#i am set up for failure because i have several mental illnesses and no social skills and a very very tiny social battery

[crazysodomite]

it truly doesn’t matter if youre a good person or if you try to improve yourself... the only thing that matters is your social skill and social abilities

[liskantope]

I honestly kind of believe that these younger generations, (the people like me who grew up on cartoons and stuff).... seem to view jokes as a social currency, and I believe that there are cases where someone may be afraid to approach a real-life situation, if they don't have some way to attempt to 'assert their intellectual dominance' thru wit.

In my opinion, in those examples you shared of those 'exhausted by existence' slogans, the people have traded physical dominance and ability to get shit done, for a much more cowardly approach, where the individuals still 'feel like' they are not abjectly pathetic, even though their loud fanfare just drives in the point that they are. They're too scared to actually do what they gotta do, so they'd rather sit on top of a mountain and yell at everyone else... while never wanting to actually get involved in shit, because "oh it takes woooork"!

This is my own opinion. I used to sort of feel the same way that those memes describe, but I never was fucking flagrant about it.... and over time I realized that life was about getting better at taking on challenges. It's part of evolution. And those slugs wanna just go slither away, but they still want people to love them... instead of accepting that one's own actions will affect how other people see and treat them, because it's life!

I don't know. That dumb attitude has always pissed me off. It just reminds me of kids who liked the Disney channel kids' sitcoms too much, and the stale, scripted jokes that the 'hip' adult writers would come up with. Like these are the kids that modeled themselves too much after those TV execs' ideas of what kids should be.

idk, like I felt similarly, in the past, but I never let it take over my social personality. I was an absolute slug, but I knew how it's pretty socially unattractive to signal how helpless that you feel about life. At least if I was lazy, I would 'own it' as a 2kool4scool kinda choice. Yeah?

I'm having trouble fully following the thread of this ask; maybe someone else understands what it's getting at better than I do? Reading the first paragraph, I thought it must be a response to this post from months ago about how younger people use social media versus older people, but instead it's clearly (at least starting with the second paragraph) about this much more recent set of posts.

This response is also, while not malicious I don't think, rather harsh. On the individual level, I don't see the two people I was discussing (both of whom I consider friends) as "slugs" or not really willing to get over their own challenges because "oh it takes woooork" or any of that. I particularly admire the one who posted the T-shirt as in fact having much more grit and succeeding somehow at being more productive and hard-working, on the whole, than I am (despite her references to depression and apparently considering it an achievement to return a package)!

As I said before, I also relate to these memes, although certainly not severely as some of the people in my orbit. The real issue, and the real difference between me and them, as I see it, is this: they, along with much of society (far from all, but a good chunk of the younger generations) have gotten wrapped up in social movement that has over-corrected for how stigmatized mental illness and disorders and neurodivergence have been, to the point that their own individual as well as perceived society-wide inability to manage the basic demands of life is treated with a sort of complacent acceptance. And I feel some of those difficulties both within myself as an individual and on a widespread level but am stubbornly positioning myself in a more profound rebellion against them, against accepting them as a normal way of things on any level, against avoiding the inquiry into why this inability to cope with the basic demands of life now seems to be so widespread, against a failure to outright acknowledge that there's something deeply wrong about all this.

And there has to be some fine line between properly acknowledging the issue for what it is and why we shouldn't be sitting back and accepting it, and stigmatizing mental illness and neurological issues and so on and the people that suffer from them.

[yeah-all-of-it]

Vulnerable, personal shit below the cut.

So, 2021 was not great for me. I’ve alluded on here to some personal stuff I’ve been going through. That situation is, unfortunately, the ending of my 16 year marriage. Things hadn’t been great for several years (looking back, maybe they were never all that great?) But being raised with a religious background and having been involved in the Christian church clear up until covid hit (yes, that recently😖), divorce was always portrayed as one of the ultimate sins. Life wasn’t meant to be happy, it was meant to serve God and sacrifice your entire self until you died, basically. So, I sucked it up for years. In September, I decided I was done sucking it up. (He was not blindsided; he revealed he was not happy either.) I have too much life left to live to be miserable and to spend it with someone I am no longer compatible with. He’s not a bad man, at all. But I haven’t felt like a person should feel about their life partner for a very long time. I deserve to desire my partner and to feel supported by my partner and I hope to find that one day when I’m ready. My marriage gave me two beautiful children that I love more than anything, so I don’t consider it a failure. It’s just a relationship that had run its course and was not making me the best version of myself.

I discovered Shameless in late fall of 2020 and it quickly became my favorite quarantine binge. I got lost in Ian and Mickey’s relationship, how fiercely they loved each other. Maybe deep down wanted to feel a fraction of that love and passion for someone. I realized I felt none of that for the person I was married to. I found the Shameless/Gallavich Tumblr fandom in February of this year (my first fandom ever!). I think around that time, I was depressed. Undiagnosed, just going on the way I was feeling at the time. My unhappiness in my relationship was becoming more and more evident. I was SO disillusioned with people in my church that I thought I knew, completely shirking covid protocols, literally doing nothing to “love their neighbor”. No vax, no masks, no social distancing, large gatherings every week. Then I found out that they’d kicked a guy I knew off the hospitality team because he was openly gay. “You are welcome to attend here, but you can’t serve. You can’t be a face of the church.” So I had a loss of that entire community when I chose to leave for good (hadn’t set foot in the building since March 2020) and no longer associate with them. I am now on a deconstruction journey and I’m not really sure what I believe on that front, but I do know I can’t believe in a god that would send people to hell for who they love and whose followers won’t do the basic things to protect the vulnerable around them in the name of “freedom”. Choosing to walk away from that community was really hard for me even though I know in my soul it was the right thing to do. I’ve changed so much as a person over the last almost two years and I love this version of me so much more. This person loves humans more than outdated man-made traditions.

Believe me when I say, the Shameless fandom, all of YOU, are what have made this entire year bearable. Each of you has brought me so much joy. Even if my social anxiety has kept me from interacting more personally most of the time. Creating has brought me joy. I’d given up a lot of that creative part of myself over the last 16 years, basically my entire adult life. I had never written before and I’ve discovered that I love it, even if I’m not very good at it. Creating and enjoying all of your creations on this platform has been amazing and thought provoking and life changing for me. I live in a small, very un-diverse area of Appalachia. Everyone I’ve met on here of all walks of life, different countries and ethnicities, various sexualities and gender identities, mental illnesses, belief systems, all of it has broadened my horizons and I know has made me a better, more compassionate person. All of you have opened my eyes to the beautiful tapestry of humanity that exists in the world beyond the predominantly white, evangelical, conservative area in which I live. Along with Shameless, I also credit Schitt’s Creek and more recently Young Royals for broadening my horizons on love and sexual identity.

So. In 2022, I’m going to fucking LOVE the woman I am becoming better than I have ever loved her before. I’m going to keep creating content on here. I’m going to really try to get past “not knowing what to say” or worrying I’m not witty or clever enough to have conversations on here and interact with all of you lovely humans more. What I originally used as a coping mechanism, dissociating from what was going on around me, turned out to be a lifeline to who I was becoming over this past year. I can’t thank all of you enough. I’d love to tag everyone but there are literally dozens of you and I wouldn’t want to unintentionally leave anyone out. Many of you know who you are, but just know, if we’ve interacted at all on here, even as simple as we’ve reblogged something from one another, I appreciate you.

Here’s to 2022! I hope the year treats all of you amazing, beautiful people so well!❤️

[starr-fall-knight-rise]

Humans are Weird, “A Preoccupation with Death.”

Hope you enjoy :)

Analysis By Dr. Krill MD

Humanity’s preoccupation with death has always fascinated me: I say fascinated because to say that it disturbs me would be rather unscientific, and I have been attempting to reign in my anger… I have had some… complaints over the last year about the unprofessionalism of my previous papers. The GA community does not appreciate, and I quote, “Excessive swearing, and screaming” in virtual reports, so today I will attempt to be calm and relaxed as I explain to you, common human traditions based around death.

Now you must understand, from my perspective these practices are quite bizarre. Vrull have no rituals associated with death. The Vrull are disposed of and their bodies are incinerated. The ash is then disposed with by mixing into the soil to produce needed plants on the planet surface. There are no other options, and no other arrangements are made.

However, I am told that funeral rights with humans are, often, more to do with what the living need than what the deceased do. However, there are some funeral rights believed to be required in certain human cultures, so that rule does not always hold completely true.

I will begin from the moment of death.

Unlike the Vrull humans do not know their exact time of death. Granted this is not because the Vrull have a set clocking system in their bodies which sets the time in which we die, but because our society sets forth a time of our usefulness. No one knows how long a Vrull can feasibly live because no one has tried it before. I myself might plan on finding out, as I have no intention of returning for my scheduled termination, which is already a year overdue.

Humans, like most other species die in several different ways, accidents, sickness, or the sudden failure of the body due to old age, the final one generally happening peacefully and in their sleep.

However this is where humans tend to diverge from their inhuman counterparts, in that they are very social creatures, the death of a human is usually witnessed by multiple family members and friends, in the case of sickness, and is mourned many weeks after because the death of someone in your social circle changes that circle forever. Social bonds are cut and entire social lives are upended. Humans bond so heavily with each other that the loss of one of their own can lead to mental and emotional trauma extreme enough to require medication and hospitalization.

Humans plan their deaths months to years in advance. In certain instances, their jobs force them to plan their death in advance in case something were to happen. Decisions need to be made about who owns their property, where it goes, what happens to their dwellings, and how the surviving members of their family will be supported. Sometimes they plan this due to terminal illness which they knew will lead to their deaths, otherwise they might just do it out of precaution.

There are many different ways of disposing of a corpse. First of all, you must determine if any of the human parts are recyclable: this being the very morbid idea of taking someone else’s organs and giving them to another person. Now with the advancement of this technology, organ transplants from donors is not as common as it once was seeing as they can now 3D print organs. However, this method is not time effective and is very costly, in some cases leaving the harvesting of deceased human organs to be the only viable option.

Yes, they take organs from dead people… the doctor and surgeon in me admires that thought process, but the thinking breathing creature inside of me recoils heavily at the idea.

Assuming that no one requires your organs, or if you have especially requested for your organ not to be used  than there are other questions that need to be addressed. There are humans who have jobs especially in the business of taking care of dead bodies. They are generally moved in special containers and placed in refrigerated units to slow decomposition while the relatives determine what they want to do with the body.

In certain cases, where the death is suspicious, as related to murder, there are, in fact, humans who specilize in determining the cause and time of death based on the decomposition rate of a body and the stiffness of the flesh itself. This is a semi-common practice across the galaxy, and I myself have performed one or two autopsies since my professional career began though they are far more common for humans.

I find that the most humane method of human enterrement, and the one that makes most sense to me as a Vrull is the idea of cremation. The body is taken and placed in a furnace that is then heated enough to turn the body to ash leaving only bone fragments and the occasional mineral deposit. The ash may then be given to the family members or disposed of accordingly. Some humans find it comforting to keep the remains in some sort of container.... A fact which I find morbid but, we have proven in abundance that I find much of what humanity does, rather morbid.

It is only going to get worse.

The other method of disposal, popular through human history, however made someone obscure in recent centuries due to the proliferation of human burial sites…. The common north american and European Burial and funeral rights went as follows. After death, and freezing in the morgue, a special human with the job of mortician is called in to prepared the body for burial…. This is where it gets very morbid.

The body is drained of all of its fluids and then pumped full of preservatives to slow down the process of decomposition. The faces are then painted with makeup to give the corpse the appearance of sleep rather than death. The body is dressed in fine clothing and placed inside a coffin or casket: these in themselves can cost thousands of dollars as the family members decide what materials the box should be made out of and lined with, precious metals, woods like oak or steel, and the inside lined in velvet satin or silk. The body is placed inside with the person dressed in a finely tailored suit before a hearse: a special vehicle designed to carry caskets is brought to the place of mourning, generally a curch or a funeral home.

Many times the body is then put through a “viewing”.... It sounds just as bad as I make it seem, when the humans come in…. In large groups…. To stare at their dead relative. Just…. Stare at their rotting corpse before it is hauled away and lowered into an six foot hole in the earth. A decorative rock is then place on top of that inscribed with the deceased’s name so that everyone knows where to find their moldering corpse….

….

….

I am told this provides a lot of closure for family members, though I have yet to understand why staring at a painted corpse would be helpful.’

Unfortunately, with humans, this isn't the most gruesome method they have of corpse disposal, nor the most involved 

You may also chose to donate your body to science…

They might hand your bod over to a medical school, where aspiring doctors will, in groups, dissect your corpse slowly over an intervening few weeks or months. It is… gruesome, but a necessary part of the learning process. Your skeleton might even be recycled for use as a tool to demonstrate the skeletal structure to those very same students.

Perhaps your body will end up in a museum, where they will encase your nervous system in plaster and place it on a wall for school children and visiting day travelers to view.

Perhaps you might donate your body to…. A body farm. A palace where scientists will toss your corpse out into different elements to observe the rate and change of decomposition based on different dump sites. They will examine the decomposition, the moisture loss, and the bugs which take to eating your body. This research will then be used to determine the cause o death for other corpses disposed of by murderers or in similar fashion.

It is gruesome, but I suppose…. It is useful for scientific efforts.

These aren't the only methods of body disposal.

Bodies have been tied to the top of large towers

Thrown into the woods to be eaten by animals

Dumped into pits.

And in a couple of cases, launched into the vacuum of space.

Different rituals require family members to spend more or less time with the body, to wrap it in special cloth, or to anoint it with certain oils. 

The Egyptians were widely known for their complex and involved enterrement rituals commonly known as mummification.

The body was first embalmed

The brain was removed

The organs removed and placed in specialized canopic jars 

The body was then dried

Then wrapped which continued to help in the drying process 

Then the body was finally entered, and due to the sandy heat of the desert, the body was often preserved to a great and surprising degree. Egyptians believed that those things you had in life would come with you after death, and so egyptian rulers were entered with great riches and inside grand palaces 

Then of course there is the last ritual which I learned about just recently.

Certain tribal societies will….. Eat…. their dead….

They will eat them….

As in the entire village will get together and consume the corpse in a feast, believing that without this they cannot enter the afterlife.

…..

…

…

…

…

I am going to draft a proposal to the GASC that screaming and profanities should be considered scientifically appropriate when in regards to humans

[slasherholic]

a bit of a hot take but despite his obvious flaws I don’t agree with the narrative that sam loomis is a Hardcore Ableist and objectively the shittiest psychiatrist on planet earth. I think a more nuanced outlook on the character is possible.

if michael is mentally ill, then 1960s psychiatry would have been underequipped to treat his demonstrably very severe case. the field was lacking in simple experience; the therapies used to improve his (speculated) condition often didn’t produce lasting results. therefore, halloween from sam loomis’s perspective goes like this: he is assigned a child patient with symptoms of an extreme case of a notoriously difficult to treat disorder, then slapped with a time limit of 15 years to do his work by the criminal justice system, which also insists his patient grows up at an institute for the criminally insane.

picture a mental asylum from the sixties. that’s what we’re dealing with. there was no hope of michael being healthily socialized at a place like that. his doctor was set up to fail from the very beginning.

strictly going by the canon established in the original film, we are told loomis tried for eight years to improve michael’s condition, with zero results. nothing in the original canon contradicts this. still, the “blackest eyes” speech does seem to suggest loomis was perpetuating his “evil personified” narrative about michael from day one.

so why, if loomis has always seen his patient as a murder-machine that cannot be rehabilitated, did he try for the better part of a decade to treat him? why would he waste his time?

hint: probably because he didn’t always think of michael that way.

this is a man whose pride and confidence in his abilities as a doctor have been so demolished after years of consistent, overwhelming failure to improve his patient’s condition whatsoever, that the only way he can continue to live with himself is by adopting the mentality that michael cannot be treated, that he is a lost cause.

