Training Therapists: We’re Doing It Wrong.

Becoming a therapist should not take two degrees. If we want to create a program to train therapists, it needs to be one degree that actually intends to make good counselors. We need a vocational school styled approach, explicitly focused on licensing in four years or less.

Getting a grab bag of undergraduate psych experience–which may or may not relate to counseling people, and a year of graduate school before you start interning (read: doing therapy with supervision) is useless. It’s expensive, it limits who can become a therapist in the wrong ways, and lets people who should not be practicing slip through the cracks and emerge with a license.

So We Can Stop Making Therapy a Wealthy Person’s Privilege

Look, the cost of an undergraduate degree is really high. The average public university costs per year is $15,918 [source]. So you go there for four years, and you have a degree in psychology. That’s great, except you can’t do therapy with that.

So you need a graduate degree. That’s $6,000-$15,000 [source] per year in tuition again for two years (assuming a Masters program). Of course, you also have living expenses–even assuming that you don’t have kids or a partner or a car accident or a major illness–the majority of therapists start out in debt. So what they charge for services matters. They can’t afford to spend time giving away therapy sessions, because they need food on their table. It’s harder to do sliding scale sessions if that’s not how your repayment plan works. (Sliding scale is a pay-as-you-can model.) Therapists want to be on an insurer’s list, so they can get a stream of clients.

So therapy costs money, and cheap(er) therapy requires insurance. See the problem here?

Burnout/Weeding Bad Therapists Out:

Premise: Some people who want to be therapists will actually make terrible therapists.

Arguments? No? Okay.

Undergraduate psych isn’t a lot about actually working in psych services. It’s “Look at this cool brain thing! And what about this one?!” “Stroop tasks!” “Neurons!”

And I like all of those things. I like them a lot. But they don’t tell you about how much paperwork comes from being a counselor. Or what the hours look like (hint: it’s not a 9-5). You don’t spend hours practicing how to listen and think and avoid asking “Why?” questions* all at the same time. Not everybody can do this, and that’s fine. But maybe we shouldn’t make everybody figure that out on their own. A program that mirrors the practice of mental health care lets those who can’t do it drop out early (before they get a an expensive set of degrees, hate it, feel obligated to use their education, irritate and harm clients, and then burn out.)

In undergrad, psychology is an ‘easy’ major. Being a counselor is not easy. Let’s match the training to the reality.

Intersectionality & Real Life.

I learned a lot of things about brains and people and microskills and heuristics and biases and writing a concise abstract in my major. I like all these things–I don’t like psychology just because I want to be a therapist. I love statistics and reading research and neuroscience.

You know what I didn’t learn about, beyond a passing mention that they exist?`

Gender & sexuality minorities

Why most people return to abusive situations.

Harm reduction

What systemic poverty looks like

Incest

Rape

Child abuse

What the foster system looks like in practice

Chronic illness as it relates to mental health

Bullying

Suicide prevention

Psychopharmocology (Psych medication)

Asexuality

How to ask for preferred pronouns/getting used to gender neutral pronouns

Polyamory

…or how any of these can intersect.

I would have liked to.
I want budding counselors to begin their education by learning about ALL kinds of people and systems. I want to stop assuming that living in the world gives you enough life experience to counsel anyone. Because you know who can afford to go to college for two degrees, who are encouraged and supported in doing so? Mostly privileged people. Do you know who we’re really bad at providing mental health services for? The underprivileged.

What Psych Services Jobs Can You Do With A Psych Undergrad Degree?

Seriously. Somebody.

You can work at a crisis center or hotline or be a research assistant or or or…yup, I’ve got nothing.

Tracked Classes Are Better Than Pick ‘N Choose

Psychology majors usually have a basket system for major completion. This isn’t a terrible idea, and it’s how most humanities majors work. You get some intro level classes, some intermediate classes, a handful of special seminars, and a few required things like statistics  and Writing a Paper a Specific Way That Will Be Quickly Outdated (aka Research Methods. Yes, I’m bitter). You don’t really have to get them in any order, except you might need Intro Psych first, and research seminars might need you to understand statistics and paper writing. Other than that, you take what you want, in whatever order works for you class schedule.

