Episode 136: Michael Golding on Mental Illness and Universal Explainers

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Unofficial, reviewed transcript. It may still contain mistakes; check the podcast when wording matters.

Speakers are labeled by first name where identified. Unidentified-speaker labels may refer to different people. Bracketed question marks indicate uncertain wording.

Transcript

[00:00:00]  Unidentified speaker: Hello out there.

[00:00:02]  Peter: This week on The Theory of Anything podcast, we had the absolute pleasure of interviewing Dr. Michael Golding. Michael is a psychiatric physician. He is also heavily influenced by the philosophical ideas of David Deutsch and Karl Popper.

[00:00:21]  Unidentified speaker: And at one point, he calls himself a proponent of homeschooling and taking children seriously, or the assertion that children should be raised without coercion.

[00:00:33]  Peter: I enjoyed this conversation with Michael immensely. I believe he is a fellow traveler who is wrestling with these ideas about humans and reality in a very real way.

[00:00:44]  Unidentified speaker: And I hope someone else out there gets something out of this too.

[00:00:54]  Bruce: Welcome to The Theory of Anything podcast. We've got Michael Golding here with us today, and Peter, obviously.

[00:01:01]  Unidentified speaker: Yay.

[00:01:03]  Unidentified speaker: I mean, yay that Michael's here, and yay that I'm here too.

[00:01:07]  Bruce: Michael is a friend of mine, we've been friends for quite a while, we're online friends. And we've talked quite a bit about different subjects, and I've kind of followed him on Twitter also, and really like a lot of what he has to say. So I finally decided that we really needed to bring him on the podcast and ask him questions. So Michael, can you maybe give us a little bit of background about who you are, what your position is, what you do for a living, that sort of thing?

[00:01:33]  Unidentified speaker: Sure.

[00:01:35]  Michael: I've been a board certified psychiatrist for maybe 25 years or so. I've worked in just a broad variety of settings. I've worked in academia. I've also worked with homeless populations. I've had the privilege of cutting my teeth with some of the toughest to treat back ward patients back at a time when we were allowed to keep them in inpatient hospitals for very long periods of time. And that's, I mean, we could maybe talk about that later, but that was very formative for me.

[00:02:22]  Unidentified speaker: Interesting.

[00:02:23]  Michael: And few psychiatrists nowadays, the younger ones have that opportunity. And to me, that's really, really sad because they don't get to see over like four or five or six years what can happen when you treat somebody whom they think cannot be treated. So I have that experience and also the experience of that culture, which really has not been written about much in psychiatric circles. There is, there are a few psychiatrists here in California who are starting to do it a little bit. And, you know, they're known as very, very good pharmacologists. I think because of the insight that they've gotten working with deeply, deeply ill psychiatric patients. But in addition to that, I've also had the opportunity to work in administration in a prison system, and actually one of the largest prison systems in the United States, or perhaps used to be the largest, as the statewide chief psychiatrist, you know. So I have a lot of experience with administration as well. So I've done a number of things in my years, and nowadays, I'm still in administration, and not in the same position that I once was for a variety of different reasons. And I am enjoying my life and plan to keep continuing doing psychiatry for hopefully another five, ten years, something like that. While I figure out what one would do if I were to ever retire. It's become a bit of an identity for me. So yeah, that's my background.

[00:04:28]  Unidentified speaker: It's broad.

[00:04:28]  Michael: I published some papers, done some experimental work with patients, done a lot of different things over the years.

[00:04:37]  Bruce: Before we ask any questions, I would actually like to know what your background is with David Deutsch. So David Deutsch, I read his books years ago, actually before Beginning Infinity even came out.

[00:04:47]  Unidentified speaker: So I read Fabric of Reality.

[00:04:49]  Bruce: And that book really inspired me in various ways. I ended up going back to school and studying artificial intelligence because of that book. And a lot of the stuff in the show, we've mentioned him quite a bit. And he's in some ways an inspiration for the show.

[00:05:04]  Unidentified speaker: And I know that you're friends with him.

[00:05:06]  Unidentified speaker: So can you maybe talk about your background with David Deutsch?

[00:05:10]  Unidentified speaker: Sure.

[00:05:12]  Michael: I do know David Deutsch. And I've been pleased to meet him a number of different times. And he's provided and dispensed a lot of wisdom. And we've had the opportunity to engage in wonderful conversations together over the years. I initially met him through a friend of mine. We had been engaging in discussions of mental illness. And this friend of mine had said that she really didn't think that mental illness existed. She had read Thomas Szasz's books and thought that as universal knowledge creators, we could generate knowledge that would in any given time solve a particular problem. Or perhaps I'm misrepresenting her. Or at least she thought that or heard that said. What changed her mind, and by the way, I may well be misrepresenting that. So I apologize in advance if I am.

[00:06:18]  Unidentified speaker: It was your understanding at the time, that makes sense.

[00:06:20]  Michael: That was my understanding at the time. My guess is because this person is extraordinarily bright, that that is a misapprehension. I should go back and ask actually before I state it, so I won't mention the person's name.

[00:06:33]  Peter: To put this in context, are we talking about a decade ago or before beginning of infinity?

[00:06:40]  Michael: No, no, no, no, more like two decades ago.

[00:06:43]  Unidentified speaker: Two decades ago, okay, so you're kind of like Bruce.

[00:06:45]  Unidentified speaker: You're old school here.

[00:06:47]  Unidentified speaker: Yeah, I am.

[00:06:49]  Michael: Yeah, my gray hair's a salute in honor of my age. But yes, it was for maybe 20 years ago.

[00:07:00]  Unidentified speaker: And this person had the opportunity to volunteer at a hospital and to see some of my patients.

[00:07:10]  Michael: I sort of challenged her to challenge her own ideas about what mental illness was. And I think within maybe hours, maybe days, she had just a radical, radical change in mind.

[00:07:27]  Unidentified speaker: Sometimes what's explicit rather than what's imagined helps one to criticize or refute theories better than just imagining them.

[00:07:41]  Michael: So she then became, and this is maybe the most humorous part of this of all, she now sort of went a bit into the field herself, and now is far more biological than I ever would have been, and that I am. She actually points out to me the way in which various chemical precipitants can cause problems. I'm not going to identify this person because it wouldn't be fair, but she's very much into biological psychiatry now, and seeing a few patients helped her to understand the way in which the brain can influence the mind. A dose of reality sometimes cures a whole bunch of metaphorical whimsy and a disease of the mind. I say that metaphorically because all of us, besides Szasz, know that psychiatrists are aware that there is no disease in an idea, and that it is a metaphor. Certainly, Thomas Szasz is, as you may know, a very famous critic of psychiatry, and is a psychiatrist who criticized psychiatry, said that psychiatric illnesses are metaphorical, essentially, because ideas can't be diseased.

[00:09:12]  Peter: And to clarify, was she more into the anti-psychiatry movement of Szasz?

[00:09:18]  Unidentified speaker: She wasn't.

[00:09:21]  Peter: At first, I thought you were saying that she is the one who turned you on to David Deutsch.

[00:09:24]  Unidentified speaker: She did.

[00:09:25]  Unidentified speaker: Oh, she did, okay.

[00:09:26]  Unidentified speaker: So she was into both sides.

[00:09:27]  Michael: Yes, exactly. She was into Szasz, and she knew David Deutsch very well.

[00:09:31]  Unidentified speaker: I see.

[00:09:32]  Michael: And she actually knew Thomas Szasz very well.

[00:09:34]  Unidentified speaker: Okay.

[00:09:34]  Michael: Not very well, but she knew Thomas Szasz a bit, and had actually interviewed Thomas Szasz.

[00:09:38]  Unidentified speaker: Oh, okay.

[00:09:40]  Michael: And so she introduced me to David Deutsch, and I had wonderful discussions with him on that topic, and many others, and particularly subjects other than that. And he has served as a mentor to me since, and that's been at least 20 years.

[00:09:58]  Unidentified speaker: Nice.

[00:10:00]  Bruce: So you mentioned Thomas Szasz, or Szasz, I think was what we decided.

[00:10:06]  Michael: I have no idea how to pronounce the name.

[00:10:08]  Bruce: None of us know how to pronounce it. Somebody who was from Poland told me it was spelled S-A-S, S-A-S, but I think I'm going to do Szasz, because that's easier for me to pronounce and it looks more like the way. More people probably pronounce it that way. So I'm going to go with Szasz throughout this episode, but that's probably wrong. So you mentioned him. Can you maybe talk a little bit about his ideas and your feelings about his ideas? What do you think he gets right?

[00:10:35]  Unidentified speaker: What do you think he gets wrong?

[00:10:37]  Unidentified speaker: Sure.

[00:10:38]  Michael: Perhaps I should just let your audience know ahead of time, that people can be of good individual character, treat their wives and families well, and have honorable intentions, and have really, really bad ideas that injure people. So I don't think Szasz intentionally tried to injure people. Indeed, I'm quite sure he felt he was trying to help them. But in that, I feel his contribution was a negative one, although there were some things he said that were very good. Szasz was a libertarian in many ways, certainly a very fierce advocate for human rights, and very much defended people's freedom and ability to choose. One of the things that he very much got right was that physicians or psychiatrists should not be able to force people into hospitals against their will. And I want to clarify that for a moment. I think Szasz would say that even if someone were just completely out of their mind, from my perspective, and I knew that I could help them to think better, I think he would tell me that I shouldn't be able to even immediately put them in the hospital.

[00:12:13]  Unidentified speaker: I don't agree with that.

[00:12:14]  Michael: I think I very much should be able to put them in the hospital. But it used to be that physicians were able to keep people in hospitals virtually indefinitely without a court order.

[00:12:29]  Unidentified speaker: And what Thomas Szasz got very right was that that can't be just a medical decision that has judicial implications and legal implications and moral implications.

[00:12:43]  Michael: And it needs to be more of a society wide decision. And hence, it should be judges who after a very brief period, often in 72 hours must determine whether a person stays in the hospital. And I agree with that. In fact, I agree even in some sense more strongly. I think and most of my psychiatric colleagues, I think, based on set of informal polling, that it should be judges who decide when patients leave as well.

[00:13:17]  Peter: So is this, is he part of a, this larger movement of deinstitutionalization?

[00:13:23]  Unidentified speaker: Oh, yes.

[00:13:24]  Peter: Is it fair to say that he is like the big name behind this?

[00:13:29]  Unidentified speaker: Or like, is that overstating things?

[00:13:32]  Michael: Maybe overstating it a little bit. But his deinstitutionalization was, he provided academic credulity for that point of view.

[00:13:43]  Unidentified speaker: Okay.

[00:13:44]  Unidentified speaker: He, there were, you know, a lot of people, civil libertarians and others, felt that we were keeping patients in hospitals for too long.

[00:13:56]  Michael: And it would be better if we treated them in the community. But the problem is treatment in the community never materialized. And we ended up shutting down virtually all of our long-term psychiatric hospitals, the ones that I told you about earlier, that I had the opportunity to train in. And as a consequence of that, many of them ended up homeless. And the real big consequence of that, and this is maybe not the discussion to have, if you wanted me to come back, I have other discussions about that. This led to massive increases in our prison population of mentally ill patients. And that has been, in my view, catastrophic. It's radically different. Our rates of psychiatric hospitalization, massive, massive increases in psychiatric, rather in prison incarceration rates, many of them due to our mentally ill patients, who it's both more expensive to treat them there. It's unethical to treat them there. They don't get as good care there. And more interestingly, it's more expensive to treat them there. That's an example of sort of his bad ideas leading to helping us into a rather bad place where we currently are.

[00:15:23]  Unidentified speaker: A lot of people will say, for some reason, this is repeated all the time.

[00:15:26]  Unidentified speaker: They'll say Reagan closed the institutions, which is a myth, right?

[00:15:31]  Unidentified speaker: Do you agree with that?

[00:15:33]  Michael: I don't know the history of Reagan, but I honestly don't know. But I think there were a lot of forces. There were a lot of anti-psychiatry forces. There were a lot of civil rights forces.

[00:15:49]  Unidentified speaker: It's a complicated idea.

[00:15:50]  Michael: There were a lot of humanitarian forces, and there were academic forces coming from people like Thomas Szasz who helped us to close a lot of our psychiatric institutions.

[00:16:01]  Unidentified speaker: Fair enough.

[00:16:02]  Bruce: Can you talk about your experience? You mentioned cutting your teeth there. What was your actual experience in such a hospital before they started closing down?

[00:16:11]  Unidentified speaker: Well, you might imagine that it was not perfect.

[00:16:16]  Michael: It's certainly far better than what I currently see in our prison system. I mean, the difference really was, is that, and certainly in the early days, we had far more time to try to get things right for patients. And therefore, we really learned to iteratively try medications, to learn what works for the individual, which is to say, individualizing treatment rather than just basing treatment on study averages, which don't apply to the individual.

