This is my 2022 review of Logarithmic Scales of Pleasure and Pain: Rating, Ranking, and Comparing Peak Experiences Suggest the Existence of Long Tails for Bliss and Suffering (2019; QRI link; forum link), written for the EA Forum First Decade Review; permalink of the review; read all reviews and vote for submissions here.

I would like to suggest that Logarithmic Scales of Pleasure and Pain (“Log Scales” from here on out) presents a novel, meaningful, and non-trivial contribution to the field of Effective Altruism. It is novel because even though the terribleness of extreme suffering has been discussed multiple times before, such discussions have not presented a method or conceptual scheme with which to compare extreme suffering relative to less extreme varieties. It is meaningful because it articulates the essence of an intuition of an aspect of life that deeply matters to most people, even if they cannot easily put it into words. And it is non-trivial because the inference that pain (and pleasure) scales are better understood as logarithmic in nature does require one to consider the problem from multiple points of view at once that are rarely, if ever, brought up together (e.g. combining empirical deference graphs, descriptions of pain scales by their creators, latent-trait analysis, neural recordings, and psychophysics). 

Fundamentally, we could characterize this article as a conceptual reframe that changes how one assesses magnitudes of suffering in the world. To really grasp the significance of this reframe, let’s look back into how Effective Altruism itself was an incredibly powerful conceptual reframe that did something similar. In particular, a core insight that establishes the raison d’etre of Effective Altruism is that the good that you can do in the world with a given set of resources varies enormously depending on how you choose to allocate it: by most criteria that you may choose (whether it’s QALYs or people saved from homelessness), the cost-effectiveness of causes seem to follow much more closely (at least qualitatively) a long-tail rather than a normal distribution (see: Which world problems are the most pressing to solve? by Benjamin Todd; the long-tail on the left below). In turn, this strongly suggests that researching carefully how to invest one’s altruistic efforts is likely to pay off in very large ways: choosing a random charity versus a top 1% charity will lead to benefits whose scale differs by orders of magnitude.

Log Scales suggests that pain and pleasure themselves follow a long-tail distribution. In what way, exactly? Well, to a first approximation, across the entire board! The article (and perhaps more eloquently the subsequent video presentation at the NYC EA Meetup on the same topic) argues that when it comes to the distribution of the intensity of hedonic states, we are likely to find long-tails almost independently of the way in which we choose to slice or dice the data. This is analogous to, for example, how all of the following quantities follow long-tail distributions: avalanches per country, avalanches per mountain, amount of snow in mountains, number of avalanche-producing mountains per country, size of avalanches, number of avalanches per day, etc. Likewise, in the case of the distribution of pain, the arguments presented suggest we will find that all of the following distributions are long-tails: average pain level per medical condition, number of intensely painful episodes per person per year, intensity of pain per painful episode, total pain per person during life, etc. Thus, that such a small percentage of cluster headache patients accounts for the majority of episodes per year would be expected (see: Cluster Headache Frequency Follows a Long-Tail Distribution; the long-tail on the right above), and along with it, the intensity of such episodes themselves would likely follow a long-tail distribution.

This would all be natural, indeed, if we consider neurological phenomena such as pain to be akin to weather phenomena. Log Scales allows us to conceptualize the state of a nervous system and what it gives rise to as akin to how various weather conditions give rise to natural disasters: a number of factors multiply each other resulting in relatively rare, but surprisingly powerful, black swan events. Nervous systems such as those of people suffering from CRPS, fibromyalgia, and cluster headaches are like the Swiss Alps of neurological weather conditions… uniquely suited for ridiculously large avalanches of suffering.

Log Scales are not just of academic interest. In the context of Effective Altruism, they are a powerful generator for identifying new important, neglected, and tractable cause areas to focus on. For instance, DMT for cluster headaches, microdose ibogaine for augmentation of painkillers in sufferers of chronic pain, and chanca piedra for kidney stones (writeup in progress) are all what we believe to be highly promising interventions (of the significant, neglected, and tractable variety) that might arguably reduce suffering in enormous ways and that would not have been highlighted as EA-worthy were it not for Log Scales. (See also: Get-Out-Of-Hell-Free Necklace). On a personal note, I’ve received numerous thank you notes by sufferers of extreme pain for this research. But the work has barely begun: with Log Scales as a lens, we are poised to tackle the world’s reserves of suffering with laser-focus, assured in the knowledge that preventing a small fraction of all painful conditions is all that we need to abolish the bulk of experiential suffering.

