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Autism on Acid

This post originally appeared on Blossom Analysis.

Autism on Acid (How LSD Helped Me Understand, Navigate, Alter & Appreciate My Autistic Perceptions) is an amazingly personal book written by Aaron Paul Orsini and documents his transformational experience with a variety of LSD dosages and how they have helped him in his struggles with Autism Spectrum Disorder. The book can be best seen as a case-study and an invitation for more research to be done. That being said, it’s an incredible case study and one that under four hours (do get the audiobook Aaron narrates himself) will impact not only your mind, it will also touch your heart.

Summary & Review

Introduction

Aaron was diagnosed with Autism Spectrum Disorder (ADS) at the age of 23. Four years later, at the age of 27, he had his first Lysergic Acid Diethylamide (LSD) trip. This book documents his experience of living with ADS, discovering LSD, and learning to better manage his condition. Or in other words, it will explain the opening statement:

“[W]hen LSD met my ASD, I experienced incomparable relief for — and, in some sense, a near-total resolution of — my struggles with Autism Spectrum Disorder.”

Chapter 1 – Me Before LSD

Emotional awareness and emphatic access are two traits that people with ASD have trouble experiencing (to a varying degree, it’s a spectrum). Social interactions aren’t natural and fun, they are more often draining and confusing. Aaron recounts how he specifically experienced the world from this perspective. For him, social information and seamless interaction were out of reach.

“I am in no way joking when I say that before LSD, I felt more closely related to a robot or robotic learning algorithm than I did to a human being.”

For more background, you can find the DSM-V (psychologists/psychiatrists handbook of sorts) definition of ASD here.

Chapter 2 – Autism on Acid

The diagnosis of ASD came very late and Aaron battled with depressive symptoms for a long time before his diagnosis helped him better understand himself. But it wasn’t enough, and after the death of a close friend, Aaron retreated and bought a train ticket west.

His first trip was with a tab of LSD of around 150-250 micrograms. The trip gave him access to a world he had never experienced before. A world in which he could make connections. Instead of talking to a person, he was talking with a person. He could, for the first time, understand the nuance and detail of social interactions.

“In the initial hours of the experience, as the LSD began to take effect, I felt more and more connected… with the trees and breeze and sunlight around me. I experienced a deep moment of engagement. Yes. A moment of connection, with nature, with thoughts of my parents, my family, friends, and the whole of the human family and the broader web of life. And yes I know it sounds cliche to say but I was awash in a sense of deep, deep love for so many aspects of life.”

Aaron does a very good job of also describing the (legal) risks of taking an illegal drug, and discourages anyone from doing the same.

Chapter 3 – After the First Dose

This newfound access to emotions wasn’t just amazing, it also opening him up to challenging and intense emotions. But as he learned more about himself, he discovered the nuance of emotions.

“It was as if LSD had unclogged a lifetime of emotional constipation, and there I was, sifting through my mound of unprocessed mental sh*t. But the odd part about this was that, with the assistance of LSD, It was as if LSD had unclogged a lifetime of emotional constipation, and there I was, sifting through my mound of unprocessed mental sh*t. But the odd part about this was that, with the assistance of LSD, this type of inner emotional work seemed not very burdensome.this type of inner emotional work seemed not very burdensome.”

Chapter 4 – Integration

The LSD experienced needed to be integrated into his daily life and Aaron recounts how the ASD lens is much different from average. And that until his 27th year, socializing was on the bottom of his priority list.

“The closest I can come to describing what it’s like to have an ASD-affected brain would be to compare it to relying on a mailroom clerk who receives all of the envelopes in the mail but only ever seems to have no clue as to which envelopes ought to be opened first.”

Chapter 5 – Acceptance

Through his experience with LSD, Aaron was able to accept himself, to become his own best friend. In this chapter, and in later chapters, he recognizes that the ASD lens is just one of the ways of seeing the world, and a way that he does still values. One lens is not better than the other, they are just different perspectives.

“By alternating between the lenses of ASD and LSD, I gained an intimate understanding of not only a new way of seeing, but also, critically, a wholly new and novel perspective on the ways that I had always seen. I became aware of the ways in which I was aware, and unaware, of various aspects of the ever-available stimulus. In this way, I became capable of seeing my own biases, and conditioned patterns of belief, and so many other aspects of self that had become so familiar and ingrained that they had likewise become more or less invisible to me in my day-to-day perception.”