[00:16:55]  Unidentified speaker: And as a consequence of that, we got to see over time how patients can, in fact, improve with multiple different trials of medications, and importantly, a multiple psychosocial interventions.

[00:17:11]  Unidentified speaker: Let me give you an example of this.

[00:17:13]  Michael: One of the few papers that, it was actually a poster that I really should have written up as a paper that an undergraduate UNC student did with me, was looking at rates of return to the hospital. Now, we were looking at patients who had had, I can't remember the study criteria, but I think it was like four or five previous psychiatric hospitalizations in the last year to the state hospital. Now, what kind of interventions were we able to try back in the old days? We ended up showing that of like, something like 200 out of 202, or some very high percentage of patients whom we discharged from these long-term hospitals did not return in the next two years. Which was astounding, which was the lowest rate, to my knowledge, of return or recidivism ever recorded.

[00:18:15]  Unidentified speaker: But what is the simple thing that we did?

[00:18:18]  Unidentified speaker: It wasn't medications.

[00:18:19]  Unidentified speaker: It was something that they allowed that I wish they would allow now.

[00:18:23]  Michael: What our social workers did was basically allow them to stay enrolled in the psychiatric hospital while we essentially discharge them to various places around North Carolina, various group home. And then we'd have them stay there and we'd call like every couple of days or every week these very, very sick people and ask how is Mr. Smith doing? He's doing fine or it's just isn't a good place for him. And we literally would try place after place if someone didn't work out in these trial visits, we would bring them back to the hospital. So before we finally discharge them, we iterated, we learned what worked for the person. And that is what I think is missing when you don't have continuity of care with patients anymore.

[00:19:20]  Unidentified speaker: You don't learn how to help them.

[00:19:22]  Michael: And I think this is what's wrong with so-called evidence-based studies, even though I very much love and appreciate evidence, but understanding is not based on evidence. Evidence follows from understanding, so that the term evidence-based is a bit of misnomer, even though evidence is of absolutely critical importance in my field and others. I just, the terminology seems backward to me.

[00:19:50]  Unidentified speaker: However, that aside, the ability to learn is not really accounted for in most randomized trials.

[00:20:01]  Michael: That goes for psychiatric medicine as well as physical medicine. And because it isn't taken into account, we make sort of egregious errors.

[00:20:12]  Unidentified speaker: It needs to be taken into account.

[00:20:13]  Michael: If you can learn whether someone does well, and if they don't do well by trial and error, well, bring them back to the hospital and send them somewhere else. Then ultimately, the place you pick, and we were able to do that for like two months. So now you can imagine why the authorities would get mad at us, because what was happening? They were basically, we were basically billing. The hospital was billing to care for the patient, which maybe they shouldn't have been, and the family care home was billing to take care of the patient. So it seems like it's fraud, but it's fraud in a very interesting way. Two sets of teams are monitoring the person, both in the inpatient and outpatient, and making sure that critical transition, where there's so many slips between the cup and the lip, occur. We were able to monitor and make sure that critical transition was smoothly, and essentially none of the patients returned to the hospital just by learning where they like to stay.

[00:21:11]  Unidentified speaker: Interesting.

[00:21:13]  Bruce: You mentioned the whole universal explainer thing, where some people who believe... I mean, I agree with David Deutsch, we're universal explainers, human beings are, we're the only ones that we know of in the entire universe at this point. That's what makes us separate and distinct from animals. Now, there is, amongst people who believe in that, there does seem to be a strong belief, amongst some of them, that because human beings are universal explainers, mental illness is impossible. And you already talked to this a little bit, but let me make a steel man case for it, even though I honestly don't really agree with this point of view.

[00:21:56]  Unidentified speaker: So if we are universal…

[00:21:57]  Unidentified speaker: Perfect.

[00:21:58]  Michael: We should do that.

[00:22:00]  Unidentified speaker: I agree with you.

[00:22:01]  Michael: You're quite Popperian. Try to make the opponent's argument in its strongest possible terms.

[00:22:06]  Unidentified speaker: Yes.

[00:22:07]  Unidentified speaker: So what I have in mind is something like this.

[00:22:09]  Bruce: So if we're all universal explainers, with essentially equivalent ability to understand or create explanations, I really think I can see why some would believe that that implies a lack of genetic influence and an inability for mental illness to exist. So given that animals as a species, we literally have animals and then great apes, let's say, and suddenly there's this jump to universality. And then at this point, it's the ideas that are the main driver, right? It's no longer the genes that are the main driver, right? And based on that, and then there's this idea, I can talk about this a little bit more in a second, but there's this idea of we can error correct our ideas, right? So if you've got bad ideas, you can error correct them. You can almost see why someone might look at that and say, you know what, I'm not sure there's such a thing as genetic influence. I'm not sure there's such a thing as mental illness. How would you tell the difference between, this is the way this person would argue, how would you tell the difference between a mental illness and someone just making choices that are unique or interesting, right?

[00:23:20]  Unidentified speaker: Or maybe even bad.

[00:23:22]  Bruce: And based on this argument, I can kind of wrap my mind around this idea that there's no such thing as mental illness. Can you maybe speak to that a little bit, the steel man form? How would you respond to that? And what's wrong with this argument?

[00:23:39]  Michael: I have a feeling that other than not what I said previously, but what you just said is probably what my female friend would have argued to me so many years ago. So that's well said.

[00:23:53]  Unidentified speaker: And in some ways very strong and in some ways very true.

[00:23:55]  Michael: I mean, there are several points along the way that I might quibble with. The overall argument is good in the sense that it leads to the optimistic conclusion that because we are universal explainers, we can increase our ability to understand things indefinitely. And it's therefore possible for us to understand anything that can be understood if the universe is, I guess, the way our, or at least my, at least the way our colleague, Dr. Deutsch, describes it, at least if the universe is simulatable on a quantum computer, at least if the universe is essentially simulatable on a standard digital computer with enough space and time. So how do you square that with the idea of mental illness? Well, one thing I'd quibble it with is your sense in what you said. I don't know that you actually believe this, that we have equivalent abilities to explain things.

[00:25:08]  Bruce: So, yes, let's talk about that, because I have actually challenged that idea on this podcast. So you're right that I don't actually believe that, but it's one of those things.

[00:25:15]  Unidentified speaker: I don't in any way believe that.

[00:25:18]  Bruce: Well, it's one of those things that I can kind of see why someone would believe it. So can you maybe talk to that very specifically?

[00:25:24]  Unidentified speaker: Oh, yeah.

[00:25:25]  Unidentified speaker: Okay, go ahead.

[00:25:26]  Unidentified speaker: I mean, it seems to me there's some basic truth that I think they would emphasize this idea that all of our abilities are interest driven, which I mean, I kind of see a lot of evidence for that in my life, at least, that if the kids in my math class that are interested in math tend to be good at math, it's hard to separate that, right?

[00:25:52]  Michael: Yeah, well, it's hard to separate someone being intrinsically good in math and therefore developing an interest from being good and then being good in math. Both seem to me to be true, and maybe not surprisingly so. In terms of the, first of all, just as an almost an empirical falsification of the claim, I would just, I don't know if you've ever met somebody with say Angelman's syndrome, who may have an IQ of say 30 or 40, and I think if I'm recalling correctly, it comes from a deletion on chromosome or parts of chromosome 15. These kids are really sweet, they're very nice. Some of them learn a few words. They seem to be able to understand something, but if anyone thinks that they're going to be able to, in this lifetime, understand quantum gravity or come up with a new theory of quantum gravity, I've got another thing coming. None of them ever have and that just the level of creativity isn't there. Even someone with Down syndrome trisomy 21 with an IQ of, say, 70 or 80, they're not going to be able to do that either.

[00:27:05]  Unidentified speaker: So what's not even given 100,000 years.

[00:27:08]  Unidentified speaker: Okay.

[00:27:08]  Unidentified speaker: Now that, there you go.

[00:27:10]  Unidentified speaker: Thank you.

[00:27:12]  Unidentified speaker: There you go.

[00:27:12]  Unidentified speaker: Thank you.

[00:27:13]  Unidentified speaker: Well, all right.

[00:27:14]  Unidentified speaker: Let's interview.

[00:27:15]  Unidentified speaker: Let's shift.

[00:27:15]  Michael: I'll be the interviewer.

[00:27:16]  Unidentified speaker: I'm sorry, sorry, sorry.

[00:27:18]  Unidentified speaker: No, not sorry.

[00:27:19]  Unidentified speaker: You're right.

[00:27:21]  Unidentified speaker: Thank you for helping me with my argument.

[00:27:27]  Unidentified speaker: I think you're right.

[00:27:27]  Michael: That is exactly where I was going to be going.

[00:27:29]  Unidentified speaker: And what I was going to say is that if people can understand something, then they need to be able to continue to improve their understanding to be able to ultimately explain, ultimately to explain anything.

[00:27:45]  Michael: But in order to do that, what are they going to need? Well, they're going to need knowledge. They're going to need knowledge of knowledge to be able to increase that knowledge, to figure out how to mutate ideas, how to add variability to the ideas, and then how to select them. That's knowledge of knowledge. And I would add a third point, which is really the second point. But it's, the details are a little bit different. I would say that one of the very key things, and it's something that I think experience brings, is the ability to know when to leave well enough alone with a given bit of knowledge and explore something else. Like how not to break things, if you will. That I call wisdom. It's another form of knowledge about knowledge, and it's a type of knowledge about knowledge that is learned.

[00:28:39]  Unidentified speaker: But there are two other things that drive this.

[00:28:42]  Michael: Even if we're imagining that the universe can be simulated by a Deutsch quantum computer and the rest of it, and therefore all problems are soluble because everything could be simulatable and therefore understandable, and we can reverse any problem that doesn't involve violating a law of physics.

[00:29:01]  Unidentified speaker: It's difficult.

[00:29:03]  Unidentified speaker: It's one thing to say that.

[00:29:04]  Michael: Another thing, how do you get there to be able to solve any particular problem?

[00:29:08]  Unidentified speaker: Speed and memory are really key elements of that.

[00:29:12]  Unidentified speaker: Since we've been talking in a very high-falutin way, and I don't know that everyone that's going to be listening to this podcast is very familiar with Professor Deutsch and his ideas, although I've probably already not explained enough.

[00:29:29]  Michael: But let me try to break this one down and make it much simpler, and talk about something that's really very concrete. Let's just talk about a chess program for a minute, and whether a chess program can indefinitely continue to learn, and what would it be required for just a chess program? Now, that isn't a universal explainer.

[00:29:52]  Unidentified speaker: But it's something, it has knowledge of a sense, it has know-how, if you will, of how to, of the models of chess.

[00:30:01]  Michael: It's implicit knowledge, it's not aware of its knowledge, it's not human, it's not thinking about it. A few years ago, Google created something called AlphaZero, which was, at least in the press advertisements, all that was given to the computer was a set of rules of how to play chess. And so at first it played very poorly, but literally within, as the story goes, hours, it became the most powerful chess program in the world by increasing its, if you will, knowledge of how to play chess. So that seemed to so many people as knowledge of knowledge. It knew how to increase its knowledge.

[00:30:42]  Unidentified speaker: But what happened to that program since?

[00:30:45]  Michael: The answer is, well, it didn't improve in one sense. It did improve in another. How did it improve, though? It improved not by continuing to learn just by giving the rules of chess. It continued to learn by a human being intervening and changing its programming. So now AlphaZero and I Gather Stockfish certainly can destroy any human in the world and are one of the two, if not the two strongest chess programs in the world. But I want to ask the question, because I think this is more concrete. What would have made or what would make something like AlphaZero continue to gain knowledge that doesn't mean it would be a universal explainer? Because again, there are the other components, like understanding and meaning, and we don't exactly know what those are. But at a minimum, and I think this has a lot to do with large language models, it should be able to continue to learn and get better and better, and yet it doesn't.

[00:31:48]  Unidentified speaker: So what is missing from it?

[00:31:54]  Michael: So let's imagine for a minute, we know that if we give a computer more time to think, even say alpha zero, it tends to play a better game. And if we give it less time to think, it tends to play a worse game. We also can imagine that if we, say, took away its ability to use memory, it would play a worse game. And what it does is it plays games against itself to judge its relative quality. So let's say we, and it's said to have like an ELO now of 4,000, whatever that means exactly, 4,050 or 40 or something like that. And the very best chess players in the world, whatever this means, have an ELO rating of like 2,700 or 2,800, like Magnus Carlsen.

[00:32:43]  Unidentified speaker: Yeah.

[00:32:44]  Unidentified speaker: Okay.

[00:32:46]  Michael: What would make this program actually continue to get better, which would be a prerequisite for explanations to continue to get better? Let's imagine that what we did was, and I think I'm doing this to explain why speed and memory are really, really important in the ability to improve in a reasonable time frame. Let's imagine that we designed the program to eliminate part of its memory and to restrict itself in terms of the time that it has relative to another version of itself. Now, let's imagine that we have it randomize many of its algorithms and subroutines. By the way, I'm going to come back to this point, so don't jump too quick, because this is a key point. And keep doing it until with less time to think and less memory space, it plays as well as it did previously. Not necessarily better, but just as well. So it is measurably as good.

