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Comment by thenerdhead | Hacker News Reader

> Dr Pittenger says it is now clear that covid-19 infections can trigger psychosis, fatigue and other neuro-psychiatric symptoms. A misbehaving immune system is thought to be the culprit. The idea that schizophrenia may, at least sometimes, likewise be an auto-immune disorder is also under investigation.

Until I got long covid(generally recovered now after 2 years), I couldn't comprehend this idea. I felt like I was actually going crazy. But then that lead me down a rabbit hole of reading about things like the microbiome and immune system which is a whole new domain yet to be formally explored. I highly recommend people read Ed Yong's book "I Contain Multitudes".

Post acute infection syndromes are a real thing and it is fascinating that we get to see science take on this topic in the spotlight right now. Especially Jeff Gordon and his work on the microbiome and Akiko Iwasaki and her work on long covid.

It makes you honestly question the idea of freewill. Good thing that Robert Sapolsky's new book is coming out next month on the topic!

View on HN

>It makes you honestly question the idea of freewill.

Not eating and getting low blood sugar can much more simply answer the question of "Do I have free will, or am I a subject of my internal chemical reactions".

Or, much more simply stated "You're not you when you are hungry".

> Not eating and getting low blood sugar can much more simply answer the question of "Do I have free will, or am I a subject of my internal chemical reactions".

You cannot control what you feel, but you can control your actions.

> You cannot control what you feel, but you can control your actions.

I'll respond in a way that I hope is clear and relatively objective. This will take the form of an "if-then" claim nested within another "if-then" claim.

IF a person

  (1) accepts philosophical materialism, but
  (2) remains agnostic as to quantum effects at macro scale

THEN then the following response follows logically:

It depends what you mean by "you". If you (a) mean that "you" consists of the body, including the brain; and (b) you recognize there is a physiological difference between _non-volitional_ and _volitional_ choices; then (c) yes, loosely speaking, "you" can control your volitional actions.

If you think carefully, you will recognize the above assumptions also mean:

- a person's surrounding context plays an essential role in shaping the kinds of actions that are available.

- there are no causes other than material ones (such as a soul)

You may notice I didn't use the phrase "free will" above. That is very much intentional. Even if you are a philosopher, that word is nearly impossible to use in a way with a definition that a group of people can agree on.

See also: "Volition and Action in the Human Brain: Processes, Pathologies, and Reasons" by Itzhak Fried, Patrick Haggard, ... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678016/

I think there's two conceptions of free will, one is as you described -- a body being able to act in and of itself without any influence of an external force (beyond sensation, physical constraints, etc).

That sort of punts on the question of physical determinism, where it doesn't matter if it was possible for you to have done anything other than what you did. You could be a pure clock work automaton making deterministic responses to external stimuli and still have that sort of "free will", but I don't think that would be satisfying to a lot of people.

The second kind of free will, I think would be the ability to have a free choice -- that there is some immaterial entity which can act in somehow a non-deterministic way to choose its behavior, that the course of your entire life wasn't set at the big bang -- that not only can you act independently, but that your choices _matter_ and will result in a future that was not predetermined. I think that is what a lot of people would think of as free will, and it's difficult to define or logically support IMO.

I can appreciate a lot of the sentiments above, but I don't think the comment's "two conceptions" really 'decomplects' (a Hickeyism) the key ideas. If anything, it smooshes a lot of them together: different definitions of free will, meaning, origin stories, the divine, flavors of determinism, and more.

Note that non-material causes can be just as deterministic (if not more so) as matter. Logic and math are physical but not material, for instance.

> Logic and math are physical but not material, for instance.

Logic and math are neither physical, nor material, nor causal.

I think some might be slightly troubled by hearing that logic is not causal. But I agree.

One can _test_ a set of statements to see if they are valid logical deductions from another set of statements. Even if true, this does not mean that the deducible statements are _caused_.

In some cases, that statement from above (the deduced one) might be 'realized' (noticed by people) before its premises are!

We might even be able to logically prove it is true without the other set of statements! Why? There are multiple logical paths (not always mapping to reality) that _could_ prove a particular statement.

When living things or machines do math they are doing a physical thing.

The abstract concept of mathematics doesn’t need to exist for that to happen.

They are physical causes but they are abstracted from matter. The underlying cause originates from the math/logic, not the material instantiation. Physicalism is often conflated with materialism, but the world is physically constituted by more than matter!

A lot of this world is obviously caused by the inherent formal influence of math and logic. There are ongoing mysteries in this, to be sure, but these forms are beyond matter. I’m speaking from the Pythagorean-Platonic-Tegmark school of thought. I’m trying to address the typical atheist layperson scientist who hasn’t thought through immaterial reality (rejecting it as supernatural, thinking it involves ghosts or spirits or something). I know there are reasonable counter positions to argue why math isn’t real, but I don’t subscribe.

> They are physical causes but they are abstracted from matter.

That sequence of words doesn't even denote a coherent concept. To be physical is exactly to be a state of matter/energy.

> The underlying cause originates from the math/logic, not the material instantiation.

No, logic, including math, describes the relationship between abstract concepts. It doesn't cause anything. Implication is not causation.

> I’m trying to address the typical atheist layperson scientist who hasn’t thought through immaterial reality

I'm Catholic, not atheist, and I have no problem with immaterial reality, or even immaterial causes of material effects. But I do have a problem with the simple error of describing immaterial concepts as being physical causes, or with describing systems of concepts and oc describing their relations as causes of anything, except insofar as belief in them causes behavior in the believer.

> I know there are reasonable counter positions to argue why math isn’t real, but I don’t subscribe.

There are certainly senses in which “math is real” is a valid or defensible statement, but bot in the sense of it being a physical thing which can exist as a cause.

Most physicists don’t see the world as “made” of stuff, either matter or energy. But algorithmic laws. The ontology of modern physics is weird.

Physical refers to natural causes. How could math not be causal? Not like, math in a textbook (though I’d argue that is causal too. Ideas are immaterial but they cause effects in the material world. They are thus natural, physical causes!).

Maybe you’d prefer the word “necessitate” over cause? Mathematical and logic necessitate certain effects in material reality? Personally I don’t see a difference, but maybe you do.

Can you?

