Hey Tildes,

Recently I picked up WoW again and I've felt a rush and focus I haven't felt for a while. I can play the game for an entire day. I feel nothing but guilt doing so. The one thing that gives me joy feels like something I'm not allowed to do at this stage of my life; I'm 35.

I'm in grouptherapy until march next year but I feel I'm not making any sensible progress. Others around me seem to open and loosen up, finding tangible changes that help their lives. Meanwhile I just keep resenting myself, dread doing anything that might even cost effort.

I feel I'm a fraud, a selfless good-for-nothing profiteer who blames anything but me. It fuels my self-hatred and my wish to self-isolate and act in self-destructive behavior. I also notice a growing bitterness as I get older.

I’m really frustrated by recent experiences interfacing with the mental health system for myself and for my teenager. For them, it’s really atrocious. There may be effective options for the upper classes, but they aren’t accessible to me.

This is inspired by @X08’s recent [post] (https://tildes.net/~health.mental/1iia/unable_to_feel_progress_lack_of_happiness_and_not_finding_motivation_to_keep_investing) . Obviously I don’t know about their particulars, but I’ve certainly had the experience of being a part of a group where it appears others are progressing while I am not. Partly this is a problem of how we perceive, measure, and judge “success.” “Don’t compare my insides to others’ outsides,” as the saying goes. But it is possible to a more faithful and reflective comparison, and it does happen that others similar to me* make progress where I don’t, and it’s really frustrating. I’m often wondering, what’s wrong with me that I can’t change and grow?

I don’t have a great answer, although my exceptionally shitty childhood certainly plays a great role.

What I really want to comment on, though, is how insensitive our current mental health system is to the impact disparate causes have on creating similar symptoms, and how that should inform treatment approaches. A gifted psychiatrist (of which there are shockingly few) once put it like this (paraphrasing): Before we look at treatment for depression, we have to make sure the patient isn’t just surrounded by assholes.

But it’s a real problem. CBT is touted by a lot of “weighty” authorities as a valid gold standard treatment for a wide range of MH symptoms, and is claimed to be effective regardless of causes. And it’s my opinion that there is a lot of reasonably scientifically rigorous research backing that claim up. But, it’s not all rainbows, and it’s not working for lots of people. For one, a lot of folks claiming to do CBT are really not. Actual CBT involves a lot of homework, and a lot of recipients don’t have home support and don’t do the homework. This is extra true for children and adolescents living in dysfunctional homes. But more than just patient effort, the research marking CBT as so favorable is mostly based on subjects who are only mild to moderately distressed.* The end result is everyone involved in the “evidence based” healthcare chain is signing sufferers up for CBT when that might not be the best approach. There are lots of other criticisms too. If a practitioner is not well-trained and dedicated, the practice can be very invalidating. It seeks to make the sufferer’s more cognitive process more ‘rational,’ but when that person’s experiences are really, objectively bad, it’s very rational to conclude the world is hostile and unsafe. The tool itself is prepared for this, but it takes a really effective therapist to pull off. Also, it’s not enough by itself, grieving and other healing is also required for success.

The same thing happens in 12 step groups. AA/NA is resoundingly helpful-for a certain set of alcoholics/addicts. Those who don’t make it are often exhorted to become more honest, more open-minded, or more willing.*** My observation, though, is that most of the ones that make it come from intact families with resources. This is not universally true, it’s important for me to point out that there are enough examples of success among folks with no such background to say that there is something valuable in that approach that transcends socio-economics. There are also plenty from well-resourced families who don’t make it, but many of those families are highly dysfunctional. Of this last group, folks from dysfunctional families, some of us find success in other groups. This is because AA/NA are designed for sociopaths, ACA**** is designed for the product of sociopathic parents (who are filled with shame).

I don’t know what the solution is. A lot of malaise, addiction, “maladaptive” behaviors are, I think, born in a dysfunctional society, and so long as that society remains dysfunctional, no individual focused therapy solution will create a permanent fix. I think right here and now, too, we are at one of humanity’s “high tides” of self-destruction, a result primarily of runaway capitalism (is there any other kind?). We also just came through a really nasty global trauma, everyone is feeling it some kinda way.

Thanks for attending my TEDz talk.

*Of course, when talking about something as complex as a human life, there may no way to determine how similar is enough to make valid comparisons

**Also, let’s not talk about the various biases and implementation problems with what those studies refer to as ‘validated’ assessments used for measuring level of distress

***I am, technically, an NA success story

****Adult Children Anonymous, aka Adult Children of Alcoholics and Dysfunctional Families, more info at adultchildren.org.

My wife and I will be traveling to NY in early April. I already have our "nice" dinners planned at Osteria 57 in Greenwich Village and Peak NYC at Hudson Yards. If, for some reason, I should absolutely avoid these two places...please let me know.

We need to loosely plan dinner for the other two nights. These two nights shouldn't be as expensive as the two nights above :). Both of these nights we'd like to eat closer to Astoria, where we will be staying (roughly 28th and 38th). We'll be close to Richmond Hill one of these days, so would be open to eating down there as well before returning back to Astoria.

Could you suggest a great pizza place where we could sit down and have salad and pizza?

how about a traditional Indian restaurant? Not a fusion and not some place where someone tries to do something fancy. A place I can get Chicken Tikka Masala and my wife can find Chana Masala.

Some other place that isn't Indian or pizza, but is an absolute must in Astoria?

Thank you New Yorkers!

We are planning a trip to Norway in February (toward the end).

The plan is to arrive into Oslo and take the first flight to Tromso, and spend several days there enjoying the city and embarking on several activities including:

• Fjord River Boat Tour
• Dog Sledding
• Aurora Chasing
• (maybe) Cross Country Skiing
• Visiting the Ice Domes
• Visiting Museums
• Visiting a spa

On the way back we'd like to visit Bergen for a couple of days and have yet to plan this part at all.

Any locals or people who have already visited: Is there anything you think would be a shame to miss out on while we're there? Anything you think is a waste of time and / or money?

We are doing this trip on a budget. Ultimately, Norway is expensive so "on a budget" means, we're taking cheap flights and not staying in luxury accommodation for the most part.

One last thing: I am planning to propose on this trip. I would love any advice on somewhere romantic to actually pop the question. My current plan is to do it on the aurora chasing trip if we get lucky, but otherwise I need a couple of backup plans.

We're looking at doing a trip (2 adults, 3 young kids) from northern Italy to somewhere else in the region. We were thinking about Slovenia, Austria, or maybe Switzerland.

Any thoughts on where to go or what might be a good itinerary?

• budget is medium to high. Call it a few hundred dollars a day, not including lodging.
• we'll go in Juneish for about a weekish.
• the kids are too small to walk by themselves for long. We'll have strollers/backpacks/etc.
• we'd like to try some restaurants; we like fine dining but it's tricky with kids unless we engage a babysitting service at a hotel. I like museums, my wife is meh; some short hikes would be fun, but nothing too crazy. Getting some city stuff in would be nice. We also like looking at architecture, old castles, stuff like that.
• we enjoy doing some scenic driving, but no marathon trips with the kids in the back.

Hey all, hope you're doing well today. I'm visiting NYC for the first time with my wife in January (she's been a couple of times already), and I would greatly appreciate any advice or recommendations you could offer! Of course I have to do the obligatory Broadway show and pizza, and I have this nifty little guidebook, and wow as I write this I am such a tourist.

Thanks!

I am taking a trip soon to London and will possibly be adding a couple days in Paris. It's been a hot minute (few years) since visiting the UK and would like to solicit some timely advice and tips. One thing that comes to mind: How important is it to carry cash? Would I need to pay London and Paris street vendors or any shops with cash or will a card with no exchange fees suffice? While we will of course be visiting some tourist attractions like museums, most of our time will be taken up with book stores, record shops, food and coffee shops.

My university friends and I (and everyone's significant others, so about ~15 people) are planning a big catch-up trip, which will also be the first time to the country where I live for all of them. Planning has been a little higher friction than I expected, because we want to coordinate travel times to specific cities ("let's spend 4 days in City A, then all go to City B" etc), but people also have specific activities only they want to do (scuba, theme parks, etc) within each city. However, there's way too much to choose from and there's no way we'll do everything that everyone wants to do.

So right now to gauge interest in specific cities and attractions within them, we are just using a private Facebook group where people just make an idea as a post and people vote by liking it, and people can discuss the place in the comments. Things that we have fully decided are just placed on a spreadsheet. This process works but it doesn't feel great.

I've also explored Wanderlog, and I really like the fact that you can easily search for stuff and then place it on a map, but unfortunately its UI doesn't really support "branching" trips where some people will do different things on a given day.

What tools/processes have you had success with when trying to coordinate a big group trip?

Hello everyone,

Fitness is an important part of living a healthy life, but everyone's body is different. I believe it'd be a good idea to create a fitness or health group for us to share our progress, discuss our goals, and review each other's exercise and nutritional planning. What do you all think?

~ Rain