[00:34:09]  Unidentified speaker: That we can measure.

[00:34:10]  Unidentified speaker: Is it as good?

[00:34:13]  Michael: If so, then it is now using less space, less memory space, less time to think, and less time to play equally well.

[00:34:26]  Unidentified speaker: Now, what happens then?

[00:34:28]  Michael: Essentially, its algorithm has been compressed.

[00:34:32]  Unidentified speaker: It's been compressed.

[00:34:33]  Unidentified speaker: And in a way, one can think of it as a deeper bit of implicit knowledge.

[00:34:39]  Unidentified speaker: It's smaller, it encompasses more, and implicitly understands how to play chess better, but with less computer space.

[00:34:54]  Michael: So then what would happen if you re-expanded its memory and gave it more time to think?

[00:35:07]  Unidentified speaker: I've worked out some of these equations.

[00:35:08]  Michael: I've shown them to Professor Deutsch. I've done some of this work myself, which I find very, very interesting.

[00:35:16]  Unidentified speaker: But briefly, every expectation would be that it in fact would play better than its original self, because its algorithm would have been forced essentially to be deeper, to use less space, less time, to accomplish the same measurable tasks.

[00:35:35]  Unidentified speaker: This is a measurable outcome.

[00:35:37]  Michael: And then we could keep doing it, and then this chess program should get indeed indefinitely better and better in the sense of its ability to use space and time more efficiently, knowing how to do that efficiently. Now the logical question is, well, then why don't people do that? And I think there are two answers to that. One is most don't know that they maybe should think that way, or at least in my opinion they should.

[00:36:09]  Unidentified speaker: But the second reason is that business that I said that I'd come back to.

[00:36:14]  Unidentified speaker: What about that sort of that mutation thing of algorithms and that shuffling things about to make it play equally well?

[00:36:26]  Michael: How precisely long is a program certainly coded by me?

[00:36:31]  Unidentified speaker: How long would it take the program coded by me to do that?

[00:36:35]  Unidentified speaker: Well, and play as well.

[00:36:38]  Unidentified speaker: Maybe it would take a million years.

[00:36:40]  Unidentified speaker: Maybe it would take 10 million years.

[00:36:43]  Unidentified speaker: So clearly, this program can, the logic of that program can increase the knowledge of how to generate knowledge better, particularly the knowledge of how to play chess better.

[00:36:58]  Unidentified speaker: It can go on indefinitely, and therefore we have an engine of change for how if we add understanding to it, explanations can go on indefinitely.

[00:37:08]  Michael: But it might take, as Peter says, 100,000 years, as he previously said, or a million years.

[00:37:16]  Unidentified speaker: So I think time is very relevant.

[00:37:18]  Michael: Let's take it a step farther.

[00:37:22]  Unidentified speaker: Now we have a program, in order to be able to get depth of knowledge, a compressed knowledge is able to handle more variation with less space and time use.

[00:37:37]  Unidentified speaker: What if we wanted to make a program that discovers how to do mutation and selection more rapidly, effectively evolves evolution?

[00:37:53]  Unidentified speaker: Now, I suggest that that is precisely the kind of program that we must have evolved.

[00:37:59]  Michael: It doesn't take us millions of years to come up with new ideas and select and measure whether our ideas are better.

[00:38:08]  Unidentified speaker: It's actually, we've evolved evolution.

[00:38:11]  Michael: We've made the algorithm for randomizing and selecting more efficient. But just because we've made the algorithm efficient so that in principle it can go on forever.

[00:38:24]  Unidentified speaker: That doesn't mean some people can't do it better than others.

[00:38:29]  Unidentified speaker: And that doesn't mean that somebody with Angelman syndrome is really doing it poorly, even if they're able to gain knowledge.

[00:38:36]  Unidentified speaker: And that doesn't mean that someone with Down syndrome is not doing it poorly.

[00:38:45]  Unidentified speaker: So, I would really challenge this idea that people have equivalent ability to gain knowledge.

[00:38:50]  Michael: Now, I would say we could take this one recursive level up. We could learn how to do mutation more efficiently.

[00:38:58]  Unidentified speaker: So, that's knowledge of knowledge of knowledge, right?

[00:39:02]  Unidentified speaker: And that would be how do we learn to evolve evolution more rapidly?

[00:39:10]  Unidentified speaker: And all of that is absolutely possible.

[00:39:15]  Unidentified speaker: But it starts with sort of breadth of knowledge, the ability to do things quickly.

[00:39:23]  Unidentified speaker: And then once you have much deeper knowledge, then you don't need the time and the space as much to continue to evolve because your knowledge is deeper.

[00:39:34]  Unidentified speaker: And I think a simple algorithm like trying to figure out how to use space and time more efficiently is likely to have reach.

[00:39:43]  Unidentified speaker: Reach not only to playing chess, but to a whole host of ideas.

[00:39:48]  Michael: And I personally, in my own modeling, see this sort of in a fractalized way, where sort of lower level improvements in managing how one uses space and time leads to sort of higher level sorts of efficiencies, if you will. Deeper knowledge all over the place. So I think there are many levels evolving at once of learning how to do things more efficiently. So does time and space, does memory and speed matter? You bet it does. And that I think explains the various counter examples with developmental disabilities and many things that we see in our life, or strokes, or other sorts of things, which create all kinds of interesting conditions, as though we are universal explainers, and though in principle, evolution and evolving evolution, and evolving the evolving of evolution, can in principle go on indefinitely.

[00:40:46]  Unidentified speaker: Interesting.

[00:40:47]  Unidentified speaker: Thank you.

[00:40:48]  Peter: Yeah, that's a great perspective. Thought it might be interesting if I tried briefly to steel man the other extreme position, more of a biological determinism position, and get your thoughts on that. So we had a guy named Brian Boutwell on the podcast. He's also influenced by David Deutsch.

[00:41:14]  Unidentified speaker: He, at least somewhat, I don't think he's as deep into it as you are or anything, but he at least read the book and is into Popper.

[00:41:23]  Michael: By the way, I'm not claiming to be deeply familiar with David Deutsch, either personally or professionally or anyway.

[00:41:31]  Unidentified speaker: Fair enough, fair enough.

[00:41:32]  Michael: I do know him. I've interacted with him. I know him as a gentleman and a scholar, a decent man trying to help the world.

[00:41:39]  Unidentified speaker: I get it.

[00:41:40]  Michael: And as brilliant as all get out, but I can't claim personal knowledge.

[00:41:45]  Unidentified speaker: Of course, I get it.

[00:41:46]  Peter: But anyway, Brian Boutwell, he's an interesting guy. He's got a TED talk on this and written all kinds of articles for Quillette, wrote a paper in Nature on 100 years of twin studies. Did I say he's a criminologist? So he has kind of like a similar background to you.

[00:42:10]  Unidentified speaker: He believes that criminal behavior, I don't want to put words into his mouth, but I think he believes that criminal behavior is, I don't want to say wholly genetic, but there's a distinct genetic component to it.

[00:42:26]  Peter: His perspective is that, again, 100 years of twin studies indicate that everything we can possibly measure, academic ability, temperament, mental illness, IQ, all of this, is strongly heritable. I don't think I'm putting words into his mouth to say that. I mean, a lot of people think this, obviously. The example I keep coming back to is that siblings, let me see if I can get this out right. So siblings raised, twins or siblings, raised apart, practically everything about them, that we can measure about their personalities, is highly correlated, whereas non-genetically related siblings raised together, almost nothing is correlated. I don't think that's really overstating the case.

[00:43:24]  Unidentified speaker: So the conclusion from this kind of thinking, so I'm sure you're familiar with it, and Steven Pinker's blank slate, Judith Rich Harris's the nurture assumption, is that it's not that parenting doesn't matter, but that, you know, it's mostly, mostly genetic.

[00:43:47]  Unidentified speaker: Ability is mostly just genetic, and that's just who we are in nature.

[00:43:57]  Peter: I assume that you don't quite, you wouldn't go this far. So what would you say to someone who subscribes to this kind of mindset?

[00:44:07]  Michael: Yeah, I respect it. And think that the differences in genes absolutely matter, as I just gave two examples with trisomy 1 and Angelman syndrome. Let me give you something that it's not quite 100% heritable in one sentence.

[00:44:26]  Unidentified speaker: Yeah.

[00:44:27]  Michael: Or something I would say that used to be 100% heritable, but is now, well, is 100% heritable, I guess. But it is entirely created by the environment. And hopefully that would be a good counter example of everything you just said.

[00:44:45]  Unidentified speaker: Okay.

[00:44:46]  Michael: Think about the genetic disorder called phenylketonuria. Phenylketonuria is a disease that, it's an autosomal recessive disease.

[00:45:01]  Michael: If both parents... If each parent has the, it's a phenylalanine, I think it's a, I'm trying to remember, I think it's a phenylalanine hydroxylase. It's something called PAH, P-A-H is the way it's usually abbreviated. If you lack this enzyme called phenylalanine hydroxylase, or the enzyme doesn't work particularly well, and each parent has a gene for that, there's essentially a 100% chance that the kid will have PKU and be mentally retarded. So surely that's genetic, isn't it? 100% hereditary, like it's hereditary, it just comes from the genes. We even know it did it, it's absolutely heritable, right? I mean, what else could you say? Geneticists, like your friend, couldn't say anything else other than it's heritable.

[00:45:53]  Unidentified speaker: Except nowadays, if any kid in America develops mental retardation because of those genes, probably the parent should be taken in and charged with child abuse.

[00:46:12]  Unidentified speaker: Huh?

[00:46:13]  Michael: How can it be genetic in the parent's fault? This is the problem with the meaning of the word heritability. People don't know what the word means. And let me explain.

[00:46:28]  Unidentified speaker: In what envi...

[00:46:29]  Michael: Genes only do something given the environment in which they're in. What happens if you give a kid born with this genetic defect a diet free of phenylalanine? Well, if the phenylalanine can't build up in the blood, even if they don't have the PAH enzyme, then it can't become toxic to the brain, and then the child won't develop any mental retardation.

[00:47:13]  Unidentified speaker: So is it due to the genes, or is it due to the environment?

[00:47:16]  Unidentified speaker: Come on, real quick, I'm teasing you, but…

[00:47:21]  Unidentified speaker: Obviously, it's neither or both.

[00:47:25]  Unidentified speaker: It depends on how you think about it.

[00:47:26]  Unidentified speaker: Before we understood the explanation for it, I would say logically it was due to the genes.

[00:47:32]  Michael: I'm not going to blame a parent. Back in 1905, what a monster I would be.

[00:47:40]  Unidentified speaker: Yeah, it's heritable then.

[00:47:41]  Unidentified speaker: I'll say it's due to the...

[00:47:42]  Michael: If heritable means due to genes, then it's heritable.

[00:47:52]  Unidentified speaker: But in 2026, with these low-phenylalanine diets, and kids knowing how to do it, they don't have to be mentally retarded.

[00:48:04]  Unidentified speaker: So mental retardation is due to an intervention in the environment.

[00:48:09]  Unidentified speaker: What matters is your ability to explain.

[00:48:11]  Unidentified speaker: A gene can't cause anything absent an environment that allows it to do so, absent the knowledge that interacts with it.

[00:48:22]  Michael: Indeed, nothing can cause us damage if we understand it well enough. So genes no more determine things than bacteria or anything else. What really determines things is our ability to explain and understand things and make things happen that are better. And the same thing goes for all of those twin studies about whatever or whatever.

[00:48:49]  Unidentified speaker: Now, that may make it seem like I'm not sympathetic to genetics.

[00:48:55]  Unidentified speaker: I am.

[00:48:56]  Michael: Far, far more than I think a lot of Deutschians are.

[00:49:01]  Unidentified speaker: Far more than others.

[00:49:03]  Michael: Because I really think that when you don't understand what the genes are doing, it very well can be that the genes are doing something to you. That's why I say that it really was a genetic condition, and it isn't anymore.

[00:49:17]  Unidentified speaker: So I think one has to understand what heritability means.

[00:49:22]  Michael: And I think the failure to understand...

[00:49:24]  Unidentified speaker: Let me give you one more example of something.

[00:49:26]  Michael: This is a very famous example, I don't know, to me, very famous example from David Deutsch.

[00:49:31]  Unidentified speaker: And I can hardly say this one in public, and I'm going to say it very, very carefully.

[00:49:37]  Michael: Because people really get mad when they don't understand what I'm saying. And so I have to be very careful, so I may sound a bit redundant. David Deutsch asks the question, whether lynching in the deep south is heritable in the 1830s. Well, by any analysis, using the standard mathematical tools, that we use nowadays, it certainly is. So let's take those identical twins.