I'm a type 1 diabetic, I have a continuous monitor that tells me what my glucose level is. This monitors actual interstitial fluid level and not blood sugar, this means there can be a pretty large delay between what's measured just under the skin versus what my blood stream is experiencing. If a rapid drop occurs there can be a lead time that I'm unaware of it, but others are because I'll behave in a 'cranky' or 'sharp' tone. I'm not aware this is occurring when it does. A little sugar and a few minutes and I'm back to regular me again.

You are in far less control of your actions then you believe. Internal self awareness is a poor mirror of reality.

Well said.

> You are in far less control of your actions then you believe.

No. But I say this in a way that might surprise you?

I view 'free will', as most people understand it, as an illusion.

I recognize that I, at best, have a tiny fraction of control. If I consider "me" to be a locus of control w.r.t. volitional action, then I will grant that "me" has causal impact. But what causally impacted "me" at time t? A combination of "me" at time t-1 and my environment. (I'm a materialist who is agnostic w.r.t. determinism.)

So, what does this really mean? "I" (right now) can only have volitional control only if one ignores the precursors. It is a mindbending realization to many, but it is the best theory I've found that fits reality.

There are lots of us around. We might disagree on how we define 'free will'; we may or may not 'deny free will'. But there is a huge commonality among most rational materialists who accept modern science: we do not conceptualize free will in ways that match 'mainstream' notions of it.

I consider free will fundamentally an illusion but at the abstraction level of 'me' (also a faulty abstraction) it does make sense to use these concepts sometimes.

But it's important not to confuse the map with the territory.

I agree that free will functionally doesn't exist. However for the purposes of social organization I see no better alternative than to treat each person as an agent and hold them fully accountable for their actions, regardless of upstream "causal" impacts.

If you're starving/high/whatever and you violate someone else's fundamental rights, the reasons/excuses you give as to why your control was compromised seem irrelevant. Actions and outcomes count, not intentions.

> Actions and outcomes count, not intentions.

There is a whole division in law around mens rea vs actus reus that disagrees with this take.

I'm aware, but the bar for a guilty mind is quite low. You basically have to have known what you are doing, which we assume just about every conscious person does. There are also crimes where mens rea isn't even applied to a perpetrator, but to a reasonable objective analyzer (eg. manslaughter).

> I'm aware, but the bar for a guilty mind is quite low.

Do you mean this in terms of a cross-system comparison (i.e. variation between legal systems)?

Do you mean this in terms of some philosophy that lays out a more sensible stance?

I've been digging into this somewhat; happy to learn more.

> If you're starving/high/whatever and you violate someone else's fundamental rights, the reasons/excuses you give as to why your control was compromised seem irrelevant. > If you're starving/high/whatever and you violate someone else's fundamental rights, the reasons/excuses you give as to why your control was compromised seem irrelevant. Actions and outcomes count, not intentions.

Yes, people _often_ people give rationalizations of dubious merit. These are muddled, complicated 'reflections' of the full reality. So it is wise to not give them too much weight. (But it can be very interesting to try to parse them, but that's another topic...!)

Next point. From a predictive point of view about public safety, the context and situation matters. For example, consider the case of an addict who regularly steals because he is driven by the addiction. If he can break the habit (hopefully with help of many kinds), the theft problem largely goes away. Understanding the dynamic helps us understand downstream outcomes.

yes, a prisoner may be locked inside and have a laid out routine for them, but they do still have a say in the minutiae and their small actions could actually echo into the future.

Another thought, just because our unconscious mind also plays a part, people fear that this implies mostly determinism but really why are we considering that as not also our thoughts too? They're just thoughts that our deeper mind has put forth and our deeper mind doesn't usually want to be questioned, they've got more hard data. Still you can fight this or things like suicide, soldiers. daredevils wouldn't be possible. We just don't get to see how it came to conclusions so we assume it's some hard-wired code.

It's simpler than that. Your thoughts -- the internal monologue deciding what actions to take -- are the result of physical processes in the brain. There is no way those non-physical thoughts are changing the physical processes; they happen after the fact. We have the illusion of being in the driver seat but really we are just along for the ride.

This is assuming you adhere only to what science can prove, and not religious beliefs like the soul.

But yeah, the fact that we are the result of past decisions and outside inputs going all the way back to before we even had consciousness at all is also a nice proof by induction.

> There is no way those non-physical thoughts are changing the physical processes; they happen after the fact. We have the illusion of being in the driver seat but really we are just along for the ride.

How can you conclude this with any certainty?

PBS: Your Brain: Perception Deception

https://www.youtube.com/watch?v=HU6LfXNeQM4

PBS: Your Brain: Who's in Control?

https://www.youtube.com/watch?v=yQ6VOOd73MA

Rationalization is mostly post ad hoc.

There are other interpretations of some of these experiments (e.g. regarding the action potential). In his book on free will, Mark Balaguer elaborates a little bit. I don't remember the details well, but I'll try to sketch what I think he says.

First, in my recollection, Balaguer points out the form of the argument as follows.

Given that: (1) a particular study shows that one's (perception of when they decided to act) _lags_ the (experimental measurement of the person's action potential spiking), what can we validly conclude?

Some people then claim that (2) claims of making a decision are merely post-hoc rationalizations. I get the sense that such a view is widely held among those who have heard of the experiments -- or at least the popular characterizations of them.

Balaguer says e.g. "not so fast". He points out that we need to talk about the logically necessary steps to reason from (1) to (2). He has a section on this; he claims it isn't as watertight as some think.

As I recall, part of the discussion has to do with motor planning.

Another part is this: there could be a volitional choice that precedes and causes both the action potential spike _and_ the perception/recognition. That volitional choice is unavailable to conscious awareness until some time later, presumably. If true, a person could have made the choice, noticed it later, and still be consistent with the experimental findings.

Apologies for the hazy recollection. I recall not being strongly convinced, partly because I wasn't impressed by the book overall, but I also haven't dug into these topics as much as I would like.

Lucky for us, the issue of latency between action and perception is squarely in the wheelhouse of distributed systems engineers!

> There is no way those non-physical thoughts are changing the physical processes; they happen after the fact.

How can the truth of this statement be proven? Non-physical thoughts cannot be observed, so they are out of reach of being tested for being correct.