Aaron makes the great analogy to people who are deaf. A cochlear implant is awesome, but it’s also great to be able to turn it off when you’re riding the subway.

Chapter 6 – Immersion Therapy

One of the reasons for writing the book is to inspire researchers and therapists. Aaron’s experience may serve as a template of sorts that they can try and validate or update with a larger sample size.

Through experimentation, Aaron has found that 20-50 micrograms works best as ‘LSD-Assisted Immersion Therapy’. This is more than a microdose (sub-perceptual, usually 5-10 µg) and less than a full/psychedelic/macro dose (>100 µg). This dosage helped him most with social learning and development, without being too distracting/psychedelic.

“It was a variable dose range that seemed to work well for me; a range that would decrease my fear and increase my perceptivity but still allow me to re-root and more readily integrate insights into aspects of selfhood in real-time.”

He followed the 3-day (1 on, 2 off) protocol as proposed by James Fadiman (The Psychedelic Explorer’s Guide). The rest of the chapter also describes the usefulness of other dosages (macro, micro), how to prepare it, and the preparation he undertook.

Aaron describes the LSD-Assisted Immersion Therapy as a place in which he could discover and change his conditioning maps, his routines and (unhelpful) (mental) routines.

“This process of use-testing and editing my conditioned behavioral responses allowed me to (1) recognize patterns of behavior, (2) consider potential root causes of the behavior (3) consider potential modifications to said behavior, and (4) test and integrate the behavior change IN THE MOMENT.”

Chapter 7 – What Now?

This chapter can be best described as a call-to-action, a thank you to LSD, and encouragement for more research to be done.

“LSD let me see & comprehend complicated social behaviors. LSD let me feel feelings and deeply sense the feelings of other living beings. From a single dose I woke up, from a numb and deafened black and white life, obscured by memorized maps. I fell in love with the dynamic full-color, heart-tingling, sensational, birational, expressive world of human beings being social. So – pretty please – with an fMRI image on top, please consider rescheduling so we can more readily research LSD.” (printed in a very large font)

Chapter 8 – LSD Research, Then & Now

The research on LSD and ASD is still very limited. Aaron has made available all his (up-to-date) notes and links on this website. Much of the research is from the 1960s, and good new studies have yet to be done. In the book, Aaron quotes four papers:

Chapter 9 – An Open Letter to Science

The final chapter highlights the resurgence of research being done with psychedelics. Aaron cheers this on (and donates the proceeding of the book to MAPS and Heffter).

“If I had a wish, I would wish that neuroimaging studies could continue to provide insight into what exactly happens during the psychedelic experience. I would wish that such studies could continue to reveal not only the neurological underpinnings of both psychedelic and autistic experiences, but also, in turn, the neurological underpinnings of the broader human experience. Because I strongly believe that by studying psychedelics and autism, we advance our perspective on the formation of perspectives, period. And I for one find that to be an exciting prospect indeed.”

Buy Autism on Acid

Next to the normal places, you can also get the (audio)book directly from the website. You can also collaborate/give feedback on this google doc.

Do Meaningful Work

Most of your productive time will be spent at your day job. A rough estimate of the hours you will spend doing this is 80.000 hours.

In my eyes, there are several ways (all good) through which your career can contribute to making the world a better place.

  1. Work directly on (global) issues (if you have the skills and motivation)
    1. At an effective organisation (job board)
    2. Start your own (Charity Entrepreneurship incubator)
  2. Find the best organisation in your field (‘the best’ of course differs depending on your goals)
  3. Change the impact of the organisation you work at (e.g. yearly fundraiser, changing supply chain)

For more specific career advise (and a good podcast too), go to 80.000 hours.org

I personally always keep my eyes open as to how Queal can be more sustainable, and think that by replacing many meals that were previously meat-based, we are already having a large impact.

With Blossom, I plan to donate a percentage of revenue to mental health charities.

Learn More About Effective Altruism

Some of the Effective Altruism Organisations:

Stuff I’ve read and found interesting:

Have Healthy Habits

Note: these are actions that I recommend, but as stated before, the impact of your giving will be many times larger than your habits (unless you own a yacht).

