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Short Book Reviews April 2019

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I. Method of Levels

Timothy Carey’s Method Of Levels teaches a form of psychotherapy based on perceptual control theory.

The Crackpot List is specific to physics. But if someone were to create one for psychiatry, Method of Levels would score a perfect 100%. It somehow manages to do okay on the physics one despite not discussing any physics.

The Method of Levels is the correct solution to every psychological problem, from mild depression to psychosis. Therapists may be tempted to use something other than the Method of Levels, but they must overcome this temptation and just use the Method of Levels on everybody. Every other therapy is about dismissing patients as “just crazy”, but the Method of Levels tries to truly understand the patient. Every other therapy is about the therapist trying to change the patient, but the Method of Levels is about the patient trying to change themselves. The author occasionally just lapses into straight-up daydreams about elderly psychologists sitting on the porch, beating themselves up that they were once so stupid as to believe in psychology other than the Method of Levels.

This book isn’t just bad, it’s dangerous. One vignette discusses a patient whose symptoms clearly indicate the start of a manic episode. The author recommends that instead of stigmatizing this person with a diagnosis of bipolar or pumping them full of toxic drugs, you should use the Method of Levels on them. This is a good way to end up with a dead patient.

I like perceptual control theory. I share the author’s hope that it could one day be a theory of everything for the brain. But even if it is, you can’t use theories of everything to do clinical medicine. Darwin discovered a theory of everything for biology, but you can’t reason from evolutionary first principles to how to treat a bacterial infection. You should treat the bacterial infection with antibiotics. This will be in accordance with evolutionary principles, and there will even be some cool evolutionary tie-ins (fungi evolved penicillin as a defense against bacteria). But you didn’t discover penicillin by reasoning from evolutionary first principles. If you tried reasoning from evolutionary first principles, you might end up trying to make the bacteria mutate into a less dangerous strain during the middle of an osteomyelitis case or something. Just use actually existing clinical medicine and figure out the evolutionary justification for it later.

Or maybe a better metaphor is germ theory, a theory of everything specifically targeted to treatable diseases. But fifty years elapsed between Pasteur and penicillin, penicillin alone didn’t treat every germ, we still have some germs we can’t treat, and lots of things like cancer turned out not to be germs at all. You can’t jump straight from a theory of everything – even a good, correct theory of everything – to “now we have solved all problems and here’s the one technique for everything.”

On the other hand, most existing psychotherapy is placebo-ish, and first principles can sometimes be a useful guide. So as long as we are careful to dismiss the part where we throw out all existing medicine, and dismiss the part where we use this for patients having a manic episode, we can very tentatively look at the Method of Levels and what it suggests for patients having garden-variety psychological conflict.

Perceptual control theory says that minds primarily control perceptions. This is true on very low levels, like the hypothalamus controlling (its sensors’ perception of) temperature to 98.6 F. Theoretically it may be true on very high levels, like trying to control (perceived) social status or risk. If two control systems are accidentally trying to control the same variable at different levels, then both of them expend all their energy fighting each other and can’t control anything else. For example, if your house has one thermostat (with associated AC and heater) trying to keep the temperature at 65, and another thermostat (with its own associated AC and heater) trying to keep the temperature at 75, then one thermostat will keep the heat on all the time, the other will keep the AC on all the time, and the temperature will end up at 70 with a gigantic electrical bill.

In the same way, MoL understands intrapsychic conflict as competing control systems. Suppose a gay man is living in a conservative household that stigmatizes homosexuality. He’s trying to control the amount of sex/romance he has at some level that keeps his libido happy. He’s also trying to control his community standing at some level that keeps his sociometer happy. These are conflicting goals; the more he pursues a relationship, the less the community will like him, and vice versa. He will probably feel conflicted inside and not know what to do.

PCT believes the brain has a natural reorganizing process that keeps control systems running smoothly. Powers’ description of this sounds a lot like how we think of learning in neural nets; the brain randomly changes neural weights in a specific control system, with changes that lower the control system’s error getting reinforced, until the system is running smoothly again. If there’s intrapsychic conflict, this reorganization process must not be working.

MoL says the goal of therapy is to activate this reorganization process. The most likely reason it’s failing is that the patient is trying to reorganize the specific control systems that are in conflict, whereas what really needs to be reorganized is the higher-level control system that controls both of them. For example, our hypothetical gay patient shouldn’t be trying to reorganize his sex drive or his need for community belonging. He should be trying to reorganize some higher-level system that determines both of them, maybe his desire for a high quality of life. The “quality of life” control system determines the set point values for both the “sex drive” and the “need for community belonging” control systems, so if it could give them some value where they don’t conflict, the patient’s problem would be solved.

Reorganization is guided by awareness, so the therapist needs to move the patient’s awareness from the control systems that are experiencing the conflict, up to the higher-level control system that’s secretly producing the conflict. Its suggestion is to talk about the conflict with the patient, and especially about the patient’s experience talking about the conflict. So if the patient starts telling you about how he doesn’t know how to balance his homosexuality and his desire to fit in, you can prompt him to continue with questions like:

“What comes to mind when you think about not fitting in with your community?”
“What is your experience of wishing you could be more open about your sexuality like?”
“How does talking about this make you feel?”

Eventually the patient may have what the book calls an “up-a-level-event”, where instead of talking they look like they’re kind of lost in thought, or they close their eyes for a moment, or laugh nervously for no reason. At this point they’re becoming dimly aware of the higher level that’s guiding their lower-level conversations. The therapist should pounce on this and ask questions like:

“I see you closed your eyes for a moment just then. Is there something in particular you were thinking about?”
“You looked lost in thought for a second – why was that?”
“Can you tell me more about what made you laugh just then?”