Eventually we may have sufficiently fine-grained ability to observe brain states, plus a strong enough understanding of neuropsychology, such that an outside observer can accurately predict, for a brain under observation:

1. The subjective internal mental state of the participant (e.g. "you were imagining a red balloon")

2. Actions that will be taken before they physically manifest (e.g. "you will throw rock instead of scissors")

If an outside observer can do these things without access to subjects' thoughts, especially with subjects' deliberate efforts to fool the observers, then IMO it is pretty clear evidence the thoughts are meaningless.

As for the current day, I say the preponderance of evidence is on anyone who claims otherwise. There's lots of evidence suggesting free will is an illusion, and no evidence of telekinesis or the like.

Not even eventually, currently we have AI that can decode 'pictures' from our brain activity.

https://www.smithsonianmag.com/smart-news/this-ai-used-brain...

> Non-physical thoughts cannot be observed

We wouldn't even be able to talk about them, because if we did, there would be a causal chain starting with a non-psysical thought and ending with moving a (physical) tongue. So somewhere along that chain, a non-physical thing would need to make a physical thing move. How exactly?

Neural activity physically exists. Qualia -- the experience of having thoughts -- do not.

> There is no way those non-physical thoughts are changing the physical processes

I don’t believe this to be correct. There is nothing non-physical about thoughts. Thoughts are mater interacting with mater.

Thoughts are to the brain what waves are to the ocean. They are not less physical than the brain itself.

You cannot point to a neurotransmitter or neuron or synapse and say "that's a thought." Thoughts are not material. You might say they are not real. Even if you can point to a group of neurons and processes in the brain and associate it with a particular thought, the thought itself is not real. The neurons and their behaviors are.

First, saying "x is not real" is a proven way to make a mess of a conversation. I suggest we all would be better off avoiding that phrasing, unless we're willing to really dig in and carefully clarify our definitions.

> You cannot point to a neurotransmitter or neuron or synapse and say "that's a thought."

Are you claiming it is (a) categorically impossible or (b) practically impossible? Why not?

> Thoughts are not material.

To be clear, when modern philosophers talk about 'materialism' that tends to include all of the abstractions of physics: matter, energy, waves, etc.

> You might say [thoughts] are not real.

I wouldn't say that. Here is what I would say; there are at least three key different aspects of thoughts:

1. the perceptual level; i.e. the _experience_ of having a thought

2. the conceptual level; i.e. a _concept_ that people use

3. the physical level; the physical things that are happening; may be a set of things; not necessarily contiguous

> Even if you can point to a group of neurons and processes in the brain and associate it with a particular thought, the thought itself is not real.

My top-most paragraph explains that "X is not real" statements tend to have a lot of downsides. Am I missing something? Does this add something to the discussion?

FWIW, when I said "thoughts" in the original comment, I really meant qualia / inner monologue / phenomenological experience, i.e. what you call #1 the perceptual level. Qualia are not part of materialism... which IMO makes them the most interesting thing in the universe, since they are categorically unlike everything else and yet so fundamental to our being.

I mean, yea, maybe in your world you don't want to point at an electromagnetic wave that is a wifi signal... but it is.

Signals are just as real as the components that create them.

Qualia are not a signal. You can't transmit and receive them, you can't physically detect them, there is no way to objectively describe them. When you and I both look at 450nm light there is no hope of ever knowing what the other perceives. You can say "the color of the sky on a clear day" but that is just a reference to yet more subjective experience.

Inasmuch as thoughts have a one-to-one coupling with the physical processes in the brain, then we are saying the same thing.

But qualia (the more accurate/descriptive term for what we are discussing) are inherently subjective and non-physical by definition. Both of us can observe an ocean wave using many different methods (direct observation with light, their effect on a buoy, their impact with the shore, etc). However we can never both observe your qualia. I have no way to determine that your perception of "red" and mine are equivalent. There is no way you can explain vision to a blind person; yet a blind person can have their own understanding of an ocean wave.

The trouble with this argument is it applies to your thoughts about reality, not just to your will.

Your argument implies your thoughts at time t are solely the result of your state at time t-1 and your environment. But if that's the case, your thoughts aren't about reality; they're just a result of reality, a result of whatever state you happen to be in.

But if your thoughts aren't about reality, why should your argument about free will -- or about anything else -- carry any weight?

Causal processes are not the same as logical reasoning, and if you reduce the processes of the mind to the former, you remove the possibility of rational argument.

If you consider the processes of the mind to be acausal, that also removes the possibility of rational argument.

It's possible that I'm a Boltzmann brain with nonsensical memories about environmental stimuli that mislead me about what reality is, but it's tedious to prepend every statement about reality with "the conception of reality that my state at time t-1 and my environment have lead me to believe is the most likely candidate for reality."

That doesn't seem to be a particularly useful objection to the philosophy that GP espoused, instead, you have to assume his same priors - materialist, agnostic w.r.t. determinism, and some basic assumptions about senses and a shared reality.

I didn't claim the mind's processes were acausal; simply that they could not be reduced to cause, to the exclusion of anything else. If they can be so reduced, rational argument is impossible, because causal processes are not the same as rational argument. When I punch "2 + 2 =" into a calculator and the screen says "4", it's a causal process. When my kid grasps that 2 + 2 = 4, it's different. His mind has reasoned its way to this truth; it is not simply that the brain-state "2 + 2" has produced the further brain-state "4". If that were the case, he (and we) could never know that 2+2 resulted in 4; it could just as easily produce 5, or a green rabbit, or whatever else our mind had been caused to think at any given time.

If reasoning has any validity, it cannot be reduced to causal processes.

Therefore any argument -- any attempt at reasoning -- that claims that the mind's processes are merely causal undermines itself in the very process of being made.

> causal processes are not the same as rational argument

Yes.

...I'm taking this step-by-step...

But causal processes can _generate_ rational argument. Agree or disagree?

> But causal processes can _generate_ rational argument.

There is no reason for thinking this. A causal process can be associated and simultaneous with an argument, but it can't generate it, except by accident. The state of mind '2+2' may be followed by the state of mind '4', but it could just as easily be followed by the state of mind '5'. Causal processes may make us believe one or the other, but they will not make one correct and the other wrong; nor will they be sufficient to explain how one answer is correct and the other wrong.

That's why I said 'can'. I didn't say 'always'.

