well-fitted mask and adjusts their air pressure levels. “The majority of people do well with PAP therapy, whether they have obstructive or central sleep apnea,” he says.
For OSA patients who do undergo Inspire surgery, they heal for a month, then, at their first checkup with Grbach, he turns the device on and applies different voltages to the hypoglossal nerve in the patients’ tongue.
[RELATED: Inspire Medical Launches Patient App for Its Upper Airway Stimulation Therapy]
“We get it to a level where we think their airway would be opened up,” he says. “And then we give them the remote control that would allow them to turn on and off the Inspire with all the instructions.”
The patient goes home to use it for a month before returning for their next appointment, at which time Grbach will ask a series of questions about how their sleep has been and download the data from their device.
Often, to find the optimal voltage for the patients, he advises them to undergo an in-lab sleep study. During the study, the voltage on the Inspire device is adjusted to pinpoint exactly which levels open up the airway.
For central sleep apnea patients, Grbach will recommend remedē, which simulates a breath by targeting the phrenic nerve and causing the diaphragm to contract.
“If someone has central apnea and they can’t tolerate the PAP machine, they don’t like it, or wearing the mask and feeling the air pressure, then that would be somebody who could be referred for the device,” he says.
[RELATED: Treatment Benefits of Remedē System Sustained Through 36 Months in Patients with Central Sleep Apnea]
For patients who do opt to get the remedē implant, after the surgery he will see them every few months to monitor their progress.
During these checkups, he will run a probe over the person’s skin, where the device is implanted, and then read all the data off of the device. The data shows how much the patient is using the device and how well it is working.
“When they come in, we ask them how their sleep has been,” he says.
Lisa Spear is associate editor of Sleep Review.
Illustration 3182193 © Tatjana Pilate – Dreamstime.com
from Sleep Review https://www.sleepreviewmag.com/sleep-treatments/therapy-devices/neurostimulators/choose-neurostimulators-osa-csa/
from Elly Mackay - Feed https://www.ellymackay.com/2020/08/17/why-i-choose-neurostimulators-for-some-of-my-sleep-apnea-patients/
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