I am not defending loomis’s actions. there is no rational or ethical way to defend a doctor who deems his child patient “untreatable”. michael would have been only 14 when loomis threw in the towel. his actions are inexcusable.

but I also don’t see weight behind the claim that dr. loomis is an inherently wicked, bigoted person, instead of a person who did his best to exhaust the limited resources that were available to him, before succumbing to his very human flaws and slowly internalizing the only narrative that would salvage his dignity / ensure his failures didn’t get more people hurt.

it is easy to write sam loomis off as a plot device or a two-dimensional baddie. he can be more than that.

loomis may once have genuinely cared about michael. he may once have invested a great deal of energy to achieving a breakthrough with him, despite the bleak prognosis.

in sam loomis, I don’t see a man who hates his patient because of what his patient is; I see a man whose sympathy for his patient wrestled more and more every day with the growing fear that his own shortcomings might cost another life, until one day, the sympathy lost.

maybe the position of the latter character is just as flawed, but in another time, in a more compassionate era, preferably one that didn’t stick little kids in criminal mental institutions, michael’s case would have been very possible for loomis to treat.

tl:dr shitty 1960s psychiatry failed dr. loomis, too. sam is a highly flawed man but if michael deserves to be given depth then so does he.

real tldr; I have the right to headcanon that sometimes loomis drove mikey to the mcdonalds drive thru and bought him chicken nuggies

[scripttorture]

I have a weird scenario and i want to ask about its implications, mostly focusing on soliditary confinement aspects. So I am writing about this all powerful being who is immortal+eternally youthful (with a human like mind) who gets trapped in basically a big snowglobe created by his powers. Its a big mostly open space set inside a forest with a magic mansion to occupy him and provide him basic needs and the limits of the globe are very defined. {1/4}

{Weird anon} After some time alone he comes to create a friend to accompany him and make sure everything goes well during his absence using his powers. This friend can and does leave for periods of time to fullfill his duties but comes back. The being also realises during his imprisonment his powers dwindle with time and the globe starts to get smaller as he starts to age, meaning he will either die from old age or the globe shrinking. {2/4} {WA}After what he thinks must be a long time, his graying hair biggest indication, kids who knew about his legend come to discover him. They then bring him their older sibling, then their parents to talk and after some plot he gets to get some of his powers back and be free. (Posting my questions in the last part) {3/4} {WA} I was wondering if the confinement area being comfy and big, him having this friend would help during confinement? How could he react to aging/idea of dying? Although this isnt very possible in RL, could the fact he had to create this friend ,but mostly the fact he would have no one else if he didnt, get to him? How could he interract with kids/people who found him, i know people tend to have difficulty with interractions after time. Ty for your help! {4/4} {WA EXTRA} Forgot to mention these but 3 kids are 10 to 12, older sibling is 14-15, parents are mid thirties . Again, thank you for your time.

-

That’s an interesting fantasy scenario (and not even close to the weirdest thing I’ve been asked) thank you for sharing it :)

 I think the first thing to grasp is that this character isn’t constantly in solitary confinement here and that’s a smart writing choice. You’ve got the character creating at least one companion and even though that companion isn’t always present that means it’s likely they’re both getting at least 1-2 hours of contact most of the time.

 That doesn’t mean this isn’t a stressful situation and it doesn’t mean there are no periods of solitary confinement.

 But it gives you leeway to make the effects of this fairly realistic even with the fantasy concept.

 Having a big, comfortable space doesn’t really make a difference to how well people deal with isolation. Socialising is a physical need for social species like humans. But the presence of a companion makes the world of difference.

 I think the first thing to decide is exactly how long it takes him to make his companion. A lot of people really overestimate the time we can withstand isolation.

 For reference the safe period is about a week. After that most people will start to show symptoms and the symptoms are a lot more likely to persist after release. A month is more then enough time for the character to be seriously effected. A year is a really extreme amount of time. And by the time you start getting to multiple years the chances of suicide attempts are… significant.

 With the kind of story you’re describing I get the impression you want long term effects but don’t want symptoms etc to take over the story. I think 1-3 months is a perfect time frame for that. The character would develop long term symptoms but it’s still in the realm where it’s survivable. Which means it’s less likely to take over the whole narrative.

 You’ve probably seen my masterpost on solitary confinement but here it is again just in case :) I really recommend Shalev’s Sourcebook on Solitary Confinement which is linked as one of the sources on the post.

 As with the symptoms of torture more generally you’ve got some scope to choose symptoms because not everyone will experience every single symptom. There’s still some debate about how common individual symptoms are. However broadly depression and anxiety seem to be very common and hallucinations are less common (though they seem to become more likely the longer someone is confined). It’s a good idea to pick a mix of physical and psychological symptoms.

 If you choose insomnia as a symptom remember that sleep deprivation also causes problems which you can read about in the masterpost here.

 If this is your first time writing something like this then picking out symptoms can be daunting. I try to think of it in terms of what adds to the story. I try to consider the characters, plot and overall themes. Symptoms that give you opportunities to show aspects of the character’s personality, change their relationship with other characters, highlight themes in the story and/or create interesting problems in the plot later on are all good picks.

 It’s also important to consider what you’re comfortable writing and what you feel able to write. If you don’t want to write self harm for example that’s a perfectly good reason for ruling out that symptom.

 I have a post that outlines my process for picking symptoms that might be helpful for you. :)

 I think that brings us round to the more fantasy side of the questions.

 I’ll be honest and say that I don’t know how people generally deal with the idea that they’re going to die soon. I suspect that there’d be a lot of individual variation. I think you’ll get the best answers by looking up charities that support people with terminal illnesses.

 I found a couple of links at Marie Curie that might serve as a starting point. There’s this page on palliative care. This general page (with lots of links and first hand accounts) of living with a terminal illness. You might find this page about emotionally processing a terminal diagnosis helpful.

 I would treat the emotional issues around the created companion the same as a character who is reliant on only one person for their social needs. Which can put a lot of weird strains on a relationship.

 I’m not a psychologist and what I say here is based on impressions I gained from interviews with people who are very isolated. If you see a mental health professional or someone who studies isolation more seriously saying something different take their word over mine. Because my reading and knowledge is broad rather then deep.

 Relying on one person for all your social needs isn’t healthy. We all have different needs and it’s a lot easier for those needs to be met when we’re interacting with more then one person. Being entirely reliant on one person puts a lot of pressure on that person. It can make it seem like any problems or issues the more isolated person has are the other person’s fault.

 Because they’re not magically meeting all of someone’s needs. And I say ‘magically’ because it’s almost impossible for one person to do the ‘job’ of a dozen people.

 There can be a lot of guilt, resentment and anger floating around in this sort of dependant relationship. Even when both parties are genuinely trying their best and trying to be healthy.

 Any depressive period or severe mood swing on the part of the reliant character might be interpreted as failure by the companion. As if it’s their job to ‘fix’ the mental health problems he has. And that can lead to a lot of internalised guilt and shame.

 Conversely being aware of how dependant he is could make the confined character resent the comparative freedom of his companion. They get to leave. They’ll survive the end of this snow-globe. They’ve never had to be alone as he was.

 The companion has a lot of power in this scenario because the confined character is entirely reliant on them. They also have the power to leave. Knowing that can breed resentment, whether it’s rational or not. And if it’s irrational and ‘undeserved’ that can lead to a degree of self hatred and guilt.

 For both parties anger at each other and the situation seems likely. Not necessarily all the time but I think it’s likely to come up over and over again.

 The companion has their own desires and wants. But the confined character is entirely dependant on them and may well expect them to drop everything to help him/meet his socialisation needs. And the thing is that’s unfair on both of them, because the situation is unfair.

 That’s not a critique of the story. It’s unfair for the confined character to expect the companion to be able to meet all his needs and to drop everything to help him. But it’s also not unreasonable for the confined character to grasp at his only option for fulfilling a fundamental need.

 I think that if you wanted to treat this ‘realistically’ then it would lead to a pretty unhealthy co-dependant relationship however much both characters tried to avoid that.

 But you do have the ability to reduce or avoid that in your story. Because you choose the rules for how this companion feels, acts and behaves.

 The confined character may be human-like but in a lot of ways the companion does not have to be. A realistic human-like person would not be able to support all the social needs of another person. But there’s no reason the companion has to be that human.

 If you do choose to deviate from a more human-like character I think my advice would be to think through any changes you make logically. And be consistent. If for instance the character can’t feel angry or resentful towards their creator think through what that might mean.

 Which leaves the final question about interacting with others and how difficult that can be after periods of isolation.

 The exact way this effects interactions depends chiefly on the symptoms you pick out and the character’s personality.

 Generally mentally ill people do not want to be assholes or upset other people. But we do tend to have greater difficulties interacting with people and our social interactions can go badly in ways that healthy people don’t tend to experience.

 For instance say we have a character who has a severe anxiety disorder and this disorder is often set off by noises they don’t expect. That’s a fairly common symptom and a fairly common trigger for it.

 That means that kids running around, shouting or just talking loudly about something that excites them, could set off an anxiety attack.

 Some people would get angry in that situation. Because they’re in pain and, even though they did not mean to, those kids ‘caused’ that pain.

 Some people would abruptly remove themselves from the situation. Which could leave the kids wondering why/how they upset their new friend so much.

 Some people would stick around and not blame the kids. But they might have visible signs of their anxiety attack that could be very frightening for a child who doesn’t understand what’s going on. If an adult they care about suddenly starts shaking and breathing hard and needs to sit down and looks pale- Well worry is natural. And it’s difficult to explain triggers/mental health problems while you’re in the middle of an anxiety attack.

 So there’s a set of issues that are symptom driven and around the extra difficulties interacting while mentally ill. There’s also a set of issues around… basically forgetting how to socialise.

 This doesn’t necessarily mean being age in-appropriate.

 I think the best way to think about it is a combination of finding it harder to interpret other people’s emotional cues and being less aware of the cues they’re sending out themselves. It might take longer for the character to realise they’ve upset someone or they might misidentify the other person’s emotional response.

 They might also think less before they speak. Which can mean things like- I guess not moderating what they say to account for other people’s feelings? They might come across as blunt or thoughtless or scatter brained as they jump from one topic to another. They might also have less of a grasp of when to give the other person space and let them speak.

 The biggest thing I see survivors of solitary report is that normal social interaction makes them much more anxious/nervous then it did before they were confined. Socialising has a bigger ‘cost’ then before, in terms of energy and emotional impact.

 And this often means they withdraw from it more quickly. They need to take breaks. Or they start getting more stressed and frustrated.

 I think the main thing to navigate here would be how to explain these conditions and needs to children in a way that doesn’t seem like it’s blaming the kids. Which is certainly possible, but can take some time and care to get right.

 I think I’ll leave it there and if you’ve got any further questions drop them in when the ask box reopens. I hope that helps :)

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[benchgenderstudies]

Busting Dr Cynthia Buliks Injurious Revisionism of Anorexia and Eating Disorders.

By Michael Bench, MEP, WGSGC

1.Can you tell who has eating disorders?

Cynthia says “no”.

Actual Answer: Yes.

Starvation effects are observable and anorexia is cosmetic starvation. Those females with an early eating disorder (EDNOS) or using Anorexic behaviors should be addressed and reported to school staff or counseling for their safety; Crash Dieting is disordered eating even if not a diagnosis and is part of a larger social problem of aversions to patient and honest physical conditioning. Crash diets are the tools of lushes. The very lushes that publish female targeted media promoting cleanses and ‘quick fix tips’.  Medical and health advice, if from a document, should only come from academic journals. 

2.Are mothers to blame:

Cynthia says no.

Actual Answer: Often

Mothers who have seasonal weight control efforts and use crash diets to cheat their way to a 'beach body” are modeling disordered eating. Crash diets are disordered eating. Mothers involved with pageants have also been known to use other methods like infecting their daughters with tapeworms to reach a desired thinness.

3.Are families to blame?

Cynthia says no.

Actual Answer:Yes.Situationally.

Involvement with sport, social or classist activities that prioritize gender roles before sport itself is a complicity to eating disorders and body dysmorphia. A parent who willingly lets an industry or coach alter her child’s course of physical maturity is actively neglecting their child no matter what the presumed benefits.  Families also normalize some seasonal classism, poor nutritional behavior, and poor communication that can be seen in children using anorexic trope behavior and insincere-suicidal attention getting. Mothers who believe their daughters should be paying attention to female targeted fashion media and other retail or pop culture are poorly guarding their children.

4.Is society to Blame? (Far too general. Go home Cynthia.)

Actual Answers: Media is to blame partly in that it protects its advertisers exploitation and revisionism of need/want psychology. Media also forwards health talking points for the unhealthy. The term “weight control” for example is an index case of tolerating a slothful deviant-leisure society who cheat their way to “good looks” simply for summer exhibition. Then they return indoors for winter with their indoor sloth and lazy nutritional rituals.

Coaching & Fashion: Females are not males. Training them as males or believing diet is a form of genetic engineering is magical thinking that can injure the athletes. Instead, minimum ages in sport should be raised so children in gymnastics ,for example, are not used as carnival acts. Lacking a period, a females maturity/fill out has not been “stalled”. She is amenorrheic whether with or without a visible menarche; an event itself that’s been postponed. Females cannot sustain low BMI male thinness to appear his heterosexual-binary-other. In fashion , the binary roles are actually the same , only at smaller emaciated sizes and not androgynous as reported. Fashionistas who take their model's health for granted as an act of 'luxury artification” are long guilty of endangering her health/assault , among other violations like complicit child trafficking  (Set aside whether the female volunteers the risk, the runway’s terms are decided by the foolish and nihilist cosmosexuals having very little competence about human physiology. Respecting ‘who we are” ,eh?) Females normalizing anorexic/disordered eating as a justification of their (model) career or fame are themselves a microphone for social blame. 

5.Are Anorexia and Eating disorders a White race problem/Female problem.

Actual Answer: Yes.

The democratization of Western and American market views of ideal beauty and ideal sexuality has not changed the core source of toxic constructions of binary gender. The manipulation of the female body to conform to eras if disinformation and beauty trends, ie Gibson girl and the Heroin Chic waif, show that 'disordered eating' and its long term effects are practiced as luxury fads. Actual mental disorders escalated to Anorexia Nervosa or Bulimia Nervosa stem from European and South Asian religio-social pacts of personal virtue(Breatherism/Inedia). Ever since the first London and American reports of Inedia or fad fasting the practicioners lied about how little they ate. Anorexia, breatherism and inedia have always been appropriate religious rituals used by desperate zealots for attention.. The vulnerability to this sort of radicalization around fasting links to psychological vulnerability and distortions of their self  (a specific form narcissistic personality disorder)

6. Consider the remainder of her list debunked.>>(will add the rest later)

>>Anorexia is NOT A CASH COW.

If researchers want to do genomics research, have at.   Anorexia itself has provably been found occurring as fads. If the 'formal' uppity journal community don’t have the courage to admit mental illness can be market caused and that the external sphere of society can be toxic..  it is their own failure to confront it and demand regulation. Gibson Girl, Heroin Chic, and proana ‘lifestyle’, are fads whose females are too often seen as ‘victims’ of a male privilege error rather instead their own stubborn choices and long term effects there of : I reject the notion Anorexia should be tolerated as a go-to for researchers that simply need grant money and repudiate those that attempted to distract its identity. The democratization of Anorexia as ‘everyone’s disease’ leads me to be highly suspicious of Buliks motivations as a professional  and what diet/pharm companies are handing her NCEEDUS checks. 

“ Aye , I hear you was gonna go on a crash diet. You dont wanna be one of those wanna bes..  A real crash diet , ya cut your own brake cables , go for a drive on elevated roads and see how many cliffs you can climb back up from.”

What is Anorexia Nervosa:

Behaviors of Disordered Eating are not themselves the source of the problem. All persons using crash diet and anorexic symptom behaviors however should be considered ‘eating disordered”.  Anorexic behaviors are actions of solving a problem the subject appears to suffer even if originally having a healthy proportioned body.  Current research suggests that between 3-10 exposures to any message makes an audience more willing to oblige and 'know' its message. This also means a female convinced that eternal youth is where she must rest her physical body to be beautiful is not technically a mental disorder yet. In the struggle to keep her body looking prepubescent the damages of malnutrition and gray matter deterioration lead to distortions of thought. These distortions then create  new symptoms, unoriginal symptoms that are signs of a narcissistic depression and helplessness.

Starting at that point for internal pathology....

If Anorexia is a mental illness aside from market learning then it must be recognized a problem of extreme dissatisfaction with the self that has escalated.  Anorexia Nervosa , or the most extreme form of cosmetic starvation is then to be recognized : A narcissistic depression formed from the conflict or inability to adapt to adolescent body changes. Social messages denouncing the mature female body and independence may solidify these formerly inert cautions. Further, body changes of the teen are used by marketers to embarrass and humiliate the teen for imperfections; a classic 'witch hunt' scenario of threatening the girl with being burnt at the stake for not being a sexual object. The anorexic is faced with that environment daily; an environment where she has no choice to identify as an adolescent among peers and media , whether she’s ready to adapt or not. There is a clear ‘at adolescence trigger” that points to an adaptation difficulty in a soup of marketing that denounces the aged female as roast beef, spent, junk in the trunk and other negativity. The Youngest females.. healthy or by pathology would have a difficult time concluding what is good about being female when the unhealthy deposition of fat at the waist and hips is normal for her maturity.  That is mainly due to problems in the fitness community media leaving no appreciation for fitness itself. Magazine imagery is purely body sculpted or body building.. actual athletic conditioning with the time allotment it requires. 

 I am also referring to Anorexia as a form of Gender Dysphoia who's conflicted social and internal views of teen maturity can lead to traumatized states.  This should not leave room for stable anorexics or unstable females to characterize the adoption of their injurious methods for 'an in-crowd” elitism.

Anorexia Nervosa and its less severe 'eating disorders..  should actually be called #BodyDysmorphicSIBDieting ( Self Injurious Behavior-Dieting)..It includes caloric restriction, multiple stimulant abuse, dissociative abuse and abuse of prescribed medicines,  poor choices in recovery foods which adds to their narcissistic shaming. Pro Ana websites and groups must be understood part of the symptom of a sociopathic “narcissism supply”. Because Anorexia is so well known, applying its known traits can mimic actual anorexics but these body dissatisfied people are factitious disorder candidates. (they are still disordered and mentally unwell. Thereby groups calling themselves pro Ana that taunt new members as ‘wannabes’ are not doing their job as a support group; Support groups and other health resources pages welcome members  and hope to spread positiivity. Instead pro ana sites often feature a core group functioning as an exclusive cliq who give merit to the identity of ANOREXICS as it surrounds her; the actual board member is of no consequence. The Pro Ana board is an active process of denial/bargaining by making their narcissist affliction sound positive and trendy.

In no way should statements of recovery or links on these proana sites be presumed to be safe.  Anorexia Nervosa is technically an umbrella term for three or more groups necessitating 'shortcutting dieting techniques” to achieve a desireable body. One is truly a mental illness of its own, another is a sociopathic illness that has adopted anorexic traits for its factitious parading.. but is also as serious. Also be mindful that persons starting pro anorexic boards might also be sadists and psychopaths who find artificial arousal in providing a place for harm.  All persons utilizing starvation and self abuse for an undisciplined 'thinspired body” are all heading to the same fatal end; including fashion models. Anorexia in name, in diagnosis, or in method IS STILL ANOREXIA. A refusal of recovery and presumption that anorexia is a lifestyle in name , point to a group still in denial that their practices are injurious. Denial of self failure/deception is one narcissist flaw even if the personality disorder symptoms dont apply to the factitious supplicants 

Third is a general category of body dissatisfied females who use encourage each other with SIB Diet techniques rather than actually go to a gym and perform both cardio AND resistance-exercise-for-STRENGTH.. which will infact lead to hypertrophy and better metabolism. This third group is often heckled by the others as fakers and wannarexics. In fact it is the other two groups proving the sociopathic tendencies of their guilt being made manifest on others. Since they cannot empathize, they neither should be empathized. Those yelling 'wannarexics” can be considered social trash and treated accordingly. A combined trait among all 'anorexics' is they mistake strength as an inside characteristic to excuse responsible self conditioning. .. or to justify their fears lifiting weights .. as a behavior is too masculinity  defining.  Her ego exploits her physical body and the body at times will take back such time to demand fueling.  It is then rightful the ego feels shame but not for eating .. rather for the fasting that causes binging in excess of regular fueling of activity.  This singular matter has a strong motivation to be fatally thin and is their excuse to avoid most legitimate forms of  balanced physical conditioning. The thinness is of no consequence. Those who intend to crash diet their way to a perfect body will eventually succumb to the cheapness of their diets. There is no diet that achieve what physical benefits come from physical conditioning. Research addressing diet as more important than exercise in weight control addresses a foolish society terrible at both.   MB.

[magneticmage]

I'm in the mood for it (plus it's Disability Pride month) so here are all my disabled ocs;

Under cut for Length

Additional Notes; Please do not judge me too harshly. While I have a few of these disabilities (most notably PTSD, anxiety-depression, and visual impairments) myself and personally know people who have some others, every person and their experiences are unique. I try my best to give these disabilities the space and gravity they deserve in my writing, but it is difficult for ones that I have no personal experience with. In addition, I am still learning and only human. If I have done something wrong or phrased something badly at any point now or in the future, let me know and I will do my best to fix it/do better. Apologies for the abrupt disclaimer but there we go.

Anyways!!!!

On the the List!

RWBY;

Selene Argent=Has PTSD, one prosthetic eye, and some physical scars on face and torso. I'd safely say she counts.

Baldur's Gate;

Sable Shades=Is an albino and was rendered mute at birth. He sunburns extremely easily and is near-sighted. He also often communicates through sign language.

Roan Roarke=Beyond some minor PTSD symptoms (increased anxiety and stress levels) surrounding fires, he's perfectly fine.

Faenerys Elendir=Has PTSD from her time imprisoned particular involving whips and brands as torture implements.

Rune Mistsea=Post-lycanthropy encounter, he is notably more short-tempered around the full moon along with a distinct craving for meat and violence. Otherwise, nothing else of note.

Lucine Mistsea=Beyond a notable paranoia issue when it comes to demons and cambions (but not fellow tieflings), she's fine.

Lyr(e/a/an) Lovemoor=Autistic. Too much light and noise and surrounding activity is draining and makes them short-tempered with occasional blowouts/meltdowns. Has a Thing about certain textures (very much hates slimes and oozes and squishy things for this reason, likes silks and furs and leathers). Has a fascination for all things shiny and glittery (gems and currencies are a special interest). Also often fidgets with their daggers.

Saga Musehart=Was rendered blind due to torture at the hands of prison guards. She also lost a hand (initially) and a forearm (later due to infection) and wears a prosthesis.

Cei Gloomdraft=Autistic or at least neurodivergent of some kind. Might have some ADHD, it's not quite clear yet in the few pieces I've written so far to help develop her.

Mass Effect;

(Solo Shepard Canon)

Annette Shepard=Has some lingering PTSD symptoms from surviving a raid on Mindoir, then thresher maws in Akuze, and then being spaced at the beginning in Mass Effect 2. She also suffers from some survivor's guilt Post-Virmire due to losing Ashley, and then all of Mass Effect 3 puts such a huge burden on her that she's fighting off some severe depression and despair from all the losses. She's got an old war injury in her shoulder that acts up from time to time, occasionally making her biotics misfire a barrier. She's on immuno-suppressant drugs to prevent her body from rejecting her Cerberus-added cybernetic implants and upgrades, and also some antidepressants for depression and anxiety symptoms for said lingering PTSD symptoms. Girl's a walking disaster-fire mentally but she keeps on surviving and she still looks for the good in life as it comes, so there's that.

(Shepard Siblings)

Joanna=Like Roscoe and Riley, she's also on immuno-suppressants to prevent cybernetic implant rejection. Notably, she's the most well-adjusted of the three mentally, although the losses and struggles of ME 3 start to take their toll due to depression. She spends an awkward month on the Normandy adjusting to the new medication while adjusting the amounts needed. In addition, she also goes through a whole existential crisis come the Citadel DLC about if she is really Joanna Shepard or a clone (which Riley, Roscoe, and the Normandy crew snap her out of). Her survivor's guilt is much less pronounced than Riley's though she does start the early stages of a martyr complex (it's a source of frequent and well-humored debate between Riley and Roscoe if it was already there or not) about the of Thane's death. But she does her best and keeps on going.

Roscoe=Definitely mentally ill. He's got some trauma around abandonment that starts to get fully addressed around ME 2 in part due to Jack and Miranda and is mostly resolved around ME 3 though naturally scars remain. It often manifests as anger, depression, and even callousness. Like Joanna's and Riley, he is on immuno-suppressants to prevent the potential rejection of his cybernetics. He's also got an old wound from Torfan in his abdomen that acts up under stronger pressures like before a rainstorm or different gravity levels as well as drastic temperature changes such as cold (he HATES Noveria for that reason in particular though it isn't the only one, man). Beyond all that, he's very strong-willed and gives no fucks to shit.

Riley=Much like Annette except a bit more well-adjusted due to a larger support network and character drive. Has notable flashbacks/triggers around batarians, thresher maws (this one includes panic attacks once the direct danger has passed), and hardsuit complications (they always makes sure that their helmet and everything is in working and optimal order). Has survivor's guilt from their losses on Mindoir and Akuze but between meeting Talitha and Toombs in ME 1, they confront and deal with it, beginning to heal from it. Even on Virmire with the loss of Honora and all the failures of ME 3, they do better at handling it though it still remains to varying degrees. Like Joanna's and Roscoe (and Annette again), they're on immuno-suppressant drugs to prevent issues with their body rejecting the cybernetics, with the additional ones of antidepressants to help manage some of their anxiety-depression symptoms. They also have some degree of chronic pain (maybe some kind of cystic fibrosis?) due to past overuse of their biotics that damaged part of their nervous system and occasionally causes it to misfire for no reason, often causing intense pain. Rarely and only if the pain isn't treated with extensive biotics-free rest periods and numbing agents in the form of more pills, the biotics will manifest and they'll accidentally move shit around, including themself a few times. This is most notable in ME 3 due to the nature of the larger and longer combat sequences with shorter and shorter rest times between. Though they manage as best they can with the help of their crew and family, it is still a struggle and they notably stop joking about retiring when they're dead and seem to consider it more seriously around ME 3 but save the final decision for the end of the Reaper Wars.

(Shepard Family)

Honora Hartford=She had an eating disorder when she was younger that left some lingering issues with her health but overall she's fine up until her death.

Riley's deceased siblings were overall healthy though Payton had Down's Syndrome and Brooklyn had ADHD. Harley had moderate asthma and used an inhaler.

Clover has anemia quite often and takes iron pills daily

The rest of the Shepard cousins don't have any disabilities to much knowledge though I am still fleshing them out.

(Andromeda)

Sara and Scott Ryder have some lingering damage from their cryopod accident and the Kett leader fucking with them, but otherwise they are okay.

Asher has ADHD while Shiloh struggles with a mild form of chronic fatigue. Evander, Rebecca, and Lucas are all able-bodied.

Dragon Age;

(Fereldan Wardens)

Lynera Mahariel=Dunno if this counts, but am putting it here anyways since it affects her overall health. Occasionally suffers from a type of sleep paralysis that is mixed with night-terrors. It doesn't appear to have a rhyme or reason as to when it occurs beyond perhaps stress and it's only every few months. However, it often leaves her completely drained for at least a week afterwards. She also occasionally has insomnia post-terrors as well which she self-medicates with sleeping draughts. She also has crippling period pains that appear to be consistent with ovarian cysts on her left side (though she later has it removed by Catriona once it ruptures due to injury). She also suffers from bouts of depression during Origins but that could be due to the extenuating circumstances she was under at the time.

Isemaya Tabris=When overly stressed, being exposed to strong amounts of concentrated Taint in a short period of time, or sometimes simply for no apparent reason, she suffers from intense migraines that are often treated with herbal painkillers and lying still in a dark and quiet room. Also due to a past injury to her left eye by humans, she has a harder time seeing on that side but is not completely blind.

Catriona Surana=She seems to be autistic due to her ability and predilection to hyperfocus on various studies (often Blight and magic-related but other areas do occur) as well as her obliviousness to social cues (she didn't realize she was liked by her suitors until Cale outright told her and by then she had decided she liked them already). Notably, she adapts a bit better Post-Origins due to Alistair and Leliana's influences but it still happens.

Cale Amell=Had some minor amnesia surrounding the exact events leading to his magic manifestation but later learned it was because he had set his eldest brother Azul on fire and believed he killed him as Raven helpfully supplied (Azul had instead faked his death as Cale discovers around the time of Awakening).

Fion Cousland=Briefly suffers from a minor alcohol addiction but has treatment while he is still in the functional phase courtesy of Catriona. Since then, he heavily monitors his intake and even helps Oghren get treatment for his own. He also occasionally has painful muscle twinges due to an injury that stretches from his temple to his eye and ear down to his neck on the right side. This is most notable in bad weather or when he is sick.

Barran Aeducan=Suffered from a superiority-inferiority complex towards his siblings growing up though it has greatly lessened with time and experience. It is mostly gone by the time of Inquisition though prominent traces still remain.

Tatha Brosca=She is hard of hearing and has manged to cope by learning to lip-read (not always successful, however, especially with languages she is not familiar with) in Origins and a pair of hearing "horns" designed for her by an admiring Smith caste man by Awakening. She often jokes that now she has even more in common with her Bronto companion, Salroka, due to their shared horns.

(Origins)

Vireth Mahariel=Suffers from epilepsy and often treats it with various herbal remedies, though it is not completely effective and large amounts of intense stress on his body make it worse. He also begins to develop cataracts around the time of Act 2 of Dragon Age 2, though the cause is unknown (presumed genetics or simply age at the moment).

Elthorn Tabris=Has a stutter speech impediment.

Alaros Surana=Unknown at the moment as I haven't written too much about him.

The Amell Siblings=Probably doesn't count but Azul gets motion sickness, especially on boats. Raven, Carmine, and Reed are all perfectly healthy and fine, however the latter two are the ones I've written least at the moment. Marigold has asthma that she treats with herbs.

Aelynne Cousland=Nothing comes to mind. She does have some old injuries (mentally and physically) she acquired from the attack on Highever by Arl Howe that color her later interactions with the family during the Fereldan Civil War.

Valda Aeducan=Has a notable visual impairment that is corrected with glasses, albeit there is nothing to be done for her slight colorblindness (she has a hard type distinguishing between greys, greens, and blues).

(Orlesian Wardens)

Dion Caron=Suffers from sleep apnea that is eased by a special breathing herbal-incense infused mask he wears as well as whomever in his group is on watch to check on him periodically to ensure he still breathes (most often this is either Victoire-Ainsley or Garam). He also snores and coughs due to this. Loudly.

Victoire-Ainsley Caron=Nothing of note.

Isenna Andras=She's an albino and so burns and rashes in intense light and heat. She also has a lame leg that cannot be fixed with magic and so wears a reinforced brace to aid her walk. This creates a noticeable limp.

Garam Kader=Alcohol makes him sick and he suffered from intense gender dysphoria before paying a huge sum to have an ex-Tevinter magister turned fellow Warden help him transition.

(Hawkes)

Jasper, Skye, and Violet Hawke are perfectly healthy. Albeit with some diet restrictions due to various allergies.

Gray Hawke=He is diabetic and so often has to monitor his energy levels to ensure his health. It's part of the reason he doesn't actively endanger his life like his siblings (not that he won't, just less often in comparison). He acquires a truly impressive diet regime and treatment plan upon becoming a nobleman of the Amell family, allowing him much more freedom than before.

(Marquises)

Aurore and Marcel de Serault both suffer from mild hemophilia. Marcel also has a lyrium drug addiction he is trying to break (and is actually doing quite well via weaning himself off it) due to a brief stint as a Templar while serving the Chantry.

(Inquisitors)

Armashok Adaar=Poor eyesight that cannot be fully corrected by glasses and later loses an arm due to the Anchor. He also lost a few fingers and some right hand mobility due to pre-nquisition injuries as a mercenary. He also wears a brace on his left shoulder. He wears a prosthetic eye and replacement arm.

Ransley Trevelyan=Like Cullen, he is working on breaking his own lyrium addiction from his time as a Templar and, like the other Inquisitors, loses his arm due to the Anchor. He had it replaced with a prosthetic arm for his shield side.

Paeriel Lavellan=She loses an arm alongside all the other Inquisitors, but takes the loss much harsher due to her archery skills suffering. While she will wear a prosthesis in battle or when hunting, she doesn't wear it in her day-to-day life, instead preferring to make due as needed. She also has anxiety.

Naranka Cadash=She loses her Anchor-wielding arm and gains a crossbow-and-dagger prosthetic one courtesy of her Inner Circle, much to her delight. She also suffers from some damage to her reproductive tract due to past injuries and is uncertain if she could have children.

(Inner Circle)

Kara Adaar=Beyond an intense hatred of slavery due to being kidnapped and almost sold when she was younger before being rescued by her father, she's perfectly healthy. She does require bedrest for her periods though.

Emilyse Trevelyan=She suffers from some PTSD from her abuse at Templar hands in the Circle, though she begins to recover towards the end of Inquisition.

Samrel Lavellan=Has dyslexia and uses reading aids and memory devices.

Pyrmar Cadash=He might have some PTSD from his Carta days due to a notable cave-in that lasted for a few days before his rescue.

[reveraine]

Social Distancing and Increased Paranoia

I want to preface this by saying I am not a psychologist (and anyone who is better versed in dealing with these issues, please feel free to add or straight call out errors). This is mostly based on some research I’ve done recently and some really frustrating experiences with family members.

We all have one. That family member or friend who seems to have jumped off the deep end. Who suddenly watches Fox religiously and cites more wild conspiracy theories than The National Enquirer’s monthly special. It hurts. It’s disheartening. It’s scary. Especially if that person seemed completely rational last time you talked to them in 2019, and you know that they are capable of behaving rationally.

I have been struggling with this concept for months now. Why is my usually rational relative suddenly touting conspiracy theories and flailing like the government is specifically out to get them? What changed? Was it really just Trump? Has QAnons reach really spread so far? Were they always secret members of fringe subcultures and are only just now showing it? Likely, the answer to all of these is no(or not to this extent). The biggest difference has been social isolation. 

Most of the people I personally know who have just flabbergasted me with how rapidly their understanding of the world has devolved into full-blown paranoia have several things in common:

1. They live alone or are alone 80+% of the time. They are either retired, unemployed, or spend so much time commuting that they spend long hours without meaningful human contact. 2. They often have an existing mistrust in the establishment (government, religion, banks, corporations etc). This mistrust may have seemed reasonable, or had some sort of logic behind it until recently (or not. I have a few relatives who have never made much sense) I have also known several of these people to be of a very “off-the-grid” mindset. Even if they don’t have the means or time to do so, they research it thoroughly; not in a way that says “I just want to be self-sufficient and eat well and be close to nature”, but rather, “I have to protect myself from (insert establishment or unlikely catastrophe here)”. 

This sent me to researching what causes paranoia. As it turns out, multiple studies have shown to indicate that loneliness has a very strong correlation with paranoia. As loneliness levels in individuals rise, so does their paranoia, and vide-versa.  These studies do not yet explain why paranoia and loneliness are tied together, but all studies found similar results. This does not mean that everyone who is lonely is paranoid, only that the likelihood goes up. So, your lovely Aunt Susan who suddenly started posting “news” articles about how all American Politicians are actually secret Russian Sleeper Agents could literally be suffering from a crisis of mental illness that no one is seeing. It is so hard to look past the results of paranoia, especially when it is obviously ridiculous to a brain that is not suffering from paranoia. But writing off these people and refusing to speak to them will only make this issue worse.

That being said, take care of yourself first. If you have the energy to give Aunt Susan a call, it may help her a great deal; but that call needs to be intentional. Letting them spout their paranoia at you likely will not help either of you(although if they are calm enough to truly discuss the ideas, this may actually help), and arguing with them will make it worse. 

Instead, try these things:

Be empathetic. It is likely their brain is suffering and they can’t think logically and are scared. Let them know you understand they are scared. If the things they are thinking about were true, we would all be scared. You can validate their feelings without validating the paranoia itself.

Encourage them to have more frequent social time. Are there other people you know who are in a good state of mind who can band together to make sure Aunt Susan talks to at least one person every day? 

Try changing topics, avoid current events, the news, taxes, etc. Anything that might set them off. Instead, maybe talk about a novel you recently read, or how much you love that spring is coming and the flowers will be out. If they try to swing back to conspiracies, try saying something like “I’ve had kind of a rough day and would like to talk about things that make me happy; I know you are scared about these things, but I think some positive thinking would be good for both of us.” If you do feel the need or the opening to try to correct their paranoia, it has to be very gentle. Any force and they will likely shut-down, believing that you are also trying to deceive them. This is the hardest part for me, but I’ve seen it work in deescalating the situation (but I know that the person I was speaking with trusted me very much, which may be the difference between success and failure). Gently, but firmly tell them how you see the issue. Use “I” statements. I feel, I think etc. 

Even suffering from paranoia is not an excuse for someone to abuse you. It does not excuse their actions or words towards you or someone else. It is only a possible explanation for their behavior, and offers a different way of looking at them. It is likely that a year ago, Aunt Susan never would have believed anything she has posted in the last 9 months. It is possible that social isolation has broken her brain. It is possible that she is not willfully ignorant or only seeing what she wants to see because she wants to see it, but rather that she is only seeing what she is seeing because she is sick. She needs help, not dismissal and further isolation. You don’t have to be the one to help her, especially if you are not in a place to do so emotionally, physically, or financially; but don’t assume the worst of her either. 

[oleanderblume]

Okay more spinel

Because her character is cool and I like her.

So let's get on with this.

I know a shut ton of people heavily relate to spinel because she has an ostensibly relatable backstory, but also because she represents BPD to a rather miraculous extent. And I am in the mood to explain WHY.

So, when a lot and I mean majority neurotypical folks hear of BPD they think "this person is abusive and dangerous" obviously that's not always the case, the ironic contrast I have been seeing is that despite spinel's character typing, people are falling head over heals for her while at the same time; if faced with someone who actually does have BPD they would probably feel threatened by them. More on that later.

Anyways, how does BPD work? Why is spinel a decent example for someone with bpd?

Bpd or borderline personality disorder is a trauma based disorder characterized by extreme paranoia, fear of abandonment, social withdrawal or lashing out, excessive emotional eruption (feeling everything very loudly and all at once, but only short periods of time), general lack of identity and purpose, and spiraling among other things.

Because borderline personality stems from trauma and abuse, usually neglect of some sort, the person who has it has an innate urge to please others, a desire to be seen and heard and cared for heavily contradicted by their unstable fear and paranoia surround the people they most care for, that contradiction is what causes emotional outbursts and spiraling.

So, let's apply this to spinel in a way that's understandable aside from just pointing out the similarities in the disorder and her characterization.

Spinel has a history of prolonged abuse, despite gems living for thousands upon thousands of years, spinel is relatively young in comparison to her primary abuser, pink diamond. (Because spinel was made for pink and thus existed after pink)

Pink diamond is also her primary source of companionship. To put it into time relevance, pink is like a twelve year old, and spinel is like a 6 year old.

Spinel's only goal is to entertain and be a friend to pink, but she relies heavily on pink to be consistent in her approval of what spinel does as entertainment (truthful) and she relies on pinks companionship for the relationship to function as it's supposed to. She gives entertainment and companionship in return for approval and companionship.

The balance became off kilter due to pink wanting other than that companionship, a colony, and lack of proper communication leading to her manipulating spinel into playing a game she could not win.

Pink didnt communicate her disapproval of spinel's behavior, which in turn exasperated her own enjoyment with spinel, leading to that manipulation.

This lack of communication spurs the desire for approval in spinel's character, she wants to be good and a friend, was lead to believe she was, when in reality she wasn't, in her eyes. The realization of this began to dawn on her after pink left, but likely before Steven's message ie:

"Is this how it goes, am I doing it right?"

Spinel spent 6000 years in the garden waiting for pink to come back, under the impression that if she continued to play the game, correctly, that she would eventually return. Hence, her desire to be seen as a good friend who obeys and entertains above all else.

This is why she displays a deep desire to be a good gem be good at her job, and why she feels that she inherently isn't.

After she receives Steven's message, she is forced into the realization that the game didnt matter, pink wasnt ever going to come back, from her perspective, pink didnt care for her or want to be her friend, which causes spinel to feel like she is a bad gem, that she doesnt do her job, that she isnt good enough.

Spinel has received only the information from the broadcast (I am including the book reading in this because it sets up the broadcast scene and white diamond speaks to the screen directly after) she knows very little about the rebellion, or the war, only that pink made new friends, had a son and didnt come back for her withing the numerous perceived opportunities she could have. This aspect is important, as if the broadcast told the whole truth, spinel likely would have understood a bit more of the gravity of the events that had taken place.

After spinel learns of pinks new friends and Steven's existence, this is when her severe neglect and abandonment as well as a loss of identity kick in, she is filled with rage, despair and self loathing.

Spinel has lost her identity, her purpose, because she feels she isnt good enough for what she was made to do, despite being a perfect cut, she is nothing, all she will ever be is nothing, nothing to pink, nothing to anyone, nothing to herself.

After having no companionship and no means of safe emotional outlet, spinel is effectively blindsided by the sudden and impactful amount of pain and hate she is feeling. She has no way of confronting this emotion, and she doesnt know how to confront it so she does the next best thing, vent it out on people who were closest to pink, her best friends.

Essentially spinel cant focus her rage on pink diamond because she is gone, so instead she will focus it on the people who, to her, took pink away from her.

Now, given spinel's self deprecating nature, she likely had no real plan afterward, more than likely, she fully intended to be poofed, rejuvenated or shattered. After all, she is nothing to pink, and she is even less to Steven, she doesnt deserve to exist.

From observation, the speed at which she arrived on earth from after she heard the broadcast, she was likely having a severe mental breakdown and spiral, which can be incredibly hard to get out of when one has low self esteem and no proper means of emotional release.

A spiral is when a person (or in this case a character) becomes self deprecating and an increasingly more volatile rate, they are incredibly hard to get out of because the mental illness doesnt allow positive thought, the person will feel bad for their actions or feel bad about trauma or failures and will continually throw insults at themselves or those around them for trying to convince them differently.

Spinel spirals twice in the movie, the most excellent example is her paranoia of being abandoned leading to irrational thought and self depreciative spiraling and lashing out as a means of emotional protection.

I'm not really going to speak on the middle of the movie because it essentially rehashes that emotional trauma and neglect I mentioned earlier, the only difference is that is is comparable to a person with BPD who has effectively repressed those traumatic memories and is slowly reliving them, which subsequently causes a major relapse.

What I will say however, is that some other common symptoms appear in spinel like they do with folks with BPD. Spinel has an fp. A favorite person basically.

Folks with BPD often pick a companion of theirs and become extremely attached to them, they care incredibly deeply for them, and can also feel incredibly betrayed by them when they dont act in ways that the person is comfortable ie; displaying traits that can, to the person with BPD lead to abandonment.

Folks with BPD also tend to tailor their personalities for their companions in order to receive that approval they desire most.

Spinel displays this fairly effectively when she lashes out at Steven when he tells her to stay with the new crystal gems, she also displays the tailor trait when she mimics amethysts actions during the nobody else duet.

Finally, when spinel reverts back to her dark form, she displays the other symptoms of BPD, hesitance to trust, then blind trust and desire to please, her paranoia over Steven leaving her, and the subsequent spiral leading her to lash out in effort to protect herself from more emotional trauma and eventually dropping out of her spiral and then the final, trying to leave before abandonment can happen.

This is a fairly important one, as a lot of folks with BPD tend to feel that abandonment is an eventuality, and another form of protection from that is purposely distancing oneself and leaving before that abandonment can take place.

Spinel, after her second spiral is still very much traumatized, and still very much self destructive, has low self esteem, despite wanting to be better, so to spare herself the pain of facing people she has actively harmed in her worst moments, and to spare herself from what she believes is an eventual abandonment, she desires to leave and start over.

Do I think this is healthy? Mmm..no. mostly because I know that folks with BPD have an incredibly hard time breaking paranoia, low self esteem and self destructive behavior. I definitely dont think that spinel should have left with the diamonds because they have no idea what she is capable of and what she has been through, or how to deal with her self destructive behavior in a healthy way. They arent even able to completely overcome their own abusive behavior so..no, I dont think it was a good decision to have her go with them. But that doesnt really matter right now lol.

What matters is; spinel is a good example of what it is like to have BPD, she is a good example of the low self esteem and self destructive behaviour people with BPD have. She is a good example because she isn't seen as a completely lost cause by Steven and the others, despite what she herself believes. She has an acurate portrayal of the trauma that develops bpd, the symptoms of BPD in an easily digestible way and she isnt portrayed to have these issues completely resolved by the end of the film.

She very VERY quickly jumps into another relationship that can very easily be destroyed by either the diamonds or herself, and still struggles with low self esteem and the desire to be approved of by Steven, and the diamonds.

She isnt fixed by the end. But she doesnt get treated as a terrible person either.

Most people who talk about BPD who dont have it themselves very often say that they are inherently abusive, and overlook that persons trauma. That doesnt happen for spinel, Steven sympathizes with her trauma, despite largely being sidetracked and not fully indulged in helping her for her sake, rather than helping his own needs.

It's understandable and infuriating at the same time. Because the type of person spinel is, requires a different approach and a far more delicate one at that, something Steven hasn't had the same quite of experience with yet. Which is what largely caused her to spiral the second time. And it wasnt until Steven realized how selfish he had been that he was able to even make a proper and not misleading connection with spinel.

So there you have it, my analysis of spinel, why she portrayed BPD very very well, and how bod is a largely misunderstood and stigmatized disorder.

