Discussing which jobs will be replaced around the campfire

Last fall, I went camping with several other families from my neighborhood. As we sat around the fire the conversation turned from Sam Altman’s ouster at OpenAI to what the AI revolution will mean for us more generally. We had lawyers, professors, therapists, architects, designers, teachers and parents in the conversation. While there was a lot of speculation about what humanity may lose in the AI revolution, one concern has stuck with me.

One professor of therapy insisted that there was one thing an AI model could never replace. Even though a large language model like ChatGPT could be trained to respond like a therapist, adhering to best practices and responding with empathic sounding words, an essential part of the healing that takes place between therapist and client is the experience the client has of being seen, their story being known and understood by another person. No matter how good the AI is, it cannot provide this.

An essential part of the healing that takes place between a therapist and client is the experience the client has of being seen, their story being known and understood by another person.

Humans evolved for connection

I think this is a critical observation. Human beings are wired for interpersonal connection. We evolved and succeeded in becoming the most powerful species on the planet by cooperating in groups. We devote a tremendous amount of brain power to simulating what other people around us are thinking so we can be better family members, colleagues and teammates. And yet this aspect of human minds also tends to make us attribute agency to things that are not in fact agents. Neuroscientist, Justin Barrett, in his book, Born Believers, explains the evolutionary advantage to the person who attributes the rustling they hear in the bushes to the lion waiting to pounce instead of simply assuming it’s the wind –and being wrong.

And we know from years of research that humans are likely to attribute agency and personhood to software especially when interacting with them via verbal exchanges in text.  A good deal of Chat GPT’s attractiveness as a product can be attributed to its effectiveness at responding like a person would by using large samples of human responses as its source material.

It’s obviously unethical to try to create experiences that deceive users into believing a person is interacting with them when in fact there is only software. But is it possible that users informed that they are in fact talking to software only, could still experience the positive psychological impacts of feeling seen and known simply on the quality of the responses of the software, having been trained on how humans communicate those sentiments?

Can AI make people feel seen?

In my past work at Twin Health, as we experimented with large language models, we constantly kept in mind that at the core of our member’s trust in our product is trust in the people who care about them and are paying attention to their health in a way that, often, no one really had before. Our members’ trust in the program and in the behavior and medication changes we were asking them to make is based on their trust primarily in people, not primarily their trust in their Digital Twin or AI.

This doesn’t mean companies should shy away from using these tools especially where they can unburden our human care teams from tedious repetitive work or provide real-time decision support for people in ways that on human could afford to. But it means that one key metric we should keep our eye on is how seen, cared for and in relationship our users feel as we increase automation to enable the scale that unlocks new levels of care to match to the size of the problem of chronic diseases like diabetes.

Or, how remote work can trick you into feeling more stressed than you need to

There is no trash can or recycling bin in your computer, just different ways the system tags files. But the useful fiction of the recycle bin interface lets us know what to expect about files we put there even if it’s not literally true. In a similar way, we might think of emotions as a kind of software interface to what might otherwise be an overwhelming amount of sensory and analysis data. The work our emotions are doing is a kind of summary of sensory inputs, our perceptions about them, and their matching to prior experiences.

As useful as these emotion-interfaces are, it’s important to remember that they aren’t reality itself any more than the recycle bin icon is, and to keep a critical eye on what they have to tell us about reality.

New Job: new anxiety?

I recently started a new job. I was feeling some stress about it as I learned about my new teammates and worked to pick up projects mid-stream. In the early mornings when I would wake up, I would feel a familiar, burning acid stomach feeling. I’ve always felt anxiety, dread, and fear there in my stomach and my half-awake mind doesn’t have the benefit of all the things I know when fully awake.

One day, when trying to get back to sleep, I propped up on some pillows, elevating my torso. To my surprise, the sensation I had been reading as anxiety stopped immediately. I was having a sensory experience that my mind was reading and tagging as anxiety, but by changing my position, the sensory input stopped and the emotion quickly evaporated. Sometimes these interfaces, heuristics, and strategies we use to know what we are experiencing get it wrong or at least don’t get the whole picture.

