#affective lability

[beyond-mogai-pride-flags]

Emotional Lability Pride Flag

Emotional lability: a sign or symptom typified by exaggerated changes in mood or affect in quick succession.

[musicaltrash]

"normalize this, normalize that" normalize emotional lability? psuedobulbar affect?

it's great that we're normalizing the widespread things but I didn't realize what was wrong with me until a few years ago. I had no friends because of it. and then I was so depressed and mastered hiding emotions that it didn't even show up, and people finally wanted to be friends with me. they only liked me when I stopped feeling emotive at all.

I don't expect y'all to know and research every condition possible, but at least treat people kindly if you don't know what's going on. that kid at school who has trouble expressing emotions in a normal way? they're not a "crybaby" or "too emotional." that coworker who struggles with regulating their feelings, and either shows too much or too little? there's a reason.

I don't ask for reblogs but for the love of god just be kind to people so they don't have fucked up lives and think that they're the problem.

[odettecarotte]

People with hysterical personalities have high anxiety, high intensity, and high reactivity, especially interpersonally. They are warm, energetic and intuitive "people people," attracted to situations of personal drama and risk. They may be so addicted to excitement that they go from crisis to crisis. Because of their anxiety level and the conflicts they suffer, their own emotionality may look superficial, artificial and exaggerated to others, and their feelings may shift rapidly.

Nancy McWilliams, Psychoanalytic Diagnosis, 2nd edition

[ayyliencat]

Hey there 😊 just wanted to say a thing quick.. 💖

If someone has schizophrenia/schizoaffective disorder or on the schizo spectrum, please do not say that they are gifted, that they’re clairaudient, telepathic or anything of that sort. I know you’re just trying to make sense of it all but please 💖✨don’t✨💖

It feeds into their hallucinations/delusions that they are experiencing and that is DANGEROUS to someone who is hallucinating *them already thinking that the voices are REAL, that they actually can read minds or that they are thought broadcasting and everyone can read their minds all while actually believing it to be real* and can lead to them thinking they have a gift and can lead to them putting themselves in danger by thinking that what they are being told while hallucinating is REAL because they “have a gift” or are “gifted”. I’ve been told this before early on when I was first diagnosed with schizoaffective disorder about 5 years ago I had to find out on my own with my diagnosis that not knowing what’s real and what is real is just apart of having this mental illness. We are not being haunted by demons or ghost’s, it is a mental illness just like anxiety or depression, and unfortunately we suffer from hallucinations, catatonia, depression, and labile affect(Inappropriate involuntary laughing and crying) amongst a lot more symptom’s, just like you take meds for anxiety and depression we also have to take medications, it is a mental illness and should be treated as such, with knowledge and treatment can help someone get clarity about their recovery and can help reduce their symptoms. Thank you for reading 💖✨😊

[schizodiaries]

some schizophrenia symptoms that aren’t normally talked about

confusion

restricted range of emotion

incoherent thoughts/speech

lack of motivation

boredom/anhedonia

social withdrawal

apathy

trouble sleeping

taste and smell hallucinations

distorted thinking

thought blocking

poor memory

catatonia

labile affect

i usually see schizophrenia described in terms of paranoia, visual/auditory hallucinations, and delusions - so i thought I’d put together a list of other symptoms that may be present!

[scarletskiesinthepaths]

Levi, Emotional Expression, and Social Interaction

I've seen different posts on Levi lately across different platforms that claim he is a cruel or mean person, which are fundamental misunderstandings of his character. I sort of see the problem as people mistaking Levi's emotional expressions (or lack thereof) as indicative of malicious intent or rude behavior. As such, I wanted to discuss how Levi's history and trauma have shaped how he expresses himself and relates to others. Once one has an understanding of that, it becomes evident that Levi's expressions should not be used to judge his intentions or feelings.

I wrote another post on how Levi fully meets the criteria for post-traumatic stress disorder (PTSD) on my main blog, and that diagnosis is important for understanding Levi as a character, as he's someone who's been largely affected by his trauma. To further expand on that post, we're going to discuss both Levi's affect and his ways of socially interacting with others, using concepts such as social modeling and self-monitoring.

What is Emotional Affect?

Affect, in psychology, refers to a patient's expression of emotion. Expression of emotion encompasses facial expressions, gestures, body language, tone of voice, etc. Mood, on the other hand, refers to the internal state of a patient's emotions sustained over a period of time. Affect helps us interpret a person's mood; however, there are such situations where affect can be considered inappropriate—that is, the person's affect is not entirely congruent (i.e., consistent) with the person's present mood and/or situation. A classic example of inappropriate affect would be laughing at a funeral, as that is incongruent with the context of the situation. Another example—a patient who is smiling and laughing after being involuntarily committed is considered to have an inappropriately euphoric affect.

Affect can be described across multiple dimensions, but the two most typically used are the quality of affect and the range of affect. Quality of affect is typically categorized as either euthymic (normal), dysthymic (depression, anxiety, guilt), or euphoric (an abnormally elevated sense of well-being, such as in mania). The range of affect can be labeled as labile, broad, restricted, blunted, or flat. Broad is considered the normal range of affect.

For the purposes of conciseness, we're going to focus on blunted and flat affects, as those are the range of affects that are best suited to describing Levi. Flat affect is when there is no variation in the patient's emotional expressions, regardless of their mood and situation. Blunted affect is similar, but it is a bit less severe—it means minimal variation. Practically, what do these mean?

Levi's Affect

When Kenny first finds Levi as a child, Levi is in a severe state of neglect; he is dying of starvation, he is wearing rags, his hair is unkempt, and he is sitting in the same room as his mother's decaying corpse. A typical child in this developmental range would be in extreme distress: crying, expressing fear, pleading for help, etc. However, Levi shows no such displays of emotions; he does not cry, he does not move, and he barely speaks. In fact, there is absolutely zero emotional expression, and there is no indicator he is upset about his situation (even as it is clear he must be). This is flat affect. Even in the short montage we see after Kenny has taken Levi under his "care", Levi never once shows variation in his emotional expression—no anger, no laugher, nothing.

Once Levi is an adult during the present timeline in the series, Levi exceedingly rarely displays his emotions. He often speaks in monotone, minimally varying the tone or volume of his voice—never yelling as well, even when angry. His smiles are so rare that it's a notable moment when he does smile (such as when Historia punched him at end of the "Royal Government" arc), and he never cries even after significant personal losses (except his one tear at the end of the series). His affect as an adult ranges from flat to blunted. This is significant too because we do know that his mood does vary, as it's clear from his verbal and body language the toll that different events take on him, and he does also display a sense of humor across the series. Again, though, his emotional expression does little to reflect how he's feeling.

What Causes Flat Affect?

To give a quick list of the most common causes:

Schizophrenia and other psychotic-spectrum disorders

Brain damage, such as from organic brain pathology or a traumatic brain injury

Neurodevelopmental disorders, such as autism spectrum disorder (ASD)

Severe psychological trauma, typically resulting in post-traumatic stress disorder

Major Depressive Disorder (MDD)

I will say outright that there is no evidence Levi suffers from schizophrenia, and thus, that is unlikely to be the cause of his flat/blunted affect, especially given the onset of Levi's flat affect and the exceeding rarity of childhood-onset schizophrenia. Similar reasoning applies to brain damage, so both of those can be excluded from the differential.

I do believe Levi meets the criteria for MDD in adulthood; however, that would be more so a comorbidity of his existing PTSD. Levi looked to be around 4-6 years of age at the start of Kenny's flashbacks, and MDD in that age group is quite uncommon, even when accounting for childhood-onset and adolescent-onset depression.

This leaves us with both severe psychological trauma and ASD as the two most likely causes of Levi's flat affect as a child and through adulthood. ASD can be a valid interpretation of Levi's significantly reduced affect display during childhood, as well as his consistent social difficulties throughout all of canon. Based on criteria laid out by the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), Levi can be seen as having ASD (which I'll likely make a future post on). However, the presence of severe psychological trauma confounds this diagnosis. Despite this confounding diagnosis, it is still possible he has both PTSD and ASD.

Regardless, the most likely explanation for Levi's range of affect remains severe psychological trauma. In a child that young, something had to have gone extremely wrong in his early upbringing for his significantly reduced affect display. An entire separate post can be written on this topic, but Levi demonstrates clear signs of an insecure attachment style by the time he's discovered by Kenny; this indicates that Kuchel, despite having loved Levi, was simply unable to properly care for him, and this resulted in deep and ingrained psychological trauma that affected Levi's ability to socially relate and interact with others for the rest of his life. I intend on going into more detail in a separate post, but Levi's attachment style is likely insecure-avoidant or insecure-disorganized.

Observational Learning and Social Modeling

Albert Bandura's social learning theory posits that children learn through a combination of traditional behaviorist processes (classical and operant conditioning), cognitive processes, in addition to observation and modeling. In reference to Levi, observational learning is the most salient aspect of this theory.

In simple terms, observational learning refers to the way children observe the people around them. Individuals observed are referred to as models. Models can include, but are not limited to, parents/caregivers, TV characters, school teachers, and friends within a peer group. Basically, children pay attention to these models and encode their behavior into their memory. At a later time, this behavior is then imitated. This is referred to as "social modeling".

Who were Levi's models? Kuchel, Kuchel's patrons at the brothel she worked at, Kenny, and others who lived in or frequented the Underground City.

Given Kuchel's circumstances and the danger of human trafficking in the Underground, it is likely she taught Levi to avoid interacting with anyone in order to ensure his safety. Kuchel's patrons, in all likelihood, abused her and Levi was most assuredly witness to this abuse or the effects of it in some way. Then, Kenny—Levi's most significant parental figure—was a prominent serial killer who displayed and actively taught Levi violence.

All of this points to Levi never having had the opportunity to learn proper social interaction. In fact, he was actively taught inappropriate and unhealthy ways to socially interact. Not only was Levi's emotional development stunted and severely impacted as shown through his lack of affect, but his ability to socially interact and relate to others was inhibited due to both his insecure attachment and the absence of appropriate social models. How does this manifest in Levi?

Self-Monitoring

Self-monitoring is the degree to which people monitor and adjust their self-presentations when interacting with others and across different social contexts. Whether someone is a high or low self monitor can be affected by their natural personality, their experiences growing up, and/or their neuropsychobiology.

High self monitors tend to be actively aware of the social image they are projecting, and they will be adept at responding to social cues. They will also vary the image they project dependent upon who they are interacting with and what the social circumstances are. They have greater concern over situational appropriateness, and they are often perceived as more friendly and pleasant by others.

In contrast, low self monitors tend to exhibit emotional expressiveness and social responses more congruent with their internal states regardless of social context. That is, they do not adjust their beliefs, attitudes, and dispositions to be more socially acceptable. As such, they are often perceived as rude, socially awkward, and/or unaware of others' social needs.

Levi is a low self monitor. Regardless of who he is interacting with or what the situation is, he consistently maintains the same attitudes and beliefs; he is always honest and says what he's feeling. He never adjusts his social tone, even when it would make him more appeasing to others. Throughout the series, he's often referred to as rude, socially awkward, a lunatic, etc. for his inability to self-monitor. This is a likely a result of the aforementioned psychological trauma, his lack of appropriate social models, his innate introverted nature, and his potential ASD.

Summary

My goal with this post was to explain how Levi's trauma and experiences growing up have formed the way he expresses himself and interacts with others. Levi never sets out to be seen as rude, unkind, or cruel. In fact, I'd say he is by far the kindest and most compassionate character in all of Attack on Titan. However, because of his social disposition, he is consistently misperceived by both characters in the series, as well as readers/viewers. Levi, through a combination of his innate nature and the environment in which he grew up, simply lacks the social skills and affinity for social interaction to properly explain himself and come across as more palatable to others.

Note: I am a doctor of psychology student, so much of this information has been informed by my schooling.

[transgenderer]

Kleine–Levin syndrome (KLS) is a rare neurological disorder characterized by persistent episodic hypersomnia accompanied by cognitive and behavioral changes. These changes may include disinhibition, sometimes manifested through hypersexuality, hyperphagia or emotional lability, and other symptoms, such as derealization. Patients generally experience recurrent episodes of the condition for more than a decade, which may return at a later age. Individual episodes generally last more than a week, sometimes lasting for months. Patients commonly have about 20 episodes over about a decade. Several months may elapse between episodes.

The onset of the condition usually follows a viral infection (72% of patients); several different viruses have been observed to trigger KLS.[2] It is generally only diagnosed after similar conditions have been excluded; MRI, CT scans, lumbar puncture, and toxicology tests are used to rule out other possibilities. The syndrome's mechanism is not known, but the thalamus is thought to possibly play a role. SPECT has shown thalamic hypoperfusion in patients during episodes.

KLS is very rare, occurring at a rate of 1 in 500,000, which limits research into genetic factors.[2] The condition primarily affects teenagers (81% of reported patients), with a bias towards males (68-72% of cases), though females can also be affected, and the age of onset varies.[2] There is no known cure, and there is little evidence supporting drug treatment. Lithium has been reported to have limited effects in case reports, decreasing the length of episodes and duration between them in some patients.[3] Stimulants have been shown to promote wakefulness during episodes, but they do not counteract cognitive symptoms or decrease the duration of episodes.

Patients with Kleine–Levin syndrome (KLS) experience recurring episodes of prolonged sleep (hypersomnia).[5] In most cases, patients sleep 15 to 21 hours a day during episodes.[6] Excessive appetite (hyperphagia) and unusual cravings are present in half to two thirds of cases.[6][7][8] About half of patients, mainly male patients, experience dramatically increased sexual urges (hypersexuality).[9][7] Several other symptoms usually accompany the syndrome, including marked changes in mood and cognitive ability.[5]Derealization and severe apathy are present in at least 80 percent of cases.[10] About one third of patients experience hallucinations or delusions.[7] Depression and anxiety occur less commonly; one study found them in about 25 percent of patients.[10] Individuals usually cannot remember what happened during episodes.[6] Repetitive behaviors and headaches are commonly reported.[7] Some patients act very childlike during episodes,[11] and communication skills and coordination sometimes worsen.[6]

The first time a patient experiences KLS, it usually occurs along with symptoms that are similar to those of the flu or encephalitis. In at least 75 percent of cases, symptoms occur after an airway infection or a fever. Viruses observed before the development of the condition include Epstein–Barr virus, varicella zoster virus, herpes zoster virus, influenza A virus subtypes, and adenovirus. Several days after symptoms first occur, patients become very tired.[9] In cases that occur after an infection, KLS usually starts within three to five days for teenagers and fewer for children.[16] In other cases, alcohol consumption, head injury, or international travel precede symptoms.[9][14] Lifestyle habits, such as stress, alcohol abuse and lack of sleep and stress, have also been proposed as possible triggers.[5] First episodes of KLS are preceded by a clear event in about 90 percent of cases.[8] Recurrences generally do not have clear triggers; only about 15 percent have a precipitating event.[17]

Population-based studies of KLS have not been performed. Its prevalence is about 1 to 2 cases per million people,[8] although recent studies conducted by a French research team point to a higher number of 3 per million people.[25] It occurs most frequently among Jews in the US and Israel. First-degree relatives of people who have the syndrome are much more likely than the general population to have it, although only in about one percent of cases do family members contract it. About 68 to 72 percents of patients are male. Patients with the syndrome are more likely than the general population to have genetic disorders, and about a third of people with the syndrome encountered some form of birth difficulty.[26] In a study of 186 older patients, about ten percent had preexisting psychiatric issues.[6] One study found that about ten percent of patients had a neurological condition before KLS developed.[8] The condition does not appear to occur most frequently in one season.[11]

??? extremely strange disorder.

[emotionallychargedtowel]

Following up on my post about episodes 5 and 6, here are my thoughts on the mental health side of episodes 7 and 8 of The Eighth Sense.

Hey, @waitmyturtles, it's finally finished!

As in my last T8S post, I'll start by talking about what I see going on with Jae Won (and this time, to a lesser extent, with Ji Hyun), then get into my thoughts about what his therapist is up to.

Here’s what I’ll be talking about below:

lowered affect and psychomotor symptoms

the "freeze" response and the depressive side of PTSD

"I want to heal his wounds"

Jae Won's therapist: dancing over the line

the portrayal of mental health interventions in The Eighth Sense so far

what's next?

lowered affect and psychomotor symptoms

When it comes to Jae Won, I think for the most part his deal is readily apparent to anyone with a reasonable amount of insight, whether they have mental health training or not (though I hope my perspective might help clarify some stuff). As others have pointed out, he's incredibly numb and shut down. It's clear that he feels responsible for Ji Hyun's accident even before he says so directly to his therapist, and that he has some kind of distorted thought process that is telling him that staying away from Ji Hyun will keep him safer than if he allowed himself to be close to him again. This also functions as a way of protecting himself from experiencing another loss--if he doesn't have anyone in his life that he actually cares about, he can't get hurt that way again.

By the way, just like the capacity for self-blame I talked about last time, it's remarkable how readily people who've experienced trauma can form strong beliefs that don't make rational sense (often involving magical thinking) while seeing no reason to doubt those beliefs. For example, it seems pretty certain that Jae Won is consciously telling himself, "Everyone I love dies or gets taken away from me in some way, so if I love someone I'm putting them in danger." There's no possible way this could be true, but it feels like the truth to him and he's unable to see how obviously false this belief is.

A couple of the things we're seeing with Jae Won have psychological terms that can be used to describe them more precisely. You know how Jae Won's face is super expressionless for most of episodes 7 and 8? In psychology, we use the term "affect" to mean the expression of emotion in someone's face (and to a lesser extent, other parts of their body). ("Affect" has a really different meaning in other disciplines.) Identifying the type of lowered affect Jae Won has sheds some light on his emotional state. There are standard descriptors that psychologists and others use in reports and notes to talk about people's affect. "Broad" or "full" affect means a person shows a typical amount of emotion in their expression. "Labile" affect means that the person is showing disproportionately strong emotions; often these emotions change abruptly as well (for example, if someone laughs one moment and cries the next and neither seem appropriate to the situation). Then you have descriptors for people who are showing less emotion than normal. "Restricted" affect is somewhat subdued compared to full affect. Just like it sounds, it's as if the person is (consciously or unconsciously) restricting the amount of emotion they allow others to see. A step down from restricted is "blunted" affect, which is a pretty intense symptom. Someone with blunted affect shows very little emotion, even when talking about or experiencing something upsetting. Another step down is "flat" affect. I often see people using "flat affect" to describe a person who actually has blunted or just restricted affect, but flat affect is a lot more marked than that. True flat affect means that the person shows absolutely no emotion. It's extremely rare. You're highly unlikely to meet a person with flat affect in your daily life, unless you work in an inpatient mental health facility. Where is Jae Won on this scale? His affect is blunted. This is a very big deal! When someone is experiencing mental health symptoms so marked that their affect is blunted, especially almost all of the time as we observe in Jae Won's case, there is a lot of cause for concern. As you might imagine, it's often reflective of the person being very disconnected from their own emotions. This symptom can be associated with a number of diagnoses. Some of these involve psychotic symptoms, which might interest proponents of the "everything after episode four is a hallucination" theory. But it's also associated with PTSD and depression, and I think it's pretty clear that's at the root of Jae Won's deal. After all, his affect became blunted right after he was retraumatized and massively triggered by Ji Hyun's accident.

A great example of Jae Won's blunted affect happens in the scene where Ji Hyun finally gets him to talk to him in private and he keeps insisting that everything that happened between them "was nothing." It's not normal for someone to have almost no affect when having a conversation like this, no matter how they feel about the other person or their history with them. If their relationship really meant nothing to him, we'd expect Jae Won to look flippant, irritated, contemptuous, guilty, maybe superficially sympathetic, but we'd expect him to have some degree of affect. The fact that he can sit there, dead-eyed, during this conversation speaks volumes. Another term that applies here is "psychomotor retardation." Sometimes people say "psychomotor slowing" instead to avoid the connotations of that second word there. Or you may just hear about "psychomotor symptoms." In severe depression, people's speech, movements--really, just about everything they do can become slowed. If you've ever been around someone who was severely depressed, you may have observed this. I had a friend in college whose psychomotor symptoms got so intense during a depressive episode that I misunderstood and thought she was drunk. The fact that this is coming up for Jae Won is another giant red flag that he is in a massive amount of distress.

the "freeze" response and the depressive side of PTSD

Given how much informed trauma discussion happens on tumbr, I'm guessing a lot of folks reading this may already know that contemporary trauma scholars have added to the well-known "flight or flight" set of trauma responses. The most common change is to add "freeze" to the list to make it "fight, flight, or freeze." Some also add "appease," or "fawn." We're all familiar with the fight response to trauma (go toward the feared object and try to fight it) and the flight response (run away from it). The freeze response is analogous to instinctively playing dead when attacked by a dangerous wild animal, except it's usually automatic, something our body does whether we want it to or not. People having a freeze response may dissociate, or they may find it difficult or impossible to get their body to move. The "appease" response refers to an instinctive impulse to do anything and everything to appease a person who poses a threat. It's a trauma response that frequently comes up in partner abuse situations. The "fawn" response, sometimes called a "collapse" response, is a kind of last ditch attempt by your brain to disconnect from your body so thoroughly that you'll feel less pain as a result of the trauma. I'd group it with the "freeze" response--they're kind of like different degrees of the same thing, with fawn/collapse being even more extreme than freeze. I had a mentor, Dr. S, in one of my training positions who had put together his own model of how trauma works, one he had cobbled together from a number of sources. Usually when a mental health person tells you they have this kind of homemade theory bricolage deal it turns out to be a hot mess. But Dr. S was incredibly smart and experienced and his theory was coherent and useful. I wish I knew where he got the various components from. I know he was into somatic experiencing therapy and it was part of the model but there were other traditions he had pulled from as well. But the gist, as it applies here, is this: he categorized the acute trauma responses (fight, flight, etc.) into two main groups, activating on the one hand and freeze-y/deactivating on the other. And those acute responses, the responses that a person has in the moment when the trauma is happening or soon afterward, are related to how their PTSD symptoms manifest, if they develop it. According to Dr. S, people with PTSD usually have a sort of predominant tendency where their PTSD symptoms lean more toward the freeze-y side, which is the more depressive and dissociative side, or the fight and/or flight side, which involves more overt dysregulation, anger, risk-taking, and so forth.

The thing that made me think about Dr. S's model of trauma when I watched episodes 7 and 8 was something he always said about these different ways trauma shows up as symptoms. I wish I could remember the rationale--like, what the supposed reason was that things work this way--but I remember that once he pointed it out I started seeing examples of it everywhere. He said that if you're stuck in a freeze-y, depressive state with your PTSD symptoms, you can't move directly from that into a more healthy, engaged relationship with your emotions, your memories, and the world around you. Instead of going straight from freeze mode into something healthier, he said, you have to spend some time in fight/flight mode. It's like, metaphorically speaking, there's no path out of the freeze zone without passing through fight/flight territory.

Jae Won's PTSD typically shows up in a very freeze-y way. His depressive symptoms were his most noticeable ones from the start of the series. He dissociates rather readily. He was numb even before what happened with Ji Hyun, then gets even more numb. Actually, I'd bet that when he resisted his connection with Ji Hyun before, and to an extent in 7 and 8, one of his main reasons was that Ji Hyun makes him feel alive and that scares him. Ji Hyun makes him "thaw out" in a way he doesn't feel prepared for. And then, of course, as soon as he dares to let his guard down with someone and experience real connection, what happens? A new trauma and massive triggers for his past trauma. So he goes back into freeze mode with a vengeance.

And he gets really passive. Just sort of floating along. Not kissing Eun Ji back when she kisses him, but not saying no or pushing her away either. (Well, there's one extremely gentle push after which he takes the tiniest step back, but that's it.) When we see him alone, he's just lying in bed with his eyes wide open staring into space. But there is one thing that makes him wake up, something that puts him squarely into fight mode: Tae Hyung making shitty comments about Ji Hyun. As audience members, it's natural to want to cheer this on in part because Tae Hyung is such a dick and that was incredibly below-the-belt. But I think another part of what makes us want to applaud is that Jae Won is finally thawing out again. It's fleeting. And the way the show is edited drives this home even more since there's an abrupt cut from Jae Won pummeling Tae Hyung to him talking with their professor in his office looking incredibly spaced out. But it happens.

"I want to heal his wounds"

One thing I've noticed in more than one response to episodes 7 and 8 is people being critical of Ji Hyun's words when he tells Joon Pyo, "He wants to be seen as a strong person, but has a lot of wounds. And I want to heal his wounds." Basically, I'm seeing people say that it's up to Joon Pyo to heal himself and that it's naive of Ji Hyun to think that he can "heal" him. And to an extent, they have a point. If Ji Hyun claimed he was going to singlehandedly heal Jae Won's pain and trauma, it would be extremely unrealistic. Especially if he claimed he'd do it whether or not Jae Won participates. But he says he wants to heal Jae Won's wounds, and I think that's more reasonable. I would expect that most of us, in his shoes, would at least want that on some level, even if we don't think it's possible. But more than that, I think this is an example of a certain cultural attitude, one that (in my experience) seems more prevalent in individualistic cultures like those of the U.S. and much of Europe. It's related to the idea that "no one can love you until you love yourself." I find this attitude just as unrealistic, and just as riddled with wishful thinking, as the idea that we can heal a partner by our force of will alone without their participation. Because individualism is a wishful fantasy in a way. It tells us that we can fix ourselves without having to worry about making connections with others or whether those others will be willing or able to give us the love we need. But we can't just wish away our relational needs.

Human beings are relational creatures. We develop from birth through our relationships with others. These relationships can be damaging or they can be supportive and strengthening (or, of course, both). We don't have to wait until we are perfectly self-sufficient before we're capable of receiving love, deserving of love, or able to benefit from love. When someone loves us deeply and shows that to us, when they show their love through caring for us, it makes a difference in our lives. Of course it does! And if we are completely lacking in that kind of love, life is harder for us. I could go off for pages and pages about this and I may well do so here one of these days. For now I'll say that if you're interested in combating your individualistic bias and thinking in a new way about the fundamentally relational nature of humanity, I highly recommend the first section of Kenneth Gergen's book Relational Being--it's phenomenal. (I first read it on a long bus commute and I was gasping so much that people started giving me looks. And I normally never gasp aloud at a book.) Stan Tatkin's work on attachment dynamics in couples is also really instructive here. Tatkin talks about how we've been conditioned to think it's burdensome and excessive to ask for our partners to be there for us and take care of us in certain ways that are actually imminently reasonable and part of a healthy relationship. This isn't to say that there's no such thing as a burdensome demand or an onerous expectation of a partner. But there's a whole class of caring for others that gets stigmatized in our culture that's actually not only OK but healthy and beneficial.

What about Ji Hyun? I think it's not unlikely, given his age and lack of relationship history, that he's being a bit overly idealistic. But I also think it shows an admirable degree of self-awareness that he sees that he has a desire to heal Jae Won. And honestly? He already has healed him to an extent, even if subsequent events seem to have undone it. He can't heal Jae Won just by loving him. Jae Won would have to allow himself to be close to Ji Hyun again for that to happen, and he'd also have to open himself up enough emotionally to take in what Ji Hyun has to offer. And in order for him to heal in a substantial way--for example, to stop having an active case of PTSD--he'd also have to put in some independent effort. But it's also true that if Jae Won lets him, Ji Hyun actually could make a real difference in Jae Won's healing. And Jae Won could do the same for Ji Hyun.

Jae Won's therapist: dancing over the line

Jae Won's therapist/psychiatrist has been playing around with boundaries a bit since we first encountered her. Her "just tell me what your worries are!" joke ventured a bit close to a boundary line for me, but it stayed on the right side and made sense in context so I considered it pretty skillful. Sometimes getting close to those therapy boundaries is actually really powerful. I mean, it may sound like this would just be a lapse, and then we could debate whether or not it was forgivable. But actually, playing with therapy boundaries in a careful way that doesn't go too far can be an particularly good idea, depending on the situation and the client. Sometimes factors like the formality of therapy, clients' idealization of their therapist, their worries about seeming like a good person or being a "good client," and so forth can lead to the therapy process getting completely stuck. Calling some of these things into question can be really useful.

So initially, I thought Jae Won's therapist was handling this sort of thing well. At the same time, I was concerned that she might overdo it. I had a therapist once who played around with boundaries in a safe, careful way at first, and it really benefited me, but later, he was careless about some important boundaries and actually crossed the line to the point where I had to stop working with him. I didn't know if she'd do this, but I worried about it. Then episodes 7 and 8 happened.

Some folks have taken issue with her saying to Jae Won, "Why didn't you visit recently? I almost couldn't pay my rent because you stopped coming. You know every minute counts for the consultation fee, right?" I do think she's getting into risky territory here, but she ends up on the right side of the line by my standards (albeit barely). It should be completely obvious that Jae Won's attendance at their appointments doesn't make that huge of a difference in her bottom line. I actually see some reasons to believe she's likely an administrator or instructor/professor in addition to her clinical work (I'd be happy to explain my reasons but I'm trying not to get too far in the weeds). So she likely has other things to do besides see clients. And she's the kind of clinician that probably has plenty of clients. But no matter what her job entails, the fees from one client who sees her biweekly are not going to make or break her financially. She's trying to make light of her worry when Jae Won missed appointments (probably two, since a month has passed and that would mean two biweekly sessions). Then there's the exchange about her experiences with clients dying by suicide. There are aspects of it that seem OK to me, but she crosses the line in my estimation.

When she first raises the topic, she asks him, "Did you think about extreme decisions?" This set off alarm bells for me. It's important that therapists show that they're able to speak clearly and explicitly about suicidality. Using euphemisms or beating around the bush conveys a lack of confidence and comfort with the topic that could undermine clients' faith in the therapist or make the therapist seem like someone they have to protect from learning about their suicidal thoughts or intentions. Thankfully, she switched to more direct terms quickly, so I felt like that made up for her initial vagueness.

Then she talks about how "the hardest time" in her work is "when my patients commit suicide." But instead of talking about the loss she would feel in that situation, she quickly pivots to talking about how it's difficult to decide whether or not to attend these clients' funerals. It's a weird turn. It makes it sound as if the hard part is navigating this funeral question rather than the actual loss of the patient. I'm sure that's not how she really feels, but this topic shift makes it sound that way.

I know that @waitmyturtles took issue with the way the therapist hashed out conflicting ideas around ethics in a conversation with a client, and I do think that's almost always something that should be avoided. But I also think if she had done it in the right way, it could have been OK or even a good idea. Why? Because as I wrote above, one good reason to mess around with therapy boundaries sometimes is in order to undermine the idealization of the therapist when it gets out of hand. In other words, sometimes clients need to see firsthand that therapists are human beings too and that they make mistakes and have growth areas--and that they feel confused about how to navigate some professional situations, as she talks about here. It's demystifying in a way that can be beneficial. My biggest concern is actually the fact that she's doing this around the topic of client suicide.

