“You’re in my prayers.”

[Content note: mentions of grief, loss, illness]

I follow The Best of Tumblr on Facebook for the cat photos and pop culture jokes, but recently I saw this:

[Text version here.]

I’ll admit that I used to subscribe to this way of thinking, even as an atheist. But a few things changed my mind: 1) understanding more about what it means to comfort someone, 2) learning about the dynamics of Christian privilege, and 3) listening to the experiences of those who found religion abusive.

First of all, the point of comforting someone who’s going through some shit is to help them. To help them, not yourself. While that doesn’t make intent totally irrelevant–I’ll get to that in a bit–it does mean that you need to at least try to help them in the way that they would want to be helped, not in the way that you would want to be helped. The Golden Rule is a nice thing to teach children but eventually we need more nuanced and empathic ways of looking at things.

That’s why, as I discussed in my previous post, “How can I support you?” and variants thereof is a great approach. But many Christians don’t even pause to consider that the person they’re speaking to might not be religious, and that–as I’ll also get to in a bit–is an example of Christian privilege. Much of the time, they’re not going out of their way to alienate and irritate atheists; they just conveniently forget that atheists even exist. The idea that someone might not pray, or care about your prayer, is simply invisible.

Where does intent fit in? Well, it can make a difference, but not a huge one. As I’ve written previously:

Not intending to hurt someone is different from intending not to hurt them. If someone accidentally breaks my nice vase, I might be glad in the back of my mind that they didn’t do it on purpose, but I might still be annoyed that they weren’t being careful around my nice vase, especially if they are often clumsy and break people’s things by accident. The analogy holds up for saying/doing bigoted things, too. People who say/do them rarely do so just once.

I’m not going to respect you just for not meaning to say hurtful things. That’s one of those bare-minimum-of-being-a-decent-human-being things. Actively seeking information on how not to be hurtful, on the other hand, is a rarer and more important habit to have.

The intent of phrases like “You’re in my prayers” can be especially difficult to parse. For many atheists, intentionally manipulative deployment of such phrases by Christians is a really common microaggression. They say it to us not because they don’t realize we don’t believe, but because they know we don’t. It’s a power move: “I know this means nothing to you [or even hurts you], but I’m going to say it anyway.”

That doesn’t mean that all (or even most) Christians say it for that reason, obviously. It does mean that almost all atheists have had it said to them for that reason, though. It shouldn’t be surprising that many atheists really don’t want to hear it anymore.

At this point, someone usually puts forth that, yes, sometimes referