the rehab ladder
Frame Studies · Psychology & Emotions · 2026 · 1.9k words
Sickness reveals the capriciousness of clarity. Visa navigates fog with beacons from past selves, confronts the humbling descent to basics, and climbs the rehab ladder of creative and psychological recovery.
the rehab ladder
progress requires facing the truth of where you stand
I’ve been sick a lot lately, which is rumoured to be near-inescapable if you’re a parent of a preschooler. Whenever I get sick, I’m reminded of a quote from Virginia Woolf1– “what wastes and deserts of the soul a slight attack of influenza brings to view... what ancient and obdurate oaks are uprooted in us by the acts of sickness”. Even before falling sick, a strong motif for me in recent years has been one of dereliction, of ruin, of things forgotten. The context is always collapsing. I am always forgetting what I know. A lot of my writing, and my whole way of living, really, has been a largely-futile rebellion against unyielding entropy, against the falling apart of all things, against the anesthetizing dullness of an ever-encroaching amnesia that always seems to threaten to annihilate all meaning.
That sounds quite grandiose, but the reality of it does feel quite dramatic to me when I have enough clarity to perceive it. Especially when there’s a rapid change in the amount of clarity that I have. Oftentimes, the dullness overtakes me and I struggle to really perceive anything at all. I feel unusually lucid this morning– maybe the sickness is finally receding– and I feel a corresponding desperation to make the most of the clarity I have while I have it. My sense of sanity, of well-being, of healthfulness, tends to be a very capricious, unreliable thing, and over the years I have tried to use my moments of clarity to write. Something. Anything. I write in the hope of making sense to myself, and in the hope that the sense that I have made will not be entirely unmade when my clarity recedes. I might go so far as to say, if I’ve ever seemed smart or competent, a lot of it was cobbled together in uncommon, fleeting moments of clarity. An analogy I’ve used is, “I chart my path through the fog of everyday life via the beacons that past-Visa set up for me.”
From time to time I rediscover an old twitter thread I wrote, which I have memorialized and hotkeyed as “taste FAQs”. I was uncommonly inspired when I wrote it, and was definitely channelling something greater than myself. I wrote it with a clarity that I do not typically possess. And when I reread it now, it does very much feel like stumbling upon marvellous ruins of an older civilization. I somehow preempted all of the issues that I struggle with in my work: perfectionism, frustration, a disdain for being derivative or predictable, the problem of “forcing oneself”, worrying too much about trying to be clever, preemptively judging myself and worrying about being judged by others, all of it, and underneath everything, the inescapable importance of a sincere, earnest love that carries you through all of it.
There’s something both beautiful and ominous about looking at your past work and seeing something about it that feels like a high point you will never reach again. But I’ve also been around long enough, and I’m still young enough, to say something like, well– that’s true in a particular sense, but the entire game keeps changing, and so new vistas will open up, and you will eventually reach new kinds of beauty and transcendence that you aren’t currently able to access, or maybe even conceive of. I want to believe this. I’m too young to not believe this. I have my doubts sometimes, but I can still contextualize those doubts in a wrapper of, “I don’t know what I don’t know, and I tend to imagine vaguely bad possibilities, but good is also always a possibility.”
Here I want to say, an interesting thing about the creative process is that it is ultimately humbling in the deepest sense. I believe this to be true whether you’re writing a novel or building a business. One can still end up very arrogant, selfish, narcissistic etc along multiple other dimensions, but not in the core act of creation.2 And inversely, someone can perform humility in all the socially appropriate ways– being friendly, polite, self-effacing, bending over backwards to credit others, and still lack humility in the most essential creative sense. And I would say that I’ve definitely struggled with this in recent years, and have tried writing about it, but have repeatedly, knowingly ‘missed the point’ – which I then unproductively beat myself up about, which further distracts me from the essential process. [laugh track] Sigh.