The patient might then say something like “I was just thinking about how weird it was that I care so much about what my parents think about me when I don’t even respect them”, and then the therapist should keep going on this new topic. Now the patient’s awareness is on this higher level, and so the high-level control system can reorganize itself. Maybe eventually the reorganization that works is to give the pursue-your-sexuality system a higher set point, and the care-about-community system a lower set point, which looks like the patient deciding that he should not worry so much about what community members think about him.

You might have noticed from the first set of questions that this sounds a lot like what therapists do already. Carey does suggest that insofar as current therapies work, it’s because they’re already doing MoL-ish things. He suggests that his book offers more of an account of why they work, and a way to focus on the useful things instead of the chaff.

In particular, a lot of MoL – asking patients how they feel, trying to bring their awareness from the past content to the present process, worrying a lot about small gestures – sounds like psychodynamic therapy, at least the watered-down version of it most people today use. But it’s a lot more comprehensible than most attempts to teach psychodynamics, which never seem to hang together or have concrete suggestions for what you should do at any given time. If all this book ends up giving me is a way to do psychodynamics a little bit more cohesively, I’ll consider it worth my time.

I’m not sure how well its theoretical backing holds up. I always considered the very high-level PCT stuff to be the weakest part of the theory, and this not only relies upon them but goes several steps beyond them. The idea of the reorganizing process is an interesting one. But right now it’s got about as much empirical testing as, well, Freud. Still, some of the ideas discussed here seem lucid in a way Freud didn’t, so I’ll have to think about them more.

I wouldn’t recommend this book to anyone else right now based on the first few chapters being so embarrassing, and also so bad that I wouldn’t trust people to discount them enough even if I warned them how important it was.

II. How To Read Lacan

Why did I read How To Read Lacan by Slavoj Zizek?

I could answer this question on many levels. For example, the theological level: maybe I committed some sin in a past life. Maybe I was predestined to unhappiness. Maybe, having given me free will, God is no longer able to save me from my own bad choices.

On a more practical level: I’m trying to learn more about leftism, I’m trying to learn more about continental philosophy, and I’m trying to learn more about psychoanalysis. I figured I might as well get it all out of the way at once.

I was expecting this to be incomprehensible, but I was pleasantly surprised how good a writer Zizek was. He explains everything clearly, in down-to-earth prose interspersed with mildly funny Slovenian jokes that illustrate his points.

(Lacan himself is completely incomprehensible, to the point where he might as well be speaking Martian, but this book wisely avoided quoting Lacan except where absolutely necessary).

Despite being very readable, this book never really came together. Each chapter consisted of a Lacan quote, followed by Zizek’s interpretations and thoughts. The thoughts were always things like “Sometimes the act of communication itself can communicate something” or “We are never truly engaged with another person, even during sex”. These are always kind of reasonable, Zizek always does a good job proving them and relating them to mildly funny Slovenian jokes, and I came away agreeing with all of them. But I don’t feel like I understand how any of them cohere together into an object called “Lacanianism”, and none of them really seemed like a very surprising revelation, which is one reason this doesn’t get a full book review.

My main takeaway from this is that I should forget Lacan and try to read Zizek directly. Does anyone have recommendations for good starting points?

III. The Steerswoman

The Steerswoman is popular in the rationalist community, and now I see why. The titular organization of steerswomen are a rationalist sect devoted to understanding the world around them. They especially like geography – going to the borders of the known world and filling in the edges of the map – but also just seek knowledge in general. Anyone can ask a steerswoman any question, and the steerswoman must answer. But everyone has to answer any question asked of them by a steerswoman, or else the organization blacklists them and no steerswoman will answer their questions ever again.

The steerswomen live in a not-very-fleshed-out medieval fantasy world surrounding an inland sea. Although there are standard fantasy governments like dukes and chieftains, real power is held by wizards. No one knows anything about them, not even how many of them there are, where they come from, or how they do their magic. The book centers around the inevitably conflict between the nosy steerswomen and the mysterious wizards, and particularly around one steerswoman and her Barbarian™ traveling companion who stumble across a wizardly secret.

This book is from the 80s and had a very 80s feel to it. Compared to more modern fantasy, it’s shorter and feels more bare-boned. There are no two hundred different characters to keep track of, no romantic subplots, no lavish description of random political things that happen in minor towns. Just a woman and her Barbarian™ friend going on a basic standard-issue quest, with the whole thing starting and finishing in less time than it would take George RR Martin to describe the minor clan that controls an out-of-the-way fortress.

Some people called this book feminist, but I found it refreshingly apolitical. Most (though not all) of the steerswomen are women, but the book got a relatively boring explanation out of the way quickly and didn’t come back to it. Most of the characters’ genders were not too important to their personality, and the book did not obsess over gender issues. There is a part in a utopian society where one of the men teases one of the women about how much he wants to have sex with her, and the woman laughs it off, and the man keeps teasing, and this is clearly meant to signal how the society is utopian and everyone is very open and friendly with each other. The 80s were simpler times.

I’ve only read the first book of this long series. Overall I found it fun, but didn’t feel like it spoke deeply to anything within me. The book’s rationalists were discussed shallowly enough that it feels like decent cheerleading for rationality, but nothing you can’t find somewhere else. Although the steerswomen’s question-answering gimmick was cute, I spent more time worrying about the holes in it (can’t you just get someone else to ask steerswomen your questions? how can a worldwide organization in a medieval society keep an effective blacklist? really the world-building here was not that good) than feeling like the real world needed something similar (after all, we have Google). I’ll probably try to read the next few books in the series and update this if it gets better.


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