#is interesting without even needing to be pathologized especially when the pathologizing usually leads to: nancy sucks as a sister

[maddy-ferguson]

people expect nancy to be mike's mom more than they expect joyce to be jonathan's

[amuhav]

1, 2, 3, 5, 6, 7, 10, 17, 20 ( ͡° ͜ʖ ͡°), 23, 25 for T A Y U I N.

What memory would your OC rather just forget?

All of his time back in Abor'sai? lmao. I mean, sadly he's already forgotten anything good about his childhood, so he's left with mostly just the negative experiences that came after. Though, maybe surprisingly, I would say any of the more positive experiences with his father would be top of the list, because they're one of the few things that make him regret leaving without a word. And makes it harder for him to just put the whole place and everyone behind him.

What's something about your OC that people wouldn't expect just from looking at them?

How damaged he is under the layers of self-preservation. And how desperate he is to be understood and accepted, despite his pathological self-sabotaging to stop that from happening.

What is your OC's fatal flaw? Are they aware of this flaw?

Lack of faith in other people, and by extension never letting himself have any peace or happiness, too willing to believe it will only lead to more harm. By never trusting anyone or sabotaging anything good that happens to him, it becomes something of a self-fulfilling prophecy that feeds further into his worldview that everything will hurt him if given the chance. I think he's become more aware of that, but until recently, no, he didn't see it as a flaw of his. He just saw it as protecting himself from the inevitable.

How far is your OC willing to go to get what they want?

Pretty far. Tay tends to put his survival and his immediate wants and needs ahead of anything else. He doesn't usually hurt people just for the sake of it, only if he thinks he'll gain something or he considers them to have wronged him, believes they eventually will, or if he sees them as a threat in any way. But he's generally the type to do so in indirect ways; manipulation, lying, maybe a lil theft etc. I guess I'm not saying he wouldn't take a life, if he really felt he had to, but what I am saying is he certainly would try not to. Physical harm or confrontation is certainly not a go-to unless he hasn't much choice.

How easily could your OC be convinced to do something that goes against their moral compass?

Uhhhhhh. His moral compass is kinda skewed towards Chaotic Neutral anyway lol. I don't think you'd easily convince him to do anything truly heinous if he had no reason to. On the other side of the spectrum, you'd probably also struggle to convince him to do anything too good that didn't also benefit him in some way, not unless he truly felt some obligation to do so, or ultimately agreed with the premise under all that outward bluster. In which case, you'd still have to be pretty convincing to overcome that self-preservation instinct of his, especially if whatever it was would make him vulnerable. For example, a lot of the time he'll be more likely to double down rather than take ownership of a mistake, because that would be a sign of weakness oh shit I'm realising he inherited this particular trait from his mother ignore me goodbye.

What's one way your OC has changed since you first came up with them?

Uh, once I actually had a grasp of his characterisation? Honestly, not much at all lol. I meeeean, there are definitely some points in CotS where I wouldn't have necessarily gone where the ~votes~ did, yet I still think the ways they played out, and all his actions within CotS have remained in character (which is honestly impressive when you think about it like that LMAO). But overall he's one of those characters as a writer you just... kinda instantly know them? Like, you connect with them in a way where you just know how they think and feel in almost any given situation without even ever having to give it much thought. Which I feel is pretty rare for me at least lmao.

What's an AU that would be interesting to explore with your OC?

not to sound basic bitch, but I guess Modern Day? I can't really see him in any other genre than that or the Fantasy one he's already in. But maybe... if we're talking more parallel universe AU rather than full genre/setting swap AU... one where he never left home? Because while I will always believe leaving was the best option for him, I don't know if things would have necessarily gone as badly as he thought they were heading...

What is the worst thing you have put your OC through story-wise?

everything um. leading on from the last question I guess ahaha... The bit that hasn't happened yet in the story. And again, not the leaving itself. I think leaving is the best thing he ever did for himself. But I feel ~a little guilty~ for the misunderstandings that lead up to it at least the way I have it planned because I haven't finished writing it yet so that might change I guess lolololol. That, or having him forget just why Ailos seems to hate him so much. Because it informs so much, not just of their relationship but so much of who they both are and how each of their lives came to be the way they are, but to Tay it all just seems so entirely without rhyme or reason. It's like an elephant in the room between them, but one Tay can't overcome because he doesn't even know it's there, and Ailos can't see past it nor work around it, and Tay not even knowing it exists only makes him all the more bitter. (which, like, not to excuse anything lmao, just. ya know. something something hurt people hurt people something something.)

Does your OC have a tendency to get jealous? If so, how does this manifest?

lmaoooooooo. Tay? noooooo. never. jealousy? what's that, even? asdfghklkshhhh. I don't know if he necessarily ever recognises feelings of jealousy for what they are, at least not immediately without time to actually think about it, but yeeeeeah. It is definitely not an unusual response lmao. Jealous lil bean lashes out, usually at whatever he most considers to be the root cause of his pain (I'm so sorry Eve I woulda dragged my boi to apologise right away I stg 😭) And speaking of, manifesting as a rather strong sense of possessiveness lmao.

What emotion is the hardest for your OC to process? How about express?

Happiness. He doesn't trust it. Like, real happiness, not just momentary glee at getting whatever he wants/needs in a particular moment or a plan working out for him, but true, actual-to-goodness happiness and feelings of contentment. It feels like a trap waiting to spring. So he fights it.

What is your favorite thing about your OC?

Despite all his flaws, his ability to overcome. He's so broken, and he deals with a lot of things so poorly, but he's still trying. Still surviving, still trying to find a place in the world when I think so many would have just given up and accepted defeat. And that deep down, even if he doesn't indulge in it or trust it, he still has a heart, and hasn't lost all his humanity (or the fae equivalent? lmao) along the way.

[kyidyl]

Kyidyl Explains Bone - Part 2

(these are collected under the KyidylBones tag bc I have the sense of humor of a 13 year old boy.) 

I decided to do this today since the other part was basically like boring intro stuff and that’s not really what you showed up for.  So today’s topic is: 

Human vs. Animal

Anthropology and archaeology departments the world over are often brought random bones people find to ID whether they’re human or animal, so you might be wondering how do we know the difference? Well...it takes practice.  And, honestly, if the pieces are too small we can’t tell without microscopic analysis of the bone structure, but most of the time we can tell.  

Human bone is very unique.  Our anatomy is unique because we’re the only living members of our genus Homo and the anatomical adaptations of Homo are unique among animals.  The weird combination of big brain, walks upright, fine motor control, and used to live in trees is just...weird.  Our internal microscopic structure is different than that of any other animal. We grow differently than any other animal because our young take so long to mature and are born so helpless.  So anatomically...we’re unique if you know what to look for, but fragmentary remains are super common so you can’t do it by anatomy alone.

One piece of info that’s important.  Bone is made of two components: collagen and minerals.  Squishy bits and crunchy bits respectively.  And, yes, if you’re wondering...scientists DO sometimes remove these bits for Reasons (TM).  

Context! 

Where did you find this thing? Was it a single bone in a patch of woods in your backyard? Probably animal, but not always.  In a pit at a dig with burned animal bones? Probably not a human because people don’t toss the remains of their friends and families in with dinner.  Across cultures people treat their own dead differently than their animal dead or their food.  So if you find it with the food? 99% chance it’s animal, even at a disturbed site (tho it’s not *impossible* to find people in with animal, especially in caves, very disturbed sites, or very old sites.  With very old sites you have to get comfortable with the idea that sometimes people were food and it wasn’t even that uncommon.)

Texture! 

I’m doing this one first bc I can’t give you pictures of texture so it can go outside the cut.  That microscopic structure I mentioned and differences in bone growth all lead to a different texture in human bone.  Now, I want to preface this by saying: this varies with the age of the bone and the age of the individual and the environment in which you found it.  But human bone tends to be a bit less....greasy than animal bone.  I don’t know how else to describe this, because understanding the difference in texture is literally something you can only do by handling them, but I’ll do my best.  

See, animal bone found in association with humans is normally put through some kind of alteration process.  Cooking, smoking, etc.  Human bone sometimes is - after all, people cremate their dead or dry them out or mummify them or eat them all the time - but buried bone tends to be drier in texture than animal bone.  Animal bone won’t leave greasy stains or residue, but it will feel smoother - less porous.  As humans (and animals) decay, the collagen goes first and leaves behind the minerals.  This happens at different rates for different organisms in different conditions, but human bone that has been buried will have a different texture than animal bone, and it will be slightly less smooth or greasy (listen bone grease isn’t GREASE grease it’s just like a way of talking about how dried out it is. Older = less grease.  New things will leave like food grease on your fingers.). But after you’ve felt it a few times - buried human bone has a different texture than animal bone.  

Color! 

Human bone is a different color from other kinds of bone.  It’s similar, but not the same.  And! Unless it has been bleached by the sun (something I’ll touch on more when I do the damage post.), it’s not white.  Not when it has been defleshed naturally.  So halloween decorations? Yeah, all the wrong color.  Anyway, this is where we start to get into images, so I’m going to start putting things behind the cut.  

Here is an image of mixed animal bone from my own collection: 

Ooooo so many cool things in this one picture.  There’s burned bone, small bone, big bone, MgO staining, teef!, moar different burned bone...and one of the things that gets mistaken as human most often: turtle shell.  It’s the piece that’s in the top row, fourth from the right.  It looks very much like human skull when it’s fragmentary and is easy to mistake it as such.  It’s flat and the lines look like sutures (place where the bones in the skull fused, and are now the markers of separate bones.), but they don’t go all the way through.  Anyway, this is a good depiction of the wide variety of colors animal bone comes in.  The large piece in the very lower right is close to what I’d consider an average.  

Here’s an image of human femur that has been defleshed, but not buried: 

(Source)

Probably a young adult because the bone is in good condition, and the head has been fused but the suture isn’t completely grown over (obliterated).  

These are also human femurs: 

(Source)

Side note: they all probably had rickets and that center one is a juvenile, and I’ll teach you how to ID that later on.  They were found in a cave, a burial, and an archaeological site respectively.  

This is another femur: 

(Source)

Bottom is the femur, and it has a healed break in the middle.  The top is also a femur but it has....so...so...many problems.  SO MANY.  I could barely tell it’s a femur from this angle.  

Anyway, the color and texture on that front femur is what I would consider like an average color and texture for a human bone.  And it’s tan, sure, but it’s a different color tan than animal bone, especially IRL.  

In short: human bone looks different and feels different than animal bone, even before you take into consideration things like anatomy.  

Regarding anatomy, it’s...well, it’s an incredibly complex topic and I don’t know that I can really cover it appropriately here in my blog.  It mostly boils down to the impact that bipedalism has on our bodies, the impact that a big brain has on our skulls, and the impact that our manual dexterity on our fingers.  The walking thing is especially important because it changes *everything* about our anatomy.  Like...head to toe.  Everything.  

If you’re interested in human bone anatomy I have two resource recommendations for you.  First, The Human Bone Manual.  This is the one I used for school, and it’s the most useful textbook I’ve ever purchased.  I still use it all the time.  The ebook version is around $18.  Second, this app is called Essential Skeleton 4. It’s free, and it’s the most comprehensive skeletal anatomy app I’ve ever seen (and I’ve used a LOT of them.  It’s made by the same people who make essential anatomy - but EA isn’t free.).  Unfortunately, it’s iOS only and I’ve never found a decent alternative for android. :/ 

There is a lot more to telling human from animal, but my hope is that you’ll pick it up as I make the other entries into the series.  My best advice here is to develop an eye for detail.  Be like Elliot Spencer: it’s a very distinctive ___________. 

One final note on anatomy: people almost always do not realize what size bones actually are.  Human femurs are long and they’re heavy for their size.  They’re usually at least a foot or two in length (I mean...obviously...height is a factor.). The head is good and solid, and the shaft is thick with a lot of compact bone, but when the soft tissue is gone they’re hollow.  Most of the long bones are.  Foot bones are larger than most people expect. Skulls vary in size between softball-ish and volleyball-ish.  And human bone has a distinctive density which, unfortunately, you can’t learn the feel of without handling bone.  If you pick up a bone that looks right but doesn’t feel right - you know it.  I handled a human femur that felt like bird bone (bird bone is very light with a lot of spongy bone bc they fly.) because of a pathology (a non-standard but usually naturally occurring thing on the bone.  Breaks aren’t a pathology, but their regrowth can be.  Syphilis damage is a pathology because bacteria is naturally occurring, as are things like bone cancer, osteoporosis, etc.).  Other times it’s because your damned osteology prof mixed in a human-looking animal bone with the box of remains to trip you up because the differences can be real subtle and you need to learn that.  

Anyway, I think that’s it for today.  I’ll seeya tomorrow, peoples! 

[unillustratedadventures]

Bipolar Disorders: Additional Information (per DSM-5)

In this post, I shall only be covering bipolar I, bipolar II, and cyclothymic disorder, as discussed in DSM-5 (p. 123–9). For the full definitions (i.e. full diagnostic criteria) of these disorders, please see my previous post.

Here, I shall characterise the disorders in the following, simpler ways. Roughly-speaking, an individual has a…

bipolar disorder (in general) just in case she has been impaired or dysfunctional due to a mood disturbance involving manic or hypomanic symptoms;

bipolar I (specifically) just in case she has had a full manic episode;

bipolar II (specifically) just in case she has had both a full hypomanic episode and a full major depressive episode (but no manic episode);

and

cyclothymic disorder (specifically) just in case, during a substantial period of time, she has experienced both manic/hypomanic and major depressive symptoms, almost always having one or the other, in a manner that has caused impairment or dysfunction, without ever actually having a full manic, hypomanic, or major depressive episode.

Also recall that, roughly-speaking:

manic/hypomanic symptoms are specific possible indications of having an excessive mood characterised by elevated feelings and/or irritability as well as by increased energy or activity, which in a previous post I labelled as inflated self-esteem, decreased need for sleep, increased speech, racing thoughts, distractibility, increased outward activity, and recklessness;

a full manic episode is just an excessive state of elevated/irritable mood with increased energy/activity that involves at least three of the above symptoms and causes acute clinically significant impairment or dysfunction (as reflected by particular features/outcomes);

a full hypomanic episode is just an excessive state of elevated/irritable mood with increased energy/activity that involves at least three of the above symptoms without causing acute clinically significant impairment or dysfunction (as reflected by the same features/outcomes);

major depressive symptoms are specific possible indications of having an excessive mood characterised by negative feelings and/or anhedonia (a reduced ability to experience and anticipate pleasure and positive feelings) which in a previous post I labelled as persisting negative mood, loss of interest/pleasure, appetite disturbance, sleep disturbance, psychomotor disturbance, fatigue, negative self-appraisal, cognitive-executive disturbance, and suicidal ideation;

a full major depressive episode is just an excessive state of sadness-related and/or anhedonic mood that involves at least five of the above symptoms, necessarily including persisting negative mood or loss of interest/pleasure, which causes significant impairment or dysfunction.

Diagnostic Features of Bipolar Disorders

For diagnostic features pertaining to manic/hypomanic episodes in general (as well as a discussion of the seven possible symptoms of mania/hypomania), please see this post on mania/hypomania.