A deterministic computer program _can_ generate rational argument; e.g. it can use logical deduction a.k.a. forward-chaining.

Your claim seems to be that causality (governing the behavior of human thought and action) does not _necessarily_ result in rationality (in that human)? Of course -- this is obvious.

This seems like a miscommunication. Perhaps an unavoidable one? :)

> Your claim seems to be that causality (governing the behavior of human thought and action) does not _necessarily_ result in rationality (in that human)? Of course -- this is obvious.

That's not my claim. Basic observation of oneself or others make this, as you say, strikingly obvious :)

My claim is rather that causality can't be a sufficient explanation for rationality. By this I mean that we can't explain rational thought by referring to the cerebral states that are associated with it. Remember your original claim that 'free will' is an illusion, because what impacts me at time T is [limited to] my state at time T-1, and my environment.[0] I take this to mean that my state at T is caused solely by my state at T-1 and envt. IF you're right about this, AND IF I'm right that causality can't be a sufficient explanation for rationality, then it implies that rationality is impossible.

Why can't causality be a sufficient explanation for reality? We can't explain rational thought by referring to the cerebral states associated with it, because the question of whether a thought is rational is indepedent of its associated cerebral state. There are cerebral states associated with 2+2=4 (rational), and cerebral states associated with 2+2=5 (irrational). But neither of these cerebral states is itself right or wrong. Only the thoughts associated with them are right or wrong.

I know that 2+2=4. It's not just that I have a series of successive, causal states that make me think this; it's that the content of the thought is correct. My mind has grasped a truth about reality. Similarly, someone who thinks 2+2=5 is wrong. It's not just that he has a series of successive, causal states that make him think thus; it's that the content of his thought is incorrect, and his mind has failed to grasp a truth about reality. When we say thought is correct or incorrect, rational or irrational, we refer to the content of the thought, not the brain state.

Thought must be about something other than the brain state to be right or wrong. But if thought is entirely generated, and sufficiently explained, by causal processes, it can only reflect the brain state, and can't be right or wrong. Since thought can be right or wrong, it follows that rational thought is something more than the product of causal processes, and is (at least partially) independent of them.

[0] I have added the words in square brackets myself, but I think that's your meaning.

Thanks for giving it another try.

> My claim is rather that causality can't be a sufficient explanation for rationality. By this I mean that we can't explain rational thought by referring to the cerebral states that are associated with it.

I'm zooming in on "explain" here. And I'm not getting it.

I'm not agreeing or disagreeing -- I'm not even following -- and I have some guesses as to why:

1. Are you offering a critique of the lack of free will argument I made?

2. If so, I'm not able to figure out where it lands: for? against? something else?

3. Either way, I haven't yet figured out what you mean by "explain" here.

4. Most broadly, I'm not seeing why this matters. I want to understand, but I haven't yet figured out how to get there.

If you are laying out a known philosophical position, could you please point me to a resource that explains it?

> We can't explain rational thought by referring to the cerebral states associated with it, because the question of whether a thought is rational is [independent] of its associated cerebral state.

If you had to write this over again to a broader audience, would you choose the word _explain_ here? In the context of this conversation especially, 'explain' is highly overloaded. Which sense do you mean? Perhaps what you mean is closer to _assess_ or _prove_?

Are you essentially saying this: the rationality of a statement is _assessed_ by the degree to which it adheres to the logic of rationality?

Since this is obvious, I'm inclined to think I'm still not following what you are actually trying to get across.

> When we say thought is correct or incorrect, rational or irrational, we refer to the content of the thought, not the brain state.

Yes, I agree. You've setup an example that emphasizes _conceptual_ understanding of what a person is thinking _about_.

This part is obvious too. But you want to take it further. I'm trying to puzzle that out next.

Ok, I think I'm working my way towards the part of the argumentation that has a bearing on free will.

> But if thought is entirely generated, and sufficiently explained, by causal processes, it can only reflect the brain state, and can't be right or wrong.

Not so. The above claim is confusing two things: (1) how a thought is generated (causality); (2) what a thought represents (conceptualization)

Whether a conceptualization is true or false is _independent_ of its causal origins.

This is obvious to me. But not to you? Or is more miscommunication afoot?

To expand the conversation a bit with the hopes of breaking out of what seems to be some kind of language trap ... Let's talk about how a person and a computer can arrive at / prove truth.

A person's brain can generate true concepts in many ways. One way is careful logical thinking based on true premises. Another is some other manner of thinking (pick whatever you like) which ends up being true.

Speaking of combinatorics and algorithms now, there are many ways to validate truth. It depends of course on the style of logic in play. Depending on the set of logical primitives available (e.g. modus ponens), there are many different computational pathways get from a set of premises to a conclusion. In other words, there are many ways to prove the Pythagorean Theorem.

I don't think we'll disagree. But maybe? Or maybe we'll get clear on some language barrier?

> But if that's the case, your thoughts aren't about reality; they're just a result of reality, a result of whatever state you happen to be in.

According to my premises (materialism being the key one), thoughts are the result of the combination of (a) what happened before and (b) the laws of the universe.

So thoughts can be both: (1) a causal result (previous paragraph) and (2) _about_ reality, from the point of view of one's consciousness.

Any disagreement here?

> Causal processes are not the same as logical reasoning, and if you reduce the processes of the mind to the former, you remove the possibility of rational argument.

(I'm not sure if this applies to what I was saying or not; I'll put that aside.)

I'll rephrase the comment above to help ensure I'm talking about the same thing. The claim, as I understand it, goes like this: if one believes the mind is governed by causal processes, then there is no possibility of the brain doing logical reasoning.

Am I understanding the argument as you intended?

I'll proceed with my understanding of it... I don't buy it. Computers are causal and can do logical reasoning just fine.

> Your argument implies your thoughts at time t are solely the result of your state at time t-1 and your environment.

The laws of physics also matter.

I think we're still on the same page here.

I'm trying to figure out if we disagree, and if so, where.

My mother was a T1 diabetic back in the days where insulin injections were basically a best guess based on what you had eaten and planned to eat. It was always fun as a child not knowing whether my little screw-ups would bring an exasperated sigh and a chuckle or the low-glucose demon.

I'm so happy that managing your disease is much more straightforward than it was in the 70s or 80s. It also appears that life expectancies are much higher since it's easier to avoid the extreme roller coaster of too high and too low blood sugar. Best wishes.

