Update: https://tildes.net/~health.mental/1hnb/struggling_with_nihilism_and_the_inability_to_enjoy_things#comment-e8s1

Preface #1: I know the first response with something like this will be "go see a therapist" - I have been in therapy for over a decade now. There are a lot of things it has helped with (specifically trauma-focused), but nihilism is not something I've been able to get help with. The help has ranged from things like "focus on the micro over the macro" (which I think is probably the best advice, but also can be boiled down to "don't think" and I can't not think), to "find religion" (for me at least: religion doesn't breed hope, hope breeds religion), to "I don't know how to help, I can't relate to that" (...not all therapist are good).

Preface #2: I know the quick response to "life is meaningless" is "so make your own!" but I absolutely despise that logic. If everything is meaningless, than that means making your own meaning is meaningless. It's self-defeating in and of itself. That said, I don't really care about "meaning" anyway. I personally view things as "irrelevant", as if you dig deep enough you get to a point where everything is relevant to nothing. And the conclusion to draw from that is: "it's irrelevant that everything is irrelevant" - similar meaning, but checks out logically significantly better to me. But this has it's own problems that I will go in below.

Preface #3: I know the quick response to the inability to enjoy things is "you don't enjoy things because you are depressed." What I'm positing is the inverse, "I no longer enjoy things, and it's causing me to be depressed." I'm very much not saying the former doesn't happen and I've gone through time periods like that. What I am saying is that the latter is also true, and I'm sure that other people who have dealt with depression for decades understands both "My depression is causing this to happen" and "This is causing my depression to flare" happen.

To give quick context for myself: I had become a nihilistic atheist by the time I graduated elementary school; I had a rather traumatic childhood and my official diagnosis is (C-)PTSD and all the offshoots that come from it like depression and anxiety (Bringing up as I recognize myself these are thoughts that, according to the DSM/ICD, would be from someone with mental disorders). This led to things like dropping out of high school and becoming a mute hikikomori. To make a long story short, in my late teens I got to a point of either suicide or completely revamping my life with the belief that enjoyment could be found via actually being social (friends and dating) and proper self-sufficiency/money. I chose the latter for one simple reason: there was nothing to lose, so just trust the process. It took over a decade of constant self improvement, but I became a sociable person part of different clubs and hosting my own parties/gatherings with a very active dating life. I also got my degree in comp sci and have done quite well for myself with that. And a lot on top of that just in terms of trying to make the most out of life.

Unfortunately, none of that actually helped. Having to mask to be able to be social/date is exhausting and frankly people suck, and wasting life working 9-5 one of the most depressing things to me. The reason I bring this up is because I did really fucking try, I tried the stuff that everyone says brings happiness - but it don't. And it's all just so irrelevant.

Over the last half decade or so, I just can't bring myself to care about anything. And I mean anything, even super simple things. I'll talk to people or listening to a song and think "why do I care what you have to say?". I'll watch a movie or read a book and can't keep focus because seriously who cares about these imaginary things some person thought up? People I know die and I'll just think "yeah that happens." And the absolute worst for me was when it came for knowledge. Because knowledge was the thing I always cared above all else. But what does "knowing things" matter if "things" don't matter to me?

Which brings me back to preface #2. Everything is irrelevant, but it's irrelevant that it's irrelevant. Except that society demands relevancy to justify ones own existence within it. It's not possible to live an irrelevant life and be part of society. I personally really only see two options: reject society or embrace absurdism.

Speaking strictly personally, I do not see rejecting society as a means of living an enjoyable life. Mostly because I know it will lead to me living out of my car again, spending my time embracing hedonism via drugs and alcohol to fuel escapism until the end comes. And if in the end I'm just going to fuel escapism, why not just escape to begin with?