Bipolar II and Specifics of Hypomania

Since it is true by definition that just a single manic episode is sufficient for diagnosing bipolar I, episodes of elevated//irritable mood must be only hypomanic in the course of bipolar II disorder. Roughly-speaking, hypomanic episodes are states of mood that are abnormal (e.g. in their strength, persistence, or reactivity) without being so extreme that they lead to further clinically significant issues. In particular, if an episode of elevated/irritable mood involves psychosis (i.e. delusions or hallucinations), results in marked impairment in social or occupational functioning, or requires hospitalisation to prevent harm to self or others (e.g. financial losses, illegal activities, loss of employment, or self-injurious behaviour), then it qualifies as an episode of mania. However, if it lacks any of these markers of clinical significance, but involves sufficiently many indicators of excess (i.e. inflated self-esteem, decreased need for sleep, increased speech, racing thoughts, distractibility, increased outward activity, and recklessness) then it qualifies as an episode of hypomania.

A hypomanic episode should not be confused with the several days of euthymia (i.e. baseline or normal mood) and restored energy/activity that often follows remission of a major depressive episode.

Individuals with bipolar II typically present to a clinician during a major depressive episode, and are unlikely to complain initially of hypomania. Usually, the hypomanic episodes themselves do not cause noticeable impairment. Instead, the impairment tends to result from the major depressive episodes, or from a persistent pattern of unpredictable mood changes and fluctuating, unreliable interpersonal or occupational functioning. Individuals with bipolar II might not view the hypomanic episodes as pathological or disadvantageous, although others are often troubled by the individual’s erratic behaviour.

Typical presentations of bipolar I involve all three of the recognised forms of clinically significant mood—i.e. mania, hypomania, and major depression—even though only an episode of mania is strictly necessary for diagnosing bipolar I. However, while it is typical that bipolar I individuals occasionally have episodes of major depression, individuals with bipolar II tend to have recurrent major depressive episodes that are more frequent and lengthier than those occurring in the course of bipolar I.

Despite the substantial differences in duration and severity between manic and hypomanic episodes, bipolar II is not a “milder form” of bipolar I. Compared with bipolar I individuals, individuals with bipolar II tend to have greater chronicity of illness and spend, on average, more time in the depressive phase of their illness, which can be severe and/or disabling.

Mixed symptoms—i.e. depressive symptoms in a hypomanic episode or hypomanic symptoms in a depressive episode—are common in individuals with bipolar II, and are overrepresented in females. Hypomania with depressive symptoms is particularly overrepresented in bipolar females. Individuals experiencing hypomania with mixed features often do not construe their symptoms as predominantly hypomanic (i.e. predominantly energised or elevated/irritable), but instead as predominantly depressive, e.g. as a predominantly negative or pleasure-lacking mood that just so happens to cooccur with increased energy or irritability.

Specifics of Cyclothymia

In contrast to bipolar I and bipolar II, the essential feature of cyclothymic disorder is a chronic, fluctuating mood disturbance that involves numerous distinct periods of hypomanic symptoms and depressive symptoms, of insufficient number, severity, pervasiveness, or duration to meet full criteria for a hypomanic or major depressive episode.

If an individual diagnosed with cyclothymic disorder subsequently (i.e. after the initial two years in adults or one year in children or adolescents) experiences a major depressive, manic, or hypomanic episode, then the diagnosis changes to the appropriate disorder (e.g. MDD or bipolar I), and the cyclothymic disorder diagnosis is dropped.

Although some individuals may function particularly well during some of the hypomanic periods, over the prolonged course of the disorder, there must be clinically significant distress or impairment in social, occupational, or other important areas of functioning as a result of the mood disturbance. The impairment may develop as a result of prolonged periods of cyclical, often unpredictable mood changes (e.g. the individual may be regarded as temperamental, moody, unpredictable, inconsistent, or unreliable).

Associated Features Supporting Diagnosis

During a manic/hypomanic episode, individuals often do not perceive that they are ill or in need of treatment and vehemently resist efforts to be treated. Individuals may change their dress, makeup, or personal appearance to a more sexually suggestive or flamboyant style. Some perceive a sharper sense of smell, hearing, or vision. Gambling and antisocial behaviours may accompany the episode (especially in the case of full mania). Some manic/hypomanic individuals may become hostile and physically threatening to others—and, when delusional in the course of a fully manic episode, might even become physically assaultive or suicidal. The catastrophic consequences of a fully manic episode (e.g. involuntary hospitalisation, difficulties with the law, serious financial difficulties) often result from poor judgment, loss of insight, and hyperactivity. Bipolar II is often accompanied by more general impulsivity, which can contribute to suicide attempts and substance use disorders.

During mania/hypomania, the mood may shift very rapidly to anger or depression. Depressive symptoms may also occur during a continuing manic/hypomanic episode and, if they are present, may last anywhere from moments or hours to (more rarely) days.

There may be heightened levels of creativity in some individuals with a bipolar disorder. However, it is possible that the relationship is nonlinear; greater lifetime creative accomplishments have been associated with milder forms of bipolar disorder, and higher creativity tends to be found, on average, in the unaffected family members of bipolar individuals. An individual’s attachment to heightened creativity during hypomanic episodes can contribute to ambivalence about seeking treatment, or undermine adherence to treatment.

Development and Course: Bipolar I

In bipolar I, the mean age at onset of the first manic, hypomanic, or major depressive episode is approximately eighteen years.

More than 90% of individuals who have a manic episode go on to have recurrent mood episodes.

Approximately 60% of manic episodes occur immediately before a major depressive episode.

Individuals with bipolar I disorder who have multiple (four or more) mood episodes (major depressive, manic, or hypomanic) within a single year are specified as having bipolar I with rapid cycling.

Diagnosis in Children and the Elderly

Special considerations are necessary to detect the diagnosis in children. Since children of the same chronological age may be at different developmental stages, it is difficult to define with precision what is “normal” or “expected” at any given point. Therefore, each child should be judged according to his or her own baseline.

Onset of bipolar I can occur throughout the life cycle, with first onsets even possible in the 60s or 70s. However, in late mid-life or late life, onset of manic symptoms, e.g. sexual or social disinhibition, should first prompt consideration of medical conditions (e.g. frontotemporal neurocognitive disorder), and of substance ingestion or withdrawal.

Development and Course: Bipolar II

Although bipolar II can begin in late adolescence and throughout adulthood, average age at onset is the mid-20s, which is slightly later than for bipolar I but earlier than for MDD.

The number of lifetime mood episodes (both hypomanic and major depressive) tends to be higher for bipolar II than it is for either MDD or bipolar I. However, individuals with bipolar I are actually more likely to experience hypomanic symptoms than are individuals with bipolar II.

In the course of bipolar II, the interval between mood episodes tends to decrease as the individual ages (or, in other words, the intermediate periods of euthymia tend to shorten)

Most often, the illness begins with a depressive episode. In such a case, the condition is frequently not recognised as bipolar II until a hypomanic episode subsequently occurs; this happens in about 12% of individuals with an initial diagnosis of MDD. Anxiety, substance use, or eating disorders may also precede an official diagnosis, complicating the detection of bipolar II. Many individuals experience several episodes of major depression prior to the first recognised hypomanic episode.

While the hypomanic episode is the feature that defines bipolar II, the episodes of major depression are more enduring and disabling over time.

If an individual is initially diagnosed with MDD, once a hypomanic episode has occurred the diagnosis becomes bipolar II and never reverts to MDD (despite the predominance of major depression in bipolar II).

About 5%–15% of individuals with bipolar II will ultimately develop a manic episode, thereby changing their diagnosis to bipolar I regardless of subsequent course.

Approximately 5%–15% of individuals with bipolar II have had multiple (four or more) mood episodes of hypomania or major depression within the same year. Such individuals are specified as having bipolar II disorder with rapid cycling.

By definition, psychotic symptoms do not occur in hypomanic episodes, and therefore never occur alongside manic/hypomanic symptoms in bipolar II. Additionally, psychotic symptoms appear to less frequently occur within the major depressive episodes of bipolar II than they do within the major depressive episodes of bipolar I.

Switching from a depressive episode to a hypomanic episode (with or without mixed features) can occur in bipolar II, either spontaneously or due to pharmacological treatment for depression.

Diagnosis in Children and the Elderly

Diagnosing bipolar II in children is often a challenge, especially in those with irritability and hyperarousal that is non-episodic (i.e. lacks the well-demarcated periods of altered mood). Non-episodic irritability in youth is associated with an elevated risk for anxiety disorders and major depressive disorder in adulthood, but not bipolar disorder in adulthood. Persistently irritable youths have lower familial rates of bipolar disorder than do youths who have bipolar disorder. For a hypomanic episode to be diagnosed, the child’s symptoms must exceed what is expected in a given environment and culture for the child’s developmental stage.

Compared with adult onset, childhood or adolescent onset of bipolar II disorder may be associated with a more severe lifetime course.

The 3-year incidence rate of first-onset bipolar II in adults older than 60 years is 0.34%. However, distinguishing individuals older than 60 years with bipolar II disorder by late versus early age at onset does not appear to have any clinical utility.

Development and Course: Cyclothymic Disorder

Cyclothymic disorder usually begins in adolescence or early adult life and is sometimes considered to reflect a temperamental predisposition to bipolar I and bipolar II.

There is a 15%–50% risk that an individual with cyclothymic disorder will subsequently develop bipolar I or bipolar II.

Cyclothymic disorder usually has an insidious onset and a persistent/chronic course.

Diagnosis in Children and the Elderly

Among children with cyclothymic disorder, the mean age at onset of symptoms is 6.5 years of age.

Onset of persistent, fluctuating hypomanic and depressive symptoms later in adult life needs to be clearly differentiated from bipolar and related disorder due to another medical condition and depressive disorder due to another medical condition (e.g., multiple sclerosis), before the cyclothymic disorder diagnosis is assigned.

Risk and Prognostic Factors

Known Environmental Factors

Bipolar disorders are more common in high-income than in low-income countries (1.4 versus 0.7%).

Separated, divorced, and widowed individuals have higher rates of bipolar I than do individuals who are married or have never been married, but the direction of the association is unclear.

The risk of bipolar II tends to be highest among relatives of individuals who specifically have bipolar II, as opposed to relatives of individuals who have bipolar I or MDD.

Known Genetic and Physiological Factors

A family history of bipolar disorder is one of the strongest and most consistent risk factors for having a bipolar disorder. On average, there is a 10-fold increased risk of a bipolar disorder among adult relatives of individuals who have bipolar I or bipolar II. The magnitude of risk increases with the degree of kinship.

MDD, bipolar I, and bipolar II are all more common among first-degree biological relatives of individuals with cyclothymic disorder than in the general population. There may also be an increased risk of substance-related disorders among first-degree biological relatives of those with cyclothymic disorder.

Conversely, there is some evidence that cyclothymic disorder is also more common in the first-degree biological relatives of individuals who have bipolar I.

Schizophrenia and bipolar disorders (especially bipolar I) likely share a genetic origin, as reflected in their familial co-aggregation.

In addition to genetic vulnerabilities to bipolar disorders per se, there also may be genetic factors that influence the age of onset of a bipolar disorder.

In the course of a bipolar disorder, rapid-cycling patterns are associated with poorer prognosis.

If a bipolar I individual has a manic episode with psychotic features, subsequent manic episodes are more likely to have psychotic features.

Individuals with a bipolar disorder typically return to their euthymic baseline state between mood episodes (which, while still having signs of abnormal functioning, is normal for the individuals themselves in the absence of a mood episode). However, sometimes an individual will not fully return to euthymic baseline between mood episodes, and this is more common after mood episodes that have mood-incongruent psychotic features.

More education, fewer years of illness, and being married are each independently associated with functional recovery in individuals with a bipolar disorder, even when controlling for the diagnostic type of bipolar (i.e. bipolar I versus bipolar II), the presence of depressive symptoms, and the presence of psychiatric comorbidities.

In the course of bipolar II, returning to a previous level of social functioning is more likely for individuals of a younger age and with less severe depression. This suggests that prolonged illness with bipolar II has adverse effects on recovery.

Gender-Related Diagnostic Issues

Females with a bipolar disorder:

are more likely to have rapid cycling than males who have a bipolar disorder.

are more likely to have mixed mood episodes (i.e. mood episodes that combine both manic/hypomanic and depressive symptoms) than males who have a bipolar disorder.

have patterns of comorbidity that differ from those of males, including higher rates of lifetime eating disorders.

are, among those who specifically have bipolar I or bipolar II, more likely to have depressive symptoms than males who have bipolar I or bipolar II.

have a higher lifetime risk of comorbid alcohol use disorder than do males with a bipolar disorder, and a much greater likelihood of alcohol use disorder than females in the general population.

Whereas the gender ratio is equal for bipolar I, findings on gender differences in bipolar II are mixed, differing by type of sample (i.e. registry, community, or clinical) and by country of origin. There is little to no evidence of bipolar gender differences in non-clinical samples. However, some (but not all) clinical samples suggest that bipolar II is more common in females than in males, which might reflect gender differences in treatment seeking, or other factors.

Patterns of illness and comorbidity seem to differ by gender. Females are more likely than males to report hypomania with mixed depressive features and to present with a rapid cycling bipolar disorder.

Childbirth may be a specific trigger for a hypomanic episode, which can occur in 10%–20% of females in nonclinical populations, most typically in the early postpartum period. Distinguishing hypomania from the elated mood and reduced sleep that normally accompany the birth of a child can be challenging. Postpartum hypomania may foreshadow the onset of a depression that occurs in about half of females who experience postpartum “highs.” Accurate detection of bipolar II may help in establishing appropriate treatment of the depression, which, in turn, might reduce the risks of suicide and infanticide.

Suicide Risk

The lifetime risk of suicide in individuals with a bipolar disorder is estimated to be at least 15 times that of the general population. In fact, bipolar disorder may account for one quarter of all completed suicides. Greater risk for suicide attempts and completions is associated both with a past history of suicide attempts and with a higher proportion of days spent depressed in the previous year.

In relation to bipolar II specifically, approximately one third of bipolar II individuals report a lifetime history of suicide attempts.

Although the prevalence rates of lifetime attempted suicide appear to be similar in bipolar II and bipolar I (i.e. 32.4% and 36.3%, respectively), the lethality of attempts, as defined by a lower ratio of attempted to completed suicides, appears to be higher in individuals with bipolar II.

There might be an association between genetic markers and increased risk for suicidal behaviour among individuals with a bipolar disorder, including a 6.5-fold higher risk of suicide among first-degree relatives of individuals with bipolar II, as compared to first-degree relatives of individuals with bipolar I.

Functional Consequences

Many individuals with a bipolar disorder return to their euthymic baseline between mood episodes, and thereby return to a reasonable level of functioning. However, approximately 30% of individuals with bipolar I continue to show severe impairment in work functioning between mood episodes.

Recovery in functioning lags substantially behind recovery from symptoms, especially when it comes to occupational functioning. Consequently, individuals with bipolar I or bipolar II tend to have lower socioeconomic status despite equivalent levels of education, when compared with the general population.

On cognitive tests, individuals with bipolar I tend to perform more poorly than individuals from the general population. Such cognitive impairments might contribute to the vocational and interpersonal difficulties that tend to persist through the lifespan, even during the euthymic periods between mood episodes.

Both bipolar I and bipolar II are associated with reduced cognitive empathy, or an underdeveloped theory of mind, which is present even during euthymic periods between mood episodes, especially in relation to correctly identifying and reasoning about emotions. Colloquially, this might be described as a deficit in emotional intelligence.

Differential Diagnosis (Some Noteworthy Details)

When diagnosing a specific bipolar disorder, particular care must be taken to distinguish that disorder from:

major depressive disorder (MDD)

other bipolar disorders

schizophrenia spectrum and other related psychotic disorders

generalised anxiety disorder, panic disorder, post-traumatic stress disorder, or other anxiety disorders

substance use disorders

personality disorders

attention-deficit/hyperactivity disorder (ADHD)

disorders with prominent irritabilty

Rapid Cycling Bipolar I, Rapid Cycling Bipolar II

Both disorders may resemble cyclothymic disorder by virtue of the frequent marked shifts in mood. By definition in cyclothymic disorder the criteria for a major depressive, manic, or hypomanic episode has never been met, whereas the bipolar I and bipolar II specifier “with rapid cycling” requires that full mood episodes be present.

Anxiety-related Disorders

It is possible for a bipolar disorder to cooccur with an anxiety-related disorder, such that the anxiety-related disorder is either the primary disorder or merely a comorbid disorder. Nevertheless, in order to diagnose an individual with a bipolar-related disorder, anxiety-related disorders must be ruled out as the cause of a sufficient number of potentially bipolar-related symptoms. In particular, anxious rumination might be mistaken for the racing thoughts of a manic/hypomanic episode, and efforts to minimise anxious feelings (e.g. compulsions) might be mistaken as the impulsive behaviours of a manic/hypomanic episode.

In differentiating bipolar-related disorders from PTSD, it is helpful to note that the symptoms of a bipolar-related disorder tend to differ over time as a function of mood episodes, whereas the symptoms of PTSD do not tend to be episodic in this way. Additionally, the symptoms of PTSD tend to be caused or exacerbated by a limited number of specific triggers, which remain relatively constant over time, whereas bipolar-related symptoms do not tend to be linked to specific triggers in this way.

Substance/Medication-induced Symptoms

Substances and medications can induce bipolar-like symptoms (in particular, stimulants can acutely induce manic/hypomanic symptoms, and chronically induce major depressive symptoms). Accordingly…

Substance use disorders may manifest with substance/medication-induced manic symptoms, which have to be distinguished from symptoms of bipolar I. Response to mood stabilizers during substance/medication-induced mania may not necessarily be diagnostic for bipolar disorder. Moreover, there may be substantial overlap in substance use, since it is common for individuals with bipolar I to overuse substances during a manic/hypomanic episode. Ultimately, primary diagnosis of a bipolar disorder must be established based on symptoms that remain once the relevant substances are no longer being used.

Cyclothymic disorder must be distinguished from substance/medication-induced bipolar and related disorder and substance/medication-induced depressive disorder, based on the judgment that a substance/medication (especially a stimulant) is not etiologically related to the mood disturbance. The frequent mood swings in these latter disorders, which are suggestive of cyclothymic disorder, usually resolve following cessation of the substance/medication use.

Schizophrenia Spectrum and Other Related Psychotic Disorders

Bipolar I must be distinguished from psychotic disorders (e.g. schizoaffective disorder, schizophrenia, and delusional disorder), especially when it involves manic episodes that have psychotic features. Schizophrenia, schizoaffective disorder, and delusional disorder are all characterised by at least some periods of psychotic symptoms that occur in the absence of prominent mood symptoms. Other helpful considerations include the accompanying symptoms, previous course, and family history.

Personality disorders

Some presentations of personality disorders have substantial symptomatic overlap with bipolar disorders. This is especially true with borderline personality disorder (BPD), since mood lability and impulsivity are definitive symptoms of both BPD and bipolar disorders, and are commonly involved in presentations thereof. BPD is particularly difficult to distinguish from cyclothymic disorder, because the latter is characterised by mood symptoms that are less obviously episodic in nature, and can fluctuate in a seemingly reactive manner (thereby resembling BPD more closely).

It is possible for an individual to have a bipolar disorder as well as a comorbid personality disorder (indeed, the likelihood of having a personality disorder is higher than in the general population), and a dual diagnosis should be made if the full criteria are met for both conditions. However, a presentation of shared symptoms might be distinguished as an instance of a bipolar disorder rather than an instance of BPD on the following bases:

The symptoms are not always present, and clearly represent a distinct episode.

The onset of the symptoms represents a noticeable difference from baseline, in the manner required for the diagnosis of a bipolar disorder.

The symptoms of excessive mood do not appear to be elicited directly by the causes that are more standardly associated with BPD (e.g. relationship stress, anticipation of rejection or abandonment), or appear to be just as readily elicited by other circumstances.

Attention-deficit/Hyperactivity Disorder

ADHD is sometimes misdiagnosed as a bipolar disorder, especially in adolescents and children. Many of its possible symptoms overlap with symptoms of mania/hypomania, such as rapid speech, racing thoughts, distractibility, and a reduction in the felt need for sleep. The “double counting” of symptoms towards both ADHD and bipolar disorder can be avoided if the clinician clarifies whether the symptom(s) represents a distinct episode.

Disorders with Prominent Irritability

In individuals with severe irritability, particularly children and adolescents, care must be taken to diagnose with bipolar disorder only those who have had a clear episode of mania or hypomania—that is, a distinct time period, of the required duration, during which the irritability was clearly different from the individual’s baseline and was accompanied by the onset of manic/hypomanic symptoms. When a child’s irritability is persistent and particularly severe, the diagnosis of disruptive mood dysregulation disorder would be more appropriate. Indeed, when any child is being assessed for mania/hypomania, it is essential that the symptoms represent a clear change from the child’s typical behaviour.

Comorbidity

Bipolar I

Cooccurring mental disorders are exceedingly common, with the most frequent disorders being:

any anxiety disorder (e.g. panic disorder, social anxiety disorder, specific phobia), which occurs in approximately three-fourths of individuals with bipolar I

ADHD

any disruptive, impulse-control, or conduct disorder (e.g. intermittent explosive disorder, oppositional defiant disorder, or conduct disorder)

any substance use disorder (e.g. alcohol use disorder), occurring in over half of individuals with bipolar I

Adults with bipolar I also have high rates of serious and/or untreated cooccurring medical conditions. Metabolic syndrome and migraine are more common among individuals with bipolar I than in the general population.

As mentioned above, more than half of individuals who meet the criteria for bipolar I also have an alcohol use disorder, and those with both of these disorders are at a greater risk of suicide attempts.

Bipolar II

More often than not, bipolar II cooccurs with one or more other mental disorders, anxiety disorders being the most common.

Indeed, approximately 60% of individuals with bipolar II have three or more co-occurring mental disorders.

75% of bipolar II individuals have an anxiety disorder.

37% of bipolar II individuals have a substance use disorder.

Children and adolescents with bipolar II have a higher rate of cooccurring anxiety disorders compared to children and adolescents with bipolar I, and such an anxiety disorder most often predates the bipolar disorder.

In bipolar II individuals, anxiety and substance use disorders occur at a higher rate than in the general population.

Approximately 14% of bipolar II individuals have at least one lifetime eating disorder, with binge-eating disorder being more common than bulimia nervosa and anorexia nervosa.

Typically, these commonly cooccurring disorders do not seem to follow a course of illness that is truly independent from that of bipolar II, but instead seem to have strong associations with the excessive mood states of the bipolar disorder. For example, the symptoms of comorbid anxiety and eating disorders tend to be most strongly associated with depressive episodes, while substance use disorders are moderately associated with manic episodes.

Cyclothymic Disorder

Substance-related disorders and sleep disorders (i.e. difficulties in initiating and maintaining sleep) are often present in individuals with cyclothymic disorder.

Most children with cyclothymic disorder who are treated in outpatient psychiatric settings have comorbid mental conditions.

Moreover, compared to other pediatric patients who have mental disorders, such children are more likely to have comorbid ADHD.

[pass-the-bechdel]

The Good Place season one full review

How many episodes pass the Bechdel test?

100% (thirteen of thirteen).

What is the average percentage per episode of female characters with names and lines?

49.58%

How many episodes have a cast that is at least 40% female?

Twelve of the thirteen; seven of those are 50%+, and two of those are over 60%

How many episodes have a cast that is less than 20% female?

Zero.

How many female characters (with names and lines) are there?

Twenty-four. Eight who appeared in more than one episode, four who appeared in at least half the episodes, and three who appeared in every episode.

How many male characters (with names and lines) are there?

Twenty-two. Eleven who appeared in more than one episode, three who appeared in at least half the episodes, and two who appeared in every episode.

Positive Content Status:

Solid; the nature of the show is such that they really need to be making a concerted effort to reflect positive, progressive morality, and as such faults in the content would also almost certainly be considered faults in the show itself (average rating of 3).

General Season Quality:

Magnificent! It’s a wonderful ride, whether it’s your first time through or not. Just delightful.

MORE INFO (and potential spoilers) under the cut:

So, let’s talk about plot twists. In the current entertainment landscape, it seems like everyone is intent upon ‘subverting expectations’, and the good old-fashioned plot twist is very much swept up in that, since a subversion is almost always going to play as a ‘twist’ by definition. The unfortunate thing about this current landscape is that it’s rife with ‘subversive twists’ which are really just bad storytelling; they’re only there because of some pathological fear of predictability, or worse, because the creative minds just want to feel cleverer than their audiences by delivering content that no-one saw coming, serving their own egos at the expense of coherent narratives. If your ‘twist’ is about your own (supposed) intelligence, if you’re baiting the audience by playing into a common trope and then laughing at them for thinking you meant it, if you’re changing the story out of nowhere just for shock value without bothering to build toward the twist because you’re too afraid that someone might figure it out before the reveal...that’s not a real twist. It’s not even a real subversion, it’s just a bad-faith gimmick. It’s not there for the story at all, it’s there to make the writer feel special, because apparently feeling special for delivering quality storytelling isn’t good enough anymore. A proper, genuine plot twist should:

1. make sense in the context of the narrative (it should not be tonally dissonant or jump the tracks into a different genre)

2. make sense with the content of the narrative (it may recontextualise previous events or character choices, but it does not contradict or ignore them in order to function)

3. be foreshadowed (if it comes out of nowhere, that’s not a twist, it’s a random event. It’s a deus ex machina. There’s no story in it if it isn’t built into the fabric of the narrative)

4. ultimately further the storytelling (if it has no consequences for plot or character, it’s a shock-value gimmick, not a real twist).

The above points do not guarantee that a twist will be good storytelling and not just a subversive contrivance for the fuck of it, but they should at least ensure some logical cohesion and protect the integrity of the plot instead of sacrificing it in the name of empty surprise. That covered, it’s easy to see how – even (or perhaps, especially) in this twist-saturated tv landscape we currently inhabit – the big twist for season one of The Good Place still manages to be – in technical parlance – dope. The writing protects the twist not by being ‘too clever’; it simply offers a decoy issue to drive the plot. Eleanor is a Good Place fraud; that’s the first twist in the plot, and it compels the entire season forward. Other twists - Jason’s reveal, Eleanor’s confession, the introduction of the ‘real’ Eleanor - set the stage for this being A Show That Has Twists, but in a way that makes so much contextual sense that it doesn’t set us up to be looking for the next one (a common problem for those shows that rely on ‘cleverer than the audience’ twists - they’ve set themselves up as mysteries for the audience to unravel, and then they kill their own storytelling as they twist in knots trying to keep ahead of millions of intelligent viewers). The Good Place actually tells us outright that something is wrong with this supposed ‘happy afterlife’, it just fools us into thinking that we already know what’s wrong, so that we don’t see the signs of the truth for what they are. Crucially, however, it doesn’t matter if you figure it out before Eleanor does. You can have your suspicions (or have had the show spoiled for you in advance), and you can still appreciate and enjoy it as it unfolds, you can pick up the clues and have a good time with them, and that’s something that all of those gimmicky-subversion plots out there are missing. Their ‘twists’ are not proper functioning pieces of the narrative, and so the story doesn’t work if you already know the reveal; there’s no juicy build-up to enjoy, or worse, you expose your own illogical contrivances or outright plot holes that were created in the course of writing a crappy twist just to feel relevant. The Good Place works because - like any good story - it isn’t about the twist. It’s about the journey.

An important part of what makes the twist work also is that it interweaves the sins of Tahani and Chidi with the discissions of morality without drawing too much attention to them; if all four humans had simply been frauds, it would have been narratively empty, especially if the reveals were coming late in the piece. Jason’s works because it comes out early, and because the Jianyu cover is interesting and distinctly different both to Eleanor’s ploy and to the behaviour of the rest of the neighbourhood, but if the others had turned in the same way it would have been too contrived, too easy, and it would toss out the personalities we had gotten used to (which would violate Good Twist point #2). Since the show DOES pull that trick with Michael (which works because he’s the architect of the whole situation, not a pawn within it), it’s essential that they’re more subtle with Tahani and Chidi’s reasons for being where they are, and in playing it as they do they also reinforce the show’s central deliberations on morality. It’s an inspired framework for approaching what are traditionally considered ‘heady’ themes (and y’all know I’m into it), and every decision about how to approach and balance character behaviour is coming from a position of ethical consideration, weighing not only the acts themselves, but how they compare to the moral theory of various different and conflicting philosophies. It just goes to show that you don’t have to make something ponderous and inaccessible in order to have a cerebral conversation through television - you can do it just fine with afterlife comedy.

As I noted above the cut, the nature of the show automatically lends itself to careful consideration of any feminist and/or progressive content, and as such it should keep a pretty clean bill throughout, or risk cracking its own concept. I do wish they would come out stronger on the queer side of things (as I said in the episode posts, they really aren’t vague about the idea that Eleanor is attracted to women, but her saying words about hot women is still not delivering a lot on the representation front, especially when she is known to do more than say words when it comes to dudes, and the only other queer content we get is the fact that Gunnar and Antonio are soulmates, and that doesn’t technically mean they’re romantically or sexually involved (especially since they’re fakes anyway, but that’s a whole ‘nother thing)). In the mean time though, we have a female lead, 100% on the Bechdel and an essentially balanced number of male and female characters abounding, plus some really nice variety in racial backgrounds (and great names to go along with those - it’s a bit of a peeve of mine usually when show’s include multicultural characters but land everyone with Anglicised or ‘white-friendly’ names. Let the Bambadjans of the world keep their names). We’ve taken a clear stance on even ‘benign’ sexism (i.e. the stuff that’s just men saying inappropriate things - ‘just a suggestion! just a joke! just trying to get a reaction out of you, why are you so sensitive?’ - it’s all literal demon behaviour here), and I won’t pretend that I’m expecting them to get into the real nitty-gritty, but that’s ok. I’m happy to have something which is making a point of not being problematic, because such refuges have real value. So, maybe there won’t be a lot for me to tease apart as the show progresses, but that’s not a bad thing. At the moment, we have green lights across the board, and that’s a hard thing to find. I’m going with it, and we’ll see where we end up. 