Of course you can control your actions. But that doesn't mean they can't be influenced by external factors like drugs, weather, or in your case low blood sugar.

You don't have absolute total free will in all situations. That's why development of willpower is such a huge discipline (religion, meditation, etc).

There's a range where your blood sugar starts to influence your actions, with more willpower and cultivating a less cranky personality you could certainly extend that range.

Some people have similar non-beneficail reactions to high stress situations, other people develop the skill to abstain from those actions and maintain control in those situations.

Willpower occurs after awareness. They are objectively different things.

If you are not aware of something, you cannot choose to make a reaction for or against it. For example, imagine that your body did not detect heat. If you put your hand on a burner you would instinctively withdraw from it (and yes this happens in people that do not feel pain).

Willpower is in the ballpark of conscious awareness. "I choose to do X or Y"

Training on the other hand attempts to remove the conscious decision part from the mind after awareness occurs. "If X then Y", this way you're not wasting time and brainpower trying to figure out what's going on.

I'm not sure what you are trying to say, but free will, I think, requires consciousness. If you want to train to keep your hand on a burner wouldn't that be free will. Are we implying that because we can sense pain and other things that we don't have free will. Free will doesn't mean you are omnipotent. You can choose to put your hand on a burner and you can choose to practice keeping it there, both are examples of free will. An instinct to avoid pain isn't negating the free ability to make choices.

My wife is also T1, diagnosed a couple years back with a week in ICU. She pulled through and now has a CGM and pump.

What really surprised me was her blood sugar rockets up when she has video meetings with a certain difficult colleague. While other chilled colleagues have no such effect.

That made me wonder if interacting with difficult people causes more physiological changes than I realised.

There are observable changes in the structure of the brain when people take up meditation. Not to get too crass, but we are the meat in our heads and bodies.

I'm not into mediation, but I watched something that said the brain scans of meditating experts resembled someone having a seizure or something. But the person with sat quietly.

I'm not drawing any conclusions. But I found it fascinating.

Epinephrine causes the body to release sugar into the bloodstream - it's one of the reasons you get shaky when your blood sugar gets low (if you're not T1DM at least) - your body is attempting to increase blood sugar by epinephrine. So in reverse, stressful situations that cause the release of epinephrine increase blood sugar.

There's a similar issue with e.g. running as a T1DM (as I understand it, not being one) - when you're running, your body will pump out sugar, but when you stop running, it doesn't stop instantly, so your blood sugar can spike high post-exercise. Or you can run out of sugar and crash hypoglycemic.

It's amazing that CGMs exist that can, to some degree, compensate for these things, but man the body's autoregulation on 50 different axes is fascinating.

You have clearly never met someone having a hypoglycemic event. It can absolutely change their personality, as significantly as a head injury.

The sound of breaking dishes in the kitchen, a trail of damaged but unopened candy wrappers, sitting on the floor next to the cabinets with their doors ripped off, with the sugar bowl half-spilled, thankfully recovering with some sugar under their tongue and no major bodily injury. Terrifying.

Hyperglycemia does too. (High blood sugar.) It’s known as diabetic rage. A number of things are happening there. Part of it is brain inflammation – experienced as suffering – and brain inflammation is directly behavior-modifying, causing aggression.

And indeed that’s what happens with traumatic brain injuries.

The same mechanism is behind the aggression sometimes displayed by cocaine users. Cocaine tamps down brain inflammation short-term, increases it long-term.

And indeed, people with traumatic brain injuries and central nervous system inflammation tend to have more problems with cocaine abuse.

In theory that sounds great. Unfortunately the idea that humans are highly rational is over rated. We are first and foremost, for better or worse, emotional beings.

Your fame of mind (i.e., feelings) plays a role in decision making, which drives action.

In short, beliefs (to which emotions are connected) drive behavior.

I assume you have no bad habits?

Can you instantly get back to sleep?

You never snap at anyone?

Diet is 100% what you want it to be?

Exercise on time daily?

Read HN only as much as you know it benefits you?

Marine you’re the 0.0001% who has all this down but most don’t. I’m sure there are many other examples of how most people barely control our minds and actions.

ADHD...

Uncontrolled aggression is one of common symptoms of low blood sugar. If you are not diabetic it should not just happen, your body should deal with situation. But it does happen to diabetics and they have to watch out for that.

No, you are Danny Devito. Here eat a snickers.

The sophistry here is the unsupported framing of the two as mutually exclusive. What do you think "you", the entity that does or does not have free will, are, other than a system of internal chemical reactions? Are you a soulist?

There is little evidence that consciousness comes from any particular processes at all.

It's as much conjecture to say it is just an artifact of matter as opposed to something metaphysical.

To say consciousness just appears from material complexity is actually quite absurd with little evidence.

The central epistemological question with regard to PANS / PANDAS is not free will, but rather: how do you study or measure a phenomenon that violently fights back and is possibly even willing to die in order to prevent your attempts to measure or study it?

Try getting someone who is working overtime to try and harm you and destroy everything around them to have a blood draw done, or to lie down for 45 minutes for an MRI. It's not a cake-walk. Sure, you can sedate them, but the sedating medications skew the tests. In fact, in the context of an immune-mediated disease, any sort of measurement that induces stress may alter the immune system's state and skew your results, because the immune system and stress interact.

Trying to bring objectivity to the study of PANS / PANDAS is kind of like trying to bring objectivity to quantum-physics. Good luck getting a wildly chaotic, stochastic system to reveal its "truth" to you.

I suspect you could say the same with regard to free-will.

In fact, I sometimes think of consciousness and perhaps the brain itself as an extension of the immune system. There are interesting structural similarities between lymph nodes and the brain. That would then recast all psychological problems as a sort of auto-immune condition.

Prior to getting into tech, I had an internship at the NY State Psychiatric Institute (NYSPI) where I did work helping people developing assessment tools for schizophrenic prodromes (people before they develop schizophrenia), as they were working on a predictive assessment questionaire.

Basically they were looking for risk factors but also to predict who might actually develop the disease imminently among those at risk, because if you monitor folks at risk, folks who might have subclinical symptoms, and can know who is going to have a psychotic break, you can manage and control it and have much better outcomes.