Bike > Train > Car

Plants > Vegetarian > Meat

Sweater > Heater

Durable clothes > Fast fashion

Old phone > Newest phone

More on how your consumption impacts the world can be found in The Hidden Impact.

Promote Effective Altruism

A final part of maximizing my impact is the effort I make in promoting Effective Altruism. I do this via the monthly meeting in Rotterdam which attracts between 5-30 people each month.

You can find the meetup here (600+ members). Or on Facebook.

Also find out more on our website (sign up for the newsletter there).

In future months I plan on also doing a fundraiser and making it easier for others to do fundraisers too.

Note: in the future I want to evaluate if my time doing this is worth it (does it even get others to donate? (yes I think) or make other significant changes (maybe))

Give Money Away

Up to this point, I’ve explained some of the philosophy behind effective altruism and introduced a few of the concepts. I think that I should have everyone on board at this point, so here comes the conclusion of the above: You should give away a part of your money.

Let me explain why.

You are rich!

If you make €15.000 after taxes in The Netherlands, you are among the richest 10% of people in the world. Bump that up to a corporate salary of €40.000 after taxes and you’re in the top 1.5%.

You can calculate your own ‘richness’ with this calculator from Giving What We Can. The median income in the world is about €2.000.

Giving away money buys happiness

Spending money on yourself brings you happiness, it makes possible great experiences and beautiful things. But spending everything on yourself isn’t effective.

For instance, buying high-quality food at €10 will for instance add one unit of happiness (utilon) to your life. But somewhere around the world, that same €10 will buy a whole family of five, one unit of happiness, for two weeks, totaling 70 units of happiness.

This is but a very course example. Still, I hope it gets the point across that money somewhere else will have a larger effect on happiness than spending everything on yourself.

Giving away money buys you happiness

Experiments show that giving away money also ‘buys’ you happiness. When participants in the study spent the money on others, they reported higher levels of happiness than those who spend everything on themselves.

Just like caring about the people close to us, altruism is also something that is baked into our genes. All EA asks of you, is to take a global and impartial perspective.

Just give away a little

Giving What We Can, is an organisation that promotes giving to effective charities. They recommend giving 10% of your income. Or put the other way around, to spend 90% on yourself and loved ones.

This means that you can still go on vacation, have a caramel latte, drink beers at the pub, etc.

I have three tips for starting giving:

  1. Try Giving, start at 1%
  2. Make it automatic, don’t make it an ‘active’ choice every month/year
  3. Scale up the giving when your income increase, so you don’t feel any ‘pain’ from it

It doesn’t all have to be effective

Giving effectively isn’t the perfect way to buy happiness for yourself. Helping out at a soup kitchen (and not working those hours at your high-paying job) feels much better than donating the money you could have made in those hours. Giving to that handsome guy who wrangles people for donations feels like the right thing to do.

So, here are my suggestions for thinking about giving effectively, based on the essay ‘Purchase Fuzzis and Utilons Separately‘:

  • Buy the warm feelings (fuzzies) by doing something very local like supporting a soup kitchen a few hours or helping elderly do their taxes (a small part of your time or money)
  • Buy status among friends and family by donating to your nephews fundraising effort for charity X, help out a few hours at your children’s school event (again, a small part of time or money)
  • Then with the rest of your giving, be a rationalist and give it to the most effective charities there are (see below)

Philosophy of EA

“Many people in poor countries suffer from a condition called trachoma. Trachoma is the major cause of preventable blindness in the world. Trachoma starts with bacteria that get in the eyes of children, especially children living in hot and dusty conditions where hygiene is poor. If not treated, a child with trachoma bacteria will begin to suffer from blurred vision and will gradually go blind, though this process may take many years. A very cheap treatment is available that cures the condition before blindness develops. As little as $25, donated to an effective agency, can prevent someone from going blind later in life.

How much would you pay to prevent your own child from becoming blind? Most of us would pay $25,000, $250,000, or even more, if we could afford it. The suffering of children in poor countries must matter more than one-thousandth as much as the suffering of our own child. That’s why it is good to support one of the effective agencies that are preventing blindness from trachoma, and need more donations to reach more people.”

This argument from the eminent philosopher Peter Singer illustrates many of the underlying principles of EA. According to my interpretation, they are the following.