Absurdism is mostly what I fed into while "turning my life around". But I do have issues with it. One is how much it feels like the "this is fine" fire meme; it recognizes the problem but then rejects that it's a problem. This is fine if "life" itself is not a problem and you are able to enjoy your time regardless (after all, the problem itself is irrelevant so yeah just reject it as a problem), but then that gets to my second and main issue: if you don't enjoy life, what defense against suicide does absurdism have? Yes there is the whole thing of "suicide just adds to the absurdity by claiming meaning is needed" but that's only if you are committing suicide because life has no meaning. I don't care that life is irrelevant, I care that life fucking sucks. Suicide then is not rejecting the lack of meaning, it's rejecting time spent unenjoyably.

I've been able to get through things being both meaningless and unenjoyable with the belief that things would become enjoyable. Now I'm nearly 40 years old, things have played out, and I do not buy into it anymore. Either life needs to be enjoyable, or there needs to be some relevancy to it. Which, I reject the later as even being knowable as a human. Which leaves the former.

Which then comes to the silly question, how do you just enjoy things?

I am able to recognize one of my issues with enjoying things: In order to raise my emotional floor, I have embraced being stoic. Things happen that are out of our control. Things are lost, hardships are had, people die. They are simply facts of life. The problem is that it also prevents enjoying things - enjoyable things are also out of your control, so do not embrace them for they will be gone. Which, moments in time then neither "good" or "bad", they simple are just moments in time. Every moment is simply some indefinite, irrelevant moment in time.

Which, kind of tied to that as well, but another issue I recognize: as I have understood my own trauma and how it's affected me, I've really understood just how much is deterministic in life. Which is especially sad in the case of trauma responses, and how much society basically double downs on the trauma (just easy eg of how "hysterical women" have been treated throughout history, but look at the overlap of BPD and traumatic childhoods).

But now these are not just moments in time, but determined yet irrelevant moments in time.

But that still doesn't preclude enjoying things. And I guess that's mostly what I'm for the search for in life, to figure out what things I actually enjoy/how to actually enjoy things I want to enjoy. Because enjoying life is certainly enough, but that requires life to be enjoyable.

And it's actually part of why I'm even posting this. With all the different ways I've changed my life and such, I've tried to look back at what was actually enjoyable. And long-form text communication is definitely the way I prefer to communicate (oh do I miss when 'social media' was forums). I also recognize the importance of being part of more smaller, tighter-knit communities compared to being a blob in a mass. So it's part looking for help, and part just trying to get back into posting on smaller communities.

But I also feel like I'm all over the place and I do apologize for that. I think to try to summarize to bring the points clearer...like I said before, life either needs to be enjoyable or there needs to be some kind of relevancy to it. So either how do you find relevancy/where am I wrong on that, or how do you find enjoyment (and I don't mean "try new hobbies until you find what you enjoy!" kind of stuff - I've already ran that gauntlet. I'm not asking where to find enjoyment, I'm asking how to feel enjoyment; how are you able to care about things might be a better war to phrase it)?

I work in IT, and was the caregiver for both my parents as they aged. You'd think I would be the one that people turn to to ask this question, and yet I have been utterly frustrated by my attempts to find such.

I have a few folks who are extended family and friends that are now in the early/mid stages of different forms of dementia, and a real pain point is that they no longer have the capacity to recognize ads, and will unfailingly click and install scam apps via the Apple store. Think things like 'cleaner' apps that have a $50/week subscription fee, and other abusive tactics. The #1 subject I get called about is some ad popping up after they've finished a puzzle, and now they think they're out of space, and in a panic.

This is not a small problem. The coloring and puzzles they can still do bring them happiness and stability through their day; removal of the ipads entirely causes them a lot of stress. (TV is nothing but ragebait, and a non-starter. They do have books on tape, but get tired of listening rather quickly.)

I have been completely unable to locate ad-free, paid versions of these types of apps. I'm not looking for free. I don't care about the cost. I just need apps that only do what they say they do, and don't have unexpected pop-ups, ads, or anything else, and I thought perhaps the folks here might know of some.

Any ideas?

[edit] Only five hours in, and I've already gotten more insightful, helpful responses than anywhere else I've asked. You all are the best.