The largest predictive factor of folks who were at increased risk of developing schizophrenia is if they have a family history of it as I recall. Stress, in a variety of forms, is also a big factor.

However the reason I write is because I remember that late fall and winter conception of the individual has been shown to create a small but statistically significant increase in the likelihood of developing the disease. It's unclear exactly why, but one theory is that increased risk of viral infection for the mother during certain stages of pregnancy may be a factor.

Teasing apart these sort of facotrs, even to the extent possible often requires complex multivariate analysis of general and clinical populations and either time based or retrospective analysis of risk factors. Even then the mechanisms are fairly opaque.

Covid infection may lead to increased understanding of psychotic and subpsychotic disorders, but it's more likely to simply complicate any analysis; just teasing apart the actual effects of the disease and the stress that results from the social changes necessary to contain it, in terms of development of mental illness, may not be fully possible.

Related: "Treating the Prodrome", a discussion about early treatment of schizophrenia and some speculation about possible mechanisms. [1]

This sort of work is very exciting to me! Treating schizophrenia early seems like a win for everyone - less of an impact on the individual, less of a need for antipsychotics, and less societal impact.

I've also seen some speculation about a prodrome for major depression, with a period characterized by anxiety or agitation before a full episode. Early detection of psychiatric episodes seems like a really ripe approach.

[1] https://slatestarcodex.com/2018/09/20/treat-the-prodrome/

I believe there was a RadioLab episode that discussed schizophrenia and reduced thermoregulation. Very interesting; it explained why some schizophrenic people wear lots a clothes (a phenomenon one might notice out on the city streets). Could also be used as an early diagnostic tool.

Recent research suggests that schizophrenia may also be immune-mediated or at least immune-system involved. See:

https://www.frontiersin.org/articles/10.3389/fpsyt.2022.8805...

I was at a psychiatric conference once where the presenter highlighted that the last condition that psychiatry actually "cured" was neurosyphilis, an infection-triggered version of schizophrenia, back in the 1940's.

I remember reading awhile back about a study that showed people with the flu are generally more social while the virus is spreading. There's also those nasty sugar cravings that seem to pop up when people diet, and it may be that the microbiome drives those cravings. It's a curious thing to think that the bugs in our bodies may drive our impulses.

I don't know the mechanism of the flu thing (and i have heard it, after you get infected you're more social until the virus confines you to bed), but the craving sugar thing is 100% gut biome, the grass-fed gut flora release opioids when they eat grass, which get sent, via the blood, to our brains, which make us feel good. not eating grasses means we go through opiate withdrawal!

> not eating grasses means we go through opiate withdrawal!

That's an unreasonable exaggeration. Nobody is getting significant opioid modulation and withdrawals from their microbiome.

And ketchup doesn't have enough nicotine in it, even when applied to potatoes, to notice!

This is fascinating. I wanted to know more about that but my cursory searches didn’t turn up anything except for connections between opioid use and gut microbes. It certainly feels like withdrawal!

oh, i get downvoted every time i bring this up on any social media platform that supports downvoting. see https://news.ycombinator.com/item?id=37129256 for example.

I'm not sure where all of my research PDFs wound up over the last 20 years, but start with that DOI ( 10.1016/0014-5793(92)80414-C ) from 1992(!).

There's a trend to looking into the gut for causes of certain diseases. Prior to the pandemic, there were publications that Alzheimer's, for example, was linked to gut biome.

I get the downvotes, what i say goes against conventional wisdom, that all you gotta do to lose weight is "not eat so much" - but the human body is not just your brain and heart and some tooling to allow intake of fuel as food.

There's a growing (and, depending on your views of "life", alarming) sense that our guts are in more control than we think. This can cause a lot of "free-willers" to get upset and be reactionary.

> remember reading awhile back about a study that showed people with the flu are generally more social while the virus is spreading.

Am I an idiot or is this clearly non-causal?

does seem weird as the flu usually makes me sore and not want to move at all.

You're probably still contagious for a while after the symptoms weaken.

But thinking about it, you're also probably in a good mood at the same time. So yeah, of course you're going to be more sociable.

I assume the poster meant that the infected are more social before they start having symptoms

You're probably contagious before symptom onset.

To clarify, the the claim is that individuals are more sociable when they are infected with the flu virus.

These results show that there is an immediate active behavioral response to infection before the expected onset of symptoms or sickness behavior.

https://pubmed.ncbi.nlm.nih.gov/20816312/

I did a quick skim and the main problems with the study are:

1. no placebo, so it's unclear whether it was actually due to the flu virus or some unrelated factor. The study admits this might be an issue, but casually dismisses it with "We looked for this, and found no such effects."

2. the "flu virus" in question is actually a vaccine. Needless to say there's a big difference between getting a flu shot and an actual flu.

the idea that a virus can change the behavior of the host to make it more likely to spread is one of those things that's beyond creepy. lots of scifi based on this, and the ones that are more subtle are much more effective than getting bit by a zombie trope.

Have I got bad news for you. This is past speculation in certain species:

https://www.nationalgeographic.com/animals/article/cordyceps...

Also in humans, with the rabies virus which makes people be repulsed by water, which would limit the spread of the virus since its vector is saliva.

I mean this is something well proven in parasitic infections. For example snails that climb to the top of plants to be eaten by birds when they are infected.

Also rats that are infected that go hang about places where cats have peed so they get ate spreading the infection to cats.

what makes you think that this is something I doubt? I can accept it happens and still be creeped out by it all the same.

This is already well established in humans for toxoplasmosis, for example. It’s a parasite rather than a virus, but it doesn’t seem crazy that a virus might do similar things.

Nerd-sniped: Free will is an incoherent idea. We don't choose our preferences, which dictate our choices. (And even supposing you can choose a preference, that's only due to the preexisting desire to have such a preference. Turtles all the way down.) What would an unconstrained choice even be? Just random, arbitrary? That doesn't sound "free" either.

> We don't choose our preferences

As a doxastic voluntarist, I reject this notion entirely.

> Doxastic voluntarism is a philosophical view that people elect their own beliefs; that is, that subjects have a certain amount of control over what they believe

Do you hold such a view as a first principle? Or did you arrive at it via consideration of other factors?

Do you mean to ask if someone can choose not to be a doxastic voluntarist?

