Scrupulosity: my EAGxBoston 2019 lightning talk

Link post

This was a 5 minute talk, so I ba­si­cally only had time to read the slides (dy­nam­i­cally!). I’m go­ing to provide the slides and what­ever ex­tra info I said at the time in ital­ics and give com­men­tary and con­text in plain text.

Ob­vi­ously, this is a mat­ter of de­gree. It’s not a di­s­or­der un­less it’s dis­tress­ing and in­terferes with your func­tion­ing, but I was more in­ter­ested in the way of think­ing than what counts as clini­cally sig­nifi­cant symp­toms. I should also men­tion there’s a lot unim­por­tant dis­agree­ment about whether Scrupu­los­ity should tech­ni­cally be con­sid­ered its own thing or a form or OCD or as a part of Ob­ses­sive Com­pul­sive Per­son­al­ity Di­sor­der (OCPD). Again, this in­tro­duc­tion is so broad that you can ig­nore all of these sub­tle dis­tinc­tions. The gen­eral pat­tern of re­liev­ing guilt and anx­iety from ob­ses­sions with com­pul­sions is not in dis­pute.

I ne­glected to give an ex­am­ple then, but here are a few:

I feel wretchedly guilty be­cause I think about sin­ning all day long (ob­ses­sion), so I spend hours each day recit­ing prayers for ab­solu­tion (com­pul­sion).
I am plagued by guilty and sad thoughts about the deaths of an­i­mals in fac­tory farms (ob­ses­sion), so I keep look­ing for more ways to make my ve­gan diet 100% cru­elty-free (com­pul­sion).
I feel guilty and un­de­serv­ing of my money (ob­ses­sion), so I de­vote my­self to be­ing as fru­gal as pos­si­ble (com­pul­sion).

Most peo­ple do not re­al­ize when they are act­ing com­pul­sively be­cause we think of com­pul­sions as phys­i­cal rit­u­als, such as tap­ping and count­ing in “clas­sic” OCD. But you can do any phys­i­cal or men­tal be­hav­ior com­pul­sively. One of my per­sonal com­pul­sions is self-doubt, though it’s only com­pul­sive when I do turn to it to re­lieve anx­iety from feel­ing ex­posed rather than sim­ply notic­ing or­gan­i­cally aris­ing doubt about spe­cific things. I learned to do this in part from di­course norms in sci­ence and ra­tio­nal­ism, be­cause it’s a very safe po­si­tion to say you don’t know or don’t trust your own think­ing. Be­cause self-doubt is such a virtue in those wor­lds, both my healthy doubts and my com­pul­sive, good­hart­ing doubt get re­in­forced.

There are many sto­ries of com­pul­sions start­ing when the per­son has an ex­pe­rience of great re­lief from their guilt or anx­iety by adopt­ing a cer­tain be­lief or perform­ing a cer­tain be­hav­ior. Scrupu­los­ity is also called a pro­cess ad­dic­tion be­cause it’s an ad­dic­tion to a cer­tain al­gorithm for deal­ing with dis­tress: in this case, mak­ing or obey­ing rules. I first re­mem­ber ex­pe­rienc­ing this when I stopped eat­ing meat as a lit­tle kid. All the guilt and tur­moil I had been feel­ing about the blood on my hands was gone as a re­sult of stick­ing to this rule. It made me think on some level that all dis­tress could be pre­vented or dealt with if you just fol­lowed the cor­rect rules.

An ex­ces­sive sense of per­sonal re­spon­si­bil­ity is also called “over­re­spon­si­bil­ity,” “hy­per-re­spon­si­bil­ity” (in the con­text of OCD), or the dys­func­tional at­ti­tude of om­nipo­tence. In Cog­ni­tive Be­hav­ioral Ther­apy (CBT), it is con­sid­ered one of three uni­ver­sal at­ti­tudes anx­ious peo­ple share (the other two are perfec­tion­ism and in­tol­er­ance of un­cer­tainty). I have a lot more to say about over­re­spon­si­bil­ity and its re­la­tion­ship to EA in an up­com­ing blog post.

Thought-ac­tion fu­sion is this di­a­bol­i­cal cy­cle that’s very com­mon in anx­iety and OCD. Essen­tially, when we are in fight-or-flight, the dis­tinc­tion be­tween thoughts and ac­tions gets blurred, so that just think­ing some­thing can have the weight of hav­ing done it. This usu­ally makes the per­son more anx­ious, thoughts and ac­tions get more blurred, and the down­ward spiral con­tinues.

The doubt and con­fu­sion is usu­ally fix­ated on the true mean­ing of moral pre­cepts or rules. When scrupu­lous peo­ple be­gin to doubt their own abil­ity to dis­cern moral be­hav­ior, it is un­der­stand­able that they would want to con­form to ide­olo­gies. Un­for­tu­nately, this makes them very vuln­er­a­ble to cult be­hav­ior and fun­da­men­tal­ism, sim­ply be­cause each ad­dresses their need for cer­tainty.