Even though she plays it off somewhat by seguing into an ethical quandary about funerals, Jae Won's therapist is still raising the subject of how patients' suicides affect her. And this is where I think she's really playing with fire.

There's nothing wrong with a therapist acknowledging that when/if a client ends their life, they are/would be strongly affected. To pretend otherwise would not only be disingenuous, it would make the therapist seem unfeeling and cold. But it's risky to do anything that might center oneself in the conversation about a client's suicidality. Basically, saying you worry about a client, saying you would be very sad if they died, and so forth can be not only OK but advisable if done judiciously. But spending a substantial amount of time talking about yourself when you're sitting with a client who has a substantial suicide risk is insensitive and dangerous.

Of course, this is partly because centering oneself as a therapist is almost always counter-therapeutic (not to mention shitty and wrong). But if a therapist centers themselves around this specific topic, it could also lead to losing access to vital information about the client's thoughts, intentions, and risk level.

If I'm seeing a therapist who I have a good rapport with, I'm going to be concerned if it appears I might hurt them. I may even be highly motivated to try to protect them. If I'm having suicidal ideation but I think telling my therapist about it will upset, overwhelm or frighten them? If I'm being told right and left how distressing client suicide is for them? I now have a very good reason to keep my suicidal ideation a secret. Once a therapist loses a client's trust that they can safely disclose their suicidal thoughts and intentions to them, risks immediately go way up. Bottom line: if a client doesn't feel safe telling you about that stuff, you can't help them when they're in crisis. You're operating in the dark, without access to critical information.

I continue to believe that Jae Won is at a substantial risk of suicide and/or self-harm. And he has shown time and again that he tends not to disclose much in therapy even when he's at his best. This is no time to play around with this stuff. His therapist needs to show him that she's a steadfast, safe, concerned, but also reasonably neutral figure right now if she wants to have any hope of keeping him safe. And she failed to do that in episode 7.

the portrayal of mental health interventions in The Eighth Sense so far

As before, I think that the show has shown Jae Won's therapist in a mostly positive light in the latest episodes. And without a doubt, it's a good thing that therapy is being shown at all here. But one thing we haven't seen so far is an instance of therapy actually helping Jae Won in any observable way. And I'm becoming increasingly convinced that the series will end without any specific benefit from therapy being shown. I get that this is a love story and the emphasis is bound to be on the ways in which Ji Hyun and Jae Won can make a difference in each other's lives. But if you're going to portray therapy at all, you really ought to include at least some sort of potential benefit from it. Otherwise you run the risk of sending the message that while therapy might not be actively bad, it's also not something that will help someone in a meaningful way.

I'm also concerned about how psychoactive medication is being portrayed in this series. There's been a lot of talk of prescriptions. In the deleted scene that's been making the rounds, the camera pans down at Jae Won's pill bottles as if to call attention to them, emphasizing them at a time when Jae Won seems to be falling apart. Maybe these are hints that Jae Won is going to misuse his medication at some point, or maybe not. But currently, they function as a kind of commentary. The implication seems to be something like, "Look how fucked up Jae Won is right now. He even has to take medication for his mental health!" It makes it seem like someone taking psych meds is a sad or worrisome thing on its own. This is exploitative and supportive of mental health stigma. If it turns out these cues were foreshadowing Jae Won misusing his medication to self-harm, the generalized medication stigma aspect could be less of a concern, but it still wouldn’t exactly be a progressive portrayal of mental health care. I hope the show's creators pull back from this or find a way to make it all worthwhile, but I'm becoming less hopeful about that as well.

what's next?

I have some thoughts about what's coming next for the story based on what we've seen so far. Well, I have a lot of thoughts on that subject, but I'm going to confine myself to those I see as mental health-related here.

There's a chance that Jae Won could engage in some kind of self-harm or make a move to try to end his life. It's hardly certain this will happen, but it wouldn't be out of left field. Given the attention paid at various points to Jae Won's medications, the most likely avenue of self-harm seems to be misusing them.

One potential turning point could happen if events bring up Jae Won's protectiveness toward Ji Hyun. This could come up due to something really overt if he has reason to believe Ji Hyun is physically in danger, but it's at least as likely to come up if he sees other people mistreating him. If Eun Ji continues to try to bully Ji Hyun and Jae Won witnesses it, or if Tae Hyung lashes out at him, this could have a big effect on Jae Won. After all, even in his highly depressed and dissociated state after Ji Hyun's accident, the one thing that brought him back to himself was Tae Hyung's shitty comment. I would tie this back to the idea I mentioned above, that the path from long-term freeze mode to something healthier may need to involve passing through a more activated, aggressive state in the process. Jae Won's protectiveness toward Ji Hyun could be the catalyst that causes this type of shift for him.

[phlve]

IN(F) — Introverted Intuition supported by Feeling

Continues to work instead of seeking treatment for failing health. Sometimes has phobias. Likes to go out, to dance, knows how to tell a stor. Experiences hypochondriac neuroses, claustrophobia. Before an important event experiences strong emotions, may lose appetite. he Is blind to his own hunger. He ponders what is the point of something, the meaning, symbolical nature. "What will this do for me?", he worries about what he can do to affect others, what are people thinking about, how society, the collective, perceives him, how his friends feel about him. He often smiles, has a cheerful nature, but it is usually fake, not so sincere. Neurotic, obsessive pedantic and egoist yet soft, friendly and welcoming. Expressive, he likes to maintain a comfortable emotional ambient, he focuses on making human relationships and Keeping everyone united. A hopeless romantic, prone to stalking crushes and compulsive overthinking They fall in love, they aren't loving, they are within limerence. "Teen love" - this is a good name for it. He idealizes everything, he doesn't has clear opinions, his beliefs are dictated by the collective: he either believes or gets skeptical about love, because he usually understands love only in a specific sense - the standard sense. When he thinks about emotions, he thinks about pop. mainstream. generalized emotions. Humanity for a long time idealized and represented love as romantic or erotic; so this type suffers from this: he easily believes in doing anything in the name of love, he would do anything for his loved ones, if he ever falls in love with someone, of course. Avoids showing his true feelings, he could be crying in one moment, and then in the other, he enters in a group, a collective, and he adapts to it, he stops crying and starts smiling, "acting". Very inclined to escapism, hallucinations, delusions and religion, ideology, existentialism and politics. He often relies on external sources, academics, he doesn't know how to explain things, so he needs to talk about his sources, he shows what people think, out of fear of being wrong. Anxious about being humiliated, he has a weak selt-esteem. The romantic dreamer likes to lay on a sofa with a book, or go to the countryside to spend time amidst nature. Many manifestations are inclined to cosplay, they like to live alternatives - finds ways to avoid boredom, uses old things and people in a new way and bringing the positive future into the present and past, staying light and hopeful in spite of anxieties. Struggles with videogames and orders: he is verv trial-and-error. He mav be cold. withdrawn. asocial. timid and extremely introverted; a gloomy figure with low confidence.