You can't choose to be a doxastic voluntarist as much as you can't choose not to be one. One can only become one involuntarily.

Ah, now this is getting fun.

> Do you mean to ask if someone can choose not to be a doxastic voluntarist?

No, I did not. :)

My question remains: "Do you hold such a view as a first principle? Or did you arrive at it via consideration of other factors?"

If you look closely, you can see my question doesn't assume choice was/wasn't involved. Simply how you got there.

I decided to change my preferences and it worked. It's simply evidentially true.

(involuntary laughter) well played

Ancient religion and philosophy taught that habits influence desires far more strongly than desires influence habits.

It is possible to want different desires (if you disagree, ask any recovering drug addict). So even conflicting desires can exist simultaneously on multiple planes of consciousness.

A powerful way to change your desires to be what you want them to be is to change your habits.

Yes, and that raises the question: by what mechanisms do we change our habits?

I like an idea mentioned by James Clear (author of the "Atomic Habits" book) that each action we take is a "vote" towards establishing or breaking a habit.

There are connections between this notion and neurochemistry, such as Hebbian learning.

One important mechanism for changing habits is to join a community of people who are practicing the habits you wish to practice. A thoughtful, intentional choice of whom to associate with is one of the most powerful forms of agency we possess.

Zooming out a bit, local communities of people who practice virtuous habits are an indispensable cornerstone of society, for by them we gain agency to desire and do what is virtuous.

> Zooming out a bit, local communities of people who practice virtuous habits are an indispensable cornerstone of society

That's a pretty big claim, and I'm the kind of person that tends to challenge almost everything ... but heck, I have to admit that I largely agree. Well said.

I've lived many places, and the lived experience in some particular places, in some particular ways, just works better. It often has to do with most people being both trusting and trustworthy.

I would add that _locality_ isn't only about spatial dimensions. Some online communities have high degrees of locality, in a sense.

> for by them we gain agency to desire and do what is virtuous.

Again, at first I was going to push back on how you used 'agency' here, but I think I see what you probably mean: being in a better environment _helps_ an individual to choose from a better set of options, allowing them to be the best version of themself.

Sure, but what motivates that change in habits? Does it spontaneously arise? Does is trace back to some other event? Neither of these illustrate a degree of freedom.

The idea isn't incoherent so much as the word free invites a lot of creative interpretations.

Free will is really all about making decisions that guide the evolution of the universe, rather than being a powerless observer. The fact that our decisions are constrained due to circumstances does not change the fact that we make them.

The parent comment mentions Robert Sapolsky and I can't resist linking a talk where he explores various physical and environmental factors that influence human actions - https://www.youtube.com/watch?v=GRYcSuyLiJk

If anyone finds the video above interesting, also check out his Behavioural Biology lecture series on YouTube - https://www.youtube.com/watch?v=NNnIGh9g6fA&list=PL848F2368C...

His upcoming book can be found here - https://www.amazon.ca/Determined-Science-Life-without-Free/d...

> It makes you honestly question the idea of freewill. Good thing that Robert Sapolsky's new book is coming out next month on the topic!

Watching someone go through certain kinds of dementia can have a similar effect. Simplify the input and make situations repeatable (from their perspective) on very-short timeframes and it’s hard not to notice how much we behave like automatons. It’s being able to hold a lot of context that makes us seem like we’re ordinarily not, I reckon.

There was a medical article the other day that popped up where a daughter received the first kidney transplant without life-long anti-rejection drugs. Instead they reprogrammed her immune system to see her mother's tissue as self instead of foreign body. She was on anti-rejection meds for months instead of life. I presume so they could test whether their plan worked or not.

If they can do that for life or death situations, I have hope that we can refine the process for other auto-immune diseases that are everything from lifestyle threatening up to life-threatening. My issues are middle of the list, but if arthritis had a solution other than immunosuppression while I still have cartilage, that would make me so happy.

And I'd really like to be able to eat croissants and baklava again, if that can be arranged.

> It makes you honestly question the idea of freewill.

Hell two months in any psychology course will have you questioning that. We are truly biological beings first and rational agents second.

The middle ground here seems not only theologically sound but biologically coherent as well. We have a constrained will.

Free will has never and will never exist since we are finite beings. We have a _constrained_ will that is boxed in by a number of factors: time, money, biology, knowledge, circumstances, etc. Theologically, that will is also constrained by our nature. There are certain spiritual things we cannot do in the same way we cannot do certain physical things.

By the time your internal monologue makes a decision, the neural network for it fired long ago. Non-physical thoughts don't guide the physical processes; they are simply a side effect of it.

Did you learn anything that helped in your recovery? I'm 1.5 years in and nowhere near a full recovery yet.

Was about to ask the same. I'm one year in and had a glorious month following reinfection in August but seem to have rebounded the last week or two.

I sure did. I'm writing a book on it right now. I have a couple of posts that might help:

https://jondouglas.dev/long-covid/ (Maybe outdated at this point but tells the full journey)

https://www.reddit.com/r/LongHaulersRecovery/comments/12iv4p... (Probably the most realistic summary)

The most important thing in my opinion that I don't talk about in these posts is to stay informed on the latest research and become study/trial literate. i.e. https://www.science.org/content/article/how-seriously-read-s...

Wishing you the best to recover.

I think it's really a shame that aspirin is not emphasized more as a COVID and COVID-recovery treatment, given that it's known to help reduce clotting which is an important mechanism of COVID etiology. Even Biden's physician had him take it during his case.

Would recommend CBT.

e: I'm downvoted but this is one of the only treatments with best-in-class evidence for its effectiveness in treating long covid as well as CFS and IBS. The body is a complex organism.

Where is the best-in-class evidence that CBT is effective at treating long covid and chronic fatigue syndrome?

https://pubmed.ncbi.nlm.nih.gov/37155736/

There's even more evidence for CFS - the PACE trial is a notable example. These are politicized by certain patient advocacy groups and associated publishing circles but the evidence is considered pretty strong in the broader medical sphere.

This is a very, very tall claim:

this is one of the only treatments with best-in-class evidence

Firstly, one would expect to see indications of the evidence for cognitive behavioral therapy working for a complex long-term illness with multiple documented physiological issues.

Random paper: https://www.sciencedirect.com/science/article/pii/S089662732...