[sarah-grace114]

my fight with severe anxiety and depression:

it’s always been here.

there have always been times when i told myself “i’m not good enough”, “i’m not skinny enough”, “i’m not pretty enough”, “i want to leave this place”, “maybe they’re better without me”, “why can’t i just be happy like everyone else?”. there have always been times where i couldn’t find the motivation to do anything, but these were certain periods of time. they were not long lasting, they were not constant, they were not harmful, until one day they were. until one day the world caught up to me. it was something i thought was normal, something i thought all teenagers went through because of the stereotype that has been set by previous generations that this is all just a way for us to “find ourselves” and that “teenage years are the hardest for everybody”. facing these struggles- severe anxiety and depression- is neither finding yourself nor normal, it is a sickness that goes unnoticed every single day, just because it is not something you can physically see.

we all know how the saying goes; people never want to believe what they can’t see.

the signs started off discreet, but continued to build and strengthen everyday, one struggle, one problem after another. one day i stopped loving the things i loved the most... the things that always took my mind off of all the bad things running around in my head. then the next day i found my emotions scattered, being able to switch moods quicker than i can type a word on my phone. i found myself over eating and snacking and making myself miserable as a way to cope with my problems. then the next day i would only eat 1 thing to make up for everything i ate the day prior. i began to feel lonely. i lost all connections with people because i realized how different i was compared to them. i realized nobody cared, if they cared they would have realized i haven’t texted or checked in in weeks, where as i would usually reach out every day. i cut off all ties with people who seemed not to care, only to find i had nobody left.

time began to pass and the symptoms continued to appear and continued to become more constant: not eating, binge eating, constant sadness, constant mood swings, anger over nothing, shutting myself out, forgetting simple things, anxiety over presentations or simply speaking to people, not going out in public because i thought i looked bad, being overly self-conscious, longing for someone to notice something was wrong, numbness, thoughts about how much better it would be if i were gone, if i was dead, fear that someone would find out that something was wrong, anxiety over things i formerly never had a problem with, wanting attention, wanting friends, being easily annoyed, overly tired, wanting to be unbothered, wanting to be alone.

as contradicting as these things are, i wanted them, i needed them, and they never came. they still haven’t.

i tell myself nothing is wrong. what would my family think if they found out i was mentally ill? would they call me sick and treat me like i am less than what i was, treat me like i was made of glass? would they try to pretend nothing is wrong? would they deny it, as i do now, because they don’t want to face the reality that their “perfect child” is indeed not perfect at all, but broken? what would my teammates think? would they call me dramatic and gossip behind my back because they think i want attention? what would my coaches think when i told them i needed a mental health day during season? would i get punished for something i truly had no control over?

i try to throw myself into the few things i have left that bring me joy: researching, school, reading, watching movies, scrolling through certain social media platforms, however all i seem to find is myself becoming more and more tired every day.

i’m tired of fighting a war in which i’m losing every battle. it feels as though i cannot win.

i’m tired of failure, of hiding my reality, of my family slowing catching on and not doing anything about it, of people turning a blind eye, of people telling me it’s going to be okay when they have no idea what they’re saying will be okay or how to make it okay. i’m tired of the lies and trying so hard to be someone i’m not, just to feel like i belong. im tired of being able to hide it so well. im tired of being too scared to ask for help because i’m afraid of what people will think of me. i’m tired of everyone thinking i’m okay and not even turning their heads when i try to hint that somethings wrong.

i’m tired.

but i’m fighting. that’s good right? i’m still fighting.

i’m still here despite how much i don’t want to be. i’m still fighting for my family and the people who still claim to be my friends even though we haven’t talked in weeks, months even. i’m still here because i know my brother would hate himself for continuing to mess with me, fight with me, and insult me (as his way of joking around and play fighting), thinking it was harmless when it was actually hurting me. he would hate himself for not stopping when i told him to and realize that was the reason i would continue to get mad and upset. he would hate himself for not understanding my attempts at trying to hint to him that something was wrong. my dad would blame himself for being too hard on me to do better, for pushing me too hard. my mom would hate herself for not seeing that her baby was suffering, that she couldn’t wait to leave this awful place. she would blame herself for not being able to do anything or noticing my changes in behavior. and my little sister wouldn’t have her big sister to help her navigate through her own problems, to steal clothes from, to look up to, to talk about boys and everything else in harsh this world. and my puppy, my little tuck tuck, who never failed to brighten my day, would go looking in my room for me everyday not knowing that i would be gone forever, that i would not be coming back home. i’m here for them. i’m not living this life for me anymore, i never should have been in the first place. i’m living it for them and i’m living it for God, because with Him i can do all things. no matter my suffering, my sadness, or how miserable i am, he endured worse so that i could live my life with hopes of being forgiven on judgement day and enter his kingdom of eternal life, eternal happiness, and eternal worship. yes i am in pain, and yes i am still badly struggling, but i am trying. i am trying for them.

[deardiary1993]

I Became Pro-Choice After My Friend Had Three Abortions

 I grew up a child of a teen mom in one of the reddest of red states in the south, going to a church that proudly exclaimed that they were bible thumping fundamentalist Baptist, needless to say, abortion wasn't anywhere on my radar, 'that was just something evil selfish women did, somewhere far far away so they could go out and be whores'... or so I thought. I met one of my best friends in 2013, for the sake of this story we will call her Kayla. Kayla was so very much alive, she had a million friends and was so loving and generous, She moved to the United States from Ukraine as a preteen and traveled all over the Red, White & Blue throughout her life, together we took trips to Daytona Florida and even Louisiana for Mardi Gras and generally stayed getting into trouble together, She was a wild child and was so raw and honest about everything rather people liked it or not, still today I've never met anyone quite like her; but along with her radiance and glow, Kayla had some serious demons hiding just below the skin, after weeks of doctors blaming nose picking for her nose bleeds she was diagnosed with leukemia when she was a child, she struggled with hair loss and medication-induced weight gain that caused bullying and self-consciousness, eventually, she got healthy and confident again just in time to experience adolescence, with her being considered fairly universally attractive it took no time at all for her to find admirers, and with her being a wild young teen with zero parental supervision she was also keen to dabble into drugs, cigarettes, and some heavy alcohol, that she had a particular fondness for; this is when Kayla encountered her first pregnancy, but we'll come back to that later; in early adulthood Kayla lived with her older brother in a house their parents got for them, together they threw crazy parties and trashed the place as well as sold and ran cocaine and other drugs out of it. Kayla even joined the traveling carnival for a time being which her alcoholic mother wasn't even aware of until 6 months later when she called Kayla looking for her older brother, "No, mom, I don't know where he is, I've been on the road for 6 months", but as one does Kayla eventually came back home and she and her bother continued their out of control lifestyle; that is until one evening after a cab dropped her off at home after a night out, Kayla wondered into her house and noticed the top of a pizza box on the counter with some barely legible writing on it, it was a suicide letter, her brother had hung himself in the shed in their backyard and she took her pocket knife and went back there and cut him down herself; with her brother gone, she and her home became a target and shortly after his death Kayla was robbed and physically assaulted as well as tied up by two men, this experience caused major anxiety and Kayla stopped sleeping a night and slipped further into her vices and began to spend much of her time at the neighborhood bar, at this bar she attracted even more men, most of whom she had wrapped around her finger, one even taking his own life after she denied his advances, "I can't blame myself for that, I just can't" she once told me, and judging from my own personal experiences at this bar I know other men are undoubtedly guilty of taking advantage of her during her all too common blackouts, I heard people speak of it. Not too long after her brothers suicide her father passed as well, "It's because he stopped drinking, his veins exploded" she explained to me once in one of her many drunken rambles, which was when she did most of her talking regarding her losses. Now, how did I enter the picture? I met Kayla while working at a discount store, she was a new hire and 10 years older than me, I complimented how fast she was able to clean up the shoe area and it was at that point she claimed me as hers and we became fast friends. A month into knowing Kayla we were chatting while cleaning the store after closing. I don't remember the context but I remember her saying "I got it sucked out'" "Sucked out?" I questioned "I killed it" she replied she was talking about her abortion, at this point in time she had two and her third would come later in 2015, I remember not saying anything out loud, but judging her and feeling disgusted with her, even reconsidering our friendship for a moment, before her I only knew of my trashy prostitute cousin having an abortion and as for my cousin she was easy to write off, but I liked Kayla and she trusted me with this information that most women would keep to themselves, it was wrong of me to judge her, because she trusted me not to; and with that my first wall I had against abortion fell. After that, I became more open to the idea of abortion, even learning more about it so I would be better equipped to defend my friend if she so needed it. 1 in 4 women have had an abortion, some you even know but most would never tell you, the stigma is too great, there are too many people like me out there ready to judge. I did find frustration in the fact that Kayla would hook up with people unprotected, and that she would continue to make this same mistake again and again, but I knew she had no place being a mother, she was mentally ill from a lifetime of trauma, she was reckless, she abused drugs, smoked like a chimney and drank like a fish, any child she would be forced to carry would suffer, it would be born with terrible health problems and no quality of life, if it came out alive at all, it would be passed from foster home to foster home never to be adopted. It would be more wrong of Kayla to have that baby rather than it was for her to have an abortion, She wasn't going to change, it wouldn't be fair for the child who would have to develop inside her. Kayla's life ended at the young age of 34 on October 9th, 2017, she stopped eating and started drinking even more than before, her mother never got an autopsy on her but I believe it was kidney failure due to her complaining of lower back pain on the day she died. Her funeral was paid for exclusively by her friends and it was beautiful! Many, many people came and shared stories of her. You may not think everything my friend did with her life was good, honestly neither do I, but I don't judge her, who am I to judge her, I cared for her and she taught me that everyone has a story. So yes, if a woman simply wants an abortion I think she should be able to have one, even if she wants several abortions I think she should be able to have them. Now that I'm a mother myself I know just how important my role is. All babies should be wanted. Kayla wasn't made to be a mom; Your sister/ aunt/cousin/friend may not be ready to be a mom, who knows? all I know is having sex doesn't qualify you to raise a human being, you have to want it, and before you judge a woman for her choice, ask yourself, What's her story, and is she really, really ready for motherhood? ______________________________________________________________

Todays Charity: The mission of Planned Parenthood is to provide comprehensive reproductive and complementary health care services in settings which preserve and protect the essential privacy and rights of each individual, to advocate public policies which guarantee these rights and ensure access to such services, to provide educational programs which enhance understanding of individual and societal implications of human sexuality, and to promote research and the advancement of technology in reproductive health care and encourage understanding of their inherent bioethical, behavioral, and social implications.  Click Here To Donate Planned Parenthood

[nothlits-archive]

just putting this here because i have few followers and would rather talk into the void and delete later if necessary than try to condense my feelings into a tweet thread and perhaps be berated for it.

this year has been so bad and it’s only the beginning of march, to the point i made myself physically ill from stress for a while and now am actively dealing with the symptoms of depression that i usually don’t have. i’ve had problems disorder for so long that being depressed is just how i operate but now i’m actively upset a lot of the time about a lot of things, or about a few specific things, and it’s making it difficult for me to function and do daily tasks that i have no choice in doing.

despite telling management i only wanted 30 hours a week i now work 38-41 hours a week doing physical labor while dealing with chronic pain on top of the new depression. i can’t cut my hours now because i swear if i don’t get out of this house by the end of summer i will not survive, so i have to make as much money as possible to be able to move my bf here from florida and get an apartment. 

and trauma is influencing my thoughts on whether this is even an ethical thing to do considering people i trusted also moved me from texas to florida under the guise of wanting to help me have a better life and then proceeded to traumatize me severely. and i feel like somehow this is all karmic retribution and punishment of some sort and i’m doomed to repeat what they did to me. all of this despite knowing i love and care about my bf and would never want to do to someone what those people did to me under any circumstances.

my relationship of two years that i felt secure in fell apart as i was forced to realize my then partner is completely delusional and impossible to talk to anymore, which is not their fault, they just need much much more help than i am capable of giving them and the mental load on me was becoming too much. but instead of parting amicably, i got dragged through the mud as they made it messy, involved my friends (some of which i do not talk to about personal life), said cruel things to me and to my bf, and attempted to villainize me and blame me for feeling hurt by this entire situation. we broke up in late january and i haven’t processed all of my feelings yet and don’t even know how to begin to. every day, it feels like it comes at me full force again. i don’t even know how to be their friend anymore or talk to them because i’ve had my feelings so disrespected and i’m now fearful in all relationships for now. being told by someone you love that you could never be enough for them is a hard thing to deal with and i feel like i’m dealing alone.

i feel alone all the time in general. i don’t have a good relationship with my family besides my mom and younger sibling, who live six hours away. i don’t have a home environment i would describe as safe and i’m frequently threatened or otherwise made to feel worthless by people i live with, but i have nowhere else to go because i can’t afford an apartment alone making 10.20 an hour besides being unable to live alone because of being autistic and traumatized. i do everything for myself by myself for the most part. i get treated like i’m lazy and never do anything. i bend over backwards for people constantly in every aspect of my life and i cannot stop or i will feel selfish and worthless and things will fall apart. i feel like if i’m not doing something, i have no value. and i have little value as it stands.

i don’t feel like people respect me, especially online. i feel like an easy target to be misunderstood or made into the bad guy because i don’t know how to talk to people or i can’t be vulnerable enough for people to relate to me or feel any sympathy for me. in group settings i feel outcast and people either put me on a pedestal or see me as cruel for reasons outside my control. i am just a person with feelings who is struggling at any given moment to stay alive and i wish people understood that rather than expecting the impossible from me, or deciding to treat me like i can’t comprehend suffering. 

i know i’m isolating myself from my friends and from socializing in general so i can’t even be upset that i feel alone really, but i also wish that others would care for me and take care of me instead of always having to be the person giving until i can’t anymore. it feels selfish to want that and i know it isn’t even a possibility given my situation, but it’s still something i desire theoretically and something i don’t think i’ve ever had. especially in the aftermath of this breakup, it feels impossible to do enough for anyone and i keep catching myself going out of my way to be the person giving support in whatever way possible and i am emotionally exhausting myself but i don’t know how to just stop and let things be. because now i’m being conditioned to believe that the things i do for others are being tallied up and if i don’t meet some threshold unknown to me, i might as well have done nothing. people in my life can easily see me as worthless and still let me keep trying to be something they know i can never be. even people i think love me and see me as genuinely worth having around, because that just happened to me after 2 years of being led on. 

reflecting in general on this past relationship, i am realizing so many things that just absolutely destroy me emotionally, and it feels like there’s no catharsis in this. there’s no way to make things feel better again besides waiting things out and feeling what comes to me, but it’s too painful to deal with. i think about dying a lot, but know i couldn’t handle the aftermath in the event of (another) failure. 

i have lost my ability to write or draw, which were my two main methods of expression and entertainment. so now i sit by myself every day when i’m not at work and i do nothing, because there isn’t anything that really matters to me and i can’t find the energy or will to put attention into something that might help me. so i just do nothing. i just exist in complete silence. i go weeks without buying groceries or cooking now. sometimes i remember to take my meds (none of which are for mental health). i tried to read a book and read less than 100 pages in three weeks and had to return it to the library. sometimes i open comfort content and look at it for a minute and put it away again because i can’t play/read/watch/consume it comfortably, ironically. 

everything is bad. i want to feel like something is good again, but i can’t. i’ve suffered for 3 months straight. my ex broke my heart. i have to get extensive dental surgery that i could be using the money for to move and will take my entire tax return. i feel like my friends and partner hate me because now i have to be afraid lest i be betrayed again in such a huge way. i have no outlet. i have no idea how to process my feelings. 

[bluewatsons]

Steve Matthews et al., Stigma and Self-Stigma in Addiction, 14 J Bioethical Inquiry 275 (2017)

Abstract

Addictions are commonly accompanied by a sense of shame or self-stigmatization. Self-stigmatization results from public stigmatization in a process leading to the internalization of the social opprobrium attaching to the negative stereotypes associated with addiction. We offer an account of how this process works in terms of a range of looping effects, and this leads to our main claim that for a significant range of cases public stigma figures in the social construction of addiction. This rests on a social constructivist account in which those affected by public stigmatization internalize its norms. Stigma figures as part-constituent of the dynamic process in which addiction is formed. Our thesis is partly theoretical, partly empirical, as we source our claims about the process of internalization from interviews with people in treatment for substance use problems.

I suppose they think you’re the sort of person going to steal their VCR … ’cause [of] that typical image of a drug addict as some sort of homeless, stinking kind of shambling person who can barely speak and stuff, and I was never like that even when I was using, but that’s the impression. —Adam

Introduction

Owen Flanagan (2013) has recently proposed an account of addiction that includes a shame condition. “Addicted” persons interpret themselves as both failing in effective agency and not living up to their own normative standards, and their recognition of this leads to a set of negative self-regarding attitudes, central to these being shame. Flanagan thinks, and we agree, that the sources of the shame condition connect to the affected individual’s perceived inability to be an effective reasons-responsive agent, someone, as he says, who passes her own survey. However, we think that in addition to this narrow source of shame there is a wider source: the public stigmatization of addiction and of people experiencing addiction.

To be fair to Flanagan, he too includes socially sourced shame in addition to the phenomenon of shame in one’s own eyes. Indeed, he says (2013, 3) that addiction is “ … actually a person-in-a-particular-social-world disorder.” There is, however, the question of emphasis. We claim that a narrow source of shame—a loss of face for failures to live up to one’s own standards—misses much of what explains it, namely the fact that affected persons mark themselves out to themselves—they self-stigmatize—after absorbing negative social attitudes about addiction, addictive behaviour and “addicts.” Even the concept of shame in one’s own eyes, where one tries to meet some personal normative standard, is unlikely not to suffer from the leakage of social norms into personal care of oneself. These standards are derived from social learning where we quickly learn that in letting ourselves down we typically let down others who rely on us.