[00:50:17]  Unidentified speaker: Do they...

[00:50:18]  Michael: If you had a white kid who was raised by a black family, their odds of being lynched are essentially zero. But even if that black kid, whose identical twin were raised by a completely different family, he shares the same likelihood or a higher likelihood of being lynched.

[00:50:44]  Unidentified speaker: Why?

[00:50:46]  Unidentified speaker: Because his genes...

[00:50:48]  Michael: Because he shares genes in common.

[00:50:49]  Unidentified speaker: What do those genes do?

[00:50:51]  Unidentified speaker: Those genes cause black skin color.

[00:50:55]  Unidentified speaker: And what does that black skin color do?

[00:50:58]  Unidentified speaker: That black skin color causes racist white people to want to hurt people.

[00:51:06]  Unidentified speaker: So is lynching heritable?

[00:51:10]  Michael: Oh, absolutely it is.

[00:51:13]  Unidentified speaker: But in the same way that PKU is heritable, it depends on how the environment interacts with the gene.

[00:51:21]  Unidentified speaker: If you eliminate the evil white people, then lynching is no longer heritable.

[00:51:27]  Unidentified speaker: If you eliminate the phenylalanine, it's not that it's no longer heritable, it's no longer caused by genes.

[00:51:33]  Unidentified speaker: If you eliminate the phenylalanine, then the genes are no longer causing anything.

[00:51:38]  Unidentified speaker: So this is a good reason why we need explanation in science.

[00:51:45]  Unidentified speaker: Cause is not good enough.

[00:51:48]  Unidentified speaker: Cause doesn't tell you what's relevant or not.

[00:51:52]  Michael: Otherwise, lynching is heritable, or rather lynching is due to genes in the Old South, and PKU is due to genes. Mental retardation is due to genes when both can be easily overcome with a simple environmental intervention. Explanation matters. Causality is not really the operative variable.

[00:52:16]  Unidentified speaker: Does that make sense?

[00:52:17]  Unidentified speaker: No, that's fascinating perspective.

[00:52:20]  Bruce: So yeah, really early in the show, in this podcast, I made a similar argument that there is nothing that the genes can cause that once we understand how it causes it, we can't intervene. But if we don't understand how it's causing it, then it might as well just be heritable.

[00:52:39]  Unidentified speaker: Correct.

[00:52:40]  Unidentified speaker: Yeah, I agree.

[00:52:43]  Michael: Or, but I would add, or cultural rather than due to the parents. Because both of those things, PKU was due to a lack of cultural knowledge. Lynching is due to a lack of cultural knowledge too. Anything that one can attribute to heritability, one can also attribute to culture.

[00:53:07]  Unidentified speaker: Studies can't disentangle.

[00:53:10]  Unidentified speaker: Genetic studies can't disentangle that, no matter how detailed the math.

[00:53:16]  Michael: The only thing that can disentangle it is explanation.

[00:53:19]  Bruce: So, along those same lines, there is an idea, again, people who believe that humans are universal explainers, which includes myself. We have this idea that I've heard, that I actually think is a very beautiful idea. And it's this idea that the evil in the world comes from bad ideas, and that bad ideas can be error corrected and changed because we're universal explainers. And I think that I love this idea, like I really do, for a number of different reasons. I think it hints at the idea of something that we might call free will.

[00:53:55]  Unidentified speaker: I think it's extremely hopeful.

[00:53:58]  Bruce: It does seem to me, though, that there are certain mental illnesses, and here I think of maybe paranoid schizophrenia comes to mind, that seems to at least in edge cases challenge this idea. So now I'm not an expert in this, but as I understand paranoid schizophrenia, this isn't just merely a case of someone with bad ideas, and we can error correct them. There's actually something wrong with their ability to error correct in the first place, due to presumably something wrong with their brain. I actually have a neighbor. She's not my neighbor anymore, but she was got hit on the head, and she became paranoid. And there was a night and day change from the way she was before she got hit on the head, and the way she was after she got hit on the head. And she became paranoid, and I accidentally called her once. I was like going over a list of people in a list of people in my church congregation, and I called her instead of somebody else. And she was convinced I was working for a conspiracy, an evil conspiracy.

[00:55:03]  Unidentified speaker: I'm so sorry.

[00:55:06]  Bruce: And so I talked her out of that, and she became convinced that I had simply been used by the evil conspiracy.

[00:55:13]  Unidentified speaker: Right.

[00:55:13]  Unidentified speaker: It was actually amazing.

[00:55:14]  Michael: Beautiful confabulation, isn't it?

[00:55:16]  Unidentified speaker: Yes, yes.

[00:55:17]  Unidentified speaker: Right, right.

[00:55:19]  Bruce: There's just no way you can convince me that this is just a matter of her having some bad ideas. There's clearly some sort of functional problem going on that is causing her to not error correct, okay? So, to what degree does the existence of certain types of mental illnesses like a paranoid schizophrenia, I'm sure we could pick even stronger examples of this, does it undermine this beautiful idea, or is it more like it only undermines it in very small edge cases?

[00:55:50]  Unidentified speaker: And in general, it's true.

[00:55:52]  Bruce: What would be your at least opinion on that subject?

[00:55:56]  Michael: Yeah, that's a hard one. It's a beautiful question. I work with such people all the time. And I want to say, because I want to be sort of philosophically neat, but I understand it's not practically, and I sort of am able to error correct myself even as I'm about thinking this and about to say it. But let me just say what I first was going to think and then error correct myself. What my first response was, I want to divide this into either people can indefinite, they are in general on average, sort of error correcting more and improving their performance. The machine really is mutating, selecting its chess program. And now with less space and memory, it really is playing better. It really does have sort of deeper algorithms because it plays as well as it used to play, but now with less space and memory. And then when one gives it more time and space, it really is playing a better chess game. Either we really are able to come up, compress our knowledge and come up with deeper and deeper theories that explain more and more on average, or we can't. And so, now I think most people with paranoid schizophrenia can continue to learn. I just think it's much harder. Surely there are cases with paranoid schizophrenia in which that is absolutely gone, in which as they're getting worse, their ideas are getting worse. I would say they don't have free will at that point. And so, I want to make the clean distinction between someone, I think someone who's dreaming, for example. Now, dreaming is a state, it's clearly chemically induced.

[00:57:58]  Michael: People clearly start, they don't know that they're not awake. They certainly perceive that what they're seeing is real, and yet pigs are flying. You know, they're deeply impulsive. You know, millions of people are chasing them, and they're, you know, jumping 100 feet in the air. They're not, not only are they not error correcting, it's getting worse. Now, one of the things that I feel so sad about, that most people don't get to see, that I feel just incredibly privileged to have seen, is what it looks like for someone to go in and out of madness. It's the gradual change that happens, where when someone's going into madness, their associations between words start becoming looser. It's like their ability to, so it's like the mutations in their ideas, the randomness in their ideas. In a way, what originally brings creativity is, which is good, is almost happening too fast. So they're mutating ideas, but starting to use them before they've really tested them to see whether they, in some sense, play chess better in some measurable way. So their ideas are getting mutated faster than they're being selected, which increases the rate of error, which then makes it even worse.

[00:59:37]  Unidentified speaker: And so, I want to say that the spiral is, when the spiral is going away from in net learning, they're either losing free will or have lost free will.

[00:59:52]  Michael: And in a sense, as it is going the other way, that is a state of free will, or you could also say maybe that free will is increasing, depending on the way you define things. So, the criticism of that is, I've seen both happen at the same time in different aspects of mind. And so, clearly, that's a simple way. When I had the thought, I was like, well, this is how I'll answer Bruce and Peter.

[01:00:24]  Unidentified speaker: And then I'm like, no, that's not quite right, is it, Michael?

[01:00:26]  Michael: I did a little correction myself, you know, as I was going along there. But I think that's how I look at it. I'm not sure that that's the only way to look at it.

[01:00:40]  Unidentified speaker: But I think when someone with paranoid schizophrenia is not gaining knowledge, and in fact, they're deteriorating, I think they either are losing free will or have lost it.

[01:00:56]  Bruce: So there's two things I want to ask you about here. So there's an interesting paper by Stephen L. Peck, who is a biologist at BYU, I live near BYU. And yet the paper is called My Madness. And he described, so what happened was his mind was attacked by a bacteria that caused him to temporarily go insane. And he writes about, he did recover, so he's writing about what it was like to be insane. And it's a very interesting paper. I think people who aren't aware of, like if you question whether insanity is real or not, go read this paper and it will convince you that it's completely real, okay? So you've got something that's physically wrong with the brain that's causing him to not think well. And so for example, some of his kids drew some little pictures, little [crayon?] pictures. And he became convinced that these children's drawings were the head of a conspiracy called the Satan Walmart Organization. Now, I don't mean that they were drawings of the leaders of the conspiracy. He thought the drawings were the heads of this conspiracy, right?

[01:02:10]  Unidentified speaker: Yeah.

[01:02:12]  Bruce: And that's like, they would like put him into a CAT scan. I'm going off of memory here, so I may get something wrong.

[01:02:17]  Unidentified speaker: But like putting him into a CAT scan, and he is convinced that the guy putting him in the CAT scan has just told him that he's part of the conspiracy and he's going to kill him inside his CAT scan, right?

[01:02:28]  Bruce: And he believes that's what that person just said. And he would actually be like watching television and he'd be watching like real television, the news. And suddenly a new story would come on about these ninjas that were part of the conspiracy that were coming after him, right? And he would later see the same ninjas down in the parking lot, right? So like, and people would talk with him and they would explain, this doesn't make sense. And he was convinced, like he believed that all his kids had been cloned and there were evil clones. And he felt that he had a moral responsibility to take care of these evil clones of his kids, because they're genetically his kids. And he had this giant moral dilemma going on in his mind.

[01:03:14]  Unidentified speaker: And they finally give him a medication.

[01:03:15]  Bruce: And he's still convinced that the, like apparently the kids were all going to show up at a certain time. And so he's waiting for that time and the medicine starting to work. And suddenly the time passes and it finally occurs to him, oh, I really was insane. Because the medicine is starting to work, right? And so you've got this, again, I want to get back to this idea of error correction, right? That it's almost like he just cannot error correct his ideas. And he mentions it was similar to dreaming, [made?]—way higher fidelity. Dreams are not nearly as consistent as the hallucinations that he was experiencing. Like he would see the people on the television, and they'd see the ninjas down in the parking lot from the hospital window. So there was a high degree of consistency that you don't get inside of a dream. But he said it had this quality where an idea would come into his head, and he just knew it was true. And he didn't have the ability to question it. And thus, the [crayon?] drawings on the wall are the leaders of the Satan Walmart organization conspiracy, right? Like, what's happening here when the brain's not functioning correctly? And, of course, you may not even know the answer. This may be beyond our current science, but just to the degree that we actually understand this or not, what's going on here that causes someone in this situation to be incapable of error correction?

[01:04:52]  Michael: Yeah, if I really understood that, we would be able to fix it. And I'd have a Nobel Prize, I wouldn't be sitting a bit. The story is a good one. You actually had mentioned his name to me, so I did look it up a little bit. It's a fascinating story. I wish everyone would read that too. I wish also that people would know when they're writing online about mental illness not existing, and this is all nonsense, and we don't know how to treat it, and we can't make this stuff go away, all of which is wrong. I wish they would understand that we as psychiatrists and neurologists see this on a daily basis. This is not uncommon for us. This is what we work with. Having it be as a result of a bacterial infection, I was a little annoyed with myself for not having been keeping up for not recognizing this organism. It's a Burkholderia pseudomallei, when I looked it up, what a great name for a bug, a bacteria. And I think probably if I had gotten ordered or done a cerebrospinal fluid analysis, which I would have on a guy like this, I think the lab would have grown it out. I didn't look that part up. And so I think I would have been saved and I would have caught it. But these kinds of things are very, you know, are very common. And our psych hospitals used to be filled with people with a bacterial infection called tertiary syphilis, which made people sick. And it in many ways resembles what people look like with schizophrenia. So we cleared out the psych hospitals when we develop treatments for that. I mean, this is a relatively kind thing.

[01:06:55]  Michael: A few years ago, the one that made the rounds was, remember the brain on fire thing where-

[01:07:02]  Unidentified speaker: A short book, by the way.

[01:07:03]  Unidentified speaker: Yeah, exactly.

[01:07:04]  Unidentified speaker: Another book, the brain on fire one.

[01:07:06]  Unidentified speaker: And that one was not about bacteria.

[01:07:07]  Michael: That one was about autoantibodies to NMDA receptors, which can be cleared with plasmapheresis, other sorts of things. So yes, this stuff happens all the time. Yes, we fix them with meds. Yes, people don't know.

[01:07:24]  Unidentified speaker: Not fix.