On the whole, this doesn’t seem unreasonable. You don’t really need to understand 200-level Social Psychology to understand 200-level Cognitive Psychology. I do, however, think you should take Developmental Psychology before you take Developmental Psychopathology. You should also take Psychopathology before you take Counseling, and you should know a little bit about neuroscience, developmental problems, and brain injuries before that too. You should definitely take more than one class about counseling people, and the second, third, and fourth classes should build on each other.

I want a program that plans classes, that puts them in the most useful order, that builds on knowledge to create a well rounded counselor by intention, not by accident.

Look, I’m going to get my two degrees and become a therapist. I would hope that I’ll be a good one. But we need to create a system that makes that the most common outcome, that doesn’t put potential therapists into debt, and that treats mental health work like a career with real requirements in terms of personality, skills, and devotion.

*With the exception of Rational Emotive Behavioral Therapy, therapists are highly discouraged from asking questions that begin with “Why…”, because they come across as implicitly judgmental, even if that’s not the intent. 

Musical Wednesdays: The Universe, Monty Python, and hate mail

As you may or may not be aware, I have been getting loads of hate mail/comments wishing me harm because I am in a relationship some people on the internet don’t approve of. So, whenever life gets me down, usually in the form of lowlife, scum-of-the-earth comments from racist, misogynist assholes, I sing myself this song and it generally makes me feel better.  Hurray astrophysics!

Whenever life gets you down, Mrs. Brown
And things seem sad or tough
And people are stupid, obnoxious, or daft
And you feel that you’ve had quite enough…

Happy Wednesday.

The Myth of ‘Fight Back’

There’s an unfortunate habit of journalists to treat stories of mental illness as triumphs of will.

She fought an eating disorder and won! Now she’s happy with her body and wears whatever she wants!

He battled depression, and now he is this Super Famous Person I Don’t Recognize!

I don’t want to knock this idea on the personal level. I’m quite sure that for some, the metaphor is useful. Maybe even the most helpful way of envisioning recovery. That’s spectacular. I’ll promote any method of recovery. Imagining tapdancing bananas? Go for it.

My concern is for how the media elects to find one narrative–a story that automatically excludes perhaps even a majority of those with mental illness, and what that means for our understanding. “Fighting” doesn’t mean miraculously getting well for everyone, sometimes fighting means just staying here.

There’s exactly three dresses on hangers in my closet. Not because I own three dresses–I almost never wear pants–but because everything else is crumpled on the floor, the bed, the desk. I’ve tried on eight outfits. Maybe ten. And right now? I’m curled up in the corner in the same shorts and shirt I started in.

I’m going to put on nice clothes and go out at some point, because it’s one of my best friend’s birthdays, and you don’t get to do otherwise. Because I want to, and because isolation when clothes make me anxious seems like failing.

But first I have to breathe. The world has to stop closing in. The music is too loud and I can feel every inch of my skin. It’s not the romance novel kind, right before the heroine lands on 6,000 count Egyptian cotton sheets–it’s raw nerves and sandpaper air. It’s been weeks since this happened, and and and…

Breathe in.

The thing about clothes is that you have to wear them. You cannot show up to an interview, to class, to any function, without clothes. So I’ll find something to wear. Eventually.

Don’t you dare tell us to fight back.

We fight to be the awkward guy with at the edge of the conversation, to show up to parties and turn in homework. We fight embarrassment when we can’t drink punch at your party, when your ‘OCD’ means you cleaned your room, and ours means obsessions and compulsions. We fight to meet deadlines and call hotlines when things get bad.

Some of us fight just to be here.

 

 

 

OSCAR Liveblog

12:04 Seth McFarlane was pretty good.  Best moment? JLaw tripping and laughing about it and Ben Affleck crying.

12:02 Closing number from Chenoweth.  GAYEST OSCARS EVER.  WE ALL WIN.

11:57 17/23

Best Picture:

Will win: Argo
Should win: Django Unchained
Should have been nominated: Hunger Games

11:54 Michelle Obama is gorgeous.  Jack is gross, but, you know, adorable in his gross way.