Extended Senses; extended emotions

If emotions are a kind of interface to the overwhelming flow of sensory inputs and perceptual judgments our minds make of them, then it follows that our senses are some of the primary inputs for our emotions. This is interesting to note when considering the current discussions of AI. Everyone seems preoccupied with the question of their sentience but no one seems to talk about how whatever sensors we give them or they find a way to get will dramatically impact whatever analog they develop for emotions or consciousness. Another way to say this is that an octopus has a different consciousness than a mammal precisely because its bodily and sensory inputs are different.

We live at a time when we have dramatically extended our sensory inputs from people and objects in our immediate vicinity to a whole host of people and systems across the planet. I have joined three different remote companies over the last 5 years. Joining each one was not so much agreeing to be at a particular place at a particular time as much as it was agreeing to hook a set of notifications up to my consciousness and engage them with a certain level of throughput.

Each time I do this I notice a distinct uptick in my anxiety, stress, and sense of overwhelm– at least until I gain enough institutional knowledge to filter the signal from the noise. Which is precisely a process that our brains do with new sensory inputs as well. At first, a new environment can feel too noisy, too bright, or smells too intense or distracting. But quickly most people’s brains filter out sensory inputs that are consistent and non-threatening. That said, difficulty doing this characterizes much neurodivergent sensory experience. Not everyone’s brains do this for them automatically.

Alarms, Alerts, and Notifications As Senses

I’ve long been scrupulous as a designer and a user about when and how I let systems interrupt my attention. I believe our attention is our most precious and scarce asset. And, once diverted, getting my attention back focused where I want it is costly. Further, these interruptions are most often un-designed or underdesigned and at worst, exploitative. Why would I invite some random app and the design and product teams behind it to hijack my attention multiple times a day?

After living with near-constant awareness of my daughter’s blood glucose and diabetes health through continuous glucose monitoring, I can tell you that I have come to feel like an additional sense. This makes a lot of sense given the work of neuroscientist, David Eagleman, on sensory augmentation and substitution.

The internet allows us to tie new senses into our minds. Is it any wonder that they are contributing to new and sometimes negative emotional outcomes?

I’ve written elsewhere about the ways that I enjoy feeling my senses extended by technology. Knowing that my daughter’s glucose is in a safe range while she and my wife are asleep sleep halfway around the world while I travel is invaluable. I love being surprised by my phone’s voice assistant reading texts from family and friends to me that arrive while I’m out on a morning walk and feeling closer to them than ever as their thoughts seem to unfold in my mind as read aloud by my voice assistant in my Bluetooth earbuds.

What gives me pause is the need to bring that same critical eye to the emotional interfaces my mind brings to these new sensory inputs. If my brain can misread signals from my stomach as anxiety, it’s probably going to misread signals from my work Slack too and roll them up into some kind of emotional experience that may or may not be a real picture of reality.

As a member of the community of design practitioners, I think we have a lot to learn from this metaphor of notifications as extended senses. How might we design notifications that don’t demand full attention hijack from our user with adrenaline-infused audio alerts, but instead follow how our senses work with more subtle dial-ups and dial-downs of attention through more senses than the visual and the auditory? I’ve begun to explore this a bit in my bgAWARE project but there’s a lot more work to be done to move away from the current all-or-nothing paradigm that’s fracturing our attention constantly.

So? What helps?

If you haven’t already, I highly recommend spending some time auditing and managing which apps and input streams are allowed to interrupt you and when. This is arguably one of the most crucial mental health interventions you can make. Slack has robust controls over when it’s allowed to ask for your attention. iOS and Android have rolled out new tools to silence, group and delay notifications. These are worth learning about and using.

As far as positive practices, the most helpful ones I’ve found for bringing this critical eye to these emotional experiences are, writing, meditation, and emotion logging.