[01:07:25]  Michael: Sometimes we control the symptoms. Sometimes we can actually clear it up, like give them antibiotics and fix their brain infection. But yes, this type of thing happens all the time. And so that's why I'm sort of incredulous when I read the Internet. And there's such a high prevalence of people who think that psychiatric illness isn't real or doesn't exist. And it sort of just reminds me of people sort of like saying atoms don't exist or something. I'm like, well, I can't exactly see it. But I mean, if you study them well enough, you sort of understand that they exist. At least it's the best explanation. So yes, it's a real thing.

[01:08:09]  Bruce: So obviously, I'm asking a question that I didn't expect you to have a full answer to. As you said, if you had the answer, you'd be winning a Nobel Prize at this point. But it does seem like at a high level that something has gone wrong with the error correction, right?

[01:08:25]  Unidentified speaker: Yeah.

[01:08:26]  Unidentified speaker: That they can't inspect.

[01:08:28]  Bruce: Now, you brought up a possibility here that I actually found really intriguing just a moment ago that it's almost like their thoughts are mutating too fast. So, they're still universal explainers. He still has some technical ability. He can explain to people around him what's going on. He can say, I've got these evil clones of my kids, and I'm worried about that. That still requires the ability to explain things, right? So it's not like he lost his ability to explain. But for whatever reason, he simply can't seem to inspect his own ideas.

[01:09:05]  Unidentified speaker: Right?

[01:09:06]  Bruce: It's such a fascinating thing to read about. You use Brain on Fire as an example, where the same sort of thing happened. Luckily, she didn't remember very much.

[01:09:15]  Unidentified speaker: So that was probably good for her, that a lot of it she discovered by watching videos herself afterwards.

[01:09:21]  Bruce: But it is like, it's almost like, you talked about the variation in selection, the fact there's evolution going on inside the brain. It's like the selection mechanism has ceased to function, or something along those lines.

[01:09:38]  Unidentified speaker: Yeah, yeah.

[01:09:38]  Unidentified speaker: No, that's exactly what I think is going on.

[01:09:40]  Michael: I mean, we speculate, I mean, psychiatrists, when we have a theory of that, at least it was as of five or 10 years ago, I haven't looked at the latest sort of philosophy of psychiatry ideas. But we think that there's something called a thalamic filter.

[01:09:55]  Unidentified speaker: That it's kind of like the high level secretary that tell whether it's going to bring something to the bosses, your conscious mind's attention.

[01:10:07]  Michael: And there are all kinds of loose associations and creative associations going on in the unconscious mind, which you have access to when you sleep. And when the thalamic filter breaks down, those associations, those loose associations are getting into consciousness before being error correct. It's like your secretary is overwhelming with you. Look here, look here, look here, look here, look here, and you can't, and you can't organize what's going on. So that's the current theory. So what's the current idea of how meds work?

[01:10:41]  Unidentified speaker: Well, meds slow that down.

[01:10:44]  Michael: They slow down the process, which then gives the error correcting, they slow down the rate of mutation, which then gives, and these are sort of my ideas put on top of some standard psychiatric ideas. My Popperian ideas on top of psychiatric ideas. And so these ideas are, medicine doesn't have knowledge or insight, can't debug, but it can slow something down. And then it gives one's conscious mind a chance to essentially error correct, not be exposed to the rapid rate of mutations that you get, for example, when you're dreaming. Now, there's a subtle psychiatric difference, I don't know if this is relevant to you guys, but it's, or to the audience, but there's a subtle psychiatric difference between dreaming and psychosis, even the psychosis that the Baylor professor was describing. And that has to do with something we call focus. And the Baylor psychiatrist and people with paranoid schizophrenia usually retain reasonably good focus.

[01:11:54]  Unidentified speaker: And that means that their ability to sustain attention on one thing or one idea is intact.

[01:12:08]  Michael: When it's not intact, that's more like the dreaming state or more like what happens when you have high fevers or when you've just had a lung transplant, and 50 percent of people coming out of lung transplants go nuts and you actually tie them down. So people are going crazy all the time. Mental illness is delirium in that case is very real. People call psychiatrists all the time, we use meds and we help them not be crazy anymore. And if we didn't do that, if we didn't tie them down gently and lovingly and as best as we can to make them comfortable and we didn't give them meds, we would be very properly sued. They'd pull out their breathing tube and they'd die. But these are folks that have very poor focus and that's the difference between sort of a focused crazy, a focused madness and an unfocused madness, which is like delirium. And there are physical differences too. They're not really good enough to be, to make it to prime time. But if you check an EEG, an electroencephalogram, of people who have a poorly focused sort of a state, a delirium, often it's slowed. Whereas if you check an EEG on someone with schizophrenia, it really isn't that much slowed. So yes, there are biological errors in the filtering device, in the thalamic filter. That filter breaks down, it's sort of your unconscious associations get projected into the conscious. You're overwhelmed by them. You can't, the world becomes just not understandable.

[01:13:54]  Michael: I mean, the part about the article you gave me that I really found very interesting is his comment that prior to my experience, I imagine that going insane merely involved seeing and hearing things that were not there. So I was surprised to find that not only my sensual, my sensual experience had been rearranged and recreated, but also that my entire belief structure about the world was rewritten. And I find that interesting because I don't consider someone who's just hallucinating to have a mental illness. And I think most of us don't. There has to be an error in the thinking part of it. If you start hallucinating, Bruce, we're not going to say you have schizophrenia. Can I tell you a very funny, briefly story about myself?

[01:14:46]  Unidentified speaker: Sure.

[01:14:48]  Unidentified speaker: Okay.

[01:14:49]  Michael: This was in the early days of phones, and please don't make too much fun of me. I was in a parking lot and I just parked my car, and I started hallucinating, I thought, the news.

[01:15:03]  Unidentified speaker: So I looked at my phone, it was off.

[01:15:09]  Michael: Looked at the radio, it was off. Looked all around me, it was off. So I was hearing a voice that was speaking to me, so then I, oh my God, and of course, you know, I'm a psychiatrist, so then I'm getting a little bit scared. So then I opened the car door, start walking, I still hear the voice. And that's the news, I'm like, what the? And then I sat down for a second, I said to myself, okay, hang in there, Michael.

[01:15:39]  Unidentified speaker: Think about this for a second.

[01:15:43]  Michael: Are you aware that something is not there?

[01:15:46]  Unidentified speaker: Really?

[01:15:47]  Michael: And I'm like, yes, you are. Okay, so what can you do when you can't tell? Well, not everybody has this experience. Maybe you can speak to your wife and ask.

[01:15:56]  Unidentified speaker: I really thought I was going crazy.

[01:15:59]  Michael: But then I recognized in some sense, because I knew what mental illness was, that this is different than schizophrenia, whatever the hell is happening to me.

[01:16:07]  Unidentified speaker: Let me tell you what it was.

[01:16:08]  Michael: I mean, this is the early days of phone.

[01:16:09]  Unidentified speaker: The phone was black and it turned off.

[01:16:11]  Michael: The screen thing was off, but it actually was on a radio station. And I was just carrying around with me and I wasn't aware of it.

[01:16:19]  Unidentified speaker: But I literally was listening to the news and I was saying, this is absolutely amazing.

[01:16:23]  Unidentified speaker: So my mind is simulating this, things that aren't really happening.

[01:16:30]  Michael: That aren't really happening.

[01:16:31]  Unidentified speaker: But boy, does it sound real.

[01:16:35]  Bruce: So can I give you a similar example that happened to me when I was younger?

[01:16:39]  Unidentified speaker: Go ahead.

[01:16:40]  Bruce: So you have a little sleepover with your siblings, right? And so you're all together in one room, and you're having fun, and you stay up really late talking. And I started to hallucinate. And I wasn't crazy or mentally ill in any way.

[01:16:57]  Unidentified speaker: Yeah.

[01:16:58]  Bruce: I could tell I was hallucinating. And so I started saying, oh, cool, I'm hallucinating. I can see this little family of people running across the... The lights were out, right? So I'm hallucinating in the dark, right?

[01:17:11]  Unidentified speaker: But I can still see things.

[01:17:12]  Bruce: And this big purple dancing skeleton comes into the room. I'm like, I can see a purple dancing skeleton.

[01:17:17]  Unidentified speaker: Yes, yes.

[01:17:20]  Bruce: And so I knew I was just hallucinating. I knew it was because I was tired.

[01:17:23]  Unidentified speaker: I had stayed up.

[01:17:25]  Bruce: When I would close my eyes, I would still see the hallucinations, so they weren't actually in the room.

[01:17:29]  Unidentified speaker: Yeah.

[01:17:29]  Unidentified speaker: Right.

[01:17:30]  Bruce: So I was able to check that. So the error correction was still functioning.

[01:17:34]  Unidentified speaker: Yes, absolutely.

[01:17:35]  Unidentified speaker: Even though I was hallucinating, right?

[01:17:37]  Unidentified speaker: Absolutely.

[01:17:38]  Unidentified speaker: And people don't understand that isn't a mental illness.

[01:17:43]  Unidentified speaker: Yeah.

[01:17:44]  Unidentified speaker: It's just not.

[01:17:45]  Unidentified speaker: I mean, people also say, well, you're in the business of trying to control people with—by hospitalizing them and forcing them into your control program.

[01:17:59]  Michael: And I find that whole thing funny because in a way, we're doing the opposite and giving people back control of their own minds can sometimes be very, you know, very dangerous.

[01:18:15]  Unidentified speaker: Let me give you an example.

[01:18:16]  Michael: Let's say, and I've had examples sort of like this. I'm going to exaggerate it just to make a point. So I never had something quite like this, but I had a patient who was, you know, who was, seemed to me, very much a legitimate Nazi kind of guy. And he was deeply, deeply paranoid and hallucinating. Not paranoid in the way that Nazis are, which is kind of a logical set of false assumptions, then leading to a conclusion without the kind of loosening of associations that you, that feels biological when you're talking to someone with schizophrenia. He had the usual misunderstandings, sort of cultural delusions about Jews. You know, he would comment about my last name. This is the kind of guy that is not going to be very effective as a Nazi. His mind is thoroughly disorganized. He is seeing things that aren't there, hearing things that aren't there. On the other hand, I mean, if I really were into controlling him, what would I do?

[01:19:29]  Unidentified speaker: Well, I'd leave him like he was.

[01:19:33]  Michael: Because a guy like that's probably more likely to die. We'll get no support from anyone.

[01:19:40]  Unidentified speaker: What is your job as a psychiatrist?

[01:19:42]  Unidentified speaker: Your job as a psychiatrist is to help him to think better, to help him be more rational, if you will, in his irrationality.

[01:19:54]  Michael: So in helping deal with his break into schizophrenia, I was making him a more powerful Nazi. That isn't trying to control somebody. That's probably doing the opposite.

[01:20:06]  Unidentified speaker: You're really trying to give people their freedom back.

[01:20:10]  Michael: Now, I like to say, and I tease my medical colleagues because they tease me about psychiatry. But maybe with the exception of surgeons and pediatricians, pediatricians have antibiotics that they can give to kids and the kids then get their whole life back and surgeons remove something bad appendix or something, and the person gets 20, 30 more good years.

[01:20:38]  Unidentified speaker: But a lot of my medical colleagues are treating things like congestive heart failure, various forms of cancer, other sorts of things that tend to be chronic and disabling, and they can help, and sometimes they cure cancer, which is just wonderful when they do.

[01:20:57]  Unidentified speaker: But when you help a heart function, the heart doesn't all of a sudden start healing itself.

[01:21:08]  Michael: That's very different from a brain.

[01:21:11]  Unidentified speaker: Once you get its ability to error correct back intact, so that it can grow knowledge again, I have to do very little, and my patients then really become very powerful, amazing human beings, not because of what I did, although at best what I did was a precipitant, but because the mind has this ability to grow and learn and be creative.

[01:21:42]  Michael: And so I tease my medical colleagues when they say, well, you're not doing very much, you don't know what you're doing.

[01:21:52]  Unidentified speaker: All of it is true.

[01:21:54]  Michael: I'm really not doing very much. And I don't exactly know how it all works. But I do know that once I get somebody going in the right direction, their own creativity then can take over in a way that my medical colleagues really can't do.

[01:22:11]  Unidentified speaker: They just make maybe their heart a little stronger or something, but the heart doesn't start then regenerating and healing itself and making five hearts.

[01:22:18]  Michael: Whereas the brain becomes more and more powerful because the mind is. And that I find very satisfying about my field and is why I went into it.

[01:22:28]  Bruce: We've mentioned dreaming several times.

[01:22:30]  Unidentified speaker: Let me ask you about dreaming.

[01:22:32]  Bruce: So I've noticed that when I'm dreaming, I'm not really myself, right? The dreaming version of myself can't seem to think straight. He does reason to a degree, so might still count as a universal explainer. But his error correction seems largely turned off. He rarely even realizes that. And that's why despite this irrational world taking place, he never really seems to, he meaning me, never seems to notice that it's a dream.