I'm a pretty introspective person. I grew up with an emotionally abusive parent, struggled with my mental health from teenagerhood, and been to more therapy than I can remember since the time of my parents' divorce when I was eight. My siblings and I have done a lot of deconstructing over the years to figure out what the heck happened to us (the abuse was pretty insidious and, of course, we normalized it) and how it affected us internally. I'm also most likely autistic and have always struggled to socialize correctly, which led to a LOT of observation and imitation that was both conscious and unconscious.

Despite all this practice at introspection though, in the past few years, I've come to realize I am wildly out of touch with my own emotions. I am tempted to blame much of this on the fact that I was always collecting social "scripts" to follow, so that I could react appropriately to jokes, or good/bad news, or whatever. If you're acting, you don't actually need to know how you feel. And if you feel something different from standard, it's irrelevant because it's "wrong" to feel that way, so you ignore it. So it took me a long time to realize that my display for other people was actually pretty disconnected from whether I was actually feeling anything. I don't feel it was dishonest, though, because I still would have wanted to show sympathy, excitement, etc. for the people I care about. It just takes me so long to process things that I wouldn't have been able to do it within the same conversation if I didn't have a ready script.

I know that some autistic people experience alexithymia/emotional blindness, but it doesn't look terribly well understood. I know I should probably get back on the therapy horse, for a number of reasons including this one, but I'm pretty leery. I never felt like it helped me much. (Although most of it, at the time, was to help me with "depression". Which I certainly had, but there was no understanding from either my end or theirs that the cause was likely rooted in ADHD/autism.) And I did try to start up again last year; I found a psychologist who specialized in ADHD and autism, and although she seemed understanding at first, I felt like I couldn't establish any clear communication and we just kept talking past each other. At this time, I super don't have the energy to keep trying new therapists, and waste weeks or months on each one before I figure out we won't click.

So I ask: have any of you folks ever dealt with emotional blindness? If so, how have you learned to identify your emotions? Do you keep a feelings journal, and how do you even know what to put in at first? Any advice is welcome!

Every time I find myself in an ADHD related thread on the internets, I feel like I'm seeing my personal struggles being described by others (Anxiety, Depression, executive function issues... the list goes on).

My intermittent attempts to seek out a diagnosis (or rule it out) end quickly with all the utter shite noise in the search results (literally everyone is selling something).

I'm hoping some of you who've been down this road can shed some light. Should I just schedule and appointment with my GP and start a conversation or???

Thanks (hope I got this in the right sub-tilde)

UPDATE: Thank you all so much! I ended up setting an appointment with a nearby adhd clinic that does 2 brain scans, a bunch of bloodwork, several questionnaires, and a couple meetings with a psychiatrist/psychologist (can never remember which is which). 1st scan is on Monday morning, 1st meeting with psych* is in early December. Feeling optimistic.

Reading through all your comments, I feel connected and optimistic in a way I've never felt before when pondering what I can see to be atypical behavior/emotions/response to stimuli but felt powerless to address.

Thanks so much for helping a stranger on the internet, hoping to pay it forward someday.

So I've watched this If Neurodivergents Conducted Job Interviews Like Neurotypicals and one thing struck me as odd. Is it not like normal when somebody tells you they've been sick recently for you to share your own experience with similar condition?

I do have ADHD and automatically share when this exact situation comes up, but is this like a no-no among neurotypical folks?

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 hate TODO lists. Even when they're for a single day.

I inevitably put more in my TODO list than I can accomplish in a day. When the new day begins, and I see the tasks I did not accomplish before, I feel anxious, sad, and even ashamed. Then I find some of that anxiety is for how my partner will judge me for the unfinished tasks on my list that she tells herself she expected me to accomplish.

While I have worked on self-compassion for years, occasionally it is not there. I have worked on having boundaries between my partner's own issues and my mental health.

I wonder how others with ADHD, particular those with partners, cope.

EDIT: I started using an allegedly ADHD-friendly planner yesterday. These feelings came pouring out of me this morning, hence the post. Yet I've had these similar difficulties for years.

