I think this is a valid point, and the reason I haven’t tried these drugs and don’t plan to. There are huge benefits to developing the mental strength and discipline to lean into discomfort consistently and just do what needs to be done- and all types of addiction provide one of the hardest, and therefore most valuable and useful obstacles here. As Marcus Aurelius said “The impediment to action advances action. What stands in the way becomes the way.”
I’ve found that the general act of leaning into challenges and mild physical discomfort has a ripple effect on my mind, and all types of addiction and dopamine seeking behaviors become automatically less interesting- almost exactly like what people report on these drugs. If I take a cold shower or work out every morning even when I don’t feel like it- pretty soon I’m eating healthier and limiting my alcohol, caffeine, and screen time without even really trying to.
That said, it only works if you manage to actually do it. It’s much better to get over addiction with a drug than to continue suffering from the addiction, and be unable to escape, especially something that causes as much damage as alcohol can.
One idea I had was to set a deadline for overcoming an addiction, and to just use the drug if you reach the deadline and the mental approach is still unsuccessful.
I wonder if you have more ”grit” than Sugar Ray Leonard, one of the greatest boxers of all time. His fight with Roberto Duran are legendary.
As so many boxers (and many athletes for that matter) he was addicted to drugs and alcohol for many years. Probably sexual abuse he suffered as a kid had something to do with it. He was able to quit, but I think cold shower and a run in the morning was not quite enough to do it.
Nobody just starts abusing their body with chemicals. It is not difficult to quit, you can stay off your Jones for months, but if you do nothing to the demons that made you enter the 36th chamber in the first place, you are going to slip sooner or later. It takes more than a splash of cold water on the face.
Marcus Aurelius was literally a god and the emperor of the world. He prob had little bit more resources to help gim other than stoism. Similarly if you have loving family and friends, a good therapist and some sort of medication,you canmaybe wim the fight with the devil that gets you to use. Training and getting used to being uncomfortable surely helps, but you won’t kick anything for long only with them.
Therefore these drugs won’t be a solution either. Are you going to use them rest of your life? Whatever it is that makes you want to drink, smoke, shoot, gamble or whatever is still going to be there. Bit used together with therapy and loving environment might help. Of course, most addicts have no access to any of these resources.
I agree with all of what you said, and I'd argue that the stoics including Aurelius probably would have as well. Leaning into discomfort is just a step that can help you actually do things like get therapy and be present and engaged in a loving environment. At least for me that's the case- I have seemed to need all of those things together as a system to really thrive in life, not just one or the other.
CBT and ACT are modern therapy methods based on stoic methods, very widely used, and very effective for regular people that aren't emperors.
They are most often effective if you can afford them was my point. I have ADHD as well and boxing (waking up before work to run in cold November morning, 9 rounds with a heavyweight who had nobody his size to spar, thousand ab movements afterwords and hey it’s only Tuesday) helped me tremendously with focus, staying of the booze and so on, but if I had not done years of therapy and had meds as well as found more varing environment, I prob would no be hete. And I was lucky to have a god job to pay for all that.
I do think you need tremendous mental effort, or grit, even to fight serious addiction. But it is only a start.
CBT effectiveness is highly overstated, from anecdotal experience and talking with psychiatrists in a social setting.
It works for a subset of the population that doesn’t question stuff too much and is more or less ok with gaslighting themselves. There is evidence that it loses effectiveness the higher up the IQ scale you go.
The vast majority of mental health issues are a “not treating the root causes” problem. People stuck in a life they despise for various reasons and have no realistic way of changing those root causes. This ranges everywhere from the single mom with 3 kids and an eviction notice all the way to the high powered corporate executive stuck in an empty do-nothing career path.
Not everyone is wired the same but we’ve created a society that you must conform to extremely rigid norms or be at risk of destitution.
If you're wired like Marcus Aurelius, maybe it'll work out ok.
Peoples' neurochemistry differs enormously. One person's positive reinforcing experience is another's nociceptive hell. (source: Ph.D. neurophysiologist here)
Arguments like yours presuppose humans have free will, that it's widely distributed, and if $whoever would just get on it, they'd progress.