“Long pe­ri­ods of highly dis­tress­ing moral ru­mi­na­tion”– this is is the thing that made me want to give this talk. The pa­per I drew from went on to say “that pa­tients be­lieve are helping them solve their prob­lem ra­tio­nally.” So, ob­vi­ously, in EA we rec­og­nize long, highly dis­tress­ing pe­ri­ods of moral ru­mi­na­tion. I’m not say­ing they are all un­pro­duc­tive or symp­toms of a prob­lem, but I think we could stand to re­mem­ber that we aren’t always try­ing to solve a prob­lem in the ex­ter­nal world. Some­times we’re try­ing to solve our feel­ings in the guise of the prob­lems we’re most com­fortable solv­ing.

Many ex­perts say that a “de­bil­i­tat­ing fix­a­tion on moral is­sues” is scrupu­los­ity’s most dam­ag­ing symp­tom be­cause it leaves lit­tle proc­cess­ing power for the rest of life.

Pri­ori­ti­za­tion and eco­nomic think­ing have scarcity baked in. There’s an ac­knowl­edg­ment from the get-go that not ev­ery­thing is go­ing to get done and no one’s record is go­ing to be perfect.

I per­son­ally have seen a lot of re­spect for self-care in EA, moreso than in other moral com­mu­ni­ties I was a part of, any­way.

Max­i­miz­ing is a hard one, be­cause it’s only our whole thing. I think draw­ing a line as to how much you can do is difficult in prin­ci­ple, and if you’re a scrupu­lous per­son who doesn’t have a nat­u­ral sense of their per­son line, it’s even worse.

To­tal­iz­ing: peo­ple who get re­ally in­volved in EA tend to get REALLY in­volved in EA, which means be­ing sur­rounded by mes­sages of moral max­i­miz­ing and sac­ri­fice. I be­lieve that EA se­lects for scrupu­lous peo­ple (like me), which con­cen­trates these ten­den­cies in a very con­nected com­mu­nity.

EA in­tro­duced me to things I would never have felt re­spon­si­ble for on my own. Such as pick­ing the most effec­tive ca­reer or the en­tire fu­ture.

Essen­tially, for me EA has helped a lot by tak­ing moral­ity se­ri­ously as a real world pro­ject. With ev­i­dence-based char­ity comes a lot of so­bri­ety. But it’s also hurt be­cause my way of think­ing is mag­nified in this com­mu­nity and I’m con­stantly made aware of all the things I could, in the­ory, be do­ing to help the world.

Your self­ish de­sires are a part of you, worth keep­ing in touch with. If you ac­tu­ally don’t know your self­ish de­sires or feel like that part of you is blocked, that’s a huge red flag. It means you’re not be­ing hon­est with your­self, per­haps be­cause you don’t feel safe be­ing hon­est with your­self. Go­ing from my per­sonal ex­pe­rience alone, I would sug­gest that all peo­ple with scrupu­lous ten­den­cies check in with their self­ish de­sires reg­u­larly as on-go­ing hy­giene. Hav­ing trou­ble find­ing them is an early warn­ing sign for me. (Plus, it’s kind of a fun “in­ter­ven­tion” be­cause there’s the promise of grat­ifi­ca­tion when you figure out what you want. :P )

Ex­po­sure and re­sponse pre­ven­tion is just “ex­po­sure ther­apy,” where the scrupu­lous per­son ex­poses them­selves to the guilt- or anx­iety-pro­vok­ing stim­u­lus with­out do­ing the com­pul­sion to re­lieve the anx­iety. After re­peated ex­po­sure with no feared con­se­quence, the lim­bic sys­tem learns that the stim­u­lus is not dan­ger­ous, and the re­ac­tion ex­tin­guishes. Depend­ing on how se­vere your symp­toms are, you might want to do this with the help of a ther­a­pist.

Be kind to your­self and for­give your­self for strug­gling with this. It’s okay to be small hu­man with limited pow­ers, it’s okay to strug­gle with scrupu­los­ity, and it’s okay to be you. In my case, scrupu­lous symp­toms are re­lated to feel­ings of worth­less­ness, like I alone have to live up to this perfect moral stan­dard be­cause some­how I can’t af­ford to be as im­moral as a nor­mal per­son. I can’t effec­tively tackle par­tic­u­lar ob­ses­sions or com­pul­sions if I don’t start by heal­ing my sense of fun­da­men­tal wor­thi­ness, be­cause then I’m just play­ing whack-a-mole with new symp­toms.

Boundaries, here I’m talk­ing about pro­tect­ing your psy­chic and emo­tional space. Give when your cup runs over, but what’s in the cup is yours. It’s im­por­tant to set ex­pec­ta­tions with oth­ers, but for scrupu­los­ity I’m talk­ing about set­ting bound­aries with your­self to re­spect your own needs and hap­piness.