11:53 SHELLEY!?!??!?!!!!

11:52 Meryl and DDL are like prom king and queen of this shit forever. Jack Nicholson is perennial class clown.

11:49 Jennifer Lawrence wins for Best Animated GIF!!!

Daniel Day-Lewis is funnier than the host.

11:48 16/22

Best Actor:

Will win: Daniel Day-Lewis for Lincoln
Should win: Joaquin Phoenix for The Master
Should have been nominated: Anthony Hopkins for Hitchcock

11:45 Meryl Streep looked like she was scratching her butt, but she was just dealing with the fact she was stepping on her dress.

11:44 Jennifer Lawrence is so funny – You’re all standing up because I fell and that’s really embarrassing .

11:43 15/21

Best Actress:

Will win: Jennifer Lawrence for Silver Linings Playbook
Should win: JLaw (A); Quvenzhané Wallis for Beasts of the Southern Wild (E)
Should have been nominated: JLaw for Hunger Games

11:41 REACHED MY TWITTER LIMIT ARGH

11:33 Ang Lee. Boo. 14/20

Best Director:

Will win: Steven Spielberg for Lincoln
Should win: Benh Zeitlen for Beasts of the Southern Wild (A); Michael Haneke for Amour (E)
Should have been nominated: Kathryn Bigelow for Zero Dark Thirty

11:31 New Grey Poupon Commercial! I was just talking the other day about how I missed Grey Poupon commercials!!

11:26 I AM SO EXCITE I DIDN’T THINK HE’D WIN but now Emmett and I are tied and I’m not gonna win. 14/19

Best Original Screenplay:

Will win: Zero Dark Thirty (A); Django Unchained (E)
Should win: Django Unchained (A); Moonrise Kingdom (E)
Should have been nominated: Looper

11:24 14/18 (A); 13/18 (E)

Best Adapted Screenplay:

Will win: Argo
Should win: Argo (A); Silver Linings Playbook (E)
Should have been nominated: Hitchcock

11:22 She was so adorable accepting and trying not to cry and mess up her makeup.  LUVHUH.  Gayest Oscars of all time?

11:16 13/17; 12/17 Congrats Adele

Best Song:

Will win: Skyfall
Should win: Ted

11:12 Wow Scarlett Johannson has a good voice!

11:10 12/16 (A); 11/16 (E)

Best Score:

Will win: Life of Pi
Should win: Life of Pi

11:09 CATHERINE ZETA JONES DRESS IS AMAZING.  Queen Latifah wearing something from David’s Bridal.  Renee looks like she’s got stung in the face by a bee.

11:08 Tired. Is it over yet?

11:05 The problem with opening with Shirley Bassey is that you set the bar so high that even Babs doesn’t seem terribly impressive.

11:01 Nora Ephron ;_;

RAY BRADBURY ;_; ;_;

11:00 Tony Scott ;_;

10:58 George Clooney has aged so much with the beard that it makes me uncomfortable that he’s introducing the dead people.  Don’t Die George.

10:51 “Harry Potter and the Half-Drunk Princess.” – hahahahahahahaha PourMyCoffee on Twitter Love you Dan Rad and KStew

10:50 Lincoln! Dammit. 11/15 (A); 10/15 (E)

Best Production Design:

Will win: Les Miserables
Should win: Anna Karenina
Should have been nominated: The Dark Knight Rises 

10:47 In defense of Anne Hathaway, who I love. http://www.slate.com/blogs/browbeat/2013/01/31/why_do_people_hate_anne_hathaway_one_reason_is_simple_sexism.html

10:45 Sandra Bullock is my soulmate

736739206

10:39 You know, the women have really brought it with the singing tonight. Maybe Les Mis would be better if it was actually Lesbo Mis.

10:37 I love Adele’s voice so much that it almost overcomes how much I don’t really like this song.