Importantly, we are not claiming that socially induced shame, or self-stigmatization, applies in equally robust proportions to the population of individuals affected by addiction.Footnote1 Indeed, we are not claiming it applies to all individuals experiencing addiction. Our claim is that for a significant subset of those who experience public stigma, the process of self-stigmatization does indeed take place and this process is an element in the social construction of the addiction condition itself. Footnote2 The burden of the paper is to explain and defend this claim, while recognizing its limits. These limits fit well with what Corrigan and Watson (2002: 36) have claimed in relation to what they call the “fundamental paradox of self-stigma” as this applies to those with a mental illness. They point out that there may be three types of response to public stigma. In addition to the group for whom public stigma leads to losses in self-esteem (the group of interest here), there are those who respond to stigmatizing prejudice with righteous indignation or even anger, and there are those who are simply indifferent to the treatment they receive as an out-group. We do not have figures on how these subgroups map onto the population of individuals affected by addiction, however, we take it as very plausible that these distinctions apply also in this domain, and so, given this, appropriate limits are placed on the scope of the proposed link between public and private stigma in the condition of addiction.Footnote3

Our central claim is supported by a study undertaken by the authors.Footnote4 The primary broader aim of the study was to investigate the impact of addiction on the moral self-conception, practical identity, and values of people in treatment for substance use problems. Material from the qualitative component of the study supports the view that affected individuals’ perceptions of public stigma feed into their (normative) self-conception. The case of most interest in the present context occurs when the person experiencing substance use problems identifies with the negative stereotype(s) of “addict” and related terms.

Our intention here is to make the case for how it is that there can be a link between public stigma and the development of the shame condition. Our thesis can be stated this way: public stigma figures in the social construction of addiction in a significant range of cases. The idea is that when public stigma is internalized by the person experiencing addiction (as self-stigmatization) it is a source of the shame condition Flanagan identifies. We take as our project here to unpack the move from public stigmatization to internalization of that stigma. Seeing how that process works will thus provide some support for, and understanding of, the social constructivist account.

To be clear, then, our main claim, that public stigma is an element in the constitution of addiction in a significant range of cases, is best situated within the literature that sees the phenomenon of addiction as socially constructed. Here, addiction is understood as the product of the interaction of substance, biology, individuals, settings of use, discourses, practices, and policies. It is historically and socially contingent, emerging through rather than preceding people’s and society’s understandings and experiences of it (Fraser, Moore, and Keane 2014; Granfield and Reinarman 2015). There are several studies that highlight the social situated-ness of addiction. A background starting point for these studies is the work done by Alexander and colleagues who noticed the connection between social conditions and conduciveness by rats to self-administer drugs—the famous Rat Park experiments (Alexander, Coambs, and Hadaway 1978). Then there are the studies done by Robins on Vietnam veterans who had used heroin extensively and regularly in Vietnam, yet ceased all substance use when back in the United States (Robins 1974, 1993); or the recent studies by Hart and colleagues on cocaine and opioid users in poor neighbourhoods where public stigma and police discrimination feeds into the lived experiences of addiction (Hart and Krauss 2008; Hart et al. 2000; Hart 2013). Of course we are not claiming that the internalization of stigma by some individuals is the only link between socially toxic circumstances and addiction experiences but rather that this process is central and important, and understanding how it plays out is important to any account of addiction within this tradition.

Stereotyping and Self-stigmatization

It is a truism that social persons judge one another, interpret and evaluate each other’s behaviour, and find ways inevitably to group each other into ready-made normative categories. In stranger–stranger encounters we tag persons into types based on how they present, filtered through our own readily available stock of characters. This takes place perhaps pending the addition of further information that might fill out their actual social identity. But sometimes further facts about this person are not forthcoming, and we then proceed in our social interactions with an information-poor picture of the person before us. Of course the process of tagged group identification occurs spontaneously and heuristically as an understandable effect of facilitating social interaction. Sometimes, for instance, it quite inoffensively makes sense to read off the character or role of a person from their self-presentation, even if just as an ice-breaker in conversation. When, for instance, I wear my team insignia I do not feel in the least bit pigeonholed by the person who assumes that I am a sports fan of a certain type; and the same is true across a range of type-castings for getting an initial fix on who I am. Alas, this is not always the case, and so what might normally be a harmless and useful social process becomes corrupted when the categories become negative stereotypes and especially when those stereotypes are highly misleading representations of their members.

Stereotypes, as we will use the concept, are memetic categories that are supposed to characterize (“typify”) a group or individual and are based on simplistic generalizations. Their transmission through a culture occurs because the meme tends to go unchallenged and because of its fittingness with other cultural categories. Our use of “stereotype” dissociates from any possibly deserved moral attribution. So “negative stereotype” may involve an attribution of disapproval, but this leaves open any question concerning whether this disapproval is justified. Almost any group or individual can be the target of stereotyping, even apparently laudable groups such as those in the professions. The act of stereotyping relativizes to groups making these attributions, and usually the groups with powerful influence over public information are the most successful at promulgating their favoured memes. So, for instance in certain social quarters being a “greenie” is a negative stereotype, but the category of environmentalist necessary to it is arguably morally laudable. It is important to the current account that the stereotype of “addict” be understood in the way just described, viz., as a category based on a simplified generalization, tending to be spread by those with an interest in its preservation and yet, as we claim, giving rise to no implication of wrongdoing, moral badness, or weakness.

The negative stereotype associated with addiction comes about from public stigmatization of addicted persons. Comments by some of our respondents illustrate their awareness of its dangers:

I mean there’s a time in my life where I’d be paranoid about sitting around other people’s possessions you know ‘cause if anything went missing generally nine out of ten people in the room would be dismissed and I’d get the blame ... there’s a lot of discomfort within yourself after coming out of that lifestyle or existence really. —TomFootnote5

I think the further that you go into addiction the further that, you know, you’re labelled and you’re stigmatized by being an addict. And the further that you go into addiction the harder it is to get out. —Bill

How easy is it for people to access this [the interview transcript]? Like does it go into a vault or whatever? Do you know what I mean? You know how people do their doc … they do essays and all that sort of thing and do they go into this? ... Yeah. People get so easily stigmatized, that would be horrible. —Brenda

The process of self-stigmatization is pronounced in addiction (Lloyd 2013; Luoma et al. 2007). It comes about via internalization of the negative stereotype, a resultant loss of self-esteem, and acting out of the negative public image. This public image excludes affected individuals from public engagement by seeing them as, for example, unreliable or untrustworthy. Affected individuals will then exclude themselves from public life, for example, by failing to apply for work or by removing themselves from public sight; or they will cease to see themselves as responsible citizens; or they will begin to see themselves as legitimate objects of the treatment meted out to them. Above all, they will be motivated to continue to consume in order to forget, set aside, or reduce the negative feelings arising from their shame. This is an instance of what, following Hacking (1995a, 1995b) we refer to as a looping effect. The normatively loaded classification of a group—in this case “addicts”—feeds back into behaviour that exhibits the classification. In this sense public stigma of addiction has the unfortunate tendency to feed into, sustain, or exacerbate the very practices it sets out to reproach.

Flanagan’s Shame Condition

As noted above Owen Flanagan (2013) has recently proposed a shame condition as part of what he calls a twin normative failure model of addiction. In addition to the normative failure of effective agency and loss of control (common to most accounts), the affected person, in so far as she recognizes her repeated failures, “ … cannot pass her own survey” (this slightly unusual formulation simply means that the agent recognizes her own failures of effective agency, failures that thwart “the hopes, expectations, standards, and ideals she has for a good life ... ”)(Flanagan 2013, 1). In not passing her own survey, Flanagan says, she is bewildered and disappointed, and in particular the shame generated by recognition of her failures leads to “desperation and motivation to heal” (1). Flanagan intends his shame account “to describe normal and reliable features of addiction” (1). The exceptions he says include certain co-morbidity cases in which psychopathology accompanies addiction (such as those experiencing mania), people with access to their drug who have “no other choice-worthy options,” and the rich untroubled adventurous substance user who may revel in the lifestyle, a “Richard Burton, Richard Harris, Peter O’Toole … Christopher Hitchens [or] Keith Richards type” (8).

For convenience we will call Flanagan’s condition the shame condition, but really it is a condition with wider remit and includes other negative emotions and self-focused attitudes, for instance guilt. Now because our focus is on the link between public stigma and the shame condition, we will not spend time giving our own preferred elaboration of what is at stake in the shame condition; however, a comment is needed about the complex nature of guilt and shame in addiction. Shame is directed towards one’s whole self, whereas guilt is a feeling of culpability for an action. The shame of one’s addiction is then compounded by the aggregation of perceived guilt. Obviously this claim highly simplifies matters; for instance often the guilt or regret comes only after an affected individual reflects on what they have done. As Marc Lewis (2011, 191) puts it in relation to a period of his own addiction:

… I could not escape the shadows of guilt and shame for very long. The voices that I imagined scolding me, haranguing me, came from inside after all. They fed off my own angry shock at the lengths I was apparently willing to travel in order to feel potent and strong, free and resplendent. I continued to rebuild my own prison, taking chances that showed a terrible disregard for my safety, my life, leading back to a small, dark pool of anger and despair …

And as one of our own study respondents put it:

[A]t the end of the day, you’ve got to be happy with yourself and I’m not happy with myself, I don’t look in the mirror and say I love myself, I don’t even like myself, I self-loathe myself, I hate myself, I hate what I’ve done to myself and done to others by doing it to myself. —Tim

By including shame among the conditions of addiction the theorist does not thereby subscribe to the so-called moral model of addiction. (Flanagan [2013] denies that his own account commits him to “moralizing addiction”). The reason for this is twofold: first, the emotion of shame is often cut loose from the conditions that would warrant genuine moral censure. Second, shame is broader than a sense of culpability or “guilty mind” condition in the criminal law (mens rea). One may experience shame in many types of blame-free conditions. All that is required (in the typical cases) is a failure to present or compose oneself in a manner deemed appropriate by oneself or others or a failure to publicly display one’s agency uncompromised by external or incidental interferences, or to present oneself as socially different on account of some physical feature, deformity, cultural, or religious presentation.

Take for instance bodily self-presentation. For the affected individual on the street this can be significantly disabling. There is no culture we know in which the mainstream celebrates deviant bodies, and indeed western cultures typically emphasise bodies that are strong, young, and healthy. Having an illness often makes people feel ashamed, although they have done nothing to be ashamed of. We imagine how we compare with others, with our former selves, or with the prevailing normative standards. With the loss of control over our body, we lose control over an image that defines us, and we lose control over what is tacitly, sometimes even explicitly, a carefully chosen self-presentation. At these times we try to diminish this unwanted visibility, we stay in during bad days, we cancel visits from friends, we try to control the information our body sends out.

The experience of shame dissociates from an affected individual’s sense of blameworthiness so that shameful actions need not be immoral actions. This bears further elaboration. The shame condition obtains independently from either a sense the affected person has of doing the wrong thing or of what is wrong. Of course, many affected individuals are ashamed of their addiction and what they do in that capacity, and so the shame of addiction is causally related to their sense that addiction is socially discreditable. They frequently blame themselves for it as well. On the other hand, many affected persons do not feel as though they are to blame, either for being addicted or for many of the things they have done. Nevertheless they will be motivated to disguise their addiction in public because it compromises them as social persons.Footnote6

In a closely related point David Velleman (2001, 44) explains that one can feel shame “without being ashamed of anything in particular.” He gives the example of the shame teenagers experience on account of being seen by their peers in public accompanying their parents. They do not think their own parents are “especially discreditable as parents” (2001, 44), and so the source of the shame is not them. So, true, there is no specific object grounding the shame experience, but nevertheless, and as Velleman sets out, there is a perfectly good explanation for the experience having to do with the teenage efforts at giving birth to an adult social identity, and those efforts entail the need to erase the presence of the childlike social identity. This seems exactly right and it has its analogue in the story we are telling about addiction. To the extent that one is compromised by presenting socially with an addiction identity it is disabling to one’s social agency. One need not believe one’s compulsive consumption is discreditable in order to experience the shame that comes from addiction, but the knowledge that others will discredit those they have marked out as (for example) low types, is often sufficient for one to erase or hide one’s addiction identity in public.

The Link Between the Shame Condition and Public Stigma

We think the sources of the shame condition typically go beyond the affected person’s inability to be an effective reasons-responsive agent, someone who passes her own survey, which makes the source of addiction’s shame look too narrow. We think it crucial to locate a central source of addictive shame in connection to the truism of stereotyping mentioned earlier: the fact that social persons judge one another, interpret and evaluate each other’s behaviour, and find ways inevitably to group each other into ready-made normative categories, in this case the negative stereotypical category of “addict,” “junkie,” “ freak,” “fiend,” “user,” “druggie,” “dopehead,” and so on. Not every use of these terms conjures negative feelings to be sure—especially when a term’s pejorative sting is neutralized via in-group adoption—but it is the connotation of exclusion-for-being-a-bad-person that carries negative weight. And when the affected person assents to the stigmatized content (either through reflection or implicitly), they have at that point internalized it, and this leads to a kind of self-accusation. For not only have they failed self-examination, they regard themselves as being the subject of society’s survey, and here they fail as well. The internalization of public stigma gives rise not just to losses in esteem, it is revealed also in attempts to conceal an addiction identity, for example, in reticence to pursue work or to undertake independent living opportunities (Corrigan and Watson 2002, 38).

We do need to be careful in how we characterize the translation between public stigma and internalization of the negative beliefs to the stigmatized addict. Corrigan and Watson put the point in terms of characterizing self-stigma using the concepts of public stigma that are mirrored within the individual (2002, 38). We think at certain points such mirroring of concepts must be understood only instrumentally. The origin of the concept of stigma has it as an interpersonal process or more accurately a process in which those with power and authority in a social system direct others to be marked out for identification and careful treatment. In the case of a person who is stigmatized by others, and who then, accepting this treatment, stigmatizes herself, the self-prejudice and self-discrimination that follows is real enough but only once we correct for differences in process between the inter-personal case and the intra-personal case. Obviously I cannot refuse to give myself the job I have advertised, refuse to give money to myself as I beg in the street, or refuse myself the accommodation I have just advertised and applied for. Nevertheless, I can self-sabotage in multiple ways that make my life go a lot worse precisely because I have come to agree with society’s mark on me which says “I am not a worthy person to participate in social life.” It is an important and non-trivial exercise to analyse the moral psychology of the self-stigmatized to investigate the multiple ways in which such self-sabotage plays out. Comments by some of our respondents illustrate the generative role of self-stigma in producing self-sabotage:

I struggle [with] people offering me help, I still think that I’m not worthy of it ’cause they ... everyone’s been offering me to help move and I said “no, no, it’s alright man I’ll get a taxi or I’ll carry it or whatever,” and yeah the guy … the guy at [treatment service] said the other day he sees it as me being … me myself thinking I’m not worthy of anyone’s help. —Graham

Once we start something good we feel guilty because we feel like we don’t deserve it. —Diane

Other respondents explicitly described their behaviour as self-sabotage:

I know a lot about all of these drugs, I know how to get off them, I know treatments, I know all that, I know as much as the doctors sometimes, don’t get me wrong and people think … sometimes people think addicts are stupid dumb idiots and that, a lot of us … I’ve met a lot of really intelligent addicts, you know, so I don’t think that at all, I know I’ve got potential as well but there’s just something in me that, yeah, keeps self-sabotaging. —Tim

I think it’s self-sabotage, every time I nearly get somewhere I fuck it up and I don’t deliberately do it but that’s what happens and I … sort of realized every time I almost get somewhere something dramatic happens or I’m a drama queen in some way and I don’t know what it is, it’s fear I think, fear of whether or not I can hold it together to do something because if I fail at one more thing I’ll just be even more ashamed of what I can’t do. —Nicole

It is remarkable that in their descriptions of self-sabotaging behaviour, these respondents also include negative judgements about their identity (“people think addicts are stupid dumb idiots,” “I’m a drama queen”), highlighting the close link between self-sabotage, negative self-image, and self-stigma. These, in turn, further consolidate the negativity attaching to the addict stereotype and concomitant disruption to normative agency.