[drmichaelvohrer]

Pediatric Head Deformities

Pediatric Head deformities

Pediatric head deformities are often seen as unnecessary to treat as they would anyway disappear spontaneously. What if not….

Why does a baby’s head become a deformity?

The skull of a baby is a very thin bone which grows within the first year tremendously. The volume of the head doubles within the first 6 to 7 months of life. Dependent on gravity and weight load, the skull bone is shaped and flattened in the weight bearing areas, as long as the child is mainly lying in its bed.

Some head deformities even developed before birth or even during birth. Those usually become better within a short period after the child is born.

Since the 1990 the incidence of head deformities is increasing, as the prophylaxis campaign of sudden infant death demands to position babies on the back while sleeping. Especially it the head is pointy consequently the head will tilt and rotate to one side.  

In case a child is positioning on one side preferably the skull flattens on this side and the exact opposite side which shapes a parallelogram like pattern of the whole skull. This pattern is called Plagiocephaly (“Plagio” Greek=oblique).

In case the baby would permanently be positioned on the back of the head a flat dorsal head could develop. This is called Brachycephaly (brachy= short).

Sometimes babies have orthopedic conditions which force the head to tilt in a certain position e.g. if one of the neck muscles is too short or injured during birth. Then this restricted movement does not allow the child to symmetrically move or position the head.

In rare cases the growth plates in the child’s skull are fused or partially fused which causes the head consequently to grow into an asymmetric shape.

Is an oblique head a problem for the baby?

It is often said that the obliquity is just a cosmetic problem which does not make any significant problems to the children. Recent studies are showing an interesting relationship in between the development of the child itself as well as the head shape.

The question is always why a child takes one specific position to develop a head deformity. A certain number of children develop a head deformity secondary as their development does not necessarily follow the physiologic milestones. In these cases the child has a developmental disadvantage and as a result the head shape changes due to the developmental delay, for example the inability to turn to one side, or the inability to free itself out of a certain position.

These children should be diagnosed properly and treated. Specific neurodevelopmental Physiotherapy can help these children developing their abilities. Very often then the head shape corrects within a reasonable timeframe.

Generally spoken we want to be as much symmetric as possible in the skull, as symmetry should be given in the eyes, ears, jaws, the basis of the cervical spine. Long term studies are still missing to scientifically confirm whether the oblique skull will really lead to increased numbers of orthodontic problems like crossbite or problems like migraine, cervical spine problems etc.

How can a pathologic head shape be diagnosed?

Your pediatrician or pediatric orthopedic doctor usually makes a complete examination of your child. Head shape, range of motion and development will be examined. Sometimes an ultrasound of the head helps to rule out more significant growth plate related deformities.

How can a plagiocephaly be avoided or treated?

There a different treatment options if you discover an obliquity of your child’s head. These are dependent on the individual age and development of the baby. Your pediatric orthopedic doctor or pediatrician can help you in the diagnosis and discuss with you the treatment options.

Positioning therapy, positioning of the bed in relation to room attractions and toys, alternate breastfeeding can help adapting the baby’s head rotation to both sides.

Daily “tummy time” under observation will strengthen the related neck muscles and decrease the load on the head and can prevent positional head deformities

There are certain either wedged or donut shaped pillows which can be placed under the mattress or the bedsheet to proper align the baby’s head. Here the actual guidelines to prevent sudden infant death do recommend a positioning therapy but do also explicitly restrict to put pillows in infant’s beds.

Specific developmental Physiotherapy (Bobath, Vojta) can help improving the baby’s milestone and motoric development.

In case the deformity will not improve up to a certain age a helmet therapy can guide the growth of the head to a proper alignment over time.

What does the helmet treatment do?

Individually measured and produced Helmets will guide the growth of the head without putting pressure to the physiologic growth. With the individual shape of these Helmets growth is distributed more in the areas which are more deficient in growth, so automatically the head shape corrects during further growth. The Helmet should be worn about 23 hours during a day in this time. In relation to any other therapy Helmets can correct Head deformities fast and safe

When is the best time to start a helmet treatment?

As the head grows significantly within the first year of life and the growth speed is less active after the first year it is an advantage to be finished with the helmet treatment at the age of about one year. To achieve an appropriate result your doctor might recommend the treatment depending on the clinical findings between the age of 6 to 8 months, to be finished with the treatment at the age of 1 year. A helmet treatment which is started too late might have to be continued for a longer period of time and might not be able to completely correct the head deformity.

Are there any risks or downsides involved in doing the helmet treatment?

Modern Helmets are ultra-lightweight, often 3D printed and extremely air ventilated, so that the possibility of sweating, skin irritation and pressure marks under the helmet can be minimized.

In case the insurance does not cover the cost there are expenses for the manufacturing of the helmet. These can vary dependent on the used materials and need for adaptions. Usually a specific maintenance of the helmet and usually digital head measurement follow up is included in the cost.

Summary:

The therapy of head deformities requires an early and stage related therapy which has a n excellent outcome if parents are involved and instructed. Prophylaxis of head deformities has a major impact on the development and is easy to do if instructed regularly. In case a deformity develops stage related therapy from adaption of daily habits, positioning, to physiotherapy and orthotic treatment with Helmets is a proven therapy pathway.

Dr. Michael Vohrer

Peadiatric Orthopaedic Surgeon

Circle Care Clinic

Plagiocephaly

mild                                       moderate                                            severe

Brachycephaly                                   asymmetric Brachycephaly

Plagiocephaly                                    Scaphocephaly

Plagiocephaly                                    Helmet function                                              

[villainever]

Eve and the Performance of Morality

The "descent into darkness" as a format for a character arc is relatively common these days, especially in prestige television, and while it's more often played out with men than women, it's not unheard of as a trajectory for female characters. What's so interesting about Eve's development is how FAST it is happening. On a poorly-written show, this would be because the writers were rushing, too caught up in Point B to plot a satisfying journey there from Point A. But Killing Eve is basically a masterclass in good screenwriting, and it leaves us with the unshakeable feeling that this is the only way it COULD happen for Eve.

Other "descending" characters are so often ordinary, but transformed by their remarkable circumstances. They are pushed by the people around them and unfortunate events into compromising on their ideals and values, slowly shifting inch by inch until they've lost sight of who they were. And often, this is where they're killed off, or a redemption begins.

But even though she changes, Eve isn't transformed. She's REVEALED. And not just to us, but to herself. She isn't surrounded by people pushing her to darkness -- in fact, Elena, Hugo, Kenny, Jess and Niko are all trying to hold her back from it. Instead, she chases darkness. She follows Villanelle further and further, around a dozen corners in the gloom, and when the light's gone entirely, Eve realises that she can still SEE. Eve is made for the darkness, and Villanelle knows it from the beginning, but Eve is still working it out.

While I don't think Eve has the same compulsion towards violence that Villanelle does, I do believe they are an example of the nature/nurture conflict. Eve was raised by good people in a good place and got a good education, then married a good man and got a good job. "Nice and normal". At every turn, she was socialised and conditioned to mimic morality and empathy, and while Villanelle often acts this out as well, for Eve, the acting is still subconscious. She believes it comes from an innate impulse, rather than years of being told what to do and how to react. Neither Villanelle nor Eve really connect with people effortlessly on an emotional level, but Villanelle accepts that about herself, while Eve can almost pretend it's been bred out of her.

Eve's stable life and her moral framework are dependent on one another, so they implode at the same time. Staying in the realm of 'normal' with Niko necessitates a certain performance of conventional morality, but when Villanelle not only doesn't demand that performance but actually demonstrates an existence without it, Eve finds it harder and harder to maintain her home life.

Once the door has been opened, it can't be closed again. Eve is realising who she is, and more importantly, who she ISN'T. In 205, Martin says, "Don't add. Take away." And this is how we're experiencing Eve's arc. We take away outside pressure to be normal. We take away moral influences. We take away the expectation of goodness. And this leaves Eve looking a lot more similar to Villanelle than she's perhaps ready to admit yet to herself.

It's worth noting how Niko has identified Eve as self-obsessed, because she definitely is. But a lot of that self-obsession manifests in her fascination with Villanelle -- not only because Eve really likes Villanelle and stops caring about what distracts her from wholeheartedly pursuing her, but because Eve RECOGNISES some part of herself in Villanelle, and almost uses her as a mechanism for self-discovery. She watches what Villanelle does, and enjoys it, while being able to maintain the distance that comes from not having physically done it herself.

As I mentioned earlier, we've seen the "descent" arc before in modern television. One that springs to mind in Piper on OITNB. In S1, Piper commits increasingly selfish acts, but still considers herself a good person -- indeed, nothing she does can be really that bad, because she's a Good Person. Over S2 and S3, she continues downwards, until by S4, she's no longer able to reconcile the two versions of herself, so she decides she must be a Bad Person. Because of her pathological need to be liked, this doesn't work for her either, and ultimately, Piper ends up trying to do good things to become a genuinely Good Person.

Eve, I think, originally believed that she would hit some point like this, and bounce up from the bottom. But she won't. Why? Because at first, Eve thinks she needs people to like her, but she actually doesn't. She fires Kenny -- the last of their original team, the last person who knew Old Eve (not counting Carolyn, who has layers I won't get into here) -- and doesn't really miss him, or notice he's gone (eg. calling Hugo "Kenny"; they're interchangeable and missable). She wants Villanelle's attention, but Villanelle 'liking' her is different to the way other people might -- Villanelle wants her, is attracted to the best of the worst in her, is enjoying Eve's emergence from her crucible (or cocoon, depending on how you want to frame it). Eve's primary drive is Villanelle's interest in her, and that's certainly not holding her back in her journey.

Secondly, Eve doesn't actually care about being good. She's had numerous potential "wake-up call" moments -- stabbing Villanelle, facilitating the torture of the Ghost, nearly pushing the guy at the train station, Niko leaving, Villanelle killing someone right in front of her, etc. Yes, she had a minor breakdown over knifing Villanelle, but that was more the idea of Villanelle being gone than the stabbing itself, because the way Eve later says she thinks of it "all the time" doesn't sound as black and white as regretting it in its entirety; like Villanelle, she views it as a point of significsnt connection between them and I don't believe she'd let that go. Regardless, the point is that if she had a real gut connection to her moral compass, she would've bailed. Because really, her original mission is over. She caught Villanelle. She chased her and drew level and she's done.

But Eve's not done, because she's chasing not just Villanelle, but the Eve who can keep pace with her. She's chasing what Villanelle represents -- freedom from a system that doesn't fit Eve, not really.

What we have to remember, though, is that Eve has been socially and ideologically programmed for forty-five years. Most sociopaths lead typical lives and have long-term relationships and never really dig too deep into their psychology. It's doable. This is why Eve is slipping fast but not faster -- she's had a taste of liberation from her constraints, but her skin has long since grown over those shackles, so it's hard not to see them as a part of herself, and difficult to get them off.

But they'll come off, because Eve isn't a quiet woman with an average husband and a respectable government job. Eve is a chameleon, the way Villanelle is, only she's less deliberate and has been playing her character for far longer.

Which leads me to Villanelle's speech on life being boring and why it was so important for Eve to hear it. If we look at classic "chaotic" characters like Eve and Villanelle, they're often motivated by boredom, or rather, the desire to escape it. Villanelle and Eve are stuck in a world designed for other people.

The fact is, Eve has been bored forever. Eve was bored long before the pilot, when she was stuck in a holding pattern with Niko and imagining how she'd kill him, not because she wanted him gone but because it was INTERESTING. When she started keeping track of a female assassin but not even trying to report her, because she wasn't aiming for justice but ENTERTAINMENT.

Another fascinating element of their dynamic is that we as an audience are usually positioned to root for a redemption, but with Eve, we can't imagine anything more disappointing. We don't need her to turn it all around, we need her to dive in. Not only because it makes for a fresh storyline, but because great arcs are about characters finding who they are, and we have already grasped who Eve is. Along with Villanelle, we're waiting on her to realise it and act on it. Eve returning to her normal life would be a wolf among sheep, and I think Eve has gone too far. Not in that she's committed serious crimes she'd always be guilty of -- although she's getting close -- but because Eve is coming to understand she's not who she imagined she was, and any performance after this will be a conscious one. A decision to pretend. And guess what? That'll get boring, too. We root for a darkening Eve because we want her and Villanelle to escape that boredom, and escape it together, and forgetting this ever happened is not a way to do that.

I've smashed this out on my phone because I had a lot of thoughts and I'm not going to proofread because no one will actually read this. But essentially, I think we can expect Eve to continue using Villanelle as a proxy for a little while longer, until she's ready to cut loose her parachute. She hasn't committed to this yet because she doesn't want to forfeit the possibility of her old life to go back to (which is why she was upset over splitting from Niko even though she couldn't care less when he's actually around), but once she is reminded how horribly BORING it was, there'll be nothing to hold her back anymore. Because better to flame and implode than be smothered in a kitschy kitchen with a man you imagine blending up and pouring into a thermos. Better to be true and horrible than be nothing.

If you did read this thank you and I promise I'll stop writing mini essays and go back to regularly scheduled memes in a moment. I don't really do these because they don't interest anybody, but lmao, these two always get me thinking. hmu if you wanna trade theories lol.

[dlkardenal]

Psychopaths – A type of villain we all love to hate

A villain – if you have one – can make or break a book. When we attempt to understand their motivations we often bump into some kind of mental illness or condition that is not neurotypical. In the following weeks I will try to cover the most popular mental conditions of the villains, starting with the most common yet most misunderstood one: the psychopaths.

When we read the story of a serial killer, we can go on shrugging and saying he was a psychopath like this term explain everything. The most important thing that I want to nail down, that yes, many serial killers were psychopaths but not all of them, and not all psychopaths become murderers.

The common trait most prominent feature of psychopathy is the lack of empathy. Everything else is the consequence of this –  if they want something, they will get it and they won’t think of the feelings and needs of others for a moment. If it is their best interest, they can be charming, they manipulate or get rid of anyone in their way without the shred of doubt. Pathological lying can also occur, and they feel no remorse or regret ever. They can’t feel a real emotional connection to anyone as they are biologically incapable of that.

How do we know this?

Scientists measured the volume and activity of different brain regions in psychopaths – they found candidates for this among inmates unaware of their conditions – and compared it to neurotypical (aka. normal) people.

They found that those who showed psychopathic features, like impairment in moral judgment, manipulating and lying seemed to have increased white matter and decreased grey matter volume a certain brain area we call ventromedial prefrontal cortex, just behind the middle of your forehead. Interestingly, patients who suffer damage to this region due to an accident or infection can develop psychopathic features, depending on how old they were. Those who suffer damage under the age of 16 are more likely to show psychopathic and criminalistic behavior than those who were adults, although the damage can’t entirely replicate the disorder of psychopathy. This phenomenon is one indication that true psychopathy is developed – or rather undeveloped – very early, most likely during the time the parts of the brain responsible for affection and morals form the first time. Which means psychopaths are born.