10:34 BAM ARGO ASHLEY PULLS AHEAD OF EMMETT! 11/14 (A); 10/14 (E)

Best Editing:

Will win: Argo (A); Zero Dark Thirty (E)
Should win: Argo (A); Zero Dark Thirty (E)
Should have been nominated: Hunger Games

10:32 AWWWWWWW

BD62OERCUAAJTVg

10:28 There was an ad for Nashville with someone singing Fame and telling us to remember her name.  Unfortunately, I have no idea who she is and don’t care enough to google it.

10:23 TO THE SURPRISE OF NO ONE 10/13

Best Supporting Actress:

Will win: Anne Hathaway for Les Miserables
Should win: Anne Hathaway for Les Miserables

10:21 http://www.buzzfeed.com/hillaryreinsberg/sexist-things-at-the-oscars

10:19 There have been other ties in Oscars history, including in 1969 for best Actress. Hepburn and Streisand

10:17 WHAT A TIE.  I’m counting it but in addition to ZDT, another to Skyfall. 9/12 WHAT

Best Sound Editing:

Will win: Zero Dark Thirty
Should win: Zero Dark Thirty

10:14 now 8/11 EVERYONE IS BRITISH

Best Sound Mixing:

Will win: Les Miserables
Should win: Les Miserables
Should have been nominated: Pitch Perfect

10:12 Love Ted.  And Marky Mark.

10:10 Star Trek people to give sciencey awards.  Makes sense.

10:03 Les Miserables after all that amazing singing just highlights how marginal it is.

10:01 Damn. Jennifer Hudson.  She’s still no Shirley Bassey.

Still not impressed with Hugh Jackman’s nasal voice.

9:55 I can’t lie: I love Catherine Zeta Jones in this role.

9:54 John Travolta clips from Hairspray! Best!

9:52 Jennifer Garner and Jessica Chastain look nervous and awkward. 7/10

Best Foreign Language Films:

Will win: Amour
Should win: Amour

9:50 People on Twitter upset about Best Doc going to the “not hard” documentary.  It’s a filmmaking award, not a cause award.

9:46 Love JLaw

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9:44 Ben Affleck is so much better with long hair and a beard.  6/9

Best Documentary Feature:

Will win: Searching for Sugarman
Should win: 5 Broken Cameras
Should have been nominated: Mea Maxima Culpa

9:39 Liam Neeson makes this sound VERY DRAMATIC.  He is going to fuck you up if you don’t like this movie.

And then some good Led Zeppelin.  HARDCORE

ARGO FUCK YOURSELF

9:37 INOCENTE!! I am wrong, but congratulations! 5/8

Best Documentary Short:

Will win: Open Heart
Should win: Kings Point

9:36 Curfew was edited on a Macbook Pro.  I COULD BE UP THERE.  If the only thing necessary is a Macbook Pro.  That’s all it needs right? Right?

9:35 5/7

Best Live Action Short:

Will win: Curfew
Should win: Curfew

9:33 Great advertising timing Kerry Washington on right after her Scandal advert!

9:28 BOW. THE. FUCK. DOWN

Diamond Jubilee - Buckingham Palace Concert

9:26 Shirley Bassey is 76.  76.

9:25 Halle Berry Looks So Good.

She also said Pussy and “Guaranteed to make your heart feet bastard.” Yes girl yes.

9:20 And the best makeup and hair goes to Les Miserables 4/6

OH YEAH PINK TIGHTS

Best Makeup:

Will win: The Hobbit
Should win: Hitchcock (A); The Hobbit (E)
Should have been nominated: Looper

9:18 The winner of MOST costume goes to Anna Karenina 5/6

Best Costumes:

Will win: Anna Karenina
Should win: Anna Karenina
Should have been nominated: The Dark Knight Rises

9:16 Honestly, I think the Jaws music is a good idea and they have to do something to control the length of the broadcast.

9:13 OMGICANTEVENWHAT

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9:11 I feel like voters don’t know the difference between vis fx and cinematography. 4/5 of predictions

Best Visual Effects:

Will win: Life of Pi
Should win: Life of Pi
Should have been nominated: Looper

9:08 I love Robert Downey Jr So much.  And Sammy L J.  3/4 on predictions.

Best Cinematography:

Will win: Life of Pi
Should win: Django Unchained (A); Anna Karenina (E)
Should have been nominated: The Dark Knight Rises

9:05 K, these previews all make me want to cry.  Won’t lie. OMG Wallis is adorbs.