More and more, it appears what we have is the perception of free will, not the real thing - whatever that actually might be.
Not doubting your expertise, but I am skeptical of the idea that this method of intentionally leaning into discomfort only works for some minuscule abnormal subset of people that are just wired differently. Instead, I suspect it's tapping into something deeper about how our reward system is structured, something extremely related to how these GLP-1 agonists work, which explains why they are both effective against a shockingly wide array of seemingly different situations.
The basic idea seems to be at the core of both a lot of modern self help gurus advice that seems to actually work for a huge fraction of the people that really commit to them (David Goggins, Wim Hof, etc.) as well as modern psychotherapy systems like CBT and ACT that are proven clinically effective.
How many people are really trying this approach, and it not working for them? More often, I see people saying it sounds like it royally sucks (which is true and basically the entire point), and never trying it- which is valid, but doesn't really demonstrate that it wouldn't work for them.
It absolutely is a "nociceptive hell" at first for everyone that tries it, but when you connect that with intention, purpose, and meaning it eventually transforms into something almost enjoyable. Becoming strong enough to meet discomfort or pain feels amazing, especially for someone that usually experiences the opposite of that.
I also have ADHD, which is explained in part as a developmental disability of executive control, but I find this approach to be extremely effective for regaining executive control, even to levels that people without ADHD lack. Basically, I suspect ADHD isn't a loss of executive control at all, but the executive control is being blocked by something like the feeling of pain or drug withdrawal, and that once you are okay with just having that bad feeling all of the time, you get your executive control back. I'm curious if GLP-1 drugs also help with ADHD? My prediction is that they would.
Nothing they wrote implied minuscule or abnormal.
Can you define huge fraction and really commit? And cite evidence?
I disagree the basic idea of CBT or ACT is leaning into discomfort. In the senses articles suggest David Goggins and Wim Hof advise even less.
CBT and ACT work for many patients and don't work for many patients.
Some people liked intense exercise their whole lives. Some people hated it when they started but liked it eventually. Some people exercised daily since decades and hated every minute. Do you not believe the 1st and 3rd groups?
Pushing through bad feelings is a form of executive control. And ADHD impairments are not limited to impulse control. People who have ADHD who do not take medication have significantly higher rates of driving accidents than people who do not have ADHD or take ADHD medication. Proprioception, internal time perception, and working memory impairments are common.
> I disagree the basic idea of CBT or ACT is leaning into discomfort. In the senses articles suggest David Goggins and Wim Hof advise even less.
I am somewhat baffled by your statement, as I feel it is largely self evident being familiar with, and having tried both therapy methods with professional therapists, and both Goggins and Hof's advice for years. I think a simple wikipedia level explanation of what those things actually are would suffice to answer your question, so I have nothing major to add, unless I am misunderstanding you. Goggins whole shtick in particular is just this one basic point, make yourself as mentally tough as possible by intentionally always doing whatever is difficult. Hof is also just literally getting into very cold water consistently, which is really not easy- and he has no real philosophy or theory, he just has you do it and see what happens.
Perhaps the therapy methods are less clear, but reframing things or deciding on clear values and purpose, are in my view, psychological tools to make the difficult endurable, or in some cases even enjoyable. This makes more sense if you're seeing the methods in the context of how the ancient stoics used the same techniques that inspired those therapies- especially Epictetus.
> Can you define huge fraction and really commit? And cite evidence?
Not really, it's just firsthand experience from doing them, and having widely sought out and read the experiences of others that did online.
In other words, gathering your own anecdote, compounding that with other anecdotes through biased sampling (which kind of person will feel more motivated to share their anecdote on it? And which and anecdotes do you reject because they just didn't try hard enough?) and then projecting that onto every other human being and assuming they must experience the same thing you do.
I never claimed it works for everyone, I am doubting that it is a provable fact that it works for only a minuscule fraction of people- I am not sure exactly what fraction of people this would potentially work for.