Here’s a topic that I would like to hear some opinions (advice) on. I work in a pretty demanding software role. The positives: I am well compensated and I like the work I do. It also helps that I work on a genuinely useful product whose sole purpose is not only to extract profits from the consumer base. I also do not work overtime.

Therefore I am covered on all bases: moral, financial and personal interest. However, for the past year or so my responsibilities have grown, and I have to juggle more and more (both in number of tasks, their complexity & deadlines) during the same period of time (remember, no overtime).

So now I find myself periodically stressed for longer & longer periods of time. I don’t have energy and motivation for my hobbies, and I dread having to engage in anything more intensive than the occasional walk. But I can tell that this state of being is not sustainable for the long term.

To whoever can relate: what are your thoughts?

Edit: some good things that I have going for myself, that help a little; I have a good sleep schedule, I rarely drink, I don’t stay connected to work outside working hours and I have a very supportive partner.

Given the current state of things, I have been trying to avoid internet sites that could trigger anxiety. This is harder to do that I thought it would be. So I'm reaching out to the fine and resourceful Tildes collective for links to sites that are less known, and may provide, if not joy, at least interest, uniqueness maybe, fun, or education? Stuff that may be comforting, engrossing, or diverting to give some respite to those of us who are feeling pretty crushed.

Here are two sites I can offer, but I don't want to limit anyone's idea of what might be a good suggestion.

Futility Closet "is a collection of entertaining curiosities in history, literature, language, art, philosophy, and mathematics, designed to help you waste time as enjoyably as possible." (description from their about page)

Strange Company bills itself as "a Walk of the Weird Side of History"

(edited to add links)

On another platform a female journalist warned other women not to use menstrual tracking apps.

I worked in a co-op during college that sold very nice paper journals for tracking menstrual cycles. I replied to that thread mentioning that very nice specialized paper journals still exist.

Someone ( a man ) replied back to tell me that ADHD women have enough to deal with these days and proceeded to list all the ways something like that could fail.

I suggested sending emails to one's self along the lines of "update your diary" which someone could then read at home and take care of things.

Since I don't have ADHD my question is if people who do have ADHD really do find it to be that incapacitating?

I know it is an Internet thing to keep replying without a reason, even if it is only out of momentum. I'm wondering if that was the deal in that thread.

I posted my own thoughts here, TLDR: I am afraid and catastrophizing and thinking very black and white and spiraling quite a bit and I'm not even American.

This is not meant to be another ~news thread.

Please keep discussion in this thread to mental health only.

How are you doing?

What will the impact of this be on your life?

*TRIGGER WARNING: Racist and Anti-LGBTQ topics contained below with hurtful language *

Hello all,

TL;DR: I am wondering if there's any generally recommended resources, books, or general advice (peer-reviewed research would be ideal) on dealing with racist, close-minded family after you have made the transition to more progressive worldviews? I don't really like my family these days because of their Trump support as well as their generally close-minded, reality-denying views. It's weighing on me, because I miss having some sort of good connection with them like I used to. Their health is starting to decline, but I've gotten to the point that I don't really like them that much, and I haven't been going to see them. These two parts of me are kind of at odds with each other, and I'm struggling to find a balance.

Background & Context: I (33M) and I grew up in a rather conservative family (2 older brothers), to the point that a "light" level of racism was generally accepted and talked about in the family, and as an example, jokes using the N-word with the hard R were told by my dad and grandparents semi-regularly. I say "light" racism because we don't have a family history of racial violence or owning slaves (we're descendants of 1900's European immigrants, mostly.) I also think my family generally supported the Civil Rights Act back in the day. As a result, I grew up finding racist and gay jokes funny and frequently repeated them, and generally had a close-minded approach to the world before I went to college - but I never truly wished anyone any ill will. I got along well with my family, and while we were never super close, I at least talked to my family about stuff but we never really shared emotions or talked about depression with each other. None of us ever really learned how to deal with their emotions and talk about them. My family never traveled, either, so I never got out of my home state till I was in high school, and it was of my own volition. My parents are also conservative Christians, so they have generally anti-LGBTQ views. My mom calls LGBTQ people "abominations" per the bible, for example. It's disgusting.