Writing

Making time for personal writing, journaling and reflection often results in new perspectives and re-frames on emotions that at first seem very reliably tagged. Kevin Kelly says he writes in order to know what he thinks. This description of making time to write captures so much of what I find valuable in the practice. It gives me space to explore what I’ve been feeling and thinking in a way that I can’t do alone with my thoughts because I simply can’t sting enough of them together before they start falling out of my attention. I’ve been using the practice of morning pages: making time to sit down and write every day without agenda, without goal. I type and I don’t target a word count or a number of pages. I try to write for 20 minutes. I don’t always make time for it but I notice that when I do, I feel less anxious, more present, and more able to be the person I aspire to be to the people to whom I’m committed.

Meditation

Meditation practice builds the habit of an inner observer or executive function watching the river of thoughts and emotions roll by, driven by the current of sensory input. Meditation does this by cutting down on the signal input or limiting and focusing sensory attention.

Emotion Logging

Finally, I’ve been striving to learn and use more names for my emotions. The psychology literature is clear that the more and different kinds of emotions we learn to perceive and name in ourselves, the healthier we will be. And this makes intuitive sense given this metaphor of emotions as interfaces. We are literally giving our minds more and more nuanced interface elements with which to build emotional interfaces to summarize and understand our experience. I built an app called CharacterMe focused on helping teens understand and name their emotions. Lately, I’ve been loving the award-winning app, How We Feel, for support in taking time to attend to, name, and log my emotions.

What’s the point?

This is not an essay against Slack or email or notifications. Although I have critiques of how all 3 could work better with what we know about our senses, our attention and how they impact our emotions.

This is a call to:

1. Pay attention to what new senses we link to our consciousness

2. Remain curious and skeptical about the emotions that come along with them.

Our brains do a lot of work for us automatically and below the level of our conscious selves. But some of the emotions are as fictional as the recycle bin on your computer’s desktop. And I’ve found that my well-being is rewarded by being skeptical about these interfaces and checking my brain’s work on a regular basis.

I discovered Balaji Srinivasan last march. He was on Tim Ferris’ podcast. He’s a biochemist by training and a serial entrepreneur most recently with Coinbase. I was struck by the parallels between what he was talking about and our project at Sol: proof of work, communities of practice, financial incentives for work shared in public, increasing access to education globally outside the traditional academy.

Since then I’ve listened to a few more interviews and read a few pieces of his at 1729.com.

Like many I’m struck by his broad understanding of the forces that have shaped human history and his willingness to synthesize them with the currrent moment and act on them with an entreprenuer’s risk-tolerance.

I am concerned with his insistence on setting himself up in contrast to “Woke Capital” or techno-progressivists vs. political progressivists.

He’s an open transhumanist ideologue and brings with him all the reductionism and myopia of that movement when it comes to their conception of personhood, people with disabilities and Cartesian error of mistaking the thinking thing for the whole thing. But what I find compelling at the heart of his vision is the impulse to reform our most central social institutions.

I share the impulse to reform and the conviction that many times current forms are not capable of the kind of change needed in this time of accellerating social changes and existential threats.

America’s current foundering in the midst of the pandemic despite having access to more vaccine than any other nation is proof enough to me that our current institutions are not set up to face exponential threats of climate change, and the epistemic crisis that underlies it.

And on that point of how we know what we know, his focus on the pursuit of “truth” as facts is particularly interesting. The simplicity with which he speaks of truth strikes me as something that could only come from someone whose academic training was in the sciences not the humanities.

But I suspect he is aware of this and has rejected the post-modern critique as part of the “Woke” ideology he finds so frustratingly censorious.

He speaks openly of his intent to persuade and influence. He speaks of media narratives as “software” that can be loaded into people’s brains. He advises caution against spending time with people whose imaginations have been formed by a steady diet of cable news because they will load their software into your mind. And yet I hear in his speaking and writing an equal intent to merge new code into the minds of his audience. He speaks in long narrative soliloqies punctuated by pithy aphorisms and tweetable slogans that seem designed to spread as memes.