[01:23:01]  Unidentified speaker: Sometimes that's not true.

[01:23:02]  Bruce: Lucid dreams might happen where you suddenly, your error correction is working better and you go, oh, I'm in a dream, but that's rare. So I know my waking self would never make such obvious mistakes that he's making. And it seems to me that he also has drastically reduced impulse control and drastically reduced inhibitions. So he will do things that I would just never do. And I know that's a Freudian thing, right? That you play out these ideas that you wish you could do, but you're not allowed to. It seems to me it's more like something's not functioning. And so I will do things in a dream that wouldn't be appropriate in real life.

[01:23:42]  Unidentified speaker: No, Bruce, I'm horrified.

[01:23:44]  Michael: Oh my gosh.

[01:23:48]  Unidentified speaker: Have you told your family and friends?

[01:23:51]  Unidentified speaker: Go ahead.

[01:23:53]  Bruce: So it seems to me like I've effectively lost my mind while I'm dreaming. I don't even believe it's me in a straightforward sense. Surely I'm seeing through this person's eyes. I think of it as me at the time.

[01:24:07]  Unidentified speaker: And in some ways, it's disconnected from me.

[01:24:09]  Bruce: Like I can sometimes remember my dreams, especially if you like write them down when you just woke up. But for the most part, my dreams get erased, right? So it's not even clear to me who had the dream, because it's not really me.

[01:24:22]  Unidentified speaker: So it's not even part of my memory, right?

[01:24:25]  Bruce: Of continuity of who I am. But is that like what it's like to be insane? Like do we all become mad at night while we're dreaming? Because parts of the brain aren't working correctly and our error correction is shut down.

[01:24:41]  Unidentified speaker: Yes.

[01:24:42]  Michael: I think we all do become mad at night due to a chemical change. It's more of a delirium than a schizophrenic psychosis. But yes, I do think that's exactly right.

[01:24:53]  Unidentified speaker: Let me push back a little bit.

[01:24:54]  Michael: It's not, I don't know if it's a disagreement. I just, it's a subtlety on one thing you said. And that's that you feel that you're a universal explainer. I think you are in one sense, but not another. I think part of being a universal explainer is being able to improve, at least in my opinion, and definitely improve one's explanations. And I'm, it's not, even though you are explaining things to yourself and you're confabulating often brilliantly, the, you know, the lie center of the, what I call the lie center, the aspects of the left frontal lobe, or what others call the lie center, and I copy, is functioning beautifully, just filling in the gaps, making sense of things that are utterly nonsensical. But I'm not sure you're really improving your ability to explain. So in that sense, I would say your free will is decreasing, your capacity is decreasing, so your explanations aren't improving, even though you obviously are explaining things to yourselves in one sense of the word. And I think that the ability to improve has to do with what you said, the lack of error correcting ability. The other thing I just want to point out is the language you use, which I think is very evocative. You were speaking of yourself in the third person, like you said, he does this. You didn't say I, you said he does this. In the third person, in the Freudian sense, the German word, and I don't speak German, but I understand that in America, we imported the word id to refer to unconscious.

[01:26:39]  Michael: But my understanding, at least according to Bruno Bettelheim, whom I read many years ago, was that the translation of id, namely the unconscious, the impulsive, the type of thing that Freud felt was active at night, was it, which is sort of a third person. It is doing that, or he is doing that. It's a sort of a third person. It's not really you, is it?

[01:27:05]  Unidentified speaker: And so I can empathize with that.

[01:27:09]  Unidentified speaker: But I think that the short answer to your question is that a lot of this is, is your unconscious creative mind processing things and it's being leaked into the conscious mind.

[01:27:25]  Michael: Now, interestingly, our brain, that there must be some function to this since all of us seem to dream. I mean, not must be, but I assume there is.

[01:27:35]  Unidentified speaker: I could speculate about it.

[01:27:36]  Unidentified speaker: I have some ideas.

[01:27:37]  Michael: Other people have some ideas about it. But there's some things that are interesting about it. Evolution clearly knows that this is a dangerous state. So, what does it do? Why it paralyzes your muscles?

[01:27:52]  Unidentified speaker: And why is that?

[01:27:52]  Michael: Because, well, if you're imagining jumping and flying, that might not be a very good thing. Now, there's this interesting condition called REM behavioral disorder. And it's induced, it's often a pre-Parkinson's like condition, but more commonly nowadays, it's caused by often a lot of psychiatric drugs, for example, SSRIs. And they at least partially remove the inhibition on one's action during dreaming. And so these people, actually people with REM behavioral disorder, actually act out their dreams. So if they're thinking they're defending their family from a villain or attacking them or kicking them, they may actually kick their bed partner.

[01:28:50]  Bruce: Doesn't that happen to older people? Like isn't that like, okay, because...

[01:28:55]  Michael: It tends to happen more in older people or people with, you know, basal ganglia damage, people on different sorts of medications. But it's relatively common as a condition. And, you know, you have to work with such patients, you know, if it starts getting bad enough. And first of all, there are meds we can use to help with it. And I do, and I recommend that people take these things. But if you can't control it, then often you need to have separate the beds of husband or wife or whatever, so people don't get injured. I mean, you have to, you know, you have to do something about it if it becomes a seemingly dangerous experience. It's hard to know because the partners often want to be close together and it's infrequent. And so then what do you do? But but yeah, it's a it's a sort of a risk benefit analysis.

[01:29:45]  Bruce: So is is like sleepwalking a similar problem? I used to sleepwalk a lot as a kid.

[01:29:52]  Unidentified speaker: I don't do it anymore.

[01:29:53]  Bruce: There is not uncommon as a kid.

[01:29:56]  Michael: It's it's it's slightly different. One, I mean, there are types of sleepwalking that are like that. But sleepwalking is a different kind of parasomnia, which is sort of a different phase of sleep than [ramps?]—than REM sleep.

[01:30:14]  Unidentified speaker: Oh, I see.

[01:30:15]  Unidentified speaker: So it's not like acting out a dream.

[01:30:17]  Michael: No, it's not.

[01:30:18]  Unidentified speaker: So it's it's different.

[01:30:20]  Unidentified speaker: I mean, it's interesting also.

[01:30:25]  Michael: Sometimes I think I should have gone into sleep medicine. It's extremely interesting field. There's so many things that you don't live long enough to study all the things you'd like to learn about.

[01:30:35]  Unidentified speaker: Yes, definitely.

[01:30:36]  Unidentified speaker: Okay.

[01:30:37]  Bruce: Let me ask you a more controversial question now.

[01:30:39]  Unidentified speaker: Sure.

[01:30:40]  Bruce: We always hear about developing children. They don't have a fully developed prefrontal cortex and that that supposedly reduces a child's impulse control and ability to reason well.

[01:30:52]  Unidentified speaker: First of all, is there any truth to that?

[01:30:53]  Bruce: And if there is, or is this more like pop psychology and you hear about it, but there's nothing to it? And if it is, if there is any truth to it, is that similar to dreaming Bruce, where the impulse control is removed and they don't have as much control over themselves?

[01:31:10]  Unidentified speaker: Okay.

[01:31:11]  Michael: The first question, is that a real phenomenon? And I think probably a bit. I mean, I don't, I think it's true. Children, remember when I said that the explanatory mind should have ability to understand, should have the ability to increase understanding for that, it should have knowledge, underlying knowledge, which, you know, certainly we're not born a blank slate, and so our brains are born with certain modules and certain knowledge. And it should have knowledge of how to create knowledge. But one of the key kinds of knowledge, which I said was a subset of the second type, is knowledge of what not to change and what to leave alone and what to leave in place. And I've called that knowledge wisdom. And so the knowledge of what, although children certainly have great knowledge of knowledge, they're learning, frankly, a lot faster than we are. Their memory and speed is better. I don't think they know as well what to leave alone. And so I don't know if that's a metaphor for the kind of changes, neurological changes that you're describing or whether it actually is related to it. But I can have no problem believing that younger people are a bit more impulsive on average than older people. But of course, breaking more things by being impulsive on average is also a way of learning more things. It's kind of like mutating things, just like an example of my chess program. What are you really trying to do in order to learn faster? You're trying to break things faster. You're trying to do the mutation and test cycle faster.

[01:33:27]  Michael: So break what's already existing faster, almost every single time. You're creating errors. The goal is to create your errors as fast as you can, but simulate them hopefully, and then move on to the thing that's actually better. But kids are not just simulating things. Sometimes they're really breaking them.

[01:33:47]  Peter: That's a wonderful connection to Popperian epistemology that I'd never considered before. So it always kind of triggered my BS detector a little bit, the way people parrot this idea that, oh, your prefrontal cortex is not completely developed till you're 25 or whatever they say.

[01:34:08]  Unidentified speaker: Whatever, right. Do you have different versions of this?

[01:34:10]  Peter: It never really quite—it seemed like a little bit suspicious to me.

[01:34:14]  Unidentified speaker: It is a little suspicious, but I think there's something to, there's something to different styles of learning.

[01:34:21]  Peter: Well, you're almost connecting that to learning. You're saying that in order to maybe one of the reasons, conceivably, that children seem to learn so much. I mean, I see that with my own kids.

[01:34:34]  Unidentified speaker: It's like they'll spend, it seems to me they just spend all their time scrolling on their computer or playing their games or whatever, but then they are learning all this amazing stuff.

[01:34:45]  Peter: So I don't know where they're picking this up, but maybe it has to do with, it's connected to just they're making a lot of mistakes.

[01:34:52]  Unidentified speaker: Yeah, they are.

[01:34:53]  Unidentified speaker: They're practicing making mistakes really rapidly.

[01:34:57]  Michael: They're mutating like crazy.

[01:34:59]  Unidentified speaker: They learn fast.

[01:35:01]  Unidentified speaker: Yeah.

[01:35:02]  Michael: Yeah, if you're going to make your errors, make them as rapidly as you can so you can learn faster.

[01:35:08]  Unidentified speaker: Okay.

[01:35:09]  Unidentified speaker: Well, sounds like words to live by maybe.

[01:35:11]  Unidentified speaker: Yeah.

[01:35:14]  Michael: But please, God, let them simulate it in their [head?] rather than breaking my computer or throwing it or whatever.

[01:35:23]  Unidentified speaker: Okay.

[01:35:24]  Michael: Or playing football in the house and wrecking a table or so.

[01:35:28]  Unidentified speaker: Fair enough.

[01:35:29]  Unidentified speaker: Yeah.

[01:35:32]  Unidentified speaker: Yes.

[01:35:33]  Michael: So, I do think that's, so I think that there's some truth to that, at least in styles of learning.

[01:35:43]  Peter: It seems to me, you know, my background is as a special education and also math teacher.

[01:35:52]  Unidentified speaker: Yay.

[01:35:53]  Peter: And so, I have kind of like somewhat similar background to you and that I've seen neurological difference.

[01:36:02]  Unidentified speaker: Oh, yeah.

[01:36:03]  Unidentified speaker: For sure.

[01:36:04]  Peter: But then I also have some experience with kids that are more, you know, normal.

[01:36:11]  Unidentified speaker: Normal.

[01:36:12]  Unidentified speaker: I still have-

[01:36:13]  Unidentified speaker: My kid is normal, but yeah, I understand.

[01:36:15]  Unidentified speaker: Yeah.

[01:36:16]  Unidentified speaker: But still have now in our modern world, identifiable conditions, you know, whether ADHD or dyslexia or, or, or, you know, autism, Asperger's, however you want to.

[01:36:34]  Peter: There's, there's all kinds of things. You know, circling back to Thomas Zoss, however, we decided to pronounce that, that is all, they're all probably wrong.

[01:36:47]  Unidentified speaker: They were not Polish and we're not.

[01:36:48]  Unidentified speaker: They're all probably wrong.

[01:36:51]  Peter: But circling back to him, you know, one of the things that I, that, you know, I agree with how we, you know, I think on a previous episode, we looked at how Popper said something like, well, I agree with 95% of what you say. And I really liked Popper's take on that. Because, I mean, there's, to really give him his do, I mean, he was very concerned with the authoritarian overreach of the psychiatric industry. He said that, you know, this whole illness thing is just the wrong metaphor for what is essentially moral, I guess you could say. Just, it's essentially something that should be dealt with as theories about life that are incorrect rather than something more. An illness seems to, that metaphor seems to take it outside of our control because, you know, it's like getting cancer or something like that, which is not, it takes away agency from the individual, which I think is a fair, I mean, his, his, his take kind of seems like prescient almost in the way that, you know, I look at a math classroom as I do every day, and I see probably a good quarter of the kids or more. I mean, who have some kind of, who many of them are on meds. They have some kind of identified disorder, rightly or wrongly. I mean, I don't know, it's hard, hard to know if it's helpful for them or not to have these. And probably it's very complicated whether or not these conditions have, make their, their, their life better or not. I mean, you know, a hundred years ago, thousand years ago, our ancestors wouldn't have been identifying people as ADHD.