Part of me can’t seem to help writing about the creative process, and I’ve come to think that I should just accept it– like Sylvester Stallone saying (I paraphrase), “Ok, I’m going to be typecast as a thug, and I can’t escape that, but what if I were an interesting thug, with a soft touch and a heart of gold?” So alright, “Visa rambles about creativity” is sort of the tax you have to pay for reading anything I write, but the question is can I then go past that to get to something interesting? I suppose the simplest approach for starters is “Visa rambles about creativity and then connects that to other things.”
I’m tempted to draw a parallel to human civilization here. We are all beneficiaries of civilization, which includes all sorts of innovations ranging from power grids and indoor plumbing to fertilizer and antibiotics. Yet most of us probably wouldn’t be capable of inventing any one of those things on our own. The progress of civilization relies on the output of our best outliers. Similarly, I feel like my own development as an individual relies on the output of my best outlier sub-selves, or states, or moments. Which is an interesting thing to say out loud here, even though I’ve said it several times in several contexts. Why? Well- I’m used to thinking of myself as someone who’s bad with routines, bad with structure– and that itself is a murky statement– I ended up conflating “I’m bad at crafting good containers” with “I’m bad inside of containers”, which I think set me up for a lot of failure, a lot of flinching from the very thing I probably needed. The hardest thing for me to really properly admit, all my life, is that I’ve needed something akin to rehabilitation for my psyche. (Butterfly meme: Is this ‘therapy’?) I’ve needed to pare everything down, do absolutely nothing for a while, and start over from basics so simple that I find them insulting. I finally did a form of it in the past year, and I’m still sort of finding my footing from it.
I’ve noticed on several occasions that professional athletes and stuntpeople seem to have very little guilt or shame about the rehabilitation process when they’re learning to walk again. They’re familiar with the ladder of progression, having climbed it very far themselves. I remember seeing a stuntwoman go from doing more pullups than I can, to being reduced to 0 pullups and struggling to put on a t-shirt because of a shoulder injury, to once again, within a year or so, being able to do more pullups that I can. I remember feeling bad for them at some point, like “wow, it must suck so bad to have been so good at a thing and that have that be taken away from you”. But if they felt bad for themselves, they didn’t let it stop them from confronting the ladder again, and climbing it.
On the other hand, I think there are a lot of guys who feel weirdly self-conscious about not being as strong as they wish they were, and as a result don’t do the work they would need to do to climb the ladder of progression, to get to where they want to be. We flinch from facing the ladder at all, because we would have to face the truth of how weak we are. But until we do that, we cannot make any real progress at all.
Ultimately I think fatherhood is shaping up to be the thing that might be most effective at challenging me to face the things that I was previously averse to facing. This is narratively very convenient, and I know it, and I’m using it purposefully. You can use parenthood as a cover story, a kind of Trojan horse to smuggle all sorts of changes in your life that you were always meaning to make, but never quite found the right context for. You can stop talking to some people, you can start talking to other people. You can stop doing some things, you can start doing other things. You could always have done that at any time, theoretically speaking. But I think major life changes have a way of contextualizing those smaller changes, making them seem much less costly. Maybe they never cost much to begin with. But, y’know. If you’re going to remodel your entire house, you might as well toss out a bunch of old t-shirts and such, right? You’ll never get a better occasion to do it. Probably.
Full quote: “Considering how common illness is, how tremendous the spiritual change it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, what ancient and obdurate oaks are uprooted in us by the act of sickness…it is strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature.”
This makes me believe, for example, that people like Kanye West and Elon Musk, who may seem like arrogant egotists, necessarily have to be humble in a particular dimension. Kanye re: what looks/sounds good, Elon re: the physics and economics of the products he oversees. You just can’t make anything good otherwise. And if we want to dig a deeper layer into it and say that these people are not working alone, and are in fact mainly taking credit for other people’s work, I believe that it still takes humility to recognize which work is good and which isn’t. And there are examples of people who struggle with this despite being in a position to take advantage of it.
Originally published at https://visakanv.substack.com/p/the-rehab-ladder.