A Compounding Effect of Stigma in Addiction

In this section we explain the link between public stigma and shame in terms of a compounding effect of two features of addiction the public respond negatively towards. To do this we may compare the claims about shame made above to Erving Goffman’s three contexts for stigma (1963, 4). He cites, first, “various physical deformities,” second, “blemishes of individual character” (he mentions for example mental disorder, imprisonment, addiction, unemployment, radicalism), and third the “tribal stigma of race, nation, and religion.” It is clear that addiction self-stigmatization is located within the territory of the second grouping (indeed, Goffman explicitly says so), but we would add that many self-presenting substance users are physically marked.Footnote7 They, as it were, bear the bodily signs exposing them to (often) moralistically motivated evaluation as weak, and bad, and so compromised in their social standing. This doubling up of markings in some cases is an exacerbation of the conditions leading to self-stigmatization, and that is because a physical marking is an advertisement for the second grouping. It is a sign to the social world that the substance user is weak or bad both on their face and throughout, reaching inwards to a corrupted character.Footnote8 It removes the possibility of concealment, and thereby reduces the availability of a key technique that protects privacy, a zone where these signs might otherwise be under the control of the person. Thus physical marking (a stigma in itself) points at or advertises character blemish (a second stigma), thereby compounding the overall effect on the shamed agent. The following comments by respondents, describing physical markings and blemishes of character attaching to their substance use, are illustrative.

I look at my arms and I think God blimey, who wants to go out with that? … Heroin doesn’t leave those kind of marks, that’s ice. (…) But that affects me, do you know what I mean? Like I can’t wear short tops, I can’t … just can’t be a normal person anymore. —Isobel

I just want to be able to do what everyone else does, (…) and unfortunately I’ve got marks from my using (…) if I was doing customer service for example a doctor would know that I used to use and I don’t know if it would help me get a job, I’d have to wear long sleeves every day and there’s a lot of things I’d have to do to make myself feel presentable enough. —Martina

… [i]n my area, like you’re a marked person if they know you’re on methadone. —John

Sometimes I go outside and I really feel hated, … I thought it must be how I dress or [the] expression on my face or something. You just constantly feel like you’ve got a big neon sign on your head saying “loser,” you know, “contemptible loser.” So when someone actually … in a shop or something they’ll actually smile at you or act like you’re a normal being, human being, it’s really restorative, it cheers me up for days. —Lachlan

Shame and Guilt as Counterproductive Emotions

Flanagan claims that feelings of shame motivate the healing process (2013). This might seem to imply that self-stigmatization leads to treatment-seeking and even recovery (although we are not saying that Flanagan makes this bolder claim). There is some evidence for this but such a claim is too broad and too swift. The elimination of public stigma, we claim, would, in the first instance, greatly alleviate the experience of addiction in many cases, but we do not think that eliminating public stigma would also eliminate the motivation an affected person has to address their vulnerable status as someone locked into a seemingly interminable pattern of consumption. To put this in Flanagan’s terms, the removal of public stigma would dissolve the pressure to pass society’s survey, but the pressure to pass one’s own survey, to live up to one’s own standards, might well remain.

Often when we realize that what we are doing goes against what we regard as the correct course of action, one that fits with ideas of who we really are or should be, we do then sometimes feel shame and are motivated to live in accordance with our values again. Some studies do support the claim that stigmatization of people will motivate them to seek treatment and in that narrow sense stigmatizing people will lead to recovery (Bayer 2008). But other studies have led to doubts on this score. The question is whether the positive effects of treatment motivated by shame—which often fail to endure—outweigh the negative effects of public stigma. For public stigmatization is long-lasting, pervasive, and often inescapable; over time, it undermines confidence, trust, and the capacity to form supportive relationships (Williamson et al. 2014). Stigma has been associated with diminished self-esteem and self-efficacy and significantly interferes with a person’s life goals and quality of life (Corrigan and Watson 2002, 35, 39). In this sense, feelings of shame are counterproductive, leading to a quality of life that undermines the motivation needed to heal.

That individuals who identify as addicted have negative self-regarding feelings leading to drug use is well-supported by our qualitative data. Mostly feelings of remorse motivate change for the better, but after failing to improve one’s life time after time, aggregated feelings of guilt come to reinforce use. These feelings are then seen as salient factors in the push to use. Moreover, such feelings begin to “bond” with the motivation to consume so that the effect of using, ironically, is to blunt or eradicate the negative self-regarding feelings and attitudes of one’s use. In these examples, the shame of use turns out to be cyclical and self-perpetuating. In our study, we came across a preponderance of examples in which some version of this looping effect was displayed. When asked how he reacted when he did something he regretted, one respondent replied: “Probably got drunk.” Other respondents drew similarly explicit links between negative self-regarding feelings and substance use:

I know a lot of my heavy using was because I was ashamed of what I was doing and it didn’t … commonsense approach would be to not use. But in my case, it was, use more so I could forget how bad I was feeling about myself. —Brigitte

I’d stuffed up so many times with things. That’s why I drunk as well, it wasn’t to self harm myself, it was just to, like I say, get drunk and stop thinking about what I’d done wrong and where I went wrong. —Frank

I wake up in the morning and go oh what have I done, oh I’ll just have another drink. —Simon

Yeah oh it’s just constantly in the back of your head and that’s just even more of an excuse to drink and to just eliminate that or just for it to go away for a while but then the next morning or when you wake up sober and it’s there ten times as worse and it’s just like a revolving circle. —Peter

Shame and Diagnosis

Our thesis fits neatly with the two standard international nosological tools for substance-related disorders, viz., the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual (DSM) (2000/2013) and the World Health Organization’s (WHO) International Classification of Diseases (ICD) (1992). The DSM and ICD systems achieve the diagnosis of addiction by first establishing a general definition and then by providing more detailed subsets of symptoms in which severity of disease depends on the satisfaction of some threshold. In the DSM-5 (American Psychiatric Association 2013) the presence of just two to three symptoms would lead to a diagnosis of a mild addiction. The social impairment grouping (symptoms 5–7) and the impaired control grouping (1–4) in particular make explicit reference to normative standards. Consider:

3. A great deal of time is spent in activities necessary to obtain …, use …, or recover from its effects

5. Recurrent … use resulting in a failure to fulfil major role obligations at work, school, or home

6. Continued … use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of [the substance]

7. Important social, occupational, or recreational activities are given up or reduced because of … use

Excluding the physiological criteria of tolerance and withdrawal, then, these defining symptoms of addiction already rely on normative assumptions about appropriate standards of behaviour (Fraser, Moore, and Keane 2014). These standards include self-control (5, 7), rationality (6, 7), responsibility (5, 7), and appropriate use of time (3, 7). To be diagnosed with addiction under these systems then, is to be classified as morally compromised or deficient. To take on the classification, to self-identify as an addict, is to take up the associated self-stigma of this moral subject position. Additionally, the inclusion of the symptom of craving or compulsion to use (American Psychiatric Association 2013; World Health Organization 1992) means that the person diagnosed with addiction typically sees himself or herself as giving in to a temptation to use and so (justifiably or not) as responsible for the failures and problems specified in the social grouping.

Moreover, it is not only scientific diagnostic systems that build in a normative condition leading to the possibility of self-stigma. The constitutive role of self-stigmatization in addiction is also apparent in the twelve steps of Alcoholics Anonymous. Here, seven of the twelve steps require the person to identify and acknowledge their failures: admitting “wrongs,” “defects of character,” and “shortcomings” and making amends for harms to others (Bill W. 2001). In the twelve-step disease model of addiction, these normative failures are assumed as characteristic of all addicted persons and steps towards “recovery” demand acceptance of these as part of one’s addict identity. (It is noteworthy that Flanagan’s condition is compatible with his apparent acceptance of the twelve-step model.)

Ian Hacking’s (1995a) ideas on the looping effects of human kinds provide a useful approach to thinking about the ways in which the normalizing processes inherent in addiction diagnosis produce self-stigma. Addicted persons may be seen as a human kind—a classification of people constituted by “generalizations sufficiently strong that they seem like laws about people, their actions, or their sentiments” (1995b, 352). Addicted human kinds are constituted through particular historically and socially situated concepts of the disease of addiction and its defining symptoms. These concepts, as we have shown, are loaded with moral values. Hence, the classification as an addicted human kind is loaded with moral value. The looping effects of Hacking’s thesis refer to the processes whereby “people classified in a certain way tend to grow into the ways they are described.” Taking up a morally loaded addiction identity, then, would, for many, demand taking up the self-stigmatization we have identified.

Recovery Systems

Some further suggestive evidence that self-stigmatization plays the role we have identified is provided by the experiences of many in treatment. Some of our respondents described the turning point in their addiction in terms of self-acceptance; in other words, this turning point was accompanied by a cessation in the process of self-stigmatization (we say “accompanied by,” because we are pointing to some empirical evidence for our thesis, not a failsafe proof of it). In this connection it is worth detailing one of our cases to see how it may play out.

Alice used marijuana and LSD as a teenager, dropped out of school and ran away from home. She formed a partnership with a heroin dealer and became dependent on heroin and for many years lived a turbulent life both on and off the streets, in and out of prostitution. She later had two daughters and became fearful that the stigma of drug addiction would affect them:

[F]or years when my kids were young I was always worried about other people finding out that I was an addict and … I was worried about it being taken out on the kids. Oh your mum’s a junkie you know.

After the birth of her second daughter, Alice started on methadone and for a brief period—a couple of years—she maintained a home with her children and a new partner. Following a series of personal tragedies, however, Alice had a mental breakdown and her children were placed into foster care. Separated from her children for the next ten years, she became homeless again, recommenced heroin use, began to drink heavily, and also became addicted to valium and methamphetamine (“ice”). The turning point in her life was when she was in her late thirties and was reunited with her children and given a second chance by her father and step-mother. Her daughters told her “mum we love you the way you are.” Her parents said to her: “if you need to have a drink every day ... have your methadone every day to lead a normal life … then so be it.” It is highly plausible that this acceptance from her children and parents provided an important basis for the removal of Alice’s self-stigmatization. The acceptance of herself is captured in her own words:

I’ve come to a point in my life where I can’t say I’m proud of what I’ve done or anything, but I’ve accepted it and I’m okay with who I am. It’s taken me … like I’m 45 now. It’s taken a long time, … and a lot of that had to do with the stigma of being homeless and being a drug addict and all of that … I wouldn’t go so far as proud, but I’m happy with myself … it’s taken me ’til 45, but … I’m finally starting to do things that are productive, that aren’t counterproductive.

A plausible interpretation of Alice’s re-evaluation of her situation is that insofar as she was released from prior feelings of guilt and shame she was greatly helped in maintaining control over her substance use. (This reading of Alice’s case—that the removal of stigma had a decisive stabilizing effect on her self-control—was how one of the author’s of the study in particular interpreted the outcome. In Alice’s case, interviews were done over successive years of the entire study, providing a robust degree of continuity.)

The case of Alice is representative of a type of response exhibited by other respondents, for example:

I don’t need to use anymore, ‘cause I like myself, who I am. —Sarah

And this one:

R: (Pause) The best thing, I guess, is that I’m still alive. Yeah, and I’m … I seem to be … I’m not as hopeless as I was last year. (…)

I: And what changed, do you think?

R: Mm. Acceptance … ( … ) that my marriage was over and that there was a distinct possibility I may be on methadone or a drug replacement for the rest of my life. There is that possibility. Yeah, I think just acceptance. Accepting who I am. —Nick

An important qualification to the claim that self-acceptance blunts self-stigma involves the recognition that affected persons (in a non-use phase) can occasionally consume substances without also engaging in self-reproach. Self-acceptance includes some self-knowledge of vulnerability and a self-directed forgiving attitude. By adopting this attitude further resilience against the tendency towards shame may obtain. The desire to consume substances can then be seen as a non-self-stigmatizing part of one’s identity. The following respondents exhibited this attitude quite strongly:

Yeah I think acceptance has got a lot to do with that for me … I had to start a new life ’cause I tried changing my life so many times by stopping … and my new life is an abstinence-based life. I think that’s … for me, that’s acceptance. And not making grand statements like I’ll never use again because I mean that … yeah in my heart I think it’s my intention, but I’ve only got today. —Dan

… other times I sort of picked up the pieces and then I failed at a few things and I just went no, stuff it, I lost my place to live again and I was back to that … back to where I started, so that’s … the last time I went to rehab I said I make sure even if I do have a beer I’m not going to punish myself for it. —Paul

Objection and Response

We have claimed that shame, or self-stigmatization, figures as a part-constituent of the dynamic process in which addition is formed. But this is a normative condition, and some might object that, as such, it cannot play the theoretical role we have assigned it. Isn’t addiction supposed to be some physical state of a human being? We reply by noting that to think addiction is merely a physical state of a person is to miss something important: addiction is an externalizing disorder, and so rather than a static condition, it must be understood dynamically in terms of how behaviour over time depends on responses to social conditions. It is not merely that addicted persons are physiologically changed but rather that these changes manifest in thinking and behaviour that is maladaptive for the social environment. Public stigma giving rise to shame amounts to recognition that one is not living up to the standards of one’s social group, standards that one buys into, and so one will be disposed in manifold ways to correct this. By getting well, and by that very process, a person will detach themselves from the source of public stigma.

To bring this out, contrast the typical western case of a regular opiate user with the very interesting case of a regular opiate user in the north-western Indian state of Rajasthan. During the Riyan (opium) ceremony guests are invited to consume a small amount of opium in return for friendship. This is an old tradition in which bonding between parties is enabled all within a ritualistic frame, with specific social rules determining the process. For example, refusal to consume is viewed as an insult. Thus we have consumption of opium taking place within a normative framework that culturally endorses the activity. Given the absence of stigma and shame, could there be addiction here?

The answer is complex. On the one hand we can imagine that regular participants might experience mild withdrawal, but in the case where regular consumption takes place with a steady supply of opium, no withdrawal is experienced, and life may go on. The negative consequences of the biological effects of the opium are not present. Neither of the twin normative failures Flanagan mentions is present. Specifically, no public stigma obtains, and so no self-directed shame obtains either. Still, the biological elements of repeated consumption may be present in the form of physical withdrawal symptoms and neuro-biological adaptations. So what are we to say in relation to the question of addiction? Perhaps we should begin by noting that we appear to be in possession of all of the relevant social and biological facts pertaining to the example. The brain adaptations are present and manifest in behaviour that is contextually driven by the socio-cultural norms. Perhaps related to the Riyan ceremony are cases in which consumption outstrips the ritual requirements; but let’s bracket such cases, and let’s imagine for a moment that no negative social consequences arise. Then plausibly, no public stigma is present, and the shame condition is nowhere to be seen. On a social constructivist account there is no addiction here then. For the apparent drive to use opium in this context is not felt as a motivation with a negative valence. Moreover the desire to consume is accompanied by a social condition that carries the weight of implicit endorsement. What we have here is a case of collective willing consumption. So partakers can be in possession of a very strong desire to take opium while recognizing (again perhaps implicitly) that this is a desire which is socially endorsed.

A final comment here is in order concerning the alleged stigma-removing effects advocated by the (neurobiological) disease accounts of addiction. The line of argument is often put that in so far as addiction is seen as a chronic relapsing brain disease it will be seen as a condition that the addicted person cannot really control and so a condition that ought not attract blame, censure, reprimand, and so on. There is some evidence that this is the case, but as Buchman and Reiner (2009), 18–19) point out there are some unintended consequences to which this move gives rise. One effect, they say, is encouragement to acceptance of an “us–them” distinction (the normal and the diseased); another is that the label of diseased addict creates perceptions of dangerousness and unpredictability; and another is the self-labelling effects of having “a different kind of brain.” Social construction theory again is helpful in seeing that in attempting to translate neuroscience research for the public, there are interpretative filters that, as they put it, “ … may inadvertently contribute to the beliefs that perpetuate stigmatizing attitudes” (19).