You are effectively implying that firsthand experience and expertise are completely worthless, and people can only learn information from large scientific studies, which is nonsense- it would invalidate virtually everything humans know that allows them to effectively navigate the world. I'm a working academic scientist that often designs and executes large studies, and I only ever see these arguments and line of thinking from non-scientists that don't actually understand the limitations of scientific methods, but have turned it into some sort of pseudo-religion.
These are effectively yoga/meditation like techniques that are taught in communities I am part of, and that I have taught to friends and family. I'm not under some delusion that there isn't bias there, I have seen it not work for people, and account for that in my thinking about it. It's been life changing for me, and so I am happy to share info about it in case it might be for others, but I'm not under some delusion that it is the solution to everything.
Correct me if I'm wrong, but I get the impression that your comment isn't really about what I am actually saying, but a general anger towards anything that looks like "pulling yourself up by your own bootstraps"- an anger you can see in other comments in this thread as well. This toxic line of thinking comes from an old fashioned moral argument, that basically derives ones moral standing and worth as a person from the state of being helpless and persecuted, which requires one to actively fight against anything that might be an effective tool to overcome adversity.
I don't agree that using techniques that can help people overcome adversity in any way diminishes the challenges people face, or diminishes things like systematic injustice and addiction that certainly can be due to factors outside of one's control, and hard or impossible to overcome.
Having tools and methods that can, even sometimes, empower people to overcome, survive, and thrive, even if they don't work every time doesn't invalidate those problems, it is just one way to fight them.
“I am skeptical of the idea that this method of intentionally leaning into discomfort only works for some minuscule abnormal subset of people that are just wired differently”
That may be the aspect of this line of thinking that’s not clear then: it doesn’t work for anyone. At least, in so far as the free will is illusory, it is a hallucination that such people have that they made such decisions, and stuck to them. It’s the demon hand syndrome, the person hallucinating a rationale for its motion.
The free will question seems to be a red herring- philosophers and physicists can argue all they want about if something like free will is physically possible or not, but for all intents and purposes, even without free will, the path of someone overcoming, e.g. alcoholism after using these methods requires using them in a way that is challenging, and if you decide on the nihilistic stance that there is no free will so there is no point in ever trying to do anything, then you are guaranteed an undesirable outcome.
Perhaps beforehand it was somehow "pre-determined" which of these attitudes and paths you would take, but that is completely irrelevant for the individual just living life, they have no way to know that one way or another, or any reason to actually care, as they still need to act exactly like they have free will and made the right choice to actually play out a future as the type of person pre-determined to have a desirable outcome.
It doesn't actually feel any easier or less painful to accomplish something difficult, even if free will is some sort of illusion when looked at from the outside perspective. You still experience, e.g. trying and failing over and over and never giving up until you succeed.
I can buy that, for example perhaps there is something outside our control that decides if you are capable of never giving up, but you still cannot know until you decide to never give up and try it- so it literally does not matter except as a philosophical curiosity.
I think a more interesting biological (and philosophical) question is why and how exactly do these GLP-1 drugs work, and why exactly are they so shockingly effective? Maybe they do somehow act on the brain to offer exactly the same psychological benefits as the stoic approach I am talking about, by the same or related underlying mechanism, and they're essentially interchangeable but work more often?
This topic is a great example of how results from down-in-the-weeds biochemistry immediately raise questions at the top levels of consciousness and existence.
“Leaning into discomfort” for personal change may well work for much more than a miniscule fraction of people. It may be that such success is made more likely by some structural predisposition – an attenuated neuronal response to negative reinforcement, or some other precondition that allows its “carrier” to keep plugging to a successful outcome.
But clearly, there’s also a more than miniscule fraction of people for whom that doesn’t work. Their preconditions may deflect them from even trying that particular path, or cause them to give up along the way. I really don’t know, but that fraction seems at least as significant as the fraction for whom uncomfortable personal development paths lead to success.
Early in my career, I strongly believed in free will. I mean, I had it, right? And I didn’t regard my consciousness as all that different from my fellow hominids, so they’re probably all similarly endowed, right? Except...
Over time, research with small molecules like epinephrine and the psychedelics showed that perception/decisions/will could be profoundly influenced by neurochemistry. Ditto for various neuronal illnesses that are associated with profound personality changes.