He hides his insecurities. runs into situations of trust and marriage. Intense connections. Fantasizes about people, delusional imagination of being accepted, praised. They find difficulty to express what they want, often times they do not realize what they wish in life; they ask people "how do you create interest?" because they lack actual desires and passions. Individualistic in some manner. Creates music, laments his own existence, prone to atheism, agnosticism. Diligent but unfocused, non-disciplined, often loses concentration, but he is always doing something - it could even be living in his dreams. He compares himself with other people, tends to be jealous, envious, yandere. Inclination towards mysticism and superstition, beliefs in prophetic dreams and omens. He is a person who is emotionally labile and uninhibited, does not control his own emotions, some manifestations of the type make fun of people and are sarcastic. Some versions, instead of comforting people with the warmth of his soul, begins to manipulate other people and act capricious and touchy. "Everything is wrong" and "things didn't turn out to be as desired". Many times expresses a desire to be hugged, to be protected and helped, he is weak and thinks of himself as someone "not prepared", he worries and worries. Some people of this type spend their time alone, don't have many friends (may not even have friends. He likes to dive himself in meditation. It is important to understand everything. Therefore, if you ask him about the difficult things sometimes, you can hear the answer that he understands them (only a very peculiar). It is important that everyone knew him as well. If understanding is impossible, that human self-esteem drops, so it does not like to admit that something is not understood. It is important to praise the consistency, likes to boast that he was up to something thought of himself. Often he loves to refer to some everyday stories, because nobody will not even think to check their authenticity, in general likes to refer to someone as a way to protect their reasoning. He is a person prone more to reflection than action. "If I understand correctly, then I am a good person". The fear of turning out to be incompetent greatly narrows down the areas in which the person dares to demonstrate or apply their knowledge. This type wants to solve his problems by collecting objective data. It is necessary to consult the experts, to obtain the data and results of studies, to receive objectively reliable new information. "Any unpleasant sensation or experience it's best to endure and wait over, than to seek how to improve one's state or move to another place that offers better conditions."

[possumcollege]

Thoughts on Gendered Assessment of ADHD

I read a post this morning on the subject of medical conditions presenting differently in men and women. The main focus was on the presentation of heart attack and stroke, which do have documented, yet often overlooked differences between how they can manifest. That's important to understand and the post made its point well.

One thing that struck me as less than accurate was specifically the inclusion of ADHD as a condition that presents differently in women. It is a fact that ADHD is under-diagnosed in women. I'm not disputing that. What I think needs untangling is why it is under-diagnosed.

-

I want to acknowledge and apologize for my use of largely binary gender terminology. I don't like it but so much of the reading on the subject is based around cis/het people that is hard to escape. I'm sorry I don't have the proper shorthand to easily adjust my language here. All presentations and gender identities are valid, and all deserve the best possible care regardless of the terms we were assigned at birth.

I'm also not a doctor but most of us aren't and we still deserve to be treated with dignity and respect.

-

ADHD has historically been under-diagnosed for a few reasons. ADHD is often erroneously thought of by laypeople as a behavioral disorder. Possibly one of the reasons its name reflects the way it is perceived rather than how it affects the patent. The popular image of ADHD is a male who is hyperactive, impulsive, twitchy, generally unfocused, and prone to risky behavior.

In many cultures these physical behaviors can be written off as boys being boys, up until they become disruptive or excessive or reach an age where these behaviors are considered more problematic. The bar for what is physically noticeable is higher for boys, and can lead to delayed diagnosis.

ADHD also has cognitive and emotional components that are not so easily observed. This physical vs. mental manifestation is the most commonly cited way that ADHD presents differently in women. I do not believe that is fully accurate, but I'm biased, as I'll elaborate on later.

Women do present these symptoms at comparable rates to men but they tend to go unnoticed for longer because girls are often socialized to be quiet, reserved, and deferential from a younger age than boys. Girls are discouraged from rowdy physicality because it's traditionally considered a masculine trait. Many cultures are simply more permissive of these behaviors in boys. Socialization obscures and encourages masking of physical symptoms in girls, and incidentally masks those symptoms in boys.

The invisible symptoms of ADHD are impaired executive function, struggles with working memory/multitasking, and emotional disregulation. These are too frequently considered side-effects of being a woman in many cultures. Being emotionally labile (changeable or easily affected) and distractable or flighty is "normal" in girls so it is less likely to be observed. The cultural conception of these as feminine traits also leads to them being actively discouraged and masked in boys. It doesn't help that disregulation often manifests as frustration or aggression which, again, is "normal" for boys and men well into adulthood. 😑 Socialization obscures and encourages masking of emotional symptoms in boys, and incidentally masks those symptoms in girls.

Some researchers believe that the deficiency of dopamine and delayed development of cognitive function contributes to overstimulation which can manifest as physical hyperactivity, mental/emotional hyperactivity or both. That internal hyperactivity compounds with the traditionally "inattentive" traits like impaired working memory and exec function. This is why we now have "combined-type" ADHD instead of it being a binary hyperactive or inattentive type. There is also research that considers ADHD to be part of a larger neurodivergent matrix that includes autistic traits but that's bigger thing than I wanted to get into here. What I am saying is that human brains are not that functionally different between men and women and most of the basis for believing they are radically different comes from the age of bloody eugenics.

So while the full range of ADHD symptoms present in both men and women, women are still proportionately considered less reliable in self-reporting of symptoms, and those symptoms are more likely to go unnoticed by others as they are actively suppressed from a younger age.

While men and women can have differing ADHD presentations, a clinician needs to be evaluating the symptoms and their impact on the individual patient without limiting their prognosis by assuming an inherent sex-specific presentation. It should not be appropriate for a doctor to definitively say, "You can't have ADHD because you don't have the symptoms as they present in men."

I feel very strongly about this because it's what happened to me. Those words are permanently etched in my brain because that is the phrase that delayed my own diagnosis and treatment for three years. In those three years I was prescribed over 8 different meds for depression and anxiety that did not treat my depression or anxiety AND gave me a whole parade of debilitating side effects. For three years my mental and emotional state spiraled out of control because I didn't have "Boy's ADHD."

I've struggled with the cognitive and emotional effects of ADHD my entire life. I wasn't particularly hyperactive in the traditional sense but I was anxious as fuck forever. I was considered inappropriately sensitive and emotional. I've never been a big risk taker but I do talk a lot and tend to mirror people around me. In short I didn't have the men's ADHD red flags but I have all of them from the women's list. A competent clinician in this era should be able to make that connection. I'm endlessly thankful that I found a doctor who did.

I always wonder if there's something to the fact that two cis male doctors wrote off ADHD completely but my first female psychiatrist was willing to order neuro-psych testing by the end of our first visit. It was clear to her while the previous doctors weren't willing to consider ADHD until they could "get the depression and anxiety out of the way." I get wanting to clear the imminent threat, then seeing if the mental symptoms improved but they were dismissive of my earliest ADHD concerns and bolstered their assertions by citing my lack of typical male symptoms without even telling me what the atypical symptoms were. I should've asked but alas, I was pretty fucked up at the time. 🤷‍♀️

I generally try not to put so much of myself on the internet but I sincerely believe examples like mine are critical for a better understanding of what our needs are as neurodivergent humans, and for demanding better systems of care and support.

ADHD is a glaring example of the failures that result from narrow and inflexible standards based on archaic notions of how people work. In the beginning, ADHD didn't exist and was treated by hitting children until they behaved properly. Then it exists but it's a behavioral problem with kids and they should be segregated from the normal kids. OK, it's a thing but it only really happens to boys. It happens to boys and girls but not in the same way. Turns out anyone can have ADHD and the symptoms aren't set in stone but we're still going to make getting a diagnosis as difficult as possible and restrict access to most of the drugs that treat it on the assumption that most people just want to abuse stimulants. Progress!

Basing women's care on centuries-old assumptions about women by men is inappropriate and harmful. Basing a black patient's care on historic racial stereotypes is inappropriate and harmful. Basing the care of LGBTQ+ patients on a system that historically pathologized their existence is inappropriate and harmful. Dismissing a mental health patient's concerns and reported history solely because they do not fit a typical gendered presentation is inappropriate and harmful.

This is why the conversation of equality vs. equity must be a priority. Diagnosing every neurodivergent patient by one standard is not reliable because of the complex array of presentations and effects. There are diagnostic screening tests but they are essentially "if you tic 6+ symptoms from section A you may be hyperactive. If you check 6+ symptoms from section B you may be inattentive. If you have at least 6 from each you may be a combo deal." Conditions like these require an individualized approach or countless people will continue to be misdiagnosed or slip through the cracks. We require more doctors, more effort, and better education. There is no streamlining or automation that will make this more effective. The potential for harm here is immense and made even more difficult to address by the persistent belief that real ADHD is rare.