Lol Clooney drinking the free booze tossed to him from onstage.  That’s awesome.

9:02 KILT Y’ALL

mark-andrews-kilt

9:01 BRAVE!!!! 2/3

OMG LOVE HIS KILT

9:00 Paperman!!!! 1 for 2!

8:58 Nate Silver lied to me.  Otherwise I can’t find in substantial difference in the coverage of this event and the election.

8:53 Christoph Waltz is adorable.  And we’ve finally got some Jack Cam.

8:52:

Best Supporting Actor:

Will win: Tommy Lee Jones for Lincoln
Should win: Philip Seymour Hoffman for The Master (A); Robert DeNiro for Silver Linings Playbook (E)

Actual Winner: CHRISTOPH WALTZ

Love him, he’s wonderful.

8:49 I’ve seen Sally Field make out with Seth McFarlane and Daniel Radcliffe tap dance with Joseph Gordon Levitt. As cringeworthy as much of this opening was, uh, that’s kind of boss.

8:47 Sally Field making out with Seth followed by a Disney cover.  Oh ABC, what are you.

8:45 DAN RAD tap dancing with JGL!?!?!?! <3

8:40 Ah brief glimpse of jokes and now too dorky to survive.

8:36 Oh good finally getting controversial!  Rihanna joke. Mel Gibson joke.  Yikes.  And by yikes, I mean YES

8:35 Seth is vaguely funny.  He looks so young compared to the amount of stuff he’s done.  He looks like he could be 24.  Mocks the directorial snub of Argo.

I think it would be really hard trying to be “normal” humor.

8:30 Seriously the coverage is so boring that I’m excited to see the commercials instead.  It’s going to start sooon

8:22 Talking to the producers.  Still don’t care.

8:06 Adele looks like a giant next to Kristen.  Clooney looks old.  Gone from salt and pepper to mostly salt.  J Garner is wearing a beautiful color with an ass ruffle running down her back.  Daniel Radcliffe is wearing a giant bowtie.  Sandra Bullock is awkward cute. This is boring.  When does the show start?  When does my pizza get here?

7:57 DAN RAD DAN RAD DAN RAD <3<3<3

7:55 My Oscars predictions in full, along with Emmett’s, are at this link.  He and I didn’t disagree on very many predictions.  In fact, in all of the categories, we came up with a different prediction only twice — Best Editing (Argo vs Zero Dark Thirty) and Original Screenplay (Zero Dark Thirty vs Django Unchained).

7:50 Here’s a picture, courtesy Tom and Lorenzo, my favorite people in the universe.

Nicole Kidman Oscars 2013

7:40 OMG Nicole Kidman looks amazing.  And I never like Nicole Kidman!  Yes, I’ve given in and am watching the pre-show.  Charlize Theron is a giant.  Kristin Chenoweth is teeny.  I almost stepped on her once at a Starbucks and thought she was a little kid and then I was too embarrassed to also say I loved her voice, so I just… got out of her way.

Great stories like that and more on Ashley Oscar Liveblog 2013!!

Oscar Predictions for Every Category (slightly OCD)

83rd Academy Awards¨ Press Kit ImagesEmmett and I put together a predictions list for the Oscars that I am going to share with you.  Tonight, I’ll be live blogging the event.  This is not because I think the Oscars are particularly right in their judgments, but more that I just love the Oscars.

Best Picture:

Will win: Argo
Should win: Django Unchained
Should have been nominated: Hunger Games

Best Director:

Will win: Steve Spielberg for Lincoln
Should win: Benh Zeitlen for Beasts of the Southern Wild (A); Michael Haneke for Amour (E)
Should have been nominated: Kathryn Bigelow for Zero Dark Thirty

Best Actor:

Will win: Daniel Day-Lewis for Lincoln
Should win: Joaquin Phoenix for The Master
Should have been nominated: Anthony Hopkins for Hitchcock

Best Actress:

