Affect: An engineering-minded perspective on mental health and self-CBT

Affect is a collection of writing that takes a modern, engineering-minded approach to mental health and self-CBT. It has been started with these beliefs:

1. Poor mental health is a significant source of productivity and creativity loss in the developed world.

What would happen if our society took mental health as seriously and industriously as we take writing good code? Psychology is a science, and science is useful because it helps us solve problems.

The world has many issues. We need all the creative, effective, well-adjusted human brainpower we can get. Unrealized human potential is unequivocally bad. It seems especially wasteful when the only obstacle standing between us and problem-solving is the wiring of our own brain.

2. Traditional therapy varies wildly in effectiveness, is mostly unscalable, and has a production pipeline that chokes potentially skilled producers out too early.

Like any other profession, therapists can be:

  • 1) Incompetent to the point of doing harm

  • 2) Mediocre

  • 3) Truly and uniquely talented

The existence of buckets 1) and 2) indicate that the current gating and training mechanism for producing therapists (years of schooling + clinical practice) is imperfect. 3) exists and they can move mountains, but they can be hard to find or afford. Some innovative members of 3) share the knowledge and intuition that they have painstakingly extracted from years of clinical work through podcasts, TEDTalks, Instagram, YouTube etc. - scalable forms, with low marginal cost of reproduction and global reach.

The 1-1 therapy session can have intangible yet immense social value in the same way that a heart-to-heart does. By definition, however, it does not scale.

There is a 1979 study from The Noonday Demon by Andrew Solomon which would be a great candidate for modern reproduction. Strupp and Hadley (n=15) found that given the right criteria, college professors could be just as effective as professional therapists in helping patients with anxiety, depression, and social introversion. Anybody who’s ever had a bad therapist and a great professor would not find this surprising.

Formal training pipelines usually require someone to make the choice to become a professional psychologist in their early 20s. There is heavy social and financial pressure against re-schooling later in life, meaning that many individuals who may be skilled at producing mental health solutions may never enter this pipeline, because of a choice they made shortly after high school.

There’s a great deal of unrealized potential here.

3. An engineering culture drives creative problem-solving, and an engineering mindset can be learned by anyone.

The purpose of this publication is to advocate taking an engineering mindset to mental health, the same way that everyone should learn a bit of code nowadays.

Ineffective behavioral scripts are like psychological tech debt: they did the job at the time, but they aren’t working anymore.

Think about the following contrasts - I’ll bet you can name both companies and individuals that remind you of each side:

  • Thrive, innovate, expand the pie / fight for scraps in zero-sum survival games

  • Empowered by infrastructure to see opportunities / crippled by infrastructure and define goals narrowly within them

  • Do the hard thing now to make life easier later / take short-run profits at expense of long-run sustainability

Exceptions exist, but I will wager that companies on the left side view engineering as a core competency to build, and a point of pride - not a cost to be kept down, and fixed only when the situation becomes dire.

Likewise, mental health should not be a black box that only gets farmed out to a “professional” when it finally breaks. Every engineer knows that you learn a great deal by taking something apart and putting it back together.

We tend to take better care of the things we understand. A mind is no different.