Ignorance and inertia are liabilities in healthcare. Without continually updating the best practices and procedures we'd be stuck with bloodletting, miasmas, and choleric humors. We'd still be operating on babies without anesthesia. That's not a widely seen practice now because doctors did finally agree they should stop in the late 1980s. In the US. Doctors around the world still regularly under-medicate black patients based on beliefs that their pain tolerance is higher than white people. That myth is so pervasive that it's often used to justify excessive force by police officers against black suspects. Trans youth can be denied life-saving support if they can't meet the standards of people who do not believe they exist. The neglect and abuse these myths enable are horrific.

Inhumane treatment should never be excused because a patient didn't tic all the correct boxes.

[fatehbaz]

To pursue poetry, I left Cebu a number of times, set out to literary spaces, moved to Manila, moved to New York; after each time, I would return to Cebu, the province where I was born and where I grew up in, which also happens to be the Philippines’ cultural and economic center in the Visayas region. Living in one of the many islands in an archipelagic country with more than a hundred languages, there is always a distinct sense of leaving a center and of reaching another every time I travel, such that the country’s capital Manila is not only a geographically different space but also a linguistically and socially different world as New York, too, being in a country an entire hemisphere and ocean away, is another world. In these worlds that are not the world I first learned to inhabit, I was as an outsider constructed in ways such as being assumed to be a cisgender woman who is heterosexual and fluent in Cebuano, and also one who would write, perhaps with nostalgia for belongingness, about my hometown and the ethos of my Visayan peoples. [...]

For although I recognized I may be from another “world” I found that, nevertheless, I felt a sense of affinity almost akin to belongingness in these spaces and places that were different and away – perhaps, precisely because they were different and away – from the actual place of my origin conventionally perceived as my home. This is not to mean the inverse that I am not at home in Cebu is also true; rather, that my cognition of being at home in a world and my sensibility of affinities have grown expansive by the lived pluralities of my identities.

By “world” I mean something modified from how María Lugones thought of it as one that is inhabited by actual people whether it be a few, as in a fraction of a society, a particular society in itself or even larger to include several peoples within the realm of animating principles. A world, to my sense, also includes an affective dimension in relation to a kind of durational and geographical-spatial zone that “homes” such world and the individuals inhabiting this world. In this way, a world may be thought as a relational, rhizomatic center of affect. It can be created temporally such as when individuals are brought together by circumstances; when diverse writers come together in workshops, residencies, fellowships, or festivals that, although may seem momentary, could be enduring in its subsequent forms as their meeting of persons may take place not only within the experienced physicality of the moment but also, among others, at the intersections of a language, at the contiguous borders of coloniality, in an interlude of what may later be understood as a lifelong advocacy, in the liminal spaces where nuanced interconnections are made as writers draw from where they have been, where they are at, together at the moment, and where they intend to move towards dreamed futures.

It is in these encounters that I found my selves in worlds with Merlie Alunan, with writers from eastern Visayas who write in their own local languages similar but different from Cebuano, with literary communities in Cebu such as Women in Literary Arts and Bathalad, as well as writers from other regions across the country through which I “became” a writer from the South. South, where Cebu is cartographically located in relation to the capital, Manila, less a geographical marker of where I am from as it is, to my sense, an identity, a position by affiliation or affinity, a kind of belonging, and complicated alliance to bring the idea of “nation” outside its conception within the confines of the country’s capital. That this world, mostly populated by writers from or writing in the Southern regions of the Philippines, may also nuancedly expand to include the entire country and even the Global South, gesturing at the irreducible variation of worlds that allows a world to be a kind of center in itself, created and grown within the labile self who provisionally inhabits this world through nodes of self-identifications and self-determinations.

A world, then, is never stagnant; it is mutable. It is also interconnected in myriad of ways to many worlds that a self has previously traveled and inhabited, corporeally or otherwise. It may be first cognized through mediated introductions: overheard from someone; read from a book; seen on-screen; reimagined constantly into becoming real enough to be inhabited by a self.

---

Text by: shane carreon. “Archipelagic Interiority: Notes and Reflections on Poetic Voice and Trans Writing in the Philippines.” Kohl. Volume 9 Number 1. Special Issue: Anticolonial Feminist Imaginaries. Winter 2023. [Some paragraph breaks/contractions added by me.]

[fem-lit]

The psychological effects of self-inflicted semistarvation are identical to those of involuntary semistarvation. By 1980 more and more researchers were acknowledging the considerable emotional and physical consequences of chronic dieting, including “symptoms such as irritability, poor concentration, anxiety, depression, apathy, lability of mood, fatigue and social isolation.” Magnus Pyke, describing the Dutch famine, writes that “starvation is known to affect people’s minds and these people in Holland became mentally listless, apathetic and constantly obsessed with thoughts of food.” Bruch notes that with involuntary progressive semistarvation, “there is a coarsening of emotions, sensitivity and other human traits.” Robert Jay Lifton found that World War II victims of starvation “experienced feelings of guilt over having done something bad for which they are now being punished, and dreams and fantasies of food of every kind in limitless amounts.” Starving destroys individuality; “anorexic patients,” like others who starve, asserts Hilde Bruch, “exhibited remarkably uniform behavior and emotional patterns until they gained some weight.” “Food deprivation,” Roberta Pollack Seid sums it up, “triggers food obsessions for both physical and psychological reasons…. undernourishment produces lassitude, depression and irritability. Body metabolism slows down…. And hunger drives the hungry person to obsess about food.” The psychological terror of hunger is cross-cultural: Orphans adopted from poor countries cannot control their compulsion to smuggle and hide food, sometimes even after living for years in a secure environment.

— Naomi Wolf (1990) The Beauty Myth

[yiga-hellhole]

Hiiiiiiiii, can i get uhhhh a #1 and #27 for Zant, a #33 for Yuga, and a #48 for Ghirahim for the random character asks thing

THESE ARE INTERESTING!

Zant

#1: Canon I outright reject

now, this is only dubiously canon… the game in and of itself has nothing i object to. it builds up well! his actual character can be interpreted in a versatile way. the only things i would have changed were the frequency of how often he shows up, because i think we could have done with more sneak-peeks into what he was up to. like, how did he interact with Zelda while keeping her imprisoned in the palace? what was the encounter when he cursed Midna like? oh, so much potential.

the MANGA HOWEVER……. the suggestion that he’s at least 20 years midna’s senior who predated on her was completely uncalled for. i’m willfully ignoring anything in volume 9 and later. zant is already a terrible enough person, and any more than what he’s established to be is just plain unnecessary. the implication that he was genuinely in a (twisted) love with midna at the time of his usurpation doesn’t compute with me. he hates her, through and through! i get that the scene where he restrained her after the water temple gives some tension, but to me, that always came across as a moment of power play, a desire to mess with midna… and perhaps remnants of old affection that rotted into obsession. i like to think they were childhood friends, after all.

#27: Their guilty pleasure

you follow my alt twitter. don’t act coy with me.

i’ll say it anyway. i think he’s not only a sadist, as shown in canon, but a masochist as well. pain brings him clarity… whether inflicted on someone else, or on himself. maybe that’s also why he goes into a more meek, submissive attitude when injured in hyrule warriors… shoutout to my man whimpering and crying

Yuga

#33 Something guaranteed to make them cry

there’s a funny one. cry in what sense? i think yuga is the kind of labile person to be brought to tears by many things, whether it be rage or genuine sorrow. he loves screaming and stomping and snapping throughout the entirety of albw after all, but never did Link manage to strike the snare to make him burst into tears. as for what brings him sorrow… he’s not a man to have many genuine attachments beyond himself, i think. but an easy way to do so? you’d have to wreck one of his paintings. i like to think the statues and portraits of Link around Cia’s mansion were Yuga’s work (begrudgingly so), but nasty little twerp or not. it’s still his blood sweat and tears! careful around them!