They also found impairment in a little but very important nucleus in the middle-lower part of the brain called the amygdala. This region is responsible for controlling many things related to emotions – developing fear responses, rewarding yourself, and the process of learning through these effects. Without these, psychopaths don’t usually fear punishment and have a much milder reaction to stress. For example, you should never play poker or gamble with a psychopath as their heart-rate stays calmer than most people and they tend to take risks, stripping you of every bit of money quickly. They also have enhanced sensitivity for rewards, so they never step back until they are winning.

Having said that, most psychopaths can decide to imitate emotions, forcing themselves to fancy or take care of someone. This is a cold, rational decision without real feelings and attachment behind it, so they can cut their relationships just as easily as they formed them. They can just as easily show emotions through intelligence, shaming every Oscar-winning actor if that suits them. I seriously wonder if some awards for lead characters were handed out to psychopaths – only the main roles though, they would never accept anything less, don’t even dream of that.

What causes the neurodevelopmental impairment that leads to psychopathy is still a mystery but in conditions such as this, starting during early life and unfolding as the patient ages, the cause is most often the genetics. Yes, those pesky genes again. They do a lot, don’t they? Which one of those little cuties is responsible for this and how exactly, we are still unsure, but scientists all over the world are working hard to find out. There is a growing literature about psychopathy, if you want to read further from a neurobiological perspective, I suggest you start with the article “The Neurobiology of Psychopathy: A Neurodevelopmental Perspective”. It is free to read, and although not easy to read if you’re not used to scientific language, there are a lot of interesting little tidbits the readers could consider and learn from.

 The most common misunderstanding about this condition is that some trauma or a tragic backstory can lead to psychopathy, thus justifying the actions of our cruel and vicious, yet somehow charming mass murderer, making him sympathetic and understandable. As we discussed before, this is a myth. Childhood experiences can create a sociopath, a narcissist, but not a psychopath. It is a condition people are born with, a dysfunction in the brain. You don’t need to have shitty parents and traumatic childhood to be a psychopath.

The other very important thing is, you can’t treat psychopathy. They don’t react to pills or therapy, nothing. This is their nature and they can’t change, even those who may understand their condition and are willing to try (a rare case, but not impossible) are doomed to fail. There is no redemption for them, no one will come to change their life. They can however act as if they have changed of course, but it would remain what it is: an act. Their true nature will come forward eventually, and that will sting like nothing else. Now that I think of it, this may be an interesting plot we should get on writing… Hmmm… But back to the topic…

As for representation, there are two main types. A successful psychopath blends in with society, manipulates, lies his way through life without detection, and ends up being the head of a bank or a huge company. The unsuccessful psychopath is more impulsive, more criminalistic, and most probably ends up in jail.

My favorite portrayal is a bit of both – the infamous Hannibal Lecter, especially the Hannibal from the series because Mads Mikkelsen shows perfectly just how manipulative yet charming can a psychopath be. Dar’s favorite example is the villain/evil king from the book Graceling by Kristin Cashore, which is also a perfect portrayal beginning with him being a cruel and uncaring little kid torturing animals.

That’s all for today, my children, next time we will move onto narcissists and sociopaths, what is the difference between psychopaths and them, which are the individual traits and how they develop. Stay tuned!

Lory

[ais-n]

2| and where is the trauma? both hsin and boyd were severely sexually abused. and emilio's illness is always treated as a joke. look Ais, your series has done me so much good between the bad it did. i found i'm gay lmao and i'm grateful for that. i'm grateful that you wrote this ok. but there are things that were offensive, and maybe it was unconscious, since i doubt you wanted to be racist or write a mlm relationship but more like hetero. i wish i could just enjoy the books but my heart breaks

3| idk what the one who questioned that could possibly mean between all the things but thats what i mean. i appreciate you a lot. i hope this didn’t make you feel worse or whatever. but some people really did end up hurt badly after reading icos and im one of them. with all respect, and hope that i didnt disturb you much, farewell.

++++++++++++

Aha I just realized I can put both 2nd and 3rd asks in one! Which is good because, again, the gay comment makes me laugh out loud XD As I said in the other post, thank you again for reaching out, for explaining your concerns, and for the courage you no doubt had to bring forth in order to do so.

I’m getting right into the answers in this one although I will probably ask more questions for clarification on some of the points, as I did on the first one, to make sure I’m not misunderstanding or misinterpreting anything.

More below the cut! :)

EMILIO’S ILLNESS

I’m really sorry but I wasn’t sure what you meant by that. Which illness? How is it treated as a joke? Could you clarify? 

TRAUMA

So this I thought was super interesting that you felt there was no representation of trauma in ICoS, or I assume you also mean its aftereffects. That’s actually one of the few points I feel pretty confident saying the series does portray a lot of, both in some cases the experience of it and in other cases the repercussions. 

One of the reasons both of them are so severely dysfunctional individually and together is because of trauma.

I don’t want to muddy up this post with a huge tangent but someone had asked a few years ago about the result of the Aleixo mission on Boyd, if he was diagnosed with anything, and so on. If you’re interested, I wrote a long ass reply about the psychological effect of sex trafficking on survivors/victims and talked about some of the things you see Boyd do that are a bit reflective of that. More info at https://aisness.wordpress.com/2015/01/28/boyd-aleixo-psychology/

I think there probably would be more information on all this by now, or at least I certainly hope there would be, but at the time of writing Fade that was the sort of research that was available. 

Although, full disclosure, I don’t tend to write characters looking up the DSM symptoms for this or that; I write what feels right for them psychologically, mentally, emotionally, and oftentimes later look it up and realize they would have likely been diagnosed with this or that thing or they could be displaying traits of this or that.

At any rate, with Boyd, his trauma started early on, and pretty much everything about him is a reflection of that in some form. I don’t see trauma as specific to sexual assault; it’s most certainly a result of that but also of many other things. Boyd dealt with a lot of neglect and/or emotional abuse as a child, he was bullied by his peers, and generally speaking it was difficult for him to feel like he belonged anywhere. He was very often judged by others, often negatively, for things completely outside of his control, like his parents, their jobs, his home, the amount of money his family had, his looks, etc. 

If you look at the Mayo Clinic’s list of child abuse, Boyd falls pretty well under emotional abuse and a bit under neglect, and you can especially see the toll that had on his personality by reading the signs and symptoms of emotional abuse in particular:

Loss of self-confidence or self-esteem

Social withdrawal or a loss of interest or enthusiasm

Depression

Avoidance of certain situations, such as refusing to go to school or ride the bus

Desperately seeks affection

And general symptoms:

Withdrawal from friends or usual activities

Depression, anxiety or unusual fears, or a sudden loss of self-confidence

An apparent lack of supervision

Self-harm or attempts at suicide 

If you look at Complex PTSD, and in particular Developmental Trauma Disorder (DTD) you can see a lot of Hsin:

Attachment – “problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to others’ emotional states”

Behavioural control – “problems with impulse control, aggression, pathological self-soothing, and sleep problems”

Dissociation – “amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events”

I wouldn’t say Hsin dissociates quite that extensively but I feel like he does display some dissociative tendencies at times.

Boyd has some too, like

Self-concept – “fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self”.

I think in some ways you could argue they both display aspects of:

Affect or emotional regulation – “poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes”

When Boyd was little, he often wondered why other people were treated better than him - why, when he was getting perfect grades, he was going above and beyond whenever possible, when he was trying to be “a good boy” all the time, when he went out of his way to stay quiet and not bother anyone – why, despite all his attempts, other people were celebrate yet he was reviled, even if the people being celebrated were awful people doing awful things. He used to study other people relentlessly, trying to understand what it was about them that made them acceptable and what it was about him that made him not.

That’s why, despite being such an introvert, he’s good at blending in and going undercover; it’s why he can adjust to new situations and, in a way, act - because he always had to monitor and adjust himself his whole life just to feel seen and loved. His dad loved him on his own so it wasn’t as bad as it could have been, but with the trauma that came from the loss of his dad, and what happened with Lou, plus everything afterward, it really messed everything up.

Boyd was not a victim of childhood sexual abuse, but more of emotional abuse. Well, I guess, I should say for the most part he wasn’t.

Hsin was definitely a victim of childhood sexual abuse and probably physical abuse (that bit I can’t recall for sure). He was raped even as a small child, and that led into different aspects of his life. One reason, for example, he would go berserk and was seen by the Agency as unreliable in cases of him seeing sexual assault was because he saw, in some way, himself in those victims. It was probably his way of protecting people when he hadn’t been protected, himself. 

I can’t speak too much on Hsin’s specific mental health status or repercussions because I didn’t write him so I’m not fully in his mind, but I do know that sort of berserker aspect is part of what came from his sexual abuse and physical abuse and just generally how he grew up. If I recall correctly, a lot of that led into why he was so unstable and dangerous when Emilio first found him; why it took so long to get Hsin to find a way to deal with the violence and aggression and anger in him, in addition to everything else that would have happened regardless of that childhood trauma. Why, too, it was such a huge deal when Boyd was able to earn Hsin’s trust, because he had learned in his life to trust almost no one.

You can see some of the way they both display aspects of C-PTSD as adults as well in the list at https://en.wikipedia.org/wiki/Complex_post-traumatic_stress_disorder#Adults

I should be clear: I am NOT a psychiatrist or psychologist so I’m not suggesting that they would be specifically diagnosed with any of these disorders were they to get official diagnoses. However, the reason I bring it up is to show that a lot of the series reflects the way their coping mechanisms lead them to interact within themselves and with the outside world, all of which is often directly or indirectly tied to trauma.

Why is Boyd so terrified of anyone seeing him without his shirt in the beginning? Trauma. Why is he depressed? Trauma. Why is he suicidal? Trauma. Why does he go out of his way to avoid a certain block? Trauma. I would have to look at specific symptoms of different things but I would guess that you could also tie back some of his instability and his sometimes inconsistent reactions to trauma as well. Sometimes he does things or says things that may seem a bit reckless, or cold, or some other unexpected thing at that time - and a lot of times it’s probably in part related to how he learned to cope with things and what his levels of defensiveness are or his fears are at that moment. But he also has a complete inability to see the good in himself for a long time which also ties back, I would think, to some of the things he experienced growing up/previously.

Boyd is an incredibly unreliable narrator. He spends most of his narration thinking about how awful he is, how he should just die, how he isn’t doing a good enough job, and so forth. Yet, that fails to show the impact of some of his choices and decisions. Boyd was pretty much the first person to treat Hsin like a normal human being, to not see him as a surrogate of anything or anyone, to not have any ulterior motives or expectations of him (no matter how well-intentioned), and to truly gain his trust as a result. Yet, Boyd didn’t really see it that way. He didn’t see how important it was for Hsin that he ended up in his life; he didn’t get why Hsin was exasperated the times Boyd said he (Boyd) should just die, that there was no value to his life. He didn’t believe he could be loved so he couldn’t see it was even a possibility at first. Therefore, he spends a lot of his narration over the series belittling himself and downplaying any of his own achievements while simultaneously rewarding or acknowledging what others around him are doing. Not every moment of his narration, of course, but his default state of self is to think he sucks and others are probably better.

Conversely, Hsin is a confident narrator. He often doesn’t doubt himself, doesn’t care what other people think, and is very sure of himself in a lot of aspects like his physical prowess which, itself, is already above and beyond nearly everyone else. Yet he also learned not to trust or rely on anyone else in his life, so he’s incredibly suspicious of others because that’s how he had to learn to be. So, especially in the beginning of the series, in his narration he tends to be very factual about his own achievements and not shy away from acknowledging the things that are powerful about him (even if he doesn’t always see it as anything that special), while simultaneously seeking out anything untrustworthy, unreliable, incompetent, or unworthy about those around him. His narration tends to point out the flaws of those around him because he learned that if he doesn’t protect himself, he’s vulnerable, and when he’s vulnerable he gets hurt.

The result of that is, if you read their narrations straight as if it’s all perfectly reliable, Boyd seems even more unreliable and Hsin seems even more perfect than they actually are, because their default states of being overlap in a manner which magnifies the flaws in Boyd and the merits in Hsin. 

Both of them learned to be how they were because of how they were raised, what they went through, and more. Same as how they react to various things throughout the series.

I can’t more specifically comment on anything without knowing what in particular you were thinking of when commenting in the ask about trauma and sexual abuse. But I think generally speaking, they already start the series having learned coping mechanisms that work for them based on trauma they already individually experienced. Those coping mechanisms end up oftentimes being challenged and at times destroyed or reworked throughout the course of the series. That is what leads to a lot of their ups and downs as individuals and as a couple; why their story isn’t a straight arc going up but instead derails a lot. And why they both spend the entirety of the series coming to terms with who they are both internally and externally, and what that means for their relationship, and how they can find a way to grow as a person and a significant other. They both ultimately have to work on trust; Boyd has to learn to trust himself, Hsin has to learn to trust others, and they have to learn to trust each other.

The way people deal with trauma is not the same for everyone. Sexual abuse doesn’t result in the same reaction for all people. I’m not sure if maybe one of the things you were thinking is maybe about sexual abuse during the series itself? I already linked something that goes more in depth on Fade so I won’t touch on that book, and I really can’t speak for Hsin because he isn’t my character so I don’t want to misrepresent his thought process as hidden behind narration or actions at different points.

The only other thing I can think of that maybe you’re thinking about is Boyd’s valentine status, and how he doesn’t seem to have overtly strong reactions to anything until Fade. If that’s one aspect of what you were thinking about, part of that is just how Boyd deals with things. He tends to avoid things that are difficult for him or he has difficulty focusing on, and oftentimes shuts down emotionally. 

I think honestly he probably dissociated to some extent during a lot of things; kind of separated his body from his mind and felt like whatever happened, happened. For a lot of the time that he was a valentine early on, he had such little love for himself that regardless of how upsetting anything was, how little he wanted to do certain things, he felt on some level like he deserved it. Some things were probably a subconscious form of self-punishment for being born, for being who he is, for surviving when Lou didn’t, for surviving when his dad didn’t, for never being enough for his mother, for just plain existing. Then as time went on he grew to rely on Hsin and find strength in him. It’s also not like every mission he had was a valentine one, or even that every valentine has to end in anything physical. 

That’s why he was able to find ways of dealing with things in some form, even if he didn’t like it or was uncomfortable at times, until the Aleixo mission. He thought he knew how to handle things; he thought he had found apt coping mechanisms. But that mission tore that all apart and nearly destroyed him. His coping mechanisms didn’t work the way they had and now he had to find a new way to survive, and from there came a lot of his instability and more that you see in Fade and as I mention in that blog post.

But in short, I feel like the majority of the series ends up touching, indirectly or directly, on some form of trauma as experienced currently or in the past by one or more of the main characters, and their resulting actions then drive the plot. That is one thing we were very specific about doing: having the plot adjust to the characters rather than force the characters to adjust to the plot. That’s why Afterimage exists, actually; the original plan was sort of like 3/4 of Evenfall and then kind of jumping into aspects of Fade. But we realized at the end of Evenfall that certain things would occur which would then lead to Afterimage and Afterimage then led into aspects of Interludes, which then led into aspects of right before Fade, which then affected a huge part of Fade itself, which then informed 1/27. We didn’t set out to write a series specifically about trauma, it’s just sort of one of those things that happens if you take two characters who have been treated so cruelly or poorly for so much of their lives, and put them together as any sort of team - but especially a team that becomes a couple, and a couple that becomes all but married.