Once I got out into the real world working with people of other cultures and befriending them, my worldviews began to change. Especially once I went to college and started working in scientific research, wherein your critical thinking and objectivity are especially stressed, I started to pivot more and more to progressive views. Beyond that, the more I saw that data generally supported progressive views and policies, I started to disagree harder and harder with my parents on political topics. Additionally, I slowly lost my faith, and started to become more and more annoyed by my mother citing the bible as a reference for topics such as LGBTQ marriage rights. I now commonly refer to myself a recovering Catholic.

And then Trump happened. Honestly, in his first run, I could understand why people voted for Trump. They were tired of traditional politics and feeling like it wasn't working for them, especially in midwest and blue collar areas, so they figured "fuck it, throw some chaos into the system." But after COVID and January 6th? I just can't fathom still having a SHRED of support for that disgusting shell of a man. And yet my parents do. My mom watches Newsmax, thinks COVID vaccines are deadly, and thinks the 2020 election was stolen. She thinks Biden was kidnapped and was being impersonated by the Deep State. I can't. I just can't with her. It's all she wants to talk about, and my dad won't say anything to her about how fucking crazy the shit she spouts is.

I was also close to one of my brothers for many years, as we went to concerts and played games together mostly. We just "click" when it comes to gaming together, and it feels seamless and fun to play with him in a way that it doesn't with anyone else I've ever played with. But then, politics comes up. My brother would probably be aptly described as an incel, in that he reads 4chan still, and also has some batshit crazy views. One, for example, is that he doesn't think the races should mix, because something along the lines of black and white genes don't work as well together. He has straight up said that to me, and I regularly wonder if I should cut off contact with him for that alone. He often blames women in sexual assault cases or characterizes them as gold diggers. A part of me wonders if I am doing a disservice to the aforementioned groups by even still associating with him after saying things like that. If I am also doing a disservice to myself by even sometimes associating with someone who has such an awful worldview?

And herein lies my dilemma: I haven't gone to see my family in over 6 months, now (I live <30 mins away). My parents' health is declining - it is likely that one of them is going to die in the next 5-10 years, and yet I don't even want to go be around them, especially my mom. I still game online with my brother, but this dilemma is slowly eating away at me.

But also? I feel a deep empathy and sorrow for them, to the point that I'm choked up as I'm writing this post because they are lonely people who, in my opinion, have been grossly manipulated and mislead throughout their lives. I wouldn't want someone to give up on me, as I feel I am doing to them by avoiding them. I also used to be deeply entrenched in close-mindedness, and I wouldn't be where I'm at without people who kept trying to convince me of a better path. But the other part of me thinks: Is there a line somewhere? At some point, do you become too deeply entrenched that I can't convince you out of it? What do I do at that point? How do I even define that point?

Are there any resources or books on this topic? Are there any objective things I can do to try and improve this situation and feel better about it? I have spoken with a therapist about this in the past, but I wouldn't describe the feedback I got as very helpful. I would like to go see a therapist again, partially about this, but it's so damn expensive thanks to the American healthcare system. Any input anyone has is appreciated, even if it's anecdotal. This post is also partially just cathartic to write out as it is also to ask for feedback. Thank you.

I just got the official notice from my boss that I've been let go due to performance reasons. This wasn't a surprise to either of us at this point, as I'd been struggling to improve without sufficient improvement for a while up to this point. Can't really even blame my boss, as she really did try to gently help me get back on track over the last year. I think the likely culprit has been burnout all along -- I've been feeling like a fly stuck to fly paper for months at this point. Before getting fired I got some burnout leave started with my GP (it's not super hard to get medical leave for burnout here in Germany) but I initiated the process too late for it to make a difference for this job.