Will win: Jennifer Lawrence for Silver Linings Playbook
Should win: JLaw (A); Quvenzhané Wallis for Beasts of the Southern Wild (E)
Should have been nominated: JLaw for Hunger Games

Best Supporting Actor:

Will win: Tommy Lee Jones for Lincoln
Should win: Philip Seymour Hoffman for The Master (A); Robert DeNiro for Silver Linings Playbook (E)

Best Supporting Actress:

Will win: Anne Hathaway for Les Miserables
Should win: Anne Hathaway for Les Miserables

Best Original Screenplay:

Will win: Zero Dark Thirty (A); Django Unchained (E)
Should win: Django Unchained (A); Moonrise Kingdom (E)
Should have been nominated: Looper

Best Adapted Screenplay:

Will win: Argo
Should win: Argo (A); Silver Linings Playbook (E)
Should have been nominated: Hitchcock

Best Animated Feature:

Will win: Brave
Should win: Brave

Best Foreign Language Films:

Will win: Amour
Should win: Amour

Best Documentary Feature:

Will win: Searching for Sugarman
Should win: 5 Broken Cameras
Should have been nominated: Mea Maxima Culpa

Best Score:

Will win: Life of Pi
Should win: Life of Pi

Best Song:

Will win: Skyfall
Should win: Ted

Best Sound Editing:

Will win: Zero Dark Thirty
Should win: Zero Dark Thirty

Best Sound Mixing:

Will win: Les Miserables
Should win: Les Miserables
Should have been nominated: Pitch Perfect

Best Production Design:

Will win: Les Miserables
Should win: Anna Karenina
Should have been nominated: The Dark Knight Rises

Best Cinematography:

Will win: Life of Pi
Should win: Django Unchained (A); Anna Karenina (E)
Should have been nominated: The Dark Knight Rises

Best Editing:

Will win: Argo (A); Zero Dark Thirty (E)
Should win: Argo (A); Zero Dark Thirty (E)
Should have been nominated: Hunger Games

Best Visual Effects:

Will win: Life of Pi
Should win: Life of Pi
Should have been nominated: Looper

Best Makeup:

Will win: The Hobbit
Should win: Hitchcock (A); The Hobbit (E)
Should have been nominated: Looper

Best Costumes:

Will win: Anna Karenina
Should win: Anna Karenina
Should have been nominated: The Dark Knight Rises

Best Animated Short:

PAPERMAN WILL AND SHOULD WIN ALL OF THE THINGS <3<3<3

Best Live Action Short:

Will win: Curfew
Should win: Curfew

Best Documentary Short:

Will win: Open Heart
Should win: Kings Point

Ashley on HuffPoLive at 9PM EST talking interracial dating

At 9PM tonight Jamila Bey, my boyfriend, Emmett, and I will all be on Huffington Post Live to discuss interracial dating with Nancy Redd, who wrote the fantastic book Body Drama.  Here is the link to the segment, where comments have already begun:

http://live.huffingtonpost.com/r/segment/interracial-dating-today/511c496c2b8c2a4572000324

Kate’s Travels and Other People’s Writing

I’m traveling a great deal in the coming months. With respect to conferences, this is where I’ll be. Please comment if we’ll overlap!

Skepticamp Chicago - Website

Where: Fifth Province Pub at the Irish American Heritage Center
Address: 4626 North Knox Avenue, Chicago, IL

When: March 2nd, 11am-6pm

I’ll be talking about Myths & Misinformation in Mental Illness at 4pm. I’ve got my talk outlined, but if you have any myths you want to make sure I haven’t forgotten, comment below!

SkepTech - Website

Where: University of Minnesota

When: April 5-7

I’m really excited for this one. It’s organized by many of my friends, and the lineup is wonderful. Especially exciting to me? Stephanie Zvan is talking about psychometrics–the ways we use statistics and measures in psychology. Going to be there? Comment! And come say hi :)

Women in SecularismWebsite

Along with Miri at Brute Reason and several other FtB frequenters, I’m the recipient of a grant from Marcus Ranum to go to Women in Secularism this May. I’m over the moon. I really don’t have words to explain how amazing this is. So, if you’re going…I can’t wait to see you there.