Do Good

EA asks of you to think about how you can do good. This is a bit of an open door and at the same time a profound question. How can you use a part of your resources (e.g. time and money) to do the most good?

Utilitarianism (or consequentialism) is the philosophical way of thinking that most closely aligns with EA. This ethical theory promotes actions that maximize happiness and well-being. Or put the other way around, reduces suffering the most.

Impartiality

Impartiality means that decisions (about doing good) should be based on objective (often measurable) criteria.

But, as the example above shows, we do care about our children/family/friends more than strangers. And that is normal, that is how our brains are wired. And we should care about the people close to us.

At the same time, we live in an age of affluence. If you have a new smartphone, get coffee outside the house, or vacation to the other side of the world. Then you should be able to give a little to others, and when thinking about how to do this, impartiality should be the starting point for this.

The ‘veil of ignorance‘ thought experiment asks you a simple question: What if you were born at a random place on this earth, how would you want the world to look? If you could have been born anywhere, would you want the affluent to give to those in need?

Thinking about impartiality also brings up questions around caring (as much) for animals and people who will live in the future, I hope to answer these in later parts.

Measure What Matters

A company would be crazy not to measure how much profit they were making. They aren’t perfect at it, but they try their best to do so. So, what if I told you that until relatively recently most charities didn’t measure the outcomes of their actions.

GiveWell, one of the key EA organisations, in 2007 started researching how much good charities were doing. At that time data on how much charities were helping was scarce.

I do need to make two clarifications here. Charities do work, and as you will see some do much more than you expect. At the same time, not everything can be measured and it can be difficult to compare between charities.

Two terms that you may hear in the EA community are the following:

  • DALY: disability-adjusted life year: the number of years lost to ill-health, disability or death
  • QALY: quality-adjusted life year: the number of healthy years lived

DALY is mostly used as a societal measure (the total burden of a disease), QALY measures the benefits (the added good years by an intervention like bednets against malaria).

Effective

Using these terms, it becomes possible to compare the impact between charities, and (a bit more abstractly) broader actions like your career choice and behaviours like food and travel choices. What will become clear below is that giving usually has a much larger effect than individual actions.

EA considers the effectiveness of charities among a variety of factors. Here are so of them:

  • Neglected: Is there (a lot of) room for improvement?
  • Scalable: If you add more funding, can you do more good?
  • Tractable: Is the impact measurable? (see above)

Neglected as a term can also be explained by the concept of counterfactual reasoning. This poses the question: What would have happened if I didn’t do X? For instance, if I didn’t donate, would someone else have taken my place?

When asked about your career, a counterfactual may lead to surprising results. What if I give up the high paying job that allows me to donate much and do direct charity work (where I’m ‘average’ in doing the work), would that bring extra good to the world?

And through this lens, you can also better evaluate the following statement:

Giving money to a charity that is promoted by someone handsome on the street or at your door is most likely not effective.

Finally, the effectiveness of different charities is widely different. The QALY (added positive years) of malaria nets or deworming is 100s of times greater than giving money to sponsor the opera, make a football court for kids, or even providing food for the homeless.

As I will argue in the end of the next session, it may still be good to give some to these charities, but most of it should go to where it’s most effective.

Conclusions EA

The goal of Effective Altruism is doing as much good as possible for the world. It’s a personal commitment to improving the lives of others. And it’s a global movement of other altruists who are also doing good.

To me, Effective Altruism (EA) is both deeply emotional and rational. The ‘why’ comes from your heart. The ‘how’ comes from thoroughly and fairly evaluating what action the most good.

EA asks of you to make a commitment to doing good. Yet at the same time, it doesn’t require you to devote your whole life to charity. You can live a normal life. It will be a life that is just a little more fulfilling, just, and fair.

My commitment is to give to an effective charity (10% of income), be conscious about my personal impact (habits), and promote EA. My work should also be net-positive at the end of the day, adding happy years to the world.

EA covers many domains and can sometimes be overwhelming. Altruists in the (global) community have worked on everything from effective donations to career advice. Just start with one of the areas below and take your time to discover what is out there.

This page covers my understanding of EA and aims to give you a window into what it’s all about and how you can contribute. See this as an invitation to explore the world of effective altruism, and always feel free to shoot me an email.