[01:39:00]  Peter: And one of the reasons is because we didn't make everyone sit in a classroom for six hours or more every single day, learning things that they don't want to learn. They probably would have been out, I don't know, taking care of animals on the farm with their parents or hunting and gathering or whatever they did. So, I mean, does that, does that aspect of Thomas Szasz's ideas resonate with you? This, the idea that we could be looking at sort of an authoritarian overreach of the psychiatric industry where, where everything is medicalized or pathologized, I guess?

[01:39:43]  Michael: I can relate to aspects of that, but I don't, it's not, it's not quite the emphasis that, that I, I take. I mean, so you said many different things and I wrote them down as I was going along to try to keep track of it. First off was the 95 percent comment where Szasz, I'm sorry, where Popper in the letter to Szasz said that he agreed with 95 percent of what he was saying. To my, to my mind that, you know, let me, Karl Popper, Popper, to my mind, that's sort of like saying, well, chimpanzees and humans share, I don't know what it is, I'm just making up a number, 99 percent, 98 percent.

[01:40:39]  Unidentified speaker: It's a very large number.

[01:40:42]  Unidentified speaker: Of their genes in common.

[01:40:44]  Michael: And so essentially, we're very much like them, which is in one sense true in terms of sort of physiological structure.

[01:40:54]  Unidentified speaker: But the two-

[01:40:55]  Peter: I mean, I think we share a lot of genes with a banana, too, or something.

[01:40:58]  Unidentified speaker: Exactly.

[01:40:59]  Unidentified speaker: So yeah, but that 2 percent makes a difference.

[01:41:01]  Michael: And I think Szasz, what Szasz says that he differed with him in his, what Popper said that he differed with Szasz about I think is very significant in that letter that he sent. He first said, one, that he feels that memory is declining. And he, in my view correctly, called that a mental illness. Popper did, because why is it mental? Because memory is mentation. You're not talking about nerves or structures of nerves. You're talking about one's memory, just like one's sadness or whatever. You're talking about a psychological quality. And when a psychological quality is [impact?], we call that mental illness. That doesn't mean that the ideas are diseased, but he correctly says, and then he correctly says in that very same letter, but I'm not prepared to argue with you about definitions. And that's a very powerful Popperian thing to say also. So Oz was heavily into definitions. A mind can't be diseased, therefore there is no mental illness. An idea can't be diseased, therefore there is no mental illness. Now, that's fine, except no one thinks that the word mental illness means that ideas are diseased. That's really the area of essentialism, as ascribing some particular essential characteristic to a word or a definition or something. And it's just a philosophical error. The other thing Popper said to Szasz, which I guess goes in his 5% disagreement, is critical as well. He said that when people are sick, that, for example, have the flu.

[01:43:04]  Michael: I don't know if he used the word flu, but he imagines that there are chemicals that change, that can make a person feel ill, say as a consequence of being exposed to a virus. But he adds something to the effect that I imagine that the body's own chemicals can create the same feelings. And indeed, that's true. The flu virus increases, you know, tumor necrosis factor alpha, it increases interleukin 6, it increases interleukin 1, it increases all these cytokines from cells called macrophages that go to your brain and make you feel sick. And the question is, just if a virus can make you feel tired and depressed and not wanting to do things, and depression causes the same increase in those neurochemicals, why is one real and the other not? So just like chimpanzees are not like humans in the sense that humans tend to go to outer space and can be reworking and rewiring the, the shape at the face of the earth, and maybe at some point as we get more knowledge, the solar system and maybe even one day the galaxy.

[01:44:26]  Michael: Similarly, the huge difference in Szasz's perspective from Popper is really the relevant thing, that mind, that body can affect mind, and we didn't have the chance, maybe at some future time we can talk how changes in your mind changes the physiology of your body.

[01:44:44]  Unidentified speaker: It's an absolute loop.

[01:44:46]  Michael: And these are the things that Popper, in my view, correctly paid attention to. Now, in terms of the statement about kids being made to sit in school and sit still, particularly boys for hours on end, I couldn't agree more.

[01:45:02]  Unidentified speaker: I would just ask, I would just say that.

[01:45:07]  Michael: Let's say we even 100 percent completely agree with you, and I do, that, as you know, I favor homeschooling most of the time, or virtually all of the time. I want parents to be actively involved, I want kids to be free and to inquire about things, to learn about their interests, and I do think that all roads lead to Rome. We didn't get a chance to talk about that today, but I think whatever path a child learns, a child learns to play games, then he can learn to code the games, then he can learn math, then he can learn to 3D perception, then he can learn from 3D perception, he can learn how you can make things improve, and then he can learn evolution, and then he can learn physics. Knowledge is an interconnected web of ideas.

[01:46:03]  Unidentified speaker: So I certainly share that.

[01:46:05]  Unidentified speaker: But let's say we even-

[01:46:06]  Peter: If I may just interject, even though I'm a teacher, I agree with what you just said.

[01:46:11]  Unidentified speaker: I'm sure you do.

[01:46:12]  Peter: I've gotten a bit radical, I'm afraid.

[01:46:16]  Unidentified speaker: No, you're good.

[01:46:17]  Unidentified speaker: I really want kids to enjoy themselves.

[01:46:19]  Michael: I want them to have fun when they're learning, and to really be into it.

[01:46:25]  Unidentified speaker: But let me just ask, and I'm asking this hypothetically.

[01:46:30]  Michael: Let's say that children were being, obviously hypothetically, were being beaten in schools on a regular basis. And I guess maybe they used to be hit or something like that.

[01:46:44]  Unidentified speaker: Sure, even a generation or two, really.

[01:46:45]  Michael: Yeah, even a generation. I mean, in my generation, when I went to school, I mean, I was threatened with being hit at any number of times.

[01:46:51]  Unidentified speaker: It never happened.

[01:46:53]  Michael: But I, you know, certainly many of my friends got hit. I'm not laughing.

[01:46:59]  Unidentified speaker: It's funny.

[01:46:59]  Unidentified speaker: It's really terrible.

[01:47:00]  Unidentified speaker: People used to beat kids.

[01:47:01]  Michael: But let's say it really hurt when they were being hit. I mean, should a doctor deny a kid a pain med because the kid shouldn't have been hit? That's one way to think about it.

[01:47:15]  Unidentified speaker: And so if a child is going to be forced, to sit in a classroom, I'm not saying one should or shouldn't, but will you help them to be more independent if they are being forced to sit in a classroom and they can't?

[01:47:33]  Michael: If you give them a Ritalin to help them do better in the unfortunate environment that they're in.

[01:47:42]  Unidentified speaker: I favor home education.

[01:47:44]  Unidentified speaker: I don't, you know, particularly—I mean, there are girls like this too.

[01:47:47]  Unidentified speaker: I mean, you've seen them.

[01:47:48]  Michael: I've seen them in my practice.

[01:47:50]  Unidentified speaker: Absolutely.

[01:47:50]  Unidentified speaker: There are girls who will not sit still.

[01:47:52]  Michael: They learn by doing and running around.

[01:47:54]  Unidentified speaker: That's how they learn.

[01:47:58]  Michael: But it's still not obvious that one shouldn't necessarily give them medicine.

[01:48:05]  Unidentified speaker: I think we could give a lot less medicine if one schedules, even in school, a lot more recess, a lot more activities, a lot more active learning, or even segregates those who are more active or segregates boys from girls in some way to allow them to enjoy themselves more and better yet, to individualize and tailor education at home to the individual mind of the child whom one is taking care of.

[01:48:33]  Unidentified speaker: I agree that society shouldn't be taking away people's agency, but I think people not home schooling, for example, is really the most powerful way of taking away people's agency, not psychiatrists, you know, maybe trying to make a kid more comfortable in the classroom in which he's being held and in which there's not enough exercise and not enough physical activity.

[01:49:04]  Michael: And by the way, there are some kids who are so distractible that their ability to learn in any environment is compromised. And every now and then, a little bit of Ritalin or a little bit of a stimulant can help.

[01:49:20]  Unidentified speaker: I really don't favor giving it much.

[01:49:24]  Michael: I'm a minimalist, particularly when it comes to kids, because I want to change and shape the environment. But it's not obvious to me that it is the larger psychiatric establishment that's corralling kids and trying to control people. Our goal is really to help people, kids develop more independence. If you force kids to do things in a particular way, then we might try to help them accommodate themselves to that environment. I also think that most psychiatrists, like most parents, are not in favor of homeschooling. And so I would disagree with not just psychiatrists about that, but virtually all parents about that.

[01:50:07]  Unidentified speaker: That's my view.

[01:50:09]  Michael: I think homeschooling is better.

[01:50:11]  Peter: Yeah, I know that's an interesting perspective.

[01:50:18]  Peter: I, it, so it seems it always, even though I, you know, I've read John Holt and probably some of the same guys you have about learning and children and homeschooling and all that, but at the same time, it seems like a bit utopian to just say, I mean, it would just like involve restructuring in our entire society if we're going to snap our fingers and say, well, okay, everyone just needs to homeschool.

[01:50:50]  Unidentified speaker: I agree.

[01:50:51]  Peter: It's very hard as, you know, as a parent, I'm a parent of two teenagers and they don't want to be homeschooled.

[01:50:59]  Unidentified speaker: I know.

[01:50:59]  Peter: They want to go to school with their friends and you know.

[01:51:03]  Unidentified speaker: No, I know.

[01:51:04]  Peter: So it's complicated.

[01:51:06]  Unidentified speaker: It's just in the real world.

[01:51:07]  Michael: If they want to go to school, they should.

[01:51:09]  Unidentified speaker: I mean, I-

[01:51:10]  Michael: Yeah, sure.

[01:51:11]  Unidentified speaker: That's exactly where they should be.

[01:51:12]  Michael: If they want to be there, yeah, that's fine by me.

[01:51:17]  Unidentified speaker: Yeah.

[01:51:20]  Unidentified speaker: Some people just can't.

[01:51:21]  Unidentified speaker: They can't homeschool.

[01:51:22]  Unidentified speaker: They're, you know, one of them, they're working and there's no other choice.

[01:51:26]  Michael: I mean, they're feeling coerced, the kids are feeling coerced.

[01:51:29]  Unidentified speaker: No one's in an ideal situation to have someone stay home with them.

[01:51:33]  Unidentified speaker: I get that.

[01:51:34]  Unidentified speaker: Yeah.

[01:51:34]  Michael: Reality is not—the reality is deeply imperfect. I think the philosophy of parenting that I want is the one that has a commitment to making everybody better off and not trying to sacrifice and compromise. That's the philosophy of parenting that I favor. It's the Taking Children Seriously philosophy of parenting, recognizing that the world is deeply imperfect. I can't even always agree with myself, and sometimes I find myself hopefully not often coercing myself.

[01:52:08]  Unidentified speaker: You know what I mean?

[01:52:12]  Unidentified speaker: I'm just imperfect, but I have a commitment to try.

[01:52:14]  Unidentified speaker: I'm trying not to do that.

[01:52:16]  Unidentified speaker: I'm trying to be a person who's not suffering.

[01:52:20]  Michael: I try not to coerce kids. I try not to coerce my wife. I try not to coerce people.

[01:52:26]  Unidentified speaker: I want people to enjoy themselves.

[01:52:27]  Michael: I want to figure out ways that I can be more happy, and they can be more happy simultaneously. I don't always succeed.

[01:52:34]  Peter: But if I can say one more thing about the medication angle, and I like your perspective, it sounds like you're not completely against it. You're not like moralizing about it in the same way that a lot of people who have similar ideas might about the medication. And I agree with that because it's hard for me to say that in all circumstances no child should be medicated because I've seen too many extremes. But I will also say that at least in my personal experience, and again, this is more with the ADHD or autism side of things, where it sounds like maybe you have a lot more experience in other areas, more psychiatric disorders or however you want to put that. But it's not really clear to me that the medication actually, when you look at it a little bit more with a more maybe cynical or skeptical eye as an educator, it's not actually clear to me it works very well. Maybe you have a different experience there, but I don't know how well these meds even work.

[01:53:51]  Bruce: Before you answer that, can I give my own experience with that? And then you can kind of answer both of us at the same time.

[01:53:56]  Unidentified speaker: Sure.

[01:53:57]  Bruce: So I have seen that too. I mean, like to some degree, I'm surprised medication works at all for a mental illness. Obviously, we've got this idea of the mind being software, and so you're going to throw this medication in to affect the hardware, and that's somehow going to impact the software. It's like trying to use a hammer to unscrew a screw or something like that. So it's surprising that it does work, but it does seem like its effectiveness differs. I've never been mentally ill.

[01:54:33]  Unidentified speaker: I have been depressed before.

[01:54:35]  Bruce: When my sister got sick with cancer, I went into a depression for a while. I was very grateful to have access to antidepressants to help me get through that.