He embodies the writings of Daniel Kanneman who, in documenting the cognitive biases all human minds work within, warns and prescribes of the ways our minds are so easily manipulated to take in new beliefs by recency, repetition and confirmation bias.

Srinivasan strikes me as one of the first people I’ve found speaking publicly who is living in the reality that I started to see dimly a decade ago: that we are living in a Gutenberg moment in which our technological innovations are having an exponential impact on our social, cultural, religious and political institutions, the impact of which has barely begun.

40 years after the printing press we saw the Christian Reformation and the complete social and political upheaval of Europe in the years that followed it. We are about 20 years into the internet as a broadly accessible phenomenon.

It seems clear to me that by mearely increasing the speed of the spread of ideas (of the network throughput), we unwittingly knock over the stability of the institutions built to manage a society capable of listening, talking and changing at that prior speed.

For the people who see the moment for what it is, one of profound transition, the future is most maleable. I got into tech and design because I saw this wave swelling and I wanted, I wanted to have a hand in shaping our shared future with an eye for how it could improve things for those with the least power and privilege in our current order.

I am as impressed with Balaji’s perception of this moment and commitment to seize it as I am concerned about the vision of the future he wants to help shape.

“What Job is a Conspiracy Theory Doing? Why American Christians are Particularly Vulnerable to the Narratives of the Trump Era”

Available October 1.

keepingthefaithbook.com

—
About a month ago I got so angry about QAnon, I went on a bit of a tweet rant. A Fuller Alumn friend saw it and invited me to contribute.

In the words of the eds “If you are a Christian searching for a sense of political belonging within the church, this book is for you. If you are a Christian who is looking for brothers and sisters who will stand with you as allies in the fight for justice, this book is for you.”

I started reading the other contributors this morning and I already feel less alone. Thanks to Jesse Wheeler and especially to Suzie Lahoud who has created this space of dissent for us to push back.

“Covid 19 was fake. Oprah Ellen and others been arrested for being perverts so they make us stay home while they are on trial.”

I wasn’t aware of this particular conspiracy theory so I googled around until I learned that it’s a variant on another I had heard of. In this one, Bill Gates caused coronavirus as a cover to spread vaccination based tracking microchips. In this new version, Ellen and Oprah are secretly pedophiles who are under house arrest and they created the pandemic scare to make the rest of us have to stay home so no one will notice that they are on house arrest.

I know. It sounds crazy. How could anyone believe this?

I think that’s the wrong question if you want to understand what conspiracy theories like this mean.

A better question is: what work does this story do for the person who believes it and shares it?

If Bill Gates or Oprah Winfrey are in control of the pandemic then that means human beings, powerful, rich and famous though they may be, are in control of what is happening and there’s still hope that humans could reverse it.

Meanwhile our best clinicians and scientists are telling us that there’s a lot we don’t know and advising as we learn more each day. And if you pay attention to what we are learning it can be terrifying. What’s more, the world most of us have inhabited since birth —a world where science has made humanity mostly untouchable by the natural world— seems to have gone away overnight. We are feeling exposed to a new threat that is not well understood and our best hope of developing a cure is months or years away. We are exposed to the chaos of a random mutation in a virus we can’t see, threatening to tear down all we have built for our families and our nations and our species. We are staring into an abyss and feeling how vulnerable we had really been all along.

In the old days we told stories about how we were suffering because of the agendas or displeasure of unseen gods and deities. Those stories did similar work then. They left the door open for us to have some control over forces that threaten to roll over us like tidal waves. Now we blame Bill Gates and Oprah because it is somehow less terrifying than staring directly at our weakness and vulnerability and facing what we must do to care for one another and rebuild our shelter against the chaos.

Despite stories like this, many many Americans are still engaging in social gatherings or refusing to wear masks.