+ +

Regarding the other stuff, I haven’t had a chance yet to check if you answered my question about the hetero relationship comment, so I can’t comment on that until I know more of what you mean. But I would say that generally speaking, I don’t know that I believe it’s necessarily fair to label anything as strictly “hetero” vs “m/m” vs anything else for a relationship. That brings with it a lot of assumptions of what it means to be not only gay or LGBTQIA+, but also straight. It seems to suggest there is only a single way or a very strict set of ways for a cis male and a cis female to be together both in a relationship and to have sex, and I guess I don’t feel like that’s necessarily reflective of reality. People are very complex and so are their relationships, as well as their sex lives.

I’m not sure how specifically the series ended up hurting you but I’m very sorry you felt hurt by anything. That’s a terrible feeling to have to experience. I hope that in whatever way, however it may work best for you, you have the time and space to reflect and recover and rejuvenate. You, like everyone, deserve it.

And honestly, if that means you have to leave the series completely in your past, never to think about it again, if that’s what’s healthiest for you, I truly wish you are able to do so. Stories are there to connect with other people, to share our thoughts and sometimes help us work our way through our own while reading. No story is worth your mental health being put in question. If it is truly upsetting to you to think about the series, it is absolutely not worth your energy. You are more important than a story will ever be. Everyone is. And I say that despite how much I love and rely on stories to get me through life.

If part of your duress is you like aspects of the writing style but the series itself and its contents upset you, you could try reading some other stuff. I have some things I wrote solo that you can find on my AO3 if you want. But also you can find other writers entirely. Depending on what you’re looking for in a story, and the sort of topics you’ve learned work well for you or don’t work well for you, you should be able to find a ton of great series out there and great authors out there who will leave you with the happier aspects of your reaction to ICoS without anything more detrimental like it sounds happened for you with ICoS.

Regardless, I truly wish you the very best. As I said in the other one, please stay healthy and safe! And, if you’re in a place to manage it, stay happy as well :)

Brightest of blessings to you and yours, my friend!

[awomanonthespectrum]

Have your autism symptoms improved or worsened over time?

Answer by Thomas Gisler

It always bares repeating that every autistic’s life experience is different. There is a common neurological foundation ( AUTISM ) but how it manifests in each individual is unique.

I was very late diagnosed (age 59) and this throws a totally different factor into how I experienced autism. Childhood circumstances which included emotional abuse led me to live in a denial/dissociation detachment from my life experience. I thought that what/ who I was, was so bad and broken, it was wrong to even let these thought come into my head. I tried to be “something else” to please people and it became how I lived. Trying to react to others… looking for ways to be “a good person”. But it had nothing to do with being me. That changed a little as I got older but was pretty much how I operated until my diagnosis.

I guess the good news is the real me is still there somewhere. Looking back on all this, I think my “search” for answers was a search for myself. Even thought I knew I was different I could not admit let alone accept it - but I still knew it.. I could not understand it because of this insane self-oppression I had learned to do. Was that Masking? I guess it was a form of masking.. I’m still learning so much as I put the pieces of my life back together.

What is interesting is realizing how many of my autistic traits were still part of my life. I guess the ones that were noticeable to others and myself were the ones that were highest priority to hide or deny in some way. But often they just took other forms. I use to do lots of leg/foot stims as a child - I STOPPED those along with finger /hand stims I clearly remember my father saying “STOP THAT” in the way that ripped out my soul’s sense of self. I realize I was the “Obnoxious” kid - the self-centered kid - the loaner - friendless until later in school. I had my fixations - my sensory stims - But I kept everything out of view if it brought attention to myself.

Now that the genie is out of the bottle - I’ve been reversing all the oppressive thoughts and behaviors the best I can. I’m intentionally exploring my past and present and learning to feel what was always denied or avoided. I’m fortunate that I have very clear memories of my life. Usually those times when there was some conflict but not always. The more I let myself be, the more I see that I am autistic. It’s still hard to admit it in some ways.. Not because I feel there is something bad about being autistic but to discover that THIS is the answer.. This is why I am so different… and it is not a bad thing.. or a shameful thing… or wrong, or a disease or mental illness - ITS A DIFFERENCE! -

It comes with its share of + and - just like a neurotypical life. In fact, its the autistic traits that make me happy and whole. I am more intelligent than average. I can learn in depth and breadth that is above average. I love that I still have a child’s fascination of the world. My silly humor. I still toe-walk! The routines I both love and depend on. I like to stim in different ways. My life has finally become whole! I no longer wish for death to end this nightmare but am embracing the fun of life because now, I enjoy living. ME ME ME! I’m Homer Simpson with a brain! LOL!

There are challenges too. Some are scars from the past - some that may never heal. I’m still Dyslexic and reading is not enjoyable. I suspect alexithymia because of my difficulty knowing what my feelings are and why. As I let myself feel - I can feel anxiety much stronger - I have what I think are termed Melt-Downs - they can be total frustration and anger over a minuscule disruption in a routine or being overwhelmed by crying as if in despair, that can last from 5 seconds to an hour +. Sensory sensitivity is now a feeling I notice more and more.. sounds, light, touch… usually if I’m startled.. it is like I was hit with a cattle prod from head to toe. These were all things I learned to deny by not letting myself recognize the feelings that came with them.

I think also, as we get older we do not have the mental energy needed to manipulate and deny our true selves as we did when younger - So - this is another facet of autism - another example of how experience of being autistic can vary from person to person. I don’t know what my future holds. I know that I am finding more connections that lead me to those “ Ahhh Haaa!” moments of realization an understanding.

I have to add this… how important it is we let everyone be true to their nature. Let children who are autistic be autistic. Support them in discovering who they are and how to manage their autism with autistic means not some way that makes them feel that being autistic is wrong or bad or broken. Especially not they are some pathological mistake to be pitied. Life is hard enough without being led to believe who you are will never be good enough.

https://www.quora.com/Have-your-autism-symptoms-improved-or-worsened-over-time/answer/Thomas-Gisler-1?ch=10&share=84f14f1e&srid=C7yPi

[dixbolik-lovers]

“These are so much fun! I love reading about these girls!! I get really happy when I see stuff about them! The next three I’d like to hear about are Manipulation, Obsession and Cowardly.”

---

This is slightly (very) old, but I hope you’re still here, anon!! I really do love these asks! ;w;

MANIPULATION

-When she’s not trying to make people feel bad, she can have quite a sense of humor. Although she’s too mean to bother with it very often, she’s strangely good at telling jokes and making people laugh. Unfortunately, she’d much rather see people cry than laugh. 

-She’s extremely eloquent and good with words. Unfortunately, she mostly uses this talent to trick people into doing her bidding. Everyone has caught onto her tricks pretty well by now, but that doesn’t stop Manipulation from trying to get under everyone’s skin. She can talk circles around almost anyone, and is very proud of her ability to confuse, sway, and mislead. 

-Her hair looks like a combination of vines and dreadlocks, and is completely prehensile. She can use locks of it to restrain people so they can’t get away from her, and often uses this ability to make sure she has a captive audience. Her hair has feeling in it, though, and damage to it hurts. Every lock is like an extra limb that she’s completely aware of, and these tendrils are a lot more delicate than they look. 

-She has a habit of sticking things in both of her mouths when she’s bored. She’s a chewer who’s often seen with something in one or the other-- be it a small rock, piece of debris, or part of a plant. 

-She loves when people underestimate her, and often tries to look weak on purpose for this exact reason. When others assume that she’s weak and harmless, it makes it all the easier to get her way. It’s entertaining for her to watch people get everything about her wrong... then find out the hard way why she’s just as dangerous as the rest of them. 

-She’s a near-pathological liar. Spinning untruths comes naturally to her by now, and she often lies for no reason other than that the opportunity is there, or simply because she could use it to lead someone astray. Lying has become easier than telling the truth for her. Because of this habit, she’s hit a point where expressing her true feelings is difficult. She has a terrible time of telling the truth, especially when any part of it could make her look bad. 

-Although she’ll never admit it, she’s a little bit afraid of being alone in dark places. Something about it makes her feel way too empty. 

-She needs entertainment at all times, and can’t stand monotony or boredom. When things are the same for too long, she gets an uncontrollable urge to start stirring up trouble-- the more it hurts others, the better!. Emptiness is what she hates most in the world, especially within her own head. 

-When she cries, her tears are made of blood. Of course, she loves crying for attention, as she does with anything that helps her get her way, and as such, she’s known as a complete faker. She loves convincing people to feel sorry for her, but by now, few fall for her tricks. She can cry on command within seconds, and is an excellent actress when it comes to faking tears. 

-Surprisingly, she’s rather hyperactive. New things excite her more than anything, especially new people to play with. She’ll do anything that seems entertaining, even when she knows it’s probably a bad idea. Humans, in particular, fascinate her more than anything in the World of Fog. 

OBSESSION

-She adores physical contact, but thanks to a combination of her claws and not knowing her own strength, she can’t touch anyone without hurting them. It’s very sad to her that she can’t get close to people, but she often misses the extent of the damage she does. This doesn’t stop her from trying to get close, though, as she’s determined to get close to those she loves, no matter what she has to do. The objects of her affection are likely to wind up bloody when she reaches out to them.

-She’s naturally good with words, but her brain moves faster than her mouth can keep up with. She tends to talk quickly and in confusing circles, and repeats herself often because she needs to fill space. She’s something of a chatterbox, even if what she says only sort of makes sense. 

-She likes tying “pretty” things into her hair, like small strips of fabric and bits of string or glass. The others are fond of ripping these things out, though, so she often feels like she’s better off simply hiding them where they’ll be safe. 

-She has a large, open hole in her chest, about where her heart should be. It goes approximately halfway into her, and is always leaking-- if not dripping-- blood. She has a habit of trying to stuff all kinds of things into it, and will attempt this with anything that looks like it can properly fit. Because of the hole, she always has the feeling that something is missing, and she’ll go to disturbing lengths to try to fill up the void. 

-She’s very single-minded, and has trouble focusing on more than one thing at a time. When she gets interested in something, it’s hard for her to tear herself away. Once she’s zoned in on something, nothing can stop her. 

-She gets crushes easily and loves strongly, but her love fades as soon as she realizes that the person she’s fixated on won’t fill the void inside of her. She has unrealistic expectations of what others can do to make her feel happy and fulfilled, and when people fail those expectations, her desperate love for someone will just as quickly turn into intense hatred.

-When she first came to the World of Fog, she developed an immediate, intense crush on Selfishness. Obsession loved Selfishness for her spirit and loud, brash nature, but soon found out that Selfishness was resistant to all of Obsession’s attempts to “love” her. Obsession’s crush faded quickly. 

-She’s claimed one of the houses in the main town for herself. It’s rotted and unsteady, but mostly intact and safe to reside in. She fills one room in particular with things she’s collected (read; stolen) from the other girls in an attempt to find some sort of spark. She adores her secret treasures, openly fawning over the pieces of them that she’s managed to take for herself. However, she gets angry when anyone else tries to get close to her horde. 

-Her emotions seem strong and intense, but inside, she’s empty. She overcompensates for her lack of emotions through exaggerated behaviors. 

-She has a love-hate relationship with the other girls where she adores the idea of them, but can’t stand their real selves. Obsession always has unrealistic expectations of others. She falls in love with these expectations, then turns angry and violent when the real person fails to live up to them. She falls in love with concepts easily, but can’t tolerate the flaws that real people have. 

COWARDLY

-She picks at her skin when she’s nervous. It’s a habit that’s impossible to break by now, and she does a lot of damage with it. She usually scratches to the point of drawing blood, but has gotten down to the bone before when she’s particularly upset. It’s a clear give-away that she’s anxious or afraid. 

-She’s very sensitive to light and sound. She gets overwhelmed by these things easily, and despises bright and crowded places because of it. Both light and sound give her headaches and leave her disoriented, and when she’s stuck with either one for too long, she very nearly shuts down. Direct sunlight would have her curled up in a little ball trying to hide from the pain. 

-Her skin is rough and sharp all over. At it’s smoothest, it’s approximately the texture of fine sandpaper. However, there are sharper parts that form actual spikes, poking up an inch or two from her skin. The spikes are solid and hard, but can be broken off, and they have as much feeling in them as the rest of her.

-Because of the spikes on her skin, her clothes get ruined easily. She tears through almost everything she wears before long-- her spines and rough skin shredding the fabric just from her moving around. Her clothes never last, and she’s constantly switching out outfits for whatever she can find because of this. She hates having her skin uncovered, and almost always goes for long sleeves and floor-length skirts, even though they’ll be destroyed in no time. 

-Although they’re not as noticeable, she has claws like Selfishness. They’re smaller, but just as sharp, and between that and the spikes on her skin, direct physical contact with her is bound to hurt. 

-She suffers from minor hallucinations, both visual and auditory. These usually feature monsters just outside her field of vision that she can never quite see, or low voices whispering to her in words that can’t be made out. These hallucinations only serve to make her more paranoid, and sometimes, she has trouble differentiating between what’s real and what’s just in her head. 

-While she’s not exactly smart, she’s highly perceptive. Her strength lies in reading people and figuring out how to not get hurt. She’s always alert and aware, catches onto things quickly, and has a distinct skill when it comes to reading when people are going to get angry. 

-Despite her anxious, almost sweet personality, she’s highly two-faced. She’ll only show the parts of herself that earn favor, hiding everything else from the people around her. She never dares to show her true self. 

-She tends towards the vengeful. Because she’s bullied and hurt so often, she has a long list of people that she hates and things that she wants revenge for. She’s been hurt enough times that she has a reason to hate every other person in the World of Fog, and may actually be plotting something to hurt all of them. The only one she’d never dare to stand up against is Judgement. 

-She’s drawn to small, dark places, and is often compared to a rat, roach, or other vermin because of it. She detests those nicknames viciously. Nothing makes her angry like being called the vermin of the World of Fog. Even so, confined, hidden, lightless spaces make her feel safe. 