Now, links!

Digital Cuttlefish hates the brain (but not really, go read it):

The brain does not see patterns. The brain is a major part of how we see patterns. The brain does not do so without the eyes, and it does not do so without two very important sets of environmental histories–the individual’s interaction with the environment (literally beginning with the environment in the womb, in development), and the interaction with the environment over millennia that is reflected in the genes. The brain is not magic (which Descartes’s concept of “mind” was, technically); it is part of how we gather information from the environment and act upon that environment. Other parts include our eyes & ears, our bones and muscles, our teachers and histories, our communities and our cultures.

Stunning sun photography.

I got to see Cliff Pervocracy at UChicago’s Sex Week! This is the talk she gave.  It’s knee-slappingly funny. Like, really. Knees were slapped.

I really, really recommend every couple or group figure out a working definition of “cheating.” For my partner and me, that’s having sex without telling each other. He lets me know what he’s planning, he can have sex with the starting lineup of the Green Bay Packers, and I might have opinions about that (those opinions might be “fistbump,”) but that fundamental feeling of broken trust that comes with cheating won’t be there. Then again, for you, that might be a hard limit. You might be a Bears fan. Or you might feel like your partner kissing another person is too much and gives you that sad feeling in your stomach. Either way, if you both know where the line is—and you have enough fundamental trust that nobody’s going to rules-lawyer it with “we said hugging was okay, so I hugged his penis!” – it’s a lot easier to avoid accidentally hurting each other and a lot more clear what happened if someone does break that trust.

Alain de Botton is getting things dangerously wrong.

What could have decreased the pertussis epidemic.

As per usual, do add your own links and conferences you’re attending below!

Liberal Tips to Avoid Rape: Conservatives on Twitter get nasty

A Colorado politician said:

It’s why we have call boxes, it’s why we have safe zones, it’s why we have the whistles. Because you just don’t know who you’re gonna be shooting at. And you don’t know if you feel like you’re gonna be raped, or if you feel like someone’s been following you around or if you feel like you’re in trouble when you may actually not be, that you pop out that gun and you pop … pop around at somebody. – Rep Joe Salazar

A guy on Twitter who goes by the name “Sooper Mexican” posted a joke in response:

: yell “racist” at your rapist… that’s like the worst thing ever!

I get the joke, right — blowing a whistle is like yelling racist, completely ineffective.  I have no particular great love of the rape whistle as a rape prevention tool, but the joke’s intent, apparently, was to point to the fact that guns are the only effective way to prevent rape.

The reality is that guns are dangerous and likely to get you killed, especially if you are the victim of acquaintance or partner rape, like the majority of victims are.  But if the “joke” had ended here, it would have been mildly obnoxious and problematic, but the hashtag caught on and turned incredibly ugly.

#LiberalTips2AvoidRape if you think you can stop any one by blowing a whistle then get on your knees and blow this

Ah, see, it’s not rape if you are coerced into doing it.

#LiberalTips2AvoidRape “I don’t have to fight back, I can just abort it”

Because the terrible thing about rape is that you might get pregnant, not the violent invasion of your body!  And see, while conservatives want women to have control of their bodies in a rape situation, they don’t want them to be able to control their bodies by having sex for reasons other than procreation or to have control over whether they are pregnant or not.

#LiberalTips2AvoidRape: pray to Obama extra hard, and promise to have 3 abortions in his name..

#LiberalTips2AvoidRape Go for the Democrat politician look. You definitely won’t be raped…

Rape is about power, not about sex.  And insulting how the women in the party look is about as appealing to women as… joking about them getting raped.  So fair enough.

#LiberalTips2Avoid Rape Just shag everything. When they realize you’re an aerobic activity at best, and ObamaCare looms, they’ll head for gym

People won’t want to rape you if you’re a slut? Or maybe being slutty means you can’t be raped?  Unclear.

Not all of the advice is bad:

#LiberalTips2AvoidRape Don’t rape anybody.

The Good Men Project made an excellent point: America voted against all of the conservatives who said crazy things about rape in 2012, maybe this complete inability to understand the difference between condemning violence against women and laughing at it will haunt more campaigns in 2014.