Ghirahim

#48 Scariest moment of their life

well…. that could only have been the day Demise was sealed, right? he can act uppity and grandiose all he wants, but for the war he’s razed across hyrule, only to see the man he’s dedicated his life to get bound and disappear… if anything can bring fear to his heart, much less a fear he acknowledges (you know how i feel with GanGhira and GhiraDemi), it’d be the instant loss of his life’s purpose

[lewdestconcubine]

The Szayel Compendium (Part 7 - Relationships)

RELATIONSHIPS.

FAMILY: [Who, if anyone, does the character consider their family? Are these blood relatives? And do they have a good relationship with their family?]

Szayel has one fraternal twin brother, Yylfordt, who as a hollow, he has a complicated relationship with.  He very much loves him, but he resents that he spends his time with someone else, and that he’s essentially the physical manifestation of all of the ‘weaknesses’ and ‘impurities’ that he pulled out of himself.  He’s not sure what to do about it sometimes, and after Yyl’s death, sometimes things get complicated.  Verse dependent he sometimes will have a partner/boyfriend/girlfriend/husband/wife and/or children.  Those relationships are things that sustain him when they happen.

FRIENDSHIPS: [Do they have lots of friends, or just one or two close friends? What do they look for in a friend?] Szayel has lots of acquaintances.  There are a couple of hollows he considers his friends, and of course in RP, he has plenty of verses where he counts different muses as friends.  But canonically he suffers deeply from isolation and loneliness and does rather desperate things to change that fact, through much of it doesn’t work and isolates him further.

FRIENDS IN NEED: [How do they help a friend who is going through hard times? Do they offer advice and support, or do they feel uncomfortable, not knowing what to say?] It’s best to explain things in a way that Szayel can ‘solve’.  If he can invent something. give you a medicine or a treatment, share his knowledge, etc., he is more than willing to help a friend.  If you need to vent, its best to tell him so, and he’ll listen and support, and if it would make his friend more comfortable, or if they want a distraction, he’s more than happy to share himself physically, whether just by giving affection or by doing something sexual/sensual.  But sometimes, he just doesn’t really get what’s needed from him, so if you don’t spell things out and just expect him to be sensitive to your problems…you may end up not liking what he does.  It’s best to explain to Szayel how he can help, otherwise there may be some wild misunderstandings.

NEEDING A FRIEND: [Do they tend to go to friends when they need help and support? Or do they deal with their problems on their own? Do their friends ever worry about them?] Canonically Szayel will generally withdraw and become more paranoid or hostile.  But, in different verses, if you connect with him well enough, he’ll come by for reassurance, whether its nice words, a hug, some good food, or just being acknowledged.  If you’re the type of ‘friend’ he tends to prefer, if you can fuck him well enough that he forgets feeling terrible, it’s a bonus, and you will likely see him often.  He is not at all subtle about this, smh.

ANNOYANCES: [How do they deal with arguments and disagreements with friends or partner?] He tends to fall apart.  Finding a companion is something he stresses over.  If there’s a rift forming for any reason, he doesn’t take it well, will isolate, and just continue down an unhealthy path until he’s either asked to stop, or forced to.  Szayel is rather fragile at heart, even if he pretends that this isn’t so.

ROMANCE: [If applicable: how do they woo a potential partner? What do they look for in a potential partner?] Szayel is demiromantic, and thus really only develops romantic desires towards friends that he has, that he’s also already pursued a sexual relationship with to some degree, or at least has been able to feel physical chemistry with as far as things like..you smell good to him, your touch is comforting to him, and your presence is settling.  He looks for those who can handle his mood lability and who have a complimentary type of strength both physically and/or mentally.  As he’s essentially pan, this could be a person of any gender.

MARITAL PROBLEMS: [How do they deal with problems in their love life? Do they talk it through with their partner? Or do they bury their head in the sand?] Szayel tends to ignore problems in his relationships when he feels that everything for the most part is going well.  He’d rather swallow his own issues or secretly try and fix himself.  He’s conflict avoidant when it comes to things in his private life.  He’s terrified of being alone and will actually take very large amounts of abuse for the sake of not losing a partner.  Unless his partner can pick up on the fact that he’s unhappy and change their approaches to the problems without saying anything…you’re going to have to back Szayel into a corner to even acknowledge that there’s something wrong I the first place.  He tends to self harm and disassociate rather than tell a partner that there’s a problem, as he figures that just as anything that’s mind over matter, if he continuously works to accept a lie, eventually it will be true. 

ADVERSARIES: [What would turn them off a friendship or romance?] Being ignored.  Trying to force other ideologies on him.  Treating him as something below you, when it’s not consensual degradation.

ENEMIES: [What would make them hate someone enough to call them an enemy?] Actively working to undermine him and his accomplishments.  Otherwise, an ‘enemy’ is just the person on the other side of the fight he’s been made to fight because he’s in an army.

STRANGERS: [Do they tend to be respectful to strangers, or are they careless towards anyone who they don’t consider a friend?] Szayel tries to be courteous to those he first meets as he’d rather make a good first impression.  But he will not lie about the fact that he won’t necessarily stick his neck out for you unless you’ve shown him that you can be trusted to have his support.

FUN STUFF: [What kind of things do they like doing with a friend?] Szayel’s very much adventure and pleasure minded.  He likes experiencing fine things like art and music and good food.  He likes dressing people up and making things for them.  He enjoys traveling to unfamiliar places with a familiar person by his side.  And of course anything of a uhhh..physical nature. Szayel loves getting to know someone in the biblical sense...as merger of mind, soul, and body is deeply intertwined with the alchemical symbolism tied up in his character.

DATING: [What kind of things to they like doing with a romantic partner?] Everything listed above.  His friendships often don’t look al that different from his romances.  Sometimes there’s just as much sex.  XD  But in romance you can actually get him to more or less commit to you, and he’s unafraid to plan a future life.  Szayel has a weird purity of connection to him that makes it kind of hard to split hairs between friendship and romance, and often he’ll put a label on it to make the other person feel better.  But that’s not to say that it’s less passionate.  It just means that you have the right to tell him what makes you comfortable in his behaviors, like if you don’t approve of him being openly sexual towards good friends.  He’ll never stop dropping innuendos or flirting however, he’s not really capable of it.  Just tell him where boundaries lie.

BEST FRIEND: [If applicable - who do they consider their best friend?] This is very verse dependent.  Canonically, he’s not really shown to have very close bonds with people.

LOVE: [If applicable - who do they consider to be the love of their life?] This too is very verse dependent.  He clearly lusts over others, but that’s not the same thing. But he does form ships easily if approached the right way.

WORST ENEMY: [If applicable - who do they consider to be their worst enemy?] Canoically, he considers shinigami as the enemy, who are essentially carrying out genocide.  He also sometimes has conflicts with Aizen and with the other Espada.  He fights with Renji and Uryuu, and of course dies by Mayuri’s hand…but they’re more or less opponents, rather than enemies, if that makes sense.  After all, he’s a soldier in a war.  He doesn’t really get how certain characters were introduced to him, so depending on different AU concepts…I feel that he may be incredibly open to meeting some characters, given that they have things in common, but were forced to be on different sides because of the world they live in, rather than any conscious choice.

RESPECT: [Do they respect their enemies, even if they don’t like them? Is there anyone they disrespect? Why?] Sometimes?  I mean, for Szayel, he views it as a great honor for him to be interested in you enough to study you, experiment on you, fight you, or command his attention in any way.  To flat out ignore someone is to disrespect them, as he feels deeply disrespected when ignored.  So, take this as you will.  He’s not exactly normal, nor was his canonical ultimate opponent. 

[lactating]

lactating

Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together with lability of affect." During a manic episode, an individual will experience rapidly changing emotions and moods, highly influenced by surrounding stimuli.

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