[thecursedhellblazer]

@mythsxndlegends​​ asked:  “  Shippy thingie for Oliver? ”

Look at our idiots together || Accepting !

who hogs the duvet None of them. Oliver has slept in the most uncomfortable places ever, so he doesn’t really mind having a blanket or not, especially when the heating system takes care of keeping a comfortable temperature. As for John, he moves a lot in his sleep constantly ends up kicking the sheet off his body and off the bed, so that’s where they usually end up being in the morning. If one of them gets cold in his sleep, they usually end up pressed up against each other. Sometimes face to face, more often back to back. Of course, if they have fallen asleep tangled in each other, that’s how they’ll probably stay, no need for a blanket in the first place.

who texts/rings to check how their day is going None of them does it. They aren’t fans of texting in general and Oliver usually calls if he needs John’s help or advice with something, exploiting the chance to also ask him how he’s doing. Constantine, from his part, just texts Oliver random crap for the mere reason that Felicity told him that such kind of texts annoy the hell out of the vigilante and John is nothing if not a smug bastard when it comes to this kind of things.

who’s the most creative when it comes to gifts It depends on your definition of “creative”. John gets his hands on the most random things during his travels and there has been one time when he has brought Oliver a demon skull straight back from Hell. Useless to say, the Green Arrow had no idea of what to do with it, but he didn’t want to throw it away, so it has ended up in a glass case in their secret headquarters. Oliver’s gift are a bit less odd, but more practical. High quality Swiss knives, decent first aide kits, a talisman he retrieved thanks to one of his many contacts, even a gun with special bullets once (even if he knows that John doesn’t really use them).

who gets up first in the morning Oliver, even despite his nightly activities. John is not a morning at all and getting him out of the bed is a real challenge at times. Especially since, more often than not, he stays up till almost down and then drinks himself to sleep, which lands him very hangover the next morning. That when he sleeps at all. Both Oliver and Felicity tend to worry about his fucked up sleeping schedule, she more than him, but they just can’t be helped. And all this without mentioning all the times Oliver arrived late to his office because John had made sure he didn’t get out of the bed either.

who suggests new things in bed It’s fatally up to John. The magician had seen and tried things that Oliver can’t even start to imagine and that is a bit scary too at times, even if it brings out some interesting options for what they can try out. John, on his part, really appreciates Oliver’s abilities when it comes to tie someone up.

who cries at movies None of them does. However, John has the bad habits of making lots of comments while watching movies and that becomes a problem when the rest of the room doesn’t want to hear them. Also, it makes the team movie nights a mess because he and Curtis just can’t shut up for a moment. Diggle is always a breath away from shooting them both with tranquilizers.

who gives unprompted massages They are a rare occurrence, but they can happen and mostly they come from Oliver. John is less “touchy-feely”, so he tends not to initiate contact unless he’s aiming for sex, but he can appreciate the way the vigilante works his hands on his back and arms. John ends up giving the massages after some particularly rough intimate session they had or whenever Oliver is stressing too much or feeling to guilty over something. None of them likes to talk, so Constantine makes him sit down, with magic if he has to, and works on Oliver’s body until he has managed to loosen the worst knots in his muscles.

who fusses over the other when they’re sick None of them really fusses. Oliver worries, because John isn’t good at taking care of himself in general and, demon blood or not, he can get injured quite badly considering the kind of job he does. However, he knows better than to try and get in the other man’s way of life. As for John, he mostly isn’t around when Oliver gets wounded during missions. Felicity calls him only when it’s worse than the usual and there have been a few times he has shown up literally out of nowhere just to make sure that Oliver would recover. Of course, he always has an excuse not to admit that he is doing that.

who gets jealous easiest None of them really gets gets jealous. John might from time to time, but the feeling always comes more from the fact that he ends up thinking that Oliver would be better off with someone less messed up than he is. Oliver has been the cheater in too many relationships in the past and that makes him rationalise any possible jealous feeling he might get. Moreover, he knows that John is a flirt and and that he uses that to gets what he wants and needs from time to time. Plus, there is the chance that he feels a bit unequipped when it comes to engage someone with John’s kind of sexual experience.

who has the most embarrassing taste in music John has the weirdest ones, but not necessarily the most embarrassing. The problems start when he gets over fixated on one single song and that’s the only thing everyone who is around him is allowed to listen to. Oliver might have a few girly songs he started to like because of Felicity and Thea, and those definitely earn him some playful teasing from John’s part.

who collects something unusual John. Retrieving and collecting artifacts is part of his job and some of them are literally out of this world. Oliver has a small collection of the items he has brought home from his five years spent around the world and on Lian Yu, but even the oddest of them looks absolutely normal comparing with what John can pull out of his vault.

who takes the longest to get ready It depends. Usually Oliver, because he actually cares about getting his looks together, while John just showers and then goes out still with his bed hair. There are times, however, when Constantine spends over an hour in the bathroom because he is sleep-deprived or hangover or simply lost in his thoughts and it takes ages for him to get himself together and ready to go.

who is the most tidy and organised Oliver, and it’s pretty obvious. He keeps his things in order, stashed away in the right place and he instantly notices if something is missing or out of place. John is chaos personified. He leaves his stuff hanging around everywhere, even if he eventually cleans after himself, at least when he is at Oliver’s (let’s not talk about what he does when he is alone at his own place). Oddly enough, though, he always manages to find what he needs. The team is secretly running a poll on whether or not he puts a tracking spell on everything to make sure he doesn’t lose it.

who gets most excited about the holidays None of them is a huge fun of holidays. Oliver doesn’t mind to celebrate them quietly, with friends and what’s left of his family. John couldn’t care less for them if not for the fact that they usually mean more people messing with magic in the wrong way at the wrong time (a lot of modern holidays have taken the place of old pagans rites and they usually coincide with days when the Veil is thinner). No one, however, will ever forget that one Halloween when John introduced them to the ghosts of some of his dead mates.

who is the big spoon/little spoon It depends on the mood and on what they have been doing before finding themselves in such position. They usually don’t spoon at all and either sleep facing each other or remaining entangled in each other’s limbs. There are times when Oliver rolls over in his sleeps and plasters himself against John’s back, in an instinctive need to shield whoever is sharing his bed. John eventually moves away, because being held without him having somehow asked for it for too long makes him feel caged and brings back unpleasant memories. The other way around usually happens only if Oliver asks, with words or, more often, just making John understand what he wants without saying it.

who gets most competitive when playing games and/or sports They are both competitive, with the difference that John is a pathological sore loser. He always finds a way to cheat, no matter what they are playing, and that can be overly annoying. However, most of the times, Oliver chooses to takes it as a challenge, a way to train himself to put on a fair fight even if his opponent isn’t playing by the rules. It actually makes the competition more fun, even if there is always some lingering frustration on both sides.

who starts the most arguments John. He is the one who usually snaps or start being unreasonable about things that, in Oliver’s eyes, are perfectly logical. The problem is that, when Constantine is in one of his moods, he is beyond touchy and every pretext is good to start an argument, even when there’s no real to do so. It’s his way to unload whatever feeling is eating him up on the inside and, unfortunately, from time to time he ends up saying or doing the wrong feeling, triggering Oliver’s anger in response. Whenever the latter things happen, John ends up storming out of the building and of the city too and it takes days, if not weeks for him to come back or get in touch. And usually it’s always because Felicity or Curtis have reached out to him first (Oliver is too stubborn to do it in person).

who suggests that they buy a pet None of them is really a pet person and, with the kind of life they lead, they wouldn’t have the time to care for once. From time to time, John turns up with some magical creature he is temporarily looking after, for one reason or another, and they usually end up causing some trouble. Nothing too big, but they still leave enough of a mess to need to be cleaned up in their coming.

what couple traditions they have John likes watching Oliver working out and from time to time he even allows himself to be persuaded to join the training. That last thing had started as a joke from his part, but it ended up becoming almost a habit. Oliver also takes John sightseeing around Star City when he gets a chance, telling him about the places he has grown up in. Constantine usually ends up having them walking along the ley line that passes through the city, since he is naturally attracted to the power that comes from it, and it isn’t there for them to find some off object or even a small surge of energy on their path. John totally thrives in it and it’s one of the very few ways he can share something of his world with Oliver. They go out for milkshakes. John was skeptical at first, but Oliver insisted and eventually convinced it. It’s something he used to do while dating Laurel and he thinks that doing something normal can be good for them boths.

what tv shows they watch together None of them is really much into TV shows. They end up watching movies from time to time, whenever Oliver is up to dealing with John’s commentary or sports, when Oliver is willing to put up with John’s yelling.

what other couple they hang out with They don’t really do the whole double dating thing, especially since they don’t go on dates (or at least do and never call them such) in the first place. Usually, if they go out as a “couple” it’s a team outing plus John. They had dinner a quite a few times with Diggle and Lyla and in a couple of occasions with Curtis and his husband. There was this one, awkward time when they found themselves having coffee with Lance and Donna, and things got very awkward because the other two had no idea that John and Oliver were a thing and Donna started to ask Oliver about any potential love interest he had. The vigilante was left in a very tight spot, while John was so laughing his ass off next to him.

how they spend time together as a couple John also tags along for some of the team missions, even if in rare occasions. Moreover, there’s the time alone they spend together whenever Oliver can afford a half day off and John isn’t too busy chasing his latest interest in the occult field. They occupy it either in bed or doing some of the things aforementioned (sight-seeing, training, not-dates, movies, etc)

who made the first move John. He is the one who started to flirt with Oliver, out of fun, because he was utterly persuaded that the other was straight. And he was also the one who kept pressuring once he had grasped that Oliver might actually be interested, after all. That’s how the physical part of their relationship started. As for the emotional one, it developed on his own, without any of them ever mentioning it. And that’s the reason why they are in desperate need of having a talk about the subject.

who brings flowers home John used to show up at the lot with flowers for Thea when she was still around, bur for the rest it has never been their things. The only time Oliver was the one to bring the flowers was when John introduced him to a friend of his (and ex-girlfriend) who could have lent them a hand to deal with a cult. It turned out that Zatanna had quite a few interesting tales to share about Constantine and the magician totally regretted having brought her along.

who is the best cook Oliver. John can manage well enough, but the vigilante is the one who can whip together high quality meals all the time. Constantine doesn’t mind, also because, deep down, he knows that he needs to eat properly, at least from time to time.

[mst3kproject]

Attack of the Puppet People

This is the other movie Bert I. Gordon namedropped in Earth vs the Spider.  The screenplay was by John Worthing Yates, a guy who has a name that sounds like a Byronic poet but mostly wrote giant bug movies.  It stars June Kenney from that movie and Bloodlust!, John Hoyt from Lost Continent and The Time Travellers, and yep, John Agar.  The title is pretty much a lie, too – unless it refers to Agar tearing the head off a marionette.

Dolls Incorporated is a small toy company in Los Angeles.  The owner, Mr. Franz, needs a new secretary and hires Sally Reynolds, who is fresh out of college and has no family – an interesting choice, especially when we discover his previous secretary has vanished without a trace.  Sally soon notices that Mr. Franz has a weird habit of treating his dolls like real people, and comes to worry about his mental health.  When a salesman, Bob Wesley, asks her to marry him she is more than happy to leave the unnerving Mr. Franz behind, but Mr. Franz does not intend to let her.  With some technobabble and a contraption made out of photography equipment, he shrinks both Bob and Sally down to Barbie size to join his collection of human dolls! Somehow they must make their way back up to his office in order to un-shrink themselves, but it’s a very long way when you’re only a foot tall.

(The point of including clips from The Amazing Colossal Man, by the way, appears to have been a ham-fisted bit of foreshadowing with the line I’m not growing – you’re shrinking!  Which… okay, sure, if that made everybody feel better about the shameless self-promotion.)

The movie was made very quickly in order to capitalize on The Incredible Shrinking Man and I have to say, it puts significant effort into not being merely a ripoff. It’s not nearly as ambitious as its model in terms of special effects, but it has much more plot, being an actual story rather than a psychological study, although it does some of that, too.  I suspect that this was an idea that either Gordon or Yates had sitting around anyway and they welcomed the excuse to put it into production.

In terms of its story, this is actually one of Bert I. Gordon’s better efforts.  Like The Amazing Colossal Man, it tries to explore character a little rather than just being a monster rampage, and the character it’s interested in is Mr. Franz’.  He’s a deeply lonely man who feels everybody he cares about abandons him – starting with his wife, who ran off with a boyfriend long ago – and therefore goes to great lengths to keep them.  This obsession has grown worse and worse, until now people he’s only known a few weeks are subject to his captivity.  When he believes the police are on to him, he decides to commit suicide and take all his prisoners with him, because even in death he cannot bear to leave them behind.

The movie does occasionally waste our time, as in the sequence where one of the human dolls is commanded to sing, but not very often. Things like the tiny cat, or Sally’s efforts to go to the police, seem like sidelines but later turn out to be quite important.  My favourite part is when Franz is forced to leave his little people unsupervised when a friend drops in on him with a lengthy story to tell – he knows he can’t leave them alone for too long but he also doesn’t want to be rude to his buddy, so he keeps trying to make excuses and things get more and more awkward.  I’m pretty sure any introvert can identify with the situation, even those of us who are not mad scientists.

Attack of the Puppet People also has some of the better effects shots I’ve ever seen in Bert I. Gordon.  The dolls in their cases are nothing but paper cut-outs, always carefully held face-on to the camera in an attempt to preserve the illusion, and there are very visible seams around a miniature cat in Franz’ hands, but the images of tiny people interacting with oversized objects are actually pretty good.  There’s one of tiny Sally on a desk, with a telephone in front of her and Mr. Franz leaning in to talk to her, that’s almost seamless – the only place the illusion breaks is that he’s not quite actually looking at her. Quite a few of the oversized objects, like the telephone or coffee tin one woman uses as a bathtub, must have been specially made for the movie, and they’re detailed and convincing. The best is the oversize puppet the characters have to interact with. It really does look like something small, magnified.

The performances in the movie, on the other hand, are some of the worst I’ve seen even in a Bert I. Gordon film.  Everybody picks one note and sticks to it.  John Hoyt had been in Julius Caesar (although he’d also been in The Conqueror) and would go on to be in Spartacus (and Flesh Gordon), but here he just gives us the exact same Valium-laced smile throughout the whole movie.  Sometimes it’s creepy, lending credence to Sally’s early suspicion that Franz is a serial killer, but mostly it’s just annoying.  The long scene of technobabble while he explains how his shrinking machine works is insufferable.  June Kenney gives her usually slightly over-wrought reads that sound like a high school’s production of Shakespeare.

Then of course there’s John Agar.  His character is written as kind of a jerk, but in ways that were probably acceptable for white men in the 50’s.  His physical performance, on the other hand, makes you want to see Sally kick him repeatedly in the nuts.  He looms over her, follows a foot behind her when she is clearly uncomfortable with this, and touches her when she does not want to be touched.  Nowadays all this would earn him a restraining order but in this old movie it’s apparently supposed to be romantic.  Then there’s the way he laughs at her when she confesses that she’s slightly afraid of Mr. Franz.  How the hell did he ever persuade her to go out with him, let alone marry him?  And who fucking proposes in the middle of The Amazing Colossal Man?!

When Sally believes Bob has run off on her, she protests to Mr. Franz, “Bob wouldn’t treat me this way if he could help it!”  The audience just rolls their eyes, because they’ve already seen Bob treat her far worse.  We’ll see him do worse again, too, when he persuades Sally to abandon the others at the theatre even though they know that Franz will kill them if he finds them.

Besides Mr. Franz’ pathological fear of losing people close to him, the other place the movie goes in exploring its characters psychology is a form of Stockholm Syndrome.  When Bob and Sally meet the other ‘dolls’, they discover that their fellow prisoners have resigned themselves to their fate.  Mr. Franz mostly keeps them in jars and occasionally lets them out to party, and they’ve decided to look at it as if they’re on a sort of permanent vacation, just enjoying the party without worrying about things they don’t believe they can change.  The only rebellion apparent is the teenage girl, Lori, refusing to sing on command – and she changes her mind in a hurry when Franz threatens to put her back in her bottle.