We have recently seen the power of the viral videos in changing public opinion and raising awareness about about the experience of being Black in America. These videos haven’t haven’t solved racism but they have changed the conversation around it.

Lately I’ve been wondering how videos showing the very real suffering and death caused by the coronavirus might change our national conversation and motivate action.

Why video? Don’t we have evidence and data we can share? In the internet era many Americans have lost trust in news organizations to establish shared sets of facts through the bias-mitigating practices of journalism. And though we know video can be edited in ways that change it’s meaning, we still respond to live action footage more immediately and with our full minds and bodies.

Let me be clear: we still need empirical, objective data. We need a nationally led testing regime. We need to be led by epidemiologists and other experts who have studied past instances of these seemingly unprecedented events. We need that data to guide leadership and action.

However, these past six months have shown that data, science and arguments appealing to the intellect can not and will not motivate sufficient public action to stop the spread. We need to tell a story that resonates deep down in the body.

When I worked as a hospital chaplain, I was with people dying regularly; both people at end of life, and sudden, surprising deaths in the emergency room. Seatbelt safety was an abstract value that I was intellectually committed to. And then one night, I sat in a tiny room with a mother while she learned that her baby was dead after a car accident. Her soul-wrenching groans moved my commitment to making sure I got my baby’s car seat installed correctly, out of my head and into my body. Witnessing that motivated me to act.

Social distancing has meant that many of us are more cut off than ever from our broader communities. The pandemic has meant that even family members often don’t see their loved ones struggling for breath in their last moments. This burden falls to healthcare workers who have unequivocally been warning us of the danger of this new disease.

I’m afraid their testimony is not enough.
We need to see it for ourselves.
And hopefully, seeing will be believing.

Here are some of the things I am learning about technology design in general from my daughter’s journey into becoming a real-live cyborg.

1. INTERFACES MATTER MORE THAN ALMOST ANY OTHER SURFACE OF A DESIGN.

Where the hardware touches or penetrates your body is exponentially more important in its ability to enhance or ruin your experience than the parts that don’t. Infusion sets and their adhesives matter more than the form and industrial design of a pump. Think about how the quality of experience in smartphones went up when you were touching glass rather than plastic membranes.

2. THE MORE ELEMENTAL AND GEOMETRIC SIMPLICITY A DESIGN HAS THE LESS OBVIOUS PEOPLE CAN ASSUME ABOUT WHAT IT’S FOR.

The Libre sensor is a small white circle with a tiny bit of adhesive peeking out around the edges. It could be a nicotine patch. It could be a piercing spacer plug. It could be some biometric bitcoin wallet. Medtech has an aesthetic of rounded grey plastic that says “grey, safe, hospital railing.

You can see it replicated here in the CGM my daughter wears.

When things like the Libre or the Tandem t-slim pump that looks like the little brother of the first gen iPhone subvert that aesthetic they grant their users the ability to have them mistaken for something else and thus empower them to decide when they reveal their diabetes or not.

3. YOUR BODY DOESN’T WANT TO BE MODIFIED PERMANENTLY.

It will eventually encapsulate anything that penetrates the skin. The most successful technological adaptations, glasses, fillings, piercings, bone amplified hearing aids, find ways to avoid crossing that barrier or work within it because the body will fight you forever. This is part of why I think our largest organ of sensory input, skin, is underutilized in technology design. The best designs are reversible or better, work with the body’s natural tendencies and mechanics to make a composition together.

4. INTEROPERABILITY AND MODIFICATION ARE HUMAN RIGHTS.

I don’t risk violating intellectual property law when I tailor my pants to fit my legs or when I combine Uniqlo jeans with a J.Crew jacket. Just kidding. I can’t afford J. Crew. Similarly, I don’t hang to worry if the bluetooth headphones I buy at the airport because I forgot mine at home will work with my tablet. The standard means I can mix and match to meet my needs and they will work. And yet, when people with diabetes wanted to wear a continuous glucose monitor and have their insulin pumps slow down the insulin when they started to go low, they had to do a good bit of reverse engineering to make that work and continue to engage in a bit of cat and mouse with the manufacturers to do so. And we are talking about technology woven into our bodies.  At Tidepool.org, we believe that data created by a person’s body is owned by that person regardless of who made the hardware or software that captures it.