[01:54:45]  Unidentified speaker: But I wouldn't say they were great.

[01:54:48]  Bruce: When I'm taking an antidepressant, it pops me up a little, but it's not like it really reverses the problem, right? On the other hand, I have known people who have more severe mental illnesses. Like let's say I've known some people who have been manic depressives. And I've heard from them that often the medication actually is pretty effective, that it's a night and day difference for them when it's more severe. But I've also had ones where it just wasn't true. The medication didn't seem to be effective, and they continued to spiral into difficulties and problems. To what degree is, so my question would have been, it's kind of the same as Peter's, to what degree is medication effective? Clearly, it's sometimes effective. But it always seems like it's, it certainly isn't like taking Theraflu or something where we understand it better, and it's just a physiological problem, and the medication seems to be far more effective.

[01:55:46]  Unidentified speaker: It seems a little more hit or miss to me.

[01:55:49]  Unidentified speaker: Yeah, I think that's fair.

[01:55:53]  Michael: So in terms of effectiveness of medicine, I guess it depends on what you're measuring, although possibly debatable because of confounders and these are very difficult studies to do. You might be surprised that Ritalin is one of the few psychiatric medications that we really have good data on that actually decreases death rates in people who take it. Much of it is because, I don't know if it's in the population that you're talking about. The problem is it's kind of like, if you give Ritalin incorrectly, then it's not going to do anything. Not only is it not going to do anything, it's going to make people worse. Even some people who do have attentional problems and you give them Ritalin, it absolutely makes them worse. They become agitated on them. Rather than being able to, it's not even focused more. It's almost attention deficit more like too much attention disorder. It's more like they're able to pay attention to too much. It leads to sort of-

[01:57:07]  Peter: Sorry, death rates from suicide?

[01:57:10]  Unidentified speaker: No, no, no, no, no.

[01:57:11]  Unidentified speaker: It's from accidents.

[01:57:13]  Unidentified speaker: Oh, from accidents.

[01:57:14]  Michael: Right. Like car accidents and other sorts of things. So we have, I don't think there's any reason for it to be good for the heart. It may be even bad for the heart. I don't think it's good for blood vessels or anything of the kind. It just decreases a lot of accidental death rates. And so, Ritalin is interesting. One of the few drugs that we do have data like that. We have drugs on other things like we have it on lithium, we have it on antipsychotic, particularly Clozaril. Decreasing death rates, it's a talk I like. I do a talk on which drugs, the talk I title, I hope humorously, and I don't mean to degrade my profession, because as I told you before, I'm very proud of it. But I say, “Are Psychiatrists Real Doctors?”, is the title of the talk. And I talk about various classes of medicines and which ones have been shown to, or we have good evidence, consistent with the explanation that these medications decrease death rates, and Ritalin is on the list, obviously, if properly used. Now, so in terms of whether the meds are [a fact, but?], and this is the other issue, it's sort of, giving psychiatric drugs is not quite like giving antibiotics, as you both correctly point out, it is very much hit or miss. And it's more like neurologists treating migraines, or neurologists treating epilepsy. Some people are better at this than others, and this is where learning comes in. And, you know, without getting too much into this debate, which is a very complex debate. But, you know, the question is, do antidepressants, SSRIs and kids increase suicidality?

[01:59:11]  Unidentified speaker: What?

[01:59:11]  Michael: Antidepressants increase suicidality? Yes, they very well could. Now, I would say first, this depends on what study you look at. But there are some studies, or some people certainly, who suggest that the implication of some of the studies is that on average, suicide rates go up.

[01:59:31]  Unidentified speaker: But let's say, but let's, I don't think it's true, but let's say it is true that suicidal thing goes up on average.

[01:59:40]  Michael: Even then, is that a reason not to give a kid an SSRI? It depends on whether you're a Popperian or not, or a Popperian, and most people are Popperians in practice, but not in theory. Because the obvious question is, well, first of all, let me just tell you about some incredibly fun or scary data. There were black box warnings put out in the country a few decades ago about using SSRIs in adolescents, and this happened in multiple different countries across the world. And the reason was because they were worried about the signal in the studies about increased suicidality from an antidepressant, the very thing that's supposed to stop it.

[02:00:28]  Unidentified speaker: And when you look at what happened to the suicide rate right after the regulators said that SSRIs—be wary of SSRIs in adolescents, the prescriptions of antidepressants went way, way, way, way down because of the warning.

[02:00:48]  Michael: And a funny thing happened: the actual number of suicides went dramatically up, and in some countries it was really dramatic. I think in America, I can't remember. I'm just making up a number, so don't quote me on that, but like 20%, 30%, there's a pretty substantial increase right after.

[02:01:04]  Unidentified speaker: How does that make sense?

[02:01:07]  Michael: And you have to be a Popperian, really, to understand how it might make sense.

[02:01:13]  Unidentified speaker: And the simple question is, when we do a randomized study, are we controlling for changes in knowledge?

[02:01:24]  Unidentified speaker: No, we're actually doing the opposite.

[02:01:27]  Unidentified speaker: Let me explain why that's so.

[02:01:31]  Unidentified speaker: Let's say I give an antidepressant to a kid in a study design trial, and two weeks later the kid comes in and says, you know what, I really want to kill myself.

[02:01:46]  Michael: And I look and I notice that because I gave the antidepressant, the kid isn't sleeping, they're agitated, they're just not feeling well.

[02:01:54]  Unidentified speaker: What am I going to do?

[02:01:57]  Unidentified speaker: Why?

[02:01:58]  Michael: I'm going to take the kid off the medicine.

[02:02:01]  Unidentified speaker: Will that be considered a study failure?

[02:02:03]  Unidentified speaker: Why yes, it will.

[02:02:05]  Unidentified speaker: Should it be considered a study failure?

[02:02:07]  Michael: Absolutely, it should. Well, that just shows, you know, doctors that giving kids antidepressants is a bad thing.

[02:02:16]  Unidentified speaker: But it doesn't quite show that if you think about it for a minute.

[02:02:23]  Michael: Because what about the other kid who wasn't taken off, who got better on it? That kid may have a lower rate of suicidality.

[02:02:33]  Unidentified speaker: So what did I do when I try kids on meds?

[02:02:37]  Unidentified speaker: If someone has a bad reaction, I take them off or you iterate.

[02:02:41]  Unidentified speaker: What is that called?

[02:02:42]  Unidentified speaker: That's called learning how to treat patients.

[02:02:47]  Unidentified speaker: You learn to individualize.

[02:02:49]  Michael: A study measure is an average, not an individual.

[02:02:52]  Unidentified speaker: So what we're really doing is we're trying to learn how to treat the individual.

[02:02:56]  Unidentified speaker: It is quite plausible, and I'm not the only one who suggested this, that when the FDA came out with its warning, not only did we take off kids who would have done worse on the med, we also stopped kids who would have gotten better on the meds from getting better.

[02:03:11]  Unidentified speaker: And thus, the net suicide rate went up.

[02:03:14]  Unidentified speaker: So what should the warning be?

[02:03:17]  Unidentified speaker: By the way, the FDA may not have been incorrect in its signal based on the studies.

[02:03:22]  Unidentified speaker: But that warning doesn't mean don't give kids antidepressants if they need it.

[02:03:28]  Unidentified speaker: What it means is you better friggin watch them damn close and don't give it in the pediatrician's office and see them back five months later.

[02:03:36]  Unidentified speaker: Don't do that.

[02:03:38]  Michael: If you're gonna start a kid who might become suicidal on an antidepressant, follow them closely.

[02:03:42]  Unidentified speaker: If it makes them worse, take them off.

[02:03:45]  Unidentified speaker: If it makes them better, guess what?

[02:03:49]  Unidentified speaker: Keep them on.

[02:03:50]  Unidentified speaker: So now I come back to your question.

[02:03:53]  Unidentified speaker: Do meds work?

[02:03:54]  Michael: They very rarely work the first time. Just like migraine meds very rarely work the first time, or seizure meds very rarely work the first time.

[02:04:04]  Unidentified speaker: What we do as doctors is we iterate.

[02:04:08]  Michael: If something doesn't work, we create a theory about the kinds of things that work with people. And when patients tell us that they're feeling better, and we notice that they're doing better, and it's not just what people say, it's also what they do, then we keep them on the meds.

[02:04:23]  Unidentified speaker: And so it depends on what you mean.

[02:04:24]  Michael: If you look at a short-term study of whether meds work, the answer is most of them don't very well. And this sort of gets back to my original point that we started the interview with. I had the interesting experience of being able to follow people for like five years in these hospitals, and try med after med and combination after combination. A guy by the name of Steven Stahl is maybe the most famous psychopharmacologist nowadays, and who's really, really carefully looked at these very, very sick people and how to treat them, and uses combinations very much like we did back in North Carolina. But he, unlike me, is smart enough, bright enough, and brave enough to publish this, and he's become quite famous for doing so.

[02:05:13]  Unidentified speaker: Showing how you really can help the patients if you take this iterative approach to learning how best to treat people.

[02:05:28]  Michael: We were doing it in North Carolina in the long-term psych hospitals. And what's scary to me is that people have sort of, are losing that knowledge in our profession. Thank goodness for people like Stephen Stahl, who, you know, truth crushed to earth will rise again. And he is actively bringing a lot of this knowledge forward that was just in the back wards of these psych hospitals. But it's really very much an exercise in Popperian thinking. Drugs are not just what drugs do. Drugs are how you interact with them and make them work.

[02:06:00]  Unidentified speaker: It's the same way.

[02:06:01]  Michael: It's a theme that maybe throughout, we've had throughout this.

[02:06:05]  Unidentified speaker: It's not what genes do.

[02:06:06]  Michael: It's how you react to them. It's not that genes cause phenylketonuria or that genes, you know, cause black skin and therefore lynching. It's what you do with the black skin. What you do with the black skin is you honor it. You treat it like it's a normal skin color and like these are reasonable, good, decent people and you don't act like a complete a-hole and hurt them. That's what you do.

[02:06:29]  Unidentified speaker: In the case of phenylketonuria, what you do is you figure out what the cause it is and then take phenylalanine out of the diet.

[02:06:39]  Unidentified speaker: What you do when you give people psych meds is you watch what happens and you figure out whether it's helping them or hurting them.

[02:06:50]  Unidentified speaker: If it's hurting them, take them off.

[02:06:51]  Michael: And if it's not, keep them on and you keep trying. And so you learn how to treat people. And that's, so yes, it is a bit of a trial and error approach. Very much like I think in the middle ages, David Deutsch talked about how many of the cathedrals that people built fell because we didn't have a full-blown, full-on theory of structural engineering. But some of them didn't. And there are some awful, beautiful churches in Europe that stood.

[02:07:28]  Unidentified speaker: And that was done by process of trial and error.

[02:07:30]  Michael: We're still in that phase in psychiatry. We don't have a model of what creates general artificial intelligence. And so we're left with a trial and error. But just because we're left with trial and error doesn't mean that we can't create something beautiful. And when you look at the European cathedrals as a model, many of them are absolutely amazing. And I'm sure probably many in our audience who are listening and maybe you guys have gone and seen them, they're astounding. And that was done without any theory of general structural engineering.

[02:08:07]  Unidentified speaker: One day we'll do a lot better.

[02:08:09]  Unidentified speaker: But for now we have what we have.

[02:08:10]  Michael: And the issue is to keep trying, or as I like to say, with parenting and everything else, it's a commitment to trying to make it work. So I'll close like that.

[02:08:21]  Unidentified speaker: All right.

[02:08:22]  Unidentified speaker: Well, thank you very much.

[02:08:23]  Bruce: I don't have any more questions.

[02:08:24]  Unidentified speaker: Do you have any more questions, Peter?

[02:08:25]  Peter: I don't, but I just want to thank you so much for appearing on our humble podcast, Michael. I've really enjoyed listening to you and got a lot out of your perspective.

[02:08:35]  Unidentified speaker: Thank you, sir.

[02:08:36]  Michael: I appreciate both of you.

[02:08:37]  Unidentified speaker: You take care.

[02:08:38]  Unidentified speaker: All right.

[02:08:39]  Unidentified speaker: Bye-bye.

[02:08:39]  Unidentified speaker: Thank you.

[02:08:46]  Unidentified speaker: Hello again.

[02:08:47]  Peter: If you've made it this far, please consider giving us a nice rating on whatever platform you use, or even making a financial contribution through the link provided in the show notes. As you probably know, we are a podcast loosely tied together by the Popper-Deutsch Theory of Knowledge. We believe David Deutsch's Four Strands tie everything together, so we discuss science, knowledge, computation, politics, art, and especially the search for artificial general intelligence. Also, please consider connecting with Bruce on X at BNielson01. Also, please consider joining the Facebook group, The Many Worlds of David Deutsch, where Bruce and I first started connecting.

[02:09:30]  Unidentified speaker: Thank you.