They aren’t totally brainwashed, though.  When a chance to escape presents itself, they all pitch in to help.  The moral of the story, insofar as it seems to have one, is that freedom is better than slavery even when the slaves are well-treated and have everything taken care of for them.  The little people don’t need to work, they don’t need to pay taxes, and Mr. Franz sees to all their needs, but they are still prisoners.  Real life may be difficult and full of worries and responsibilities, but it’s better than being kept in a box!

Bert I. Gordon never used women as heroes, in the sense of actually doing anything to save the day, but it’s kind of interesting how frequently he used them as point-of-view characters.  Sally in Attack of the Puppet People joins Audrey Aimes in Beginning of the End and Joyce Manning in War of the Colossal Beast as a female lead through whose eyes we’re watching all this happen.  Male characters may be more active and heroic, but they are secondary in terms of screen time and audience identification.  I wonder if this were something intentional or not, and either way, what it might reveal about his storytelling.

Is it feminist?  I don’t think so.  In many of Gordon’s films, the characters feel helpless in the face of more powerful forces: the grasshoppers of Beginning of the End overrun the military easily, Joyce and her problem are handed around like a hot potato by people who don’t care, and even Glenn Manning is a powerless victim of his own growth.  Perhaps the choice of a passively watching woman rather than an actively heroic man as the main character is supposed to add to this.  Audrey Aimes might be the best example, in that her job, as a reporter, is to observe and record, rather than to intervene.  Consider The Magic Sword, in which Princess Helene watches her own rescue attempts in the magic mirror, while Sir George’s transition to manhood is represented by him leaving mere watching behind and actually getting involved in the events he has observed.  Or Necromancy, in which Lori Brandon is left watching herself in Mr. Cato’s thrall.  Heck with Manos, I could write a thesis on this.

If I had to pick a Stinger Moment for this movie, it would be the tiny people gathered around a huge telephone while Bob exclaims, “the police!  Does anyone know the number?”  At the time this wouldn’t have been a joke at all – 911 came into wide use only in the early 1960’s, but from a modern viewer it earns a snicker, and it would definitely have been funny in the UK, where 999 had been around since the 30’s. There’s your random fact for the day.

[a-wandering-fool]

From the blog Narcissists Suck...

Malignant Narcissism: A Brief Overview    

What is narcissism? Is it a simple case of being kinda self-involved? Is it just the human condition? This post will focus on the big picture of what this blog is about. Consider it orientation for people who are new to the subject and new to this blog. This blog is about malignant narcissism which is another name for NPD (Narcissistic Personality Disorder as its called in the bible of psychiatry, the DSM-IV.) This isn’t a blog about people who have a few narcissistic traits because that would mean talking about everyone on the planet. I’m not interested in throwing the whole planet into one box because it would render it a useless classification. It is understandable that people who are unfamiliar with the terms “malignant narcissism” or “NPD” to not really know how completely different of an animal is being discussed here than the average human being. This blog isn’t about assholes or debutantes. It is very possible to be a jerk or to be a self-focused princess and not have the disorder of NPD. If you label anyone who irritates or annoys you as a narcissist then you don’t have a grasp of what this character disorder really is. Every human being is bent to one degree or other toward selfishness. So to define NPD as “being selfish” is not a definition that makes any sense because it would just be statement about the whole human race that wouldn’t help anyone identify the problem of human evil. Some people say that all humans struggle against being selfish and so are quick to state that we are all narcissists. Not so fast. The label is important because we are trying to identify a certain sub-set. There is a specific definition here that is important to grasp if you’re going to be able to deal with the problems that proceed from calculated and predatory human evil which is at the root of the definition of malignant narcissism. Let’s look at the statement above, “…all humans struggle against being selfish.” No, they don’t. THAT is what this blog is about. The ones who don’t struggle against their selfish urges. It is about those human beings who long ago gave up any struggle against their lusts, their selfish entitlement attitude, their demands, their need to control others. Some, I believe, have never put up a real fight against their own selfish demands. Malignant narcissism usually manifests at a very young age even though it never becomes an official diagnosis until adulthood because this is how the grand poo-bahs of psychology play the game of labeling. There is a creature that exists in human form that has become distinctly different than those of us who do struggle against selfishness. In a very deliberate and conscious way these people have made a decision to not fight against their selfish impulses. They have embraced them. They have found ways to completely justify them. They are quite proud of their freedom to do anything they want to anyone they want. They may be quietly smug about it or openly boastful; nevertheless, they’re proud of their ability to get their way. They see themselves as set apart from mere humanity. They distance themselves from the human race by setting themselves apart from and above them. They do this by word and by action. They even usurp the very throne of God Himself as they position themselves as god over all they survey. They reserve to themselves the right to define reality to all in their domain. All this results in the train of woe that follows from the human embodiment of evil. I make no apologies for referring to malignant narcissists as a “creature” or any other dehumanizing term I may use from time to time. I didn’t dehumanize them. They do it to themselves. I’m just agreeing with them that they aren’t like the rest of us…only, when I say it, I mean it in the most disparaging way unlike the narcissist who pretends himself apart from all the rest of humanity as proof of his superiority. The outgrowth of the mental state of malignant narcissists as described above are very predictable and legion but it can be boiled down to some consistent traits seen among all who’ve dedicated themselves to human evil. I have covered these traits at length on this blog. I’ll try to revisit some of these predictable behaviors and attitudes of the malignant narcissist in brief. All malignant narcissists are cases of arrested development. They are perpetually living in a mindset of a young child. The age when a child is old enough to know the difference between right and wrong but very willing to do wrong if they think they won’t get caught. Like a child, they feel entitled to whatever they want. Like a child, they recreate reality to suit their fantasy about themselves and the world around them. Like a child, they want all attention focused on them. But, unlike a child, the narcissist is not subject to being molded and shaped by authority figures or reality. The narcissist is determined (read here, conscious choice) to remain a child whereas most children are driven by a desire to grow up. Children are childish and there is no crime in that. I’m not pathologizing childhood. I’m highlighting that malignant narcissists are pathological children.

This state of being leads to the other realities about malignant narcissists which are all characterized by being pathological excess of whatever we’re talking about: The narcissist has a pathological need for all attention in every context he finds himself in. It is so pathological that if you get any attention he is obsessed by the need to take it away from you because he imagines that if you get any that it is an unsurvivable diminution of this precious commodity for him. This is attached to his transcendent sense of entitlement. If he wants something then, in his mind, it belongs by native right to him. And because he wants every shred of human attention, warmth, regard, consideration, that means you can’t have any. This is at the very bedrock of the narcissist’s motivations. The need to have it all means he must take what you have. It makes you a target of his malevolent intent. It is the fountainhead of his ill will toward all others. The malignant narcissist’s pathological need to have it all leads to his existence of being pathologically envious. In other words, the most pernicious, pervasive and all-consuming state of being covetous. This translates to him envying anything you have or are. So, picture a human being utterly possessed of a pathological need for allthe attention and all good things which flow from human relationships and you have the framework for understanding the next identifying feature of the Malignant Narcissist Creature… The malignant narcissist is a predatory animal. He stalks his prey. He must do so because his malevolent intent is absolute and would frighten away any source of his supply if the target could easily discern his implacable nature and insatiable lusts and his intent to feed. So the narcissist transforms himself. He is an adept at making and wearing masks. He thrives on appearances. He is short on substance. People who are easily taken in by appearances and short on wisdom to discern substance are easy targets. The malignant narcissist is a chameleon. This is why so many people have a problem identifying what a narcissist is. To the superficial view malignant narcissists can appear to widely differ from each other. This narcissist here is a sophisticate with excellent worldly tastes, vast charm and a following of admirers. That narcissist over there is an unemployed alcoholic who lives off his wife or parents, abuses animals and his children, and hasn’t amounted to more than a pile of shit his whole life. But both of these widely disparate appearances are adaptations to environment, I.Q., accident of birth such as physical beauty, advantages such as education, sex, etc. It is important to understand the chameleon-like adaptations all narcissists are capable of and not be fooled by these adaptations to miss the substance of what they are: a pathological mess of predatory urges that feeds off of the people around them. How an individual narcissist presents himself or herself can cause huge variations in how a malignant narcissist appears to others, but make no mistake, these basic characteristics will be found in any of them. Both the charming sophisticate narcissist and the alcoholic loser are pursuing their favored forms of “narcissistic supply.”, another term for the attention “drug” that every malignant narcissist junkie is pursuing his every waking moment. How they go about it looks very different, but in principle they are after the same thing. All malignant narcissists are parasitical. They need people around them from whom they can steal what they need. Their need for people is desperate, yet their desperate need presents a conundrum for them. Their need for people runs counter to their even more desperate need to not appear like they need anything from anyone, especially you! Never forget, they are gods in their own estimation which means that even while they steal, demand or extort what they need from you they will trash you for giving it. The more they need you the more you will be subjected to their loathing. It is paradoxical unless you understand what the hell is really going on. Which is what I’m describing for you now. Stay focused on the narcissist as parasite. Because the malignant narcissist is a complete failure in the moral realm they must attach to sources of virtue. This is because no lie can exist without the truth. Evil can’t exist without some appearance of good. How does the narcissist wear an appearance of virtue? Most commonly he surrounds himself with those who possess real virtue. The close proximity makes it easy for the malignant narcissist to steal virtue for his own image. Does the narcissist need to feel powerful? He may prop himself up or feed on those who have real power if he is lucky enough to sidle up to them, or he will surround himself with people who are weak so he can feel powerful by controlling them. OR the narcissist can steal virtue and substance from her profession or from belonging to certain clubs or organizations or charities. Service professions are very attractive to malignant narcissists. So is religion. As is Motherhood. An example: the narcissist can get herself close to her prey of choice by her choice of profession. Does she like to seduce young boys? She may decide to become a teacher. She attaches herself parasitically to the profession’s high claim of being concerned about the education of young people. Who would suspect she is not a teacher because of the usual reasons? By association everyone assumes a certain amount of goodwill and character due to her choice of job. This is her cover to then commence her predation of her favorite flavor of attention. She has parasitically attached herself to the good name of teacher. She is stealing virtue she doesn’t possess so as to better reach her prey. In every situation the parasitical narcissist is preening himself. He needs a mirror to accomplish his acts of preening. That mirror is you. He plays to his mirrors. He poses in front of his mirrors to get the desired reflection back. When you show looks of interest, admiration, fear, concern, he is basking in his reflected self. His insubstantial self. A construct of reality he has created out of thin air. But see? He needs YOU to accomplish this. He needs you to hold up the mirror for him. But he isn’t looking at you. He is only interested in his own reflection in your face. You don’t exist as a person to him. You’re a means to his end. The parasite takes what he needs with no thought or benefit going to the host. If you cease giving him what he wants he will move on to a better host. He is completely heedless of his tremendous and all-consuming need of people to accomplish this act of reflection. His preening is an extension of his parasitical lifestyle, yet he is unable to comprehend this. We are only objects to the narcissist. He can’t comprehend it because he has transmogrified all the rest of us into objects. We have no needs that he must enter into his consideration. He is first and only in everything. He refuses (again, conscious choice) to see your humanity and the basic rights that come along with that humanity. You are nothing more than a tool in his hand, a pawn in his game, an object for his use. When done, he casts you aside as so much used toilet paper. People who believe the narcissist loves them are tragically naive and deceived. The narcissist has vast reservoirs of love, compassion and concern, but not one tiny bit of those things can be diverted from himself. He loves himself so utterly and completely there is no room for anyone else in his affections. The malignant narcissist is absolutely incapable of the true emotion of love for any other human being. Period. If you doubt me you will continue to suffer under the heartless tyranny of these blood-suckers. You can never successfully deal with a narcissist if you believe he loves you in any real way. He NEEDS you. But need is not love. His need is the need that will take and take and take with no concern as to whether his taking is killing you. Even if you’ve not been in close contact with a malignant narcissist, with a little imagination you can follow these descriptions to some of their outcomes. All of those outcomes are attended with ill will. Not one motivation of the narcissist is concerned with anyone else’s well-being. This is what makes them dangerous and evil. They are unsafe for human interaction. Do they see themselves as dangerous and evil? Very unlikely. Some do. Most don’t. Remember that they have justified themselves on every point. The evil they perpetrate is most times seen by them as their righteous cause. They have turned evil into good and black into white. This is easy enough to accomplish for someone who has for a lifetime tinkered with reality as much as those around them have allowed. As you can hopefully see by now, malignant narcissism isn’t about everyday variety selfishness. I’ll use the word again here, it is pathological selfishness. It is a selfishness that will destroy anything that gets in its way. When I decided to start a blog and needed to pick a name for it I chose Narcissists Suck for a reason. It wasn’t a flippancy. My nom de plume is that of a vampire slayer. Again, not a flippant choice. The primary meaning of this blog’s title is a succinct statement of truth about all narcissists – they suck the life out of their victims. Plus, I did really like the dual meaning of the title. The other meaning being the more casual statement of, “damn, these people SUCK.” Human evil is not of recent advent. It has been a part of human existence for as long as humans have existed. Some of the evidence of this fact is found in the many legends of evil of which the Vampire bears some startling correlations to what we know about malignant narcissism. Of course, there is no one definition or legend of vampires but there are some persistent themes. I’ll list a few for your perusal. The ability to hypnotize and/or charm their potential victims. Light destroys them. (Light is analogous to truth.) They are shape-shifters. They are predatory. Especially of family and neighbors where they lived before they became “undead.” They can only exist by draining the blood, life-force, of their prey. Despite their human appearance they aren’t really human. They can infect others with their vampirism. Great powers of persuasion. Hard to kill. Even starvation won’t kill it though it will render them somewhat insane. (Think here of the narcissist deprived of sources of supply. It won’t end up in a converted narcissist; crazy, yes, converted, no. They will survive until they find a fresh victim.) This isn’t an exhaustive list, but it is enough to supply the point that legends of vampirism find their close counterpart in the malignant narcissist. This blog is intended to be the sunlight that destroys these vampiric blood-suckers. Shine the light of truth on who they are and what they do and find them scattering to the dark corners of their lairs. At the very least, the sunlight dispels the hypnotic hold of the vampire on his victims and helps them get free. Thus concludes my attempt at an overview of malignant narcissism which is the focus of this blog. There are plenty of annoying and petty people out there. That isn’t what I’m talking about here. I’m talking about those humans who’ve embraced evil that stalks its own kind as prey. The most scary aspect of this kind of evil is that is will suck the life blood out of its own young. The children of narcissists are the ones who’ve seen what evil really is. The narcissist disguises himself when in public view. It is behind closed doors that the fangs come out. Pity the children. Save them if you can.

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People with NPD should be hated.   They should be ridiculed and despised.   They should be treated the fucking piece of shit that they are.

This is for you anon.   I’m not going to post your questions because I don’t want to feed that fucking troll, but this should answer some of them.