Conclusion

The thesis of this paper is that public stigmatization of addiction has a private correlate: internalization of the social opprobrium attaching to the negative stereotype of addiction leads to looping effects on behaviour. Evidence for our claim, taken from a qualitative study with addicted persons themselves, points to some direct effects of this public stigmatization, including those cases where a pattern of consumption comes to be directly motivated by the need to forget, erase, or avoid the shame of addiction itself. We make no claims regarding the extent of the looping effects we have identified. An empirical test for that would be to observe social environments that mimic social environments in which addictions are present but where stigmatizing attitudes are largely absent. In this situation, if we are correct, one would predict a diminution in the severity of addiction, or an absence altogether, commensurate with an absence of stigma in the relevant cases—the ones in which agents internalize the stereotype and so give effect to the looping mechanisms we have outlined here. If this is right, there are implications for social policy and for programmes designed to alter attitudes towards individuals experiencing addiction, their behaviour, and the way they present in social life (Patterson and Keefe 2008, 122).

Notes

For our purposes here the shame condition and the self-stigmatization condition are the same, and we will use these terms interchangeably. As we have just outlined the sources for them can be narrow (say in the case where a person experiencing addiction fails despite being given public support), or more generally these sources can be social and public (say in the case where one internalizes the negative stereotype). We focus in this paper exclusively on the latter case where shame (self-stigmatization) derives from public stigmatization.

Social construction theory is an ontological theory that contends that reality is socially constructed. In this view, phenomena—including addiction—do not exist objectively but are the product of discourses and social and cultural forces. Social constructivism is best understood as a dynamic theory in which ideas and concepts are externalized, then objectivized, and finally internalized by social actors (Berger and Luckmann 1966). In the present case, the phenomenon of addiction—the ideas, activities, and objects associated with addiction and the state of addiction itself—is objectified and reified, turned into a “thing” and externalized as existing outside the unique and varying experiences of particular individuals.

As we go on to outline, our thesis is supported by the qualitative component of a study on addiction and moral identity and agency. We are unable to determine from this material the extent to which Corrigan and Watson’s self-esteem category is represented in the overall population of people affected by addiction.

The study, funded by the Australian Research Council (DP1094144), employed a mixed methods longitudinal design. We followed up three main groups (people in treatment for problems with alcohol, people in treatment for problems with opioids, and a comparison group: alcohol and other drug workers) over a four-year period (baseline in 2012 and successive 12 month follow-up episodes in 2013, 2014, and 2015). All study participants (n=242) completed a structured baseline questionnaire. A subset of study participants also completed an in-depth interview about how they saw their life, their capacities for self-control, and their substance use. Participants in this subset were followed up and re-interviewed over the four-year period. In this paper we draw on data from the qualitative (in-depth) interviews conducted with people in mainly heroin or alcohol treatment (n=69from the Sydney node of the study, n=40 from the Melbourne node). Tiny proportions from the qualitative component were methamphetamine or poly-drug users.

Pseudonyms are used here and elsewhere for all study participant quotes, although gender has been preserved.

Interestingly the phenomenon of undeserved public shame has been described in the bioethics literature on disability. See for example the work of Havi Carel (2008), Charmaz and Rosenfeld (2006), and Toombs (2001).

Two important clarifications should be made here. First, again, care needs to be taken in linking self-presentation and stigma, for we also risk buying into the stereotype of addict that views this type as a poor, homeless, physically damaged individual. The financially well off professionally employed person who injects drugs enjoys relative anonymity which shields her from the harm of public stigma. Still, the distinction is in some ways grist to our mill: this person disguises their substance use precisely to avoid the stigma that might well lead to catastrophic exclusion from privileged life and the negative consequences of an addict identity. Second, although for space reasons we do not discuss it, the stigma of race—one of Goffman’s tribal stigmas—also can play as an exacerbating feature in this process. See, for example, Carl Hart (2013) who elaborates the institutional and racial stigmatization of addiction.

We emphasize of course that we are offering an analysis of how stigma works in the case of addiction. As noted earlier we have no truck with the so-called moral model of addiction. Public stigma of persons affected by addiction is generated by a host of unjust and uninformed moralizing that is damaging to people experiencing difficult life circumstances.

References

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Bayer, R. 2008. Stigma and the ethics of public health: Not can we but should we. Social Science and Medicine 67: 463–472.

Berger, P.L., and T. Luckmann. 1966. The social construction of reality. New York: Anchor Press/Doubleday.

Bill W. 2001. Chapter 5: How it works. Alcoholics Anonymous (PDF), 4th ed. Alcoholics Anonymous World Services.

Buchman, D., and P.B. Reiner. 2009. Stigma and addiction: Being and becoming. The American Journal of Bioethics—Neuroscience 9(9): 18–19.

Carel, H. 2008. Illness. The cry of the flesh. Stocksfield: Acumen.

Charmaz, K., and D. Rosenfeld. 2006. Reflections on the body, images of self: Visibility and invisibility in chronic illness and disability. In Body/embodiment: Symbolic Interaction and the Sociology of the Body, edited by D.D. Waskul, and

P. Vannini, 35–51. Hampshire: Ashgate.

Corrigan, P.W., and A.C. Watson. 2002. The paradox of self- stigma and mental illness. Clinical Psychology: Science and Practice 9(1): 35–53.

Flanagan, O. 2013. The shame of addiction. Frontiers in Psychiatry, 4: 1–11.

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Goffman, E. 1963. Stigma; notes on the management of spoiled identity. A Spectrum book. Englewood Cliffs, N.J.: Prentice-Hall.

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Hacking, I. 1995a. Rewriting the soul: Multiple personality and the sciences of memory. Princeton, NJ: Princeton University Press.

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Hart, C.L., M. Haney, R.W. Foltin, and M.W. Fischman. 2000. Alternative reinforcers differentially modify cocaine self-administration by humans. Behavioural Pharmacology 11(1): 87–91.

Hart, C., and R.M. Krauss. 2008. Human drug addiction is more than faulty decision-making. Behavioral and Brain Sciences 31(4): 448–449.

Hart, C. 2013. High price: A neuroscientist’s journey of self- discovery that challenges everything you know about drugs and society. New York / London: HarperCollins.

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Patterson, D.L., and R.H. Keefe. 2008. Using social construction theory as a foundation for macro-level interventions in communities impacted by HIV and addictions. Journal of Sociology and Social Welfare 35(2): 111–126.

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[weabbynormalblog]

You got this!

Failure is a good thing...What???

In my experience it breeds strength, courage, conviction and belief in oneself!

That's right every step count; even if it leads to failure. Just another learning moment.

Perfection is something we all strive for at one time or another. The error free post, the ultimate cake, meal, artwork, skill, trade or even apparently phone call. We all do our best however our best often isn't always perfect. Success at anything usually requires commitment, a solid plan, consistency, knowledge and a wide variety of skills in order to successfully achieve realistic goals. Usually an optimistic big picture approach and managing daily details are the steps that lead to overall sucess. As humans we fail time and time again, success can seem fleeting and quite elusive at times especially when frustrated.

Failure really is only a complete failure when you give up forever. Like Anthony Bourdane. Suicide ideation is not "normal" behavior or anywhere near healthy thoughts. It's the red flag. It's the failure to thrive while being overwhelmed consistently.

Happiness and joy is available to everyone, regardless of situation or station. It's a choice, another option a better possibility.

It is attainable! Take responsibility for your own happiness!!! Don't let yourself be defeated by one little moment in a bazillion of moments that come in a lifetime! Success and failure are a matter of belief. Stop that degrading story playing in your head, that you'll never be better. Start saying what is easy, what is working; go down that check list if you have to. Never measure your self worth to others. We are all unique while being quite alike too. Weight the positives and agree to improvement on the negatives. It's all good! Change your vocabulary and thinking to a more positive mind set. We do ourselves a great disservice by comparing and analyzing who we are in retrospect to others. Judging our performance, philosophy, our earnings and material wealth. We are way more than the 10% of what people see.

I learnt by failing that I don't need to be successful or perfect at anything to be happy. I can enjoy the moment regardless of handicap or pain. That's a big realization in terms of adaptation and self acceptance! My therapist said pay attention to my thoughts, all of them, not just the good ones. And I am. I went to Giant Tiger to pick up some odds and ends and was stuck in a huge line at the check out. My endurance somewhat fleeting. I employ stretching and moving around while waiting. Extreme pain in my head, just breath slow in out sit in the pain and breath through it. I survived. Learning curve don't go at lunch time silly. Understanding our pain, our limits and abilities is a good start in the healing process. It's a big deal so I'm sharing it with you. It helps and works. Practicing mindfulness, energy management, a shelf life for your emotions, good sleep hygiene, the Yoga and a process free raw food diet. I even imagine it all chipping away at my disease. I'm starting to see results now in shifting my mind set. There may not be a "cure" for CFS mental illness etc or what terrible situation has befallen you, there's still hope for you to change, adapt and to create your own joy. Try out something that will bring some relief, you never know where that will lead you. Little by little, tiny beautiful bunches of happiness and success. So I'm going to keep working my schedule no matter how grim and depressed I am. I'm going to continue to rock my adaptation by not giving in to the fear of failure, lack or the unknown. I put in the time to go out to socialize and play music once a month because it's good for me even if I have to leave early or don't even get there. There was still lots of little steps of success throughout my day. I've been working hard on my stamina and energy consumption by practicing the standing, walking, singing and playing guitar. I was caught off guard by the crippling physical exhaustion. Next time I'll try an afternoon meditation session or even a power nap on music outing night. The smooth ride was over. Overdoing any type of activity can leave me in jeopardy of injury. Like loosing physical balance; I've injured myself enough to know no thank you body, I'm listening. Often I'm in bad shape for days with flu like/sun burn/tin man symptoms.

Ok fine, body you win this one.

Failure aside, I still got out of the house. I interacted with other humans and did something that brings me joy. I find when I'm not attached to the outcome, results or expectations, my moments can be enjoyable in spite of my body. Suddenly any down time becomes worth the little bit of enjoyment. Its about the quality of those moments and those were some good quality moments. Not a complete failure as I first thought. Yes it was depressing that I couldn't physically get through 3 songs this time. What does this inability means for my physical health in the future? Then the fear old me. New me however what I did perform, I did do justice! This is to be expected, the no more energy thing. This is my normal now. It's the nature of the beast. And I was pacing myself. I guess it doesn't matter that my practicing was successful or consistent because it suddenly became nul and void up against illness. I got to be realistic here. Yes CFS is a real fucking thing! It's like the narrow mindedness that comes with "flat worlders" have friends all over the globe. My CFS/TBI clearly cut me to the quick. It let me know who's bitch I really am. No more performing of any kind tonight! The old me: I was so bummed, ready to pack it all in, no cure; minimal enjoyment and relief. Ensuing some kind of abusive self harm behavior, the old me. The new me: Ok, so it was too much for me this time. Maybe not the next. It happens to lots of people. I know exactly how Lady Gaga feels. My body and mind gave out mid performance. Severe dry mouth, balancing and memory issues. It was awkward. I was somewhat dumbfounded. I had to stop singing and playing guitar or I was going to wipe out on the stage damaging lots of nice equipment and instruments. I can't keep putting myself at risk of falling. With chronic fatigue (insert auto immun/mental disorder)etc. Safety is an issue. You literally have no choice. Your tiered body/what's broken wins. Sometimes in extreme ways. I'll rest, dust myself off and give it another go another day.

I'll keep at it. I have too! I will not let illness dictate my life. I'll find a way to live with it, cure it or kill it which ever comes first.

For love the of myself, my offspring and all the others suffering.

[popculturepsychology-blog]

What Disorder Does Bertie Have?

(NOTE: Fictional Diagnosis delves into the minds of fictional characters. The diagnoses given are a way to learn more about psychological disorders and give an individual viewpoint of made-up people. The intention of these blogs is in no way to belittle or mock the severity and real consequences of these disorders, but to simply provide a unique way of learning about diagnostics and the DSM-5. People cannot truly be diagnosed unless they are working directly with a clinician. What follows is merely the opinion of a bored masters of psychology student who watches too much TV)

Like its predecessor Bojack Horseman, Tuca and Bertie is an incredibly well written show that displays mental illness in a poignant and honest way. Bertie is shown early on to have symptoms of anxiety and it is pointed out several times throughout the first season. Anxiety can happen to anyone and in it of itself does not necessarily denote a disorder. However, the pervasiveness of Bertie’s anxiety along with the negative effects the anxiety has on her life demonstrates a likelihood of something clinical. There are a multitude of anxiety disorders within the DSM, but most do not fit Bertie’s experiences. The two most likely disorders Bertie may have are panic disorder and generalized anxiety disorder (GAD).

I am inclined to say that Bertie has GAD based on her symptomatology, though I will say that doesn’t necessarily mean she does not also have a panic disorder. These disorders frequently co-occur, and Bertie may reach the criteria. However, the one distinguishing characteristic for panic disorder that Bertie does not seem to meet based upon the show thus far comes from the first criterion:

Recurrent unexpected panic attacks

We have seen Bertie have a panic attack during the show in the Sex Bugs episode. (For clarity, I’ve added a link for the criteria for a panic attack according to the DSM. It is possible to feel panicked without having a panic attack): https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

Though Bertie does have panic attacks (or as Tuca calls them, a “case of the Berties”), they do not seem to be unexpected. For those experiencing panic disorder, the attacks can seem to come from nowhere. Bertie was stressed prior to this experience due to skipping work over her presentation. She knew where her anxiety was coming from, and accurately predicted it would worsen when she left the house. This distinction is where a key component of the DSM comes in: The panic attack specifier. Panic attacks, like anxiety, can happen to anyone with or without a mental health disorder, though many disorders increase the likelihood of experiencing them. The panic attack specifier takes this into consideration and allows clinicians to add it to an existing diagnosis (for example, PTSD does not always involve panic attacks, but if a person suffering from this disorder experiences them, the panic attack specifier can be added to the diagnosis)

This brings us to generalized anxiety disorder. The diagnostic criteria is as follows:

A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities 

B. The individual finds it difficult to control the worry. 

C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): Note: Only one item required in children. 

 Restlessness, feeling keyed up or on edge. 

Being easily fatigued. 

Difficulty concentrating or mind going blank. 

Irritability. 

Muscle tension.

Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). 

D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). 

F. The disturbance is not better explained by another disorder 

Bertie clearly fits criterion A and B. For criterion C, we’ve seen Bertie experience at least three of these during periods of anxiety, meeting the criteria. We see her getting restless or “keyed up” during periods of panic and uncertainty, such as her experience in the grocery store and during her preparation for yeast week. She has difficulty concentrating, which affects her work life (particularly in her office job) and relationship with Speckle. We’ve also seen her become irritable, with Tuca, Speckle, and her former coach when she is feeling stress and pressure. Though we have not seen specific evidence of the other symptoms, more may come out throughout the series. Regardless, she meets at least the necessary three symptoms. In regards to D, Bertie definitely fits. Calling out of work due to anxiety and disappearing on Speckle show a strong indication that there is impairment in her life due to her symptoms. As Bertie has not been shown to have an issue with substance use or any serious medical disorders, criterion E can be met, and as other disorders have been ruled out, criterion F is also met.

There are two disorders I did not mention as possibilities that I’d like to briefly mention here. The first is social anxiety disorder. Though Bertie does have anxiety related to social situations, social anxiety disorder isn’t a likely culprit. If her fears were simply related to social settings alone that diagnosis would fit, but Bertie has a multitude of fears unrelated to social situations. She gets anxiety over the possibility of change, such as with the prospect of her and Speckle buying a new house. She also has fear related to trying new things and situations she perceives as dangerous, as well as failure. This is far more consistent with GAD. The second disorder is PTSD. Bertie honestly may likely have PTSD based on her characterization. However, at this point in the series there simply hasn’t been enough shown to completely support it. Her reactions to Speckle calling her a “bad, dirty bird,” the plumber coming by, and multiple times throughout The Jelly Lakes episode we see characterization very similar to PTSD. However, due to the complex nature of this disorder there just isn’t enough for me to confidently state she meets every criterion. Perhaps season two will give us a bit more because I would love to flesh out this potential diagnosis at some point in this series, as Bertie’s experience mirrors that of many young women facing this difficult disorder.

Any characters you would like to have analyzed? Send me a message and I’ll do a piece!

(And as a final note, for those of you that find Bertie’s experiences all too familiar, it’s worth seeking help. Anxiety can be debilitating, but it is treatable. You deserve a life of happiness without being pushed down by fear, don’t be afraid to seek help).