But does Log Scales make accurate claims? Does it carve reality at the joints? How do we know?

The core arguments presented were based on (a) the characteristic distribution of neural activity, (b) phenomenological accounts of extreme pleasure and pain, (c) the way in which the creators of pain scales have explicitly described their meaning, and (d) the results of a statistical analysis of a pilot study we conducted where people ranked, rated, and assigned relative proportions to their most extreme experiences. We further framed this in terms of comparing qualitative predictions from what we called the ​​Normal World vs. Lognormal World. In particular, we stated that: “If we lived in the ‘Lognormal World’, we would expect: (1) That people will typically say that their top #1 best/worst experience is not only a bit better/worse than their #2 experience, but a lot better/worse. Like, perhaps, even multiple times better/worse. (2) That there will be a long-tail in the number of appearances of different categories (i.e. that a large amount, such as 80%, of top experiences will belong to the same narrow set of categories, and that there will be many different kinds of experiences capturing the remaining 20%). And (3) that for most pairs of experiences x and y, people who have had both instances of x and y, will usually agree about which one is better/worse. We call such a relationship a ‘deference’. More so, we would expect to see that deference, in general, will be transitive (a > b and b > c implying that a > c).” And then we went ahead and showed that the data was vastly more consistent with Lognormal World than Normal World. I think it holds up.

An additional argument that since has been effective at explaining the paradigm to newcomers has been in terms of exploring the very meaning of Just-Noticeable Differences (JNDs) in the context of the intensity of aspects of one’s experience. Indeed, for (b), the depths of intensity of experience simply make no sense if we were to take a “Just-Noticeable Pinprick” as the unit of measurement and expect a multiple of it to work as the measuring rod between pain levels in the 1-10 pain scale. The upper ends of pain are just so bright, so immensely violent, so as to leave lesser pains as mere rounding errors. But if on each step of a JND of pain intensity we multiply the feeling by a constant, sooner or later (as Zvi might put it) “the rice grains on the chessboard suddenly get fully out of hand” and we enter hellish territory (for a helpful visual aid of this concept: start at 6:06 of our talk at the 2020 EAGxVirtual Unconference on this topic).

From my point of view, we can now justifiably work under the assumption that the qualitative picture painted by Log Scales is roughly correct. It is the more precise quantitative analysis which is a work in progress that ought to be iterated over in the coming years. This will entail broadening the range of people interviewed, developing better techniques to precisely capture and parametrize phenomenology (e.g. see our tool to measure visual tracers), use more appropriate and principled statistical methods (e.g. see the comment in the original piece about the Bradley-Terry model and extreme value theory), experimental work in psychophysics labs, neuroimaging research of peak experiences, and the search for cost-effective pragmatic solutions to deal with the worst suffering. I believe that future research in this area will show conclusively the qualitative claims, and perhaps there will be strong consilience on the more precise quantitative claims (but in the absence of a true Qualiascope, the quantitative claims will continue to have a non-negligible margin of error).

Ok, you may say, but if I disagree about the importance of preventing pain, and I care more about e.g. human flourishing, why should I care about this? Here I would like to briefly address a key point that people in the EA sphere have raised in light of our work. The core complaint, if we choose to see it that way, is that one must be a valence utilitarian in order to care about this analysis. That only if you think of ethics in terms of classical Benthamite pain-minimization and pleasure-maximization should we be so keen on mapping the true distribution of valence across the globe. 

But is that really so?