Hell Yeah or No

Hell Yeah or No by Derek Sivers is a great little book with life advice from a man who has figured out some good things about life. The thinking is clear, concise, and evergreen. Definitely a book to re-read/listen to (parts of) again every year or so.

First/key idea in this blog post. And great supplement here.

“Use this rule if you’re often over-committed or too scattered. If you’re not saying “HELL YEAH!” about something, say “no”. When deciding whether to do something, if you feel anything less than “Wow! That would be amazing! Absolutely! Hell yeah!” — then say “no.” When you say no to most things, you leave room in your life to really throw yourself completely into that rare thing that makes you say “HELL YEAH!” Every event you get invited to. Every request to start a new project. If you’re not saying “HELL YEAH!” about it, say “no.” We’re all busy. We’ve all taken on too much. Saying yes to less is the way out.”

And another great idea is one about being now or future focussed.

Also see this review (selected experts) by Josh Spector.

Measure What Matters

Measure What Matters by John Doerr is the management book around goal setting as a company. From legendary investor John Doerr and influenced by Bill Campell (executive coach), and full of examples from Google and the like.

The core of the book should also be possible to be applied to oneself. So let’s dive in.

Too much to read? Watch John Doerr’s TED Talk about OKRs (11min)

OKRs

“Ideas are easy. Execution is everything.”

Objective: what is to be achieved

  • significant, concrete, action-oriented, and (ideally) inspirational
  • e.g. organize the world’s information
  • e.g. make psychedelics more accessible

Key Results: how we get to the objective

  • specific and time-bound (month/quarter), aggressive yet realistic
  • measurable and verifiable
  • e.g. grow revenue of Youtube by 30% this quarter
  • e.g. make an overview of all psychedelics companies this quarter

Goals can be harmful, people can only work towards them and ignore opportunities and ‘goal-hack’. But don’t be mistaken, goals are necessary (insert Yogi Berra quote 😉 ).

Goals create alignment, clarity, and job satisfaction.

The rest of the book dives deeper into the ‘superpowers’ of OKRs:

  • Focus and Commitment to Priorities
  • Align and Connect for Teamwork
  • Track for Accountability
  • Stretch for Amazing

and the applications and implications

  • Conversation, Feedback, Recognition
  • Continuous Improvement
  • The Importance of Culture

OKR Hygiene

  • Less is more
    • it signals what to say yes to and no to
    • three to five OKRs per cycle
  • Set goals from the bottom up
  • No dictating
  • Stay flexible
    • modify or abandon mid-cycle if needed
  • Dare to fail
    • aim higher than where you are now
    • ‘train harder than last time’
  • A tool, not a weapon
    • OKRs and bonuses are best kept separate
  • Be patient; be resolute
    • it takes some time to get used to them

Focus and Commitment to Priorities

chapters 4, 5, and 6

What is most important for the next three (or six, or twelve) months?”

Many people can’t name the priorities of their companies (or themselves for that matter).

  • You will need to repeat the OKRs until you (leadership) become tired of repeating it, then people will know them

… nothing moves us forward like a deadline.”

Quarterly OKRs are advised.

You need to pair OKRs to measure both effect and counter-effect. This means quality and quantity. Or speed and robustness. Only measuring one can lead to goal-hacking.

OKRs also mean that you don’t work on other things. These are the projects that need to get done, you can only work on another project if you update your OKRs.

The art of management lies in the capacity to select from the many activities of seemingly comparable significance the one or two or three that provide leverage well beyond the others and concentrate on them.”

Put more wood behind fewer arrows.”

Chapters 5 and 6 are examples from two companies that implemented OKRs.

Instead of reacting to external events on the fly, we’re acting purposefully on our plans for each quarter.”

Align and Connect for Teamwork

chapters 7, 8, and 9

OKRs lead to alignment because you know what everyone/the company is working on (and only 7 percent of employees fully understand the goal of a company).

Chapter 7 has an example of OKRs for a football team, some good, some bad.

OKRs should work towards the greater goal, but also can/should come from bottom-up. At that level, people know best what to do to achieve the goals. Doerr says 50-50 is a good mix.

OKRs may be internal (do X) or external (get Y revenue). Depending on the phase of a company and how much you know of the environment, you can finetune this.

One good (alignment) question to ask is: Will this thing work towards our North Star?