The Weight Requirement, and Other Ways We Diagnose Anorexia

This is a post that’s been a long time in coming. Unfortunately, every time I start it, I get upset and then have to leave it alone. So here we have it: what’s wrong with how we diagnose anorexia. Now with less ragequitting!

Anorexia has a weight requirement.

Refusal to maintain body weight at or above a minimally normal weight for age and height, for example, weight loss leading to maintenance of body weight less than 85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.

PROBLEMATIC.

Please, someone define what a normal weight is. Because I know this totally isn’t controversial. Using BMI? It doesn’t account for muscle mass, so you’re leaving out  anyone who’s particularly athletic. Using clothing sizes? Ahahahahahahaha. 

Even supposing we had some accurate scale of normal height-to-weight ratios, should a diagnosis rest on a weight? If I’m restricting caloric intake, and I drop under 85%… Bingo, I have anorexia. Ding ding ding and all that. The next day, I enter treatment, or I eat a particularly large meal, or retain a little water, and suddenly I’m at 86%. Have I suddenly developed a disorder that is markedly distinguishable from what I had on Monday? I think not.

The emphasis on being excessively thin is also in the second criteria:

Intense fear of gaining weight or becoming fat, even though underweight.

Anorexia does not just happen one day, when you stop eating and magically, everyone can tell! This, like lots of the criteria, seem to be waiting to diagnose after the disease has progressed significantly.* That’s dangerous.

This is particularly true for people who start at an above-average weight. We fetishize the idea of heavy people losing weight through whatever means possible, up to and including unhealthy ones. (Biggest Loser, anyone?) It’s going to take an especially long time for family and friends to notice such severe weight loss–and of course, they’ll probably praise and reinforce it along the way–and all the while, the disorder will become more entrenched, wreaking havoc on the body it inhabits.

Amenhorrea

In postmenarcheal females, amenorrhea, i.e., the absence of at least 3 consecutive menstrual cycles. A woman having periods only while on hormone medication (e.g. estrogen) still qualifies as having amenorrhea.

Defined as non-menstruation for three cycles, this is competing with weight measurement for least helpful criteria. For one, it isn’t useful for anyone on hormonal birth control (withdrawal bleeding is not the same as getting your period). For two, it’s a fairly useless metric. Only cisgender women who can ovulate, are not pregnant, and who have reached puberty, but not menopause can use it. (Also, you qualify for this criteria automatically if you’re on birth control. Say what?) Further, there’s not a lot of research suggesting that amenhorrea occurs in a standardized way, or that it represents the severity of deprivation. Luckily, this is heading out with the publication of the DSM-5.

Waltzing between diagnoses.

In the span of six years, I met criteria for…

Anorexia nervosa (purging type)

Anorexia nervosa (non-purging type)

Binge Eating Disorder (BED)
Note: this is a proposed conditional diagnosis, given separate status from BN and AN. 

Bulimia Nervosa (non-purging type)

Eating Disorder Not Otherwise Specified (EDNOS)

…that would be all but two of the ways one can have an eating disorder. This suggests that we may just be quantifying eating disorders incorrectly. Those qualifying for anorexia diagnoses are automatically going to fall into EDNOS as they recover and gain weight (and consequently, no longer meet the first criteria for AN). Should we rename EDNOS as “Anorexia in Remission?” No, because then you leave out the others who were diagnosed as EDNOS for other reasons, such as not qualifying for a bulimia diagnosis. If EDNOS is made up of lots of people with very different manifestations of disordered eating, can we do any useful research about the diagnosis? Will we be able to draw any useful conclusions? Probably not.

And why does it all matter? After all, society recognizes that refusing to eat is bad, right? It matters because the research doesn’t look at “a population of women who have refused to eat at some point”. It looks at “300 female patients who had been diagnosed with anorexia in the last calendar year”. That means how we assess treatment, how we examine the genetic basis, how we study the disorder is a product of how we describe it.

And we’re doing it wrong.

*Also, the face of anorexia, besides being almost always a thin woman, is always white and upper class. Incorrect, and a scary myth to perpetuate.