Second, which class of evidence are you referring to?

Third, to back the comparison in the claim you also need to present the lack of evidence for other treatments. This makes your claim very, very tall.

> Firstly, one would expect to see indications of the evidence for cognitive behavioral therapy

There is plenty of evidence if you go looking. It also looks like there is significant overlap between CFS and long covid and the PACE trial demonstrated strong evidence for the effectiveness of CBT in ME/CFS.

https://pubmed.ncbi.nlm.nih.gov/37155736/

> multiple documented physiological issues.

"proposed mechanism" != "multiple documented physiological issues" and even the presence of documented physiological issues (such as in IBS) does not preclude the benefit of CBT because the body is complicated and the mind-body duality is not real.

> comparison in the claim you also need to present the lack of evidence for other treatments.

AFAIK - there has not been any other treatment showing this sort of evidence. It is difficult to prove a negative.

The PACE trial has been widely discredited.

From Wikipedia:

”A 2010 meta-analysis of trials that objectively measured physical activity before and after CBT showed that although CBT effectively reduced patients' fatigue questionnaire scores, activity levels were not improved by CBT and changes in physical activity were not related to changes in fatigue questionnaire scores.“

Source: https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome_treat...

See especially the section on “PACE trial controversy”. It’s easy to see that it’s a poor study.

—

The paper I pointed towards describes multiple demonstrated means of neurological injury from SARS-CoV-2 infection. It’s just one single paper selected at random. It shall not be dismissed as “proposed mechanism”.

—

The unproven and unprovable negative claim was indeed yours to prove.

As I said in another comment,

> These are politicized by certain patient advocacy groups and associated publishing circles but the evidence is considered pretty strong in the broader medical sphere.

The “critiques” of the PACE study are mostly based around p-hacking the objectives until you get the results you want. PACE participants saw significantly fewer hospitalizations, lower mortality, and better reported questionnaire scores as a bonus.

Because there is a lot of ire against recommending CBT among patient advocacy groups (including threatening to kill the authors and their families), some researchers have critiqued PACE because they have found some metrics in post-analysis that PACE did not improve (classic p-hacking). But that does not represent the broader view of the field.

Described by other scientists: “[The critiques come from a] fairly small, but highly organized, very vocal and very damaging group of individuals who have, I would say, actually hijacked this agenda and distorted the debate so that it actually harms the overwhelming majority of patients.'

> It shall not be dismissed as “proposed mechanism”.

That is literally how the paper self described. I am linking you multiple RCTs demonstrating impact and you are linking speculative causes of a disease that do not yet meet Koch’s postulates. But even if a neurological mechanism holds up (not at all unlikely in my view), this is likely to not be the case for all populations currently diagnosed with long covid - but rather a subset. CBT will likely be helpful for both populations, given the evidence I have linked.

My proof of my claim is that I have researched alternative treatments for long covid and CFS and none of them have these effect sizes :) If you have contrary evidence, that’s on you to prove, but fwiw I am not going to keep replying.

And again, I’ve linked RCT evidence for the effectiveness of CBT in long covid, which I guess you have nothing to say about.

From the paper “The Neurobiology of Long COVID”:

Demonstrated effects of reactive microglia after COVID-19 include a reduction in oligodendrocytes and myelinated axons, highlighting disrupted myelin homeostasis.

—

The UK Biobank study discussed above compared magnetic resonance imaging (MRI) data before and after SARS-CoV-2 infection in 401 individuals and 385 matched controls. MRI data obtained an average of 141 days following COVID-19 diagnosis revealed widespread structural abnormalities, including a small but significant global decrease in brain volume, changes throughout the olfactory system, and structural abnormalities in the limbic system, cerebellum, and major white matter tracts (fimbria and superior fronto-occipital fasciculus)

—

Concordant findings in an MRI study of individuals with persistent cognitive impairment after COVID-19 found white matter hyperintensities correlating with verbal memory deficits

—

Another imaging and neuropsychological assessment of 223 individuals who recovered from mainly mild to moderate SARS-CoV-2 infections and 223 matched healthy controls found that among the 11 MRI markers tested, significant differences between groups were found in global measures of mean diffusivity and extracellular free water, which were both elevated in the white matter of post-SARS-CoV-2 individuals

—

And so on and so forth. Those are the first immediately obvious passages describing structural alterations to brain tissue in that one paper.

These are severe physiological issues. This is literal brain damage. This is a paper pointing to craters.

Will CBT help with impaired oxygen perfusion of tissue caused by a pathogen known to cause pervasive vascular damage and severely deranged blood clotting?

https://www.sciencedirect.com/science/article/pii/S002628622...

Also, why does CBT work when it does?

Oxytocin is directly anti-inflammatory and CBT can and does affect oxytocin secretion.

https://www.tandfonline.com/doi/full/10.1080/15374416.2023.2...

I'm in the US, so this advice is only applicable there, but LabCorp will test your blood for you without a doctor's note. I had to route around my doctor because I caught covid in the initial wave and no one knew what was going on. Your doctor may be able to help you more these days. Anyway, so I got my blood tested for all sorts of stuff, fixed deficiencies that came up, then leaned heavily on specialists to get medication to fix my symptoms. Beta blockers/other for my heart palpitations/other issues from a cardiologist, various inhalers for my lung issues from a pulmonologist, a whole slew of medications and treatments from a psychiatrist. And so much help from my friends. At the worst of it, it was exhausting walking from my bedroom to the kitchen, and I live in a small apartment. It did take years, but eventually I got there.

Learning to never push myself, because that would cause me to relapse and spend a week in bed. They have a name for it now, but that's the biggest thing that helped, really.

Hope you get a full recovery soon!

Could you tell the story of what experiencing schizoid symptoms was like? I’m always curious!

I have a number of blogs that somewhat include these feelings:

https://jondouglas.dev/little-dark-age/

https://jondouglas.dev/the-stress-of-life/

https://jondouglas.dev/save-your-soul/

https://jondouglas.dev/obsessive-compulsive/

https://jondouglas.dev/love-of-fate/

https://jondouglas.dev/from-the-ashes/

Lots of depersonalization, heightened nerves, low lows, and desire to be alone. If you've ever read Leo Tolstoy, the best description is in his novella "The Death of Ivan Ilyich".

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