Track for Accountability

chapters 10 and 11

OKRs can be tracked, and revised or adapted as circumstances dictate.

Cloud-based software could help with:

  • Making goals visible to everyone
  • Drive engagement
  • Promote internal networking
  • Save time, money, frustration

Track the goals for yourself (weekly, monthly, or whatever frequency works best). Preference of Doerr is weekly.

Then you can choose the following:

  • continue
  • update
  • start (new one)
  • stop (do let everyone who is dependent on this OKR know)

Scoring (at Google) is done as follows. A bit objective with subjective ‘did I put in the effort’ mixed in:

  • 0.7 to 1.0 = green
  • 0.4 to 0.6 = yellow (progress, but not there)
  • 0.0 to 0.3 = red (fail)

Always reflect on the progress made, as also to inform making new OKRs.

Possible questions:

  • Did I accomplish all of my objectives?
    • If so, what contributed to my success?
    • If not, what obstacles did I encounter?
  • If I were to rewrite a goal achieved in full, what would I change?
  • What have I learned that might alter my approach to the next cycle’s OKRs?

After this feedback, take a breath to savour your progress.

Stretch for Amazing

chapters 12, 13, and 14

“If companies don’t continue to innovate, they’re going to die – and I didn’t say iterate, I said innovate.” – Bill Campbell

Google divides their OKRs into two buckets

  1. Committed goals: related to metrics, aim is to get a 1.0
  2. Stretch/aspirational goals: bigger-picture, aim to get 0.7
    1. Google fails 40% of these

Stretch goals should be fine-tuned to an organisation. You should have some, but not all. And they shouldn’t be ‘fly to Mars next year’, but ‘build a working rocket next year’ (difficult, but remotely possible).

(fun fact: it was Susan Wojciki’s garage where Google started, she was employee nr 16 and YouTube’s 10x’er)

OKRs can also be seen as the ‘big rocks’ (Stephen Covey). Do those first, then add smaller and smaller pebbles and sand (to fill a jar).

Conversation, Feedback, Recognition

chapters 15 and 16

A manager’s first role is the personal one. It’s the relationship with people, the development of mutual confidence … the creation of a community.” – Peter Drucker

This is in response to not everything being able to be captured by numbers, by OKRs.

The idea is that OKRs get coupled to continuous performance management in the form of:

  • Conversations: manager and contributor
  • Feedback: bidirectional and between peers
  • Recognition: expression of appreciation

What is noted again is to decouple OKRs from compensation (otherwise the goals will be too low/high/goal-hacked). Feedback from the team and context is more important for compensation. (see graph p182)

Conversations

The conversations are driven by the subordinate. It’s about goal setting/adjusting, update on progress (what works/doesn’t work), coaching both ways, career growth, mini-performance review.

Feedback

Specific feedback to gauge if you’re doing well, what others need from you, etc. Also, feedback on the company.

Recognition

Continuous, peer-based, objective, sharing stories, tied to company goals and strategies.

Continuous Improvement

chapter 17

Story about Zume, but alas OKRs didn’t help them in the end.

The Importance of Culture

chapters 18, 19, and 20

Culture eats strategy for breakfast” – saying/John Doerr.

Culture is the parts that include someone that champions the goals (OKRs) and others that help others and motivate (CFRs).

This part is a bit more vague, but it comes down to having a culture where people are going in the same direction, OKRs can help with getting that so.

If you want to cut a man’s hair, is it better if he is in the room?” – Senegalese saying

Ideas are easy; execution is everything.” – John Doerr

OKRs checklist

Objective

  • Concrete
  • Significant
  • Action-oriented
  • Inspirational
  • 3-5 Objectives

Key Results

  • Specific
  • Time-bound
  • Aggressive but attainable
    • Either aim for complete (1.0)
    • Or aim out there with 10x projects (0.7)
  • Qualitative and quantitative (prevent goal-hacking)
  • 2-5 Key Results per Objective

Review

  • Weekly or per month
  • Change goals if ‘ladder is on the wrong building’
  • Rate (at end) from 1.0 (complete/full effort), <0.7 (progress), <0.4 (fail)
  • What contributed to the success?
  • What obstacles were there?
    • How should it be rewritten?
  • What changes for the next cycle?
  • Take a break