Luckily between my severance pay and eventually unemployment benefits, I'm not in any financial risk due to this change (advantages of moving to a country with a real social safety net). I can even get some free job training courses paid for by the state while I'm on unemployment. But between now and when that sort of thing starts, I'm wondering whether I should do something specific to help myself rest and recover from burnout. I'm planning on going back to therapy and talking to a professional about this, of course, but I'm curious whether anyone else here on Tildes has advice for how to recover from burnout other than just "take time off", since I've got that bit covered.

My only living parent has between one and five days left to live. The parent is unable to speak now and has had dementia for the last 5 years and will not recognize who I am if I go visit now in these final hours.

They live a few thousand miles away from me; it would be expensive to go and money is painfully tight right now with my partner unexpectedly unemployed and struggling to get a job comparable to the job just lost.

I’m somewhat estranged from this parent. The short version is this parent is a narcissist and really didn’t show up when I was growing up, or at any point in my adult life, or really at any point when it mattered. Despite this person being a really crappy parent, they exerted a massive gravitational pull in my life through many decades—basically, this parent loomed very large for far too long given the extreme narcissism, albeit much less so in the last decade or two. (Dementia and my coming to terms with it all and caring less and time and my having my own kids and my starting my own family all being some sort of salve.)

I have one very close friend who is telling me that it is critical to go before this parent dies because being present while they are still living will give me a kind of closure and unexpected resolutions that I cannot even anticipate now. This friend is quite adamant that going is critical for personal growth.

A different close friend says that going while the person is still alive is a complete waste and that I should go for the funeral instead where I can see other relatives and connect with my sibling and other relatives and deepen those relationships which (the friend says) will be a momentous transition point for us all, creating a better sense of family than any of us could have ever had while this person was alive. This friend insists that the healing and closure is identical pre-death and post-death, but that the extra emotional burden of seeing someone dying will derail me and never be able to be “unseen.” This person thinks spending money on two trips is foolish, so the one trip to go on is for the memorial. FWIW, My sibling is only going for the memorial.

Even if money were no object, I’m not sure I could emotionally handle going twice. I suppose I can, but that’s very time intensive and I have young kids myself who need me and for whom it would be a strain if I were gone for too long. I’ve already said it, but I have to say it again: money is really tight Going twice feels possible, but extremely difficult

I guess what I’m really trying to understand, if my feelings for this parent are presently ambivalence that grew over a decade or two from what was formerly extreme anger and hurt, is there something meaningful about going while the parent is still alive? Is there something important that happens before the person dies that is in someway healing or transformative or valuable? Is it more important to instead go when my sibling is going? Should I max the credit card and go twice? Should I risk infuriating and deeply damaging my relationships with my extended family and not go at all to save money? (This last option seems wrong, but it is a possibility, so I feel like it at least deserves considering.)

Friends of Tildes, what did you gain or lose from seeing a relative in hospice? What thoughts and wisdom do you have to share around moments like these?

Thank you in advance for sharing your stories. I’m sure your collective wisdom will help me make a better choice.

“Dopamine” has entered cultural conversations as roughly equivalent to “the feel-good brain chemical.” People talk about “dopamine hits” and “dopamine fasts” and “low dopamine.” In a recent conversation a family member talked about starting the day on his phone and scrolling feeds “because I’ve gotta get my dopamine up before work.”

There’s a seemingly widespread understanding that dopamine makes us feel good and that it can be used against us to make us do things we don’t necessarily like (like endlessly scroll feeds).

Is any of this accurate to how dopamine actually works in our brains? It feels like an oversimplification to me, but I don’t actually know.

It also seems odd to me that there’s so much focus on dopamine but not, say, oxytocin or serotonin (unless you’re a Billie Eilish or Girl in Red fan, respectively).

Is our lay understanding of “dopamine” efficient shorthand or pseudoscientific sleight of hand?

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.