I regard the GLP-1 results as a further demonstration that “free will”, whatever that is, is fundamentally mechanistic. There are few, maybe no, organismic drives stronger than hunger. A weekly injection of a GLP-1 agonist turns that drive way, way down in most of those who try it. This commonly exhibits itself in profound behavioral modification: if you were an inveterate snacker, suddenly you’re not interested in snacks. You pass them by in your pantry and at the grocery store. Your cognition around snacking changes, to the extent that not only aren’t you snacking, but you might find yourself setting a reminder that it’s time to have lunch. Given the strength of the hunger drive, that’s a very big deal, and revelatory about how we work.
I used to think I understood “free will”. Lately, I find it increasingly hard to define. I’m moving more in the direction of Robert Sapolsky as more research results come in. It feels to me a bit like the “God of the gaps” phenomenon, in which the space available for faith in the supernatural grows smaller with every scientific discovery.
It’s a remarkable time to be alive and have the luxury of considering these questions.
Ah, you might have seen my reply to someone else addressing the free will question from a philosophical angle, but despite also being in the life sciences, I never expected you were thinking about it biochemically.
I think it's obvious that we don't have "free will" in that sense, it had never really occurred to me to consider otherwise- people are definitely quite driven by instincts, neurochemicals, etc. they they can't consciously choose.
However, I think my comment in the other thread still applies- that for an individual, it doesn't really matter one way or another- your firsthand experience is still going to be one of exercising your will to increase the odds of getting outcomes you want in life, or choosing not to, and definitely not getting them.
But there is some biological clue here about who we are, and how our brains work that is fascinating, when you consider the breadth of human health problems and challenges that these GLP-1 agonists influence. I can't wait to see what more is learned about this in the future.
Having "grit" is more likely a symptom of coming from privilege. The marshmallow experiment comes to mind. Some kids were able to resist the urge to not eat the marshmallow for the promise of getting two if they waited. Others could not. The kids that could defer reward ended up having better life outcomes. In retrospect it was a test for privilege. Kids from poorer backgrounds tended to go for the immediate reward of the marshmallow. The test really showed that privileged kids have better life outcomes than kids that don't have privilege. Not really a surprising outcome.
FYI here is the follow on study that controls for socioeconomic factors: https://pmc.ncbi.nlm.nih.gov/articles/PMC6050075/
Anecdotally I've experienced something similar.
After I started committing, really committing to consistently working out, a lot of other things fell into place more or less automatically. I stopped drinking, started eating very cleanly (I became ravenously hungry; junk food and sweets aren't appealing anymore), and stopped spending as much time on gaming. I know your broader point is about leaning into discomfort, but specifically leaning into exercise seems to bring extra benefits. Exercise is medicine, as they say.
I think for this to work psychologically, it just needs to be something difficult or uncomfortable that you can do an awful lot of in a way that is sustainable, and doesn't actively harm you... all the better if you actually benefit directly from it, like with exercising, but cold showers work just as well, simply because they're uncomfortable and take much less time than working out- I personally do both.
The issue with addiction is, it’s very often a symptom of other underlying issues. Relapse are common because too often the underlying problem isn’t treated. Overcoming the addiction is hard because it means facing the thing the addiction allows you to avoid.
Addiction is also common(ism) amongst those who suffer from NDP. In this case, is it truly addiction, or simply another tool in their NPD cache of weapons.
I don’t disagree with you. But it’s also important to be aware of some of the nuances and finer points. I also recommend reading “The Courage to be Disliked”. Not that it / Adler speak to addiction but it’s a thought provoking alternative to the Freudian paradigm.
Getting rid of an addiction also counts as strengthening your mind in itself. A healthier mind will be in a better position to strengthen and fortify itself.
> There are huge benefits to developing the mental strength and discipline to lean into discomfort consistently and just do what needs to be done
Don't fall into 'I can do it, therefore everyone should be able to do it' trap.
Why would you say I am falling into that trap? My comment specifically addressed the issue that it might not work, and included a specific strategy for how to not get stuck too long on the idea of working if it does not.