5. IF YOU CAN’T MAKE IT BEAUTIFUL, LEAVE IT BLANK.

I love the image of the first cyborg body Alita wears in the recent film, Alita: Battle Angel.  It was crafted lovingly by a father for his daughter who was paralyzed to move her brain into and walk again. French curves engraved into every corner speak of love expressed in craft. And yet you would be hard-pressed to find such bespoke hardware in the medtech world. But the skin of the omnipod insulin pump is a translucent white canvas for kids and adults to scrawl messages, paint fingernail polish onto, apply stickers or festive rainbow duct tape. It’s a disposable three-day pump; a digital syringe. Like the old plaster cast left blank for signatures or covered in colored tape, design can leave room for the people who take these pieces of technology into their bodies to express themselves.

They can even come to embody the support of the people who love them in the very physical manifestation of a disease imposing itself upon you. Leaving room for the user to make it their own can reverse of a device from a disruptive symbol of oppression into an expression of power and agency. Your brand is less important than this.

6. THERE ARE ALWAYS COSTS AND BENEFITS TO TAKING ANY NEW TECHNOLOGY INTO YOUR LIFE OR YOUR BODY.

And that calculus should be engaged in critically and with periods of evaluation before one becomes dependent. I wanted to learn how to treat my daughter with multiple daily injections and finger stick blood sugar checks before we learned an insulin pump and continuous glucose monitor. Similarly, I wrote my own criteria of safety and quality of life improvement by which I would judge the success of the DIY artificial pancreas system we tried 6 months after diagnosis. Like the hospital lab that still uses a dot matrix printer because they can’t do without it one day and it still works pretty well, it’s easy to get technologies and processes embedded into our lives and then never ask ourselves if they are still worth it. Insulin pumps have existed for over 60 years but i’ve 75% of Americans with type 1 diabetes still use multiple daily injections. If you ask them why you get s wide variety of answers. Some still valid and others not as the technology advances. This is why the critical analysis needs to be ongoing. I’ve spoken to many people with type 1 who tried a continuous glucose monitor after 30-40 years of living without one to report that it had changed their lives for the better, though in many cases they were reticent to adjust their practice.

7. THE BEST TOOLS DON’T FORCE A PARTICULAR METHOD ONTO A USER, BUT INSTEAD ENABLE FLEXIBILITY, IMPROVISATION AND AGENCY IN THE USER’S PRACTICE.

I’m fond of hand tool woodworking, not because I’m a luddite but because I enjoy practices over purchases. Andy Crouch in his masterful essay, From Purchases to Practices, contrasts the inverse enjoyment curves that purchases and practices have. Purchases are most enjoyable before you have them. Afterward it’s all downhill. Practices, on the other hand, like sharpening a blade or woodworking in general aren’t very enjoyable in the beginning until one has put in the time to build skill, perceptions and judgement that come from experience. Then it starts to get fun. And the enjoyment can keep growing as one develops skill. I can’t say I enjoy diabetes nor have i met anyone else who does. But I can say it is a practice that involved the building of skill. I gravitated towards hand tools for the simple reason that I didn’t have much space. I reasoned that if the old masters could build all the furniture in the world with a small chest of tools then so could I. And that’s because almost every hand tool can be used in different ways. Some uses are more traditional than others but the further you get the more flexibility and improvisation you can find in ways of working. Some tools are highly specialized for one job. But the best tools are flexible enough to be used in a wide variety of ways by different users. They empower the cultivation of skill rather than forcing all users down the same few paths. And make no mistake, the users of the things you design can feel if you trust them with freedom to repurpose them to their own practice or if you have locked them out of the controls. At it’s best it is paternalism. At it’s worst, disrespect.