Three key points stand out: First, that imperfect metrics that are proxies for aspects of what you care about (even when not all that you care about) can nonetheless be important. Second, that if you cared a little about suffering already, then the post-hoc discovery that suffering is actually that freaking skewed really ought to be a major update. And third, there really are reasons other than valence maximization as a terminal goal to care about extreme suffering: intense suffering is antithetical to flourishing since it has long-term sequelae. More so, even if confined to non-utilitarian ethical theories, one can make the case that there is something especially terrible about letting one’s fellow humans (and non-humans) suffer so intensely without doing anything about it. And perhaps especially so if stopping such horrors turn out to be rather easy, as is indeed the case.

Let’s tackle these points each in turn.

(1) Perhaps here we should bring a simple analogy: GDP. Admittedly, there are very few conceptions of the good in which it makes sense for GDP to be the metric to maximize. But there are also few conceptions of the good where you should disregard it altogether. You can certainly be skeptical of the degree to which GDP captures all that is meaningful, but in nearly all views of economic flourishing, GDP will likely have a non-zero weight. Especially if we find that, e.g. some interventions we can do to the economy would cause a 99.9% reduction in a country’s GDP, one should probably not ignore that information (even if the value one assigns to GDP is relatively small compared to what other economists and social scientists assign it). Likewise for extreme suffering. There might be only a few conceptions of the good where that is the only thing we ought to work on. But avoiding hellish states is a rather universally desired state for oneself. Why not take it at least somewhat into account?

In truth, this is not something that classical questions in Effective Altruism pre-Log Scales couldn’t overcome either. For instance, as far as I am aware, in practice QALYs are used more as a guide than as an absolute; their value within EA comes from the fact that in practice interventions are orders of magnitude different when it comes to their cost-effectiveness when assessed with QALYs. So even though the vast majority of EAs are not QALY absolutists, the differences in QALYs saved between interventions are large enough that as an approximate guide, the metric still generates huge amounts of consilience.

(2) In turn, the post-hoc finding that hellish states are much, much worse than one would intuitively believe really should at least rebalance one’s priorities somewhat. Is there really no amount of suffering that would do so? Unless one has a utility function akin to a ReLu activation function, going far enough down into the depths of hell ought to count for something. And…

(3) Speaking candidly, fully articulating the true significance of this finding will take us to philosophically polemical territory: philosophy of personal identity where person-affecting views will see the situation quite differently than person-moment-affecting views, philosophy of mind where the ontological status of pleasure and pain might be questioned, and intricate questions that arise at the interface between the views of virtue ethicists, deontologists, negative and classical utilitarians. Of course a negative utilitarian who believes in Empty Individualism and Eternalism at the same time will likely be especially horrified by this information. But, with that said, I would suggest that there are good reasons to care about Log Scales no matter how antithetical one’s views are to philosophical hedonism. 

In particular, I would argue that deontologists and virtue ethicists should still take note. The cultivation of virtue requires a minimum of wellbeing in order to maintain motivation to live. And perhaps deontologists might find extreme suffering particularly egregious from the point of view of “things so horrible that ought not to be”. Really, the people we interviewed for the cluster headache writeup told us that experiencing such levels of hellish suffering causes profound psychological transformations (e.g. one interviewee told us that experiencing the higher ends of pain in a cluster headache feels like a profound “spiritual violation” from which you may never recover – a feeling most certainly aggravated by the seeming indifference of people at large about their plight). Virtue ethicists and deontologists might as well recognize this cause area as work that is unconscionable not to perform, regardless of arguments based on the precise mathematical optimization of the prevention of negative valence.

And finally, in all seriousness, as the cognitive intelligentsia of the world begins to see clearly the nature of the distribution of pleasure and pain, we can expect there to be a big social benefit to being the one who destroys hell. Right now there isn’t a huge social reward to be obtained by working on this cause, but I predict this will change. And, pragmatically, it is sensible to present this cause in a motivating rather than depressing light: indeed, let’s give honor, glory, and endless admiration to whoever makes tangible progress in tearing hell down. And to all of the millionaires and billionaires reading this: this could be you! You could be the one who took on the mantle of preventing all future cluster headaches, established the field of anti-tolerance drugs for severe chronic pain, or got rid of kidney stones (and you did it before it was cool!). Let’s get to work!