Two weeks ago I decided to cut alcohol out of my life. I have a weird issue though where I don't feel I necessarily relate to other problem drinkers in support spaces online, and I assume would not in-person, because I feel like my habit was never particularly bad. I've never been addicted to the degree where I have to have a drink to function, I never used it as a crutch in social situations, or anything like that. I don't mean this to put anybody down, but I've grown up around alcoholics, and even count myself among that number, but feel I somehow never fell into the worst, and have a hard time walking away from where I was because of it.

To break down my cycles of drinking:

I started with a beer a day. I liked beer, then moved on to drink/include whiskeys and other hard liquors. I'd have 1-3 drinks a night most nights from when I was of legal drinking age and could afford my own alcohol, and have a pace usually of one an hour. I enjoyed the tastes, experimenting with different varieties, and just exploring what was out there from whiskeys, cordials, weird beers, meads, anything.

Then there came a point where I started drinking heavily infrequently but regularly about seven years ago, where half a handle was gone in a week and a half and I had no idea where it went. I didn't black out at all, but would later realize I was drinking it really fast. This continued, I would stop buying hard liquor, and then buy some, and drink it quicker than I should have, rinse repeat.

The thing where I feel conflicted is I feel like I was in control, in a sense. I really enjoyed the alcohol I was drinking and would sip on it over a few hours having glass after glass. For these heavier nights I would wake up with a mild hangover, but it wasn't an every day thing. I would occasionally mess up and drink half a 750ml bottle and regret it, but tone it back down.

As far as cravings, I would crave alcohol like I crave other foods/drinks, like "I really want some Johnnie Walker Black this week" similarly to how I would think "I want a coke." Then I would clear 375ml in three days, and realize I didn't have enough to enjoy until the next paycheck (I generally didn't buy liquor more than once a pay period because I was usually interested in being more intimate with one drink at a time). Similar to how if I eat candy bars regularly I crave them, alcohol is/was the same.

Part of this led me to take a long time to give myself permission to stop drinking. I decided two weeks ago that I just don't need alcohol and sort of just said I'd commit to it, do the "one day at a time" thing. No end time, just never doing it. I feel if there's a deadline, or any conditions to drink, I'll slip back into the patterns I had which weren't entirely self-destructive, but not something I wanted to live with. As far as work functions, I'll just get a soda, mocktail, or water.

As a result, I have also hit a sort of malaise about how different things aren't. I've had dry patches where I chose not to drink, and I don't have a huge recovery story since I wasn't drinking all the time anyway, but going through these sorts of cycles. I don't feel any different because I'm not healing, I'm not going through any withdrawals or detox, I don't have any behavior to feel guilty about, or anything. I feel like a bad alcoholic, in a sense, because I don't have much to run from beyond the problem of "one is too many, two is not enough." I also feel self-conscious about not drinking alcohol, because I'm worried about how to answer if asked why.

I guess, to a point, I'm reaching out because I feel a little alone on this. I'm not sure how to navigate my not-quite sobriety (I still use cannabis edibles on rare occasion, and kava quite frequently, but not regularly). Has anybody else been in a similar situation? How did you navigate it internally?

Hey all,

Recently I've had a really dark period from (ab)using drugs to hide from the pain and feel good about myself. Friends noticed me becoming distant and needlessly shouting into the (social media) void.
One friend wrote me a long message about all these things and his conclusion was that he thought I might be a narcissist. I broke down entirely, the following days were a roller coaster ride of trying to deal with it with high and lows, talking to friends if they also noticed these things but ultimately I couldn't shake the feeling that I had to give in to my friend's accusation to mend our now wounded relationship. People pleasing is in my nature and putting others in front of my own needs is what I deal with and I cope with low self-esteem.

My therapists all said that the accusations is not something they can see myself in but regardless of this I ended up having a suicide attempt. I saw myself as a bad person and that feeling became over-encumbering.

I'm better now, and I feel closer to friends and family after some much needed talks and quitting drugs altogether.

That said, what are your takes on the overlapping diagnoses. It made myself very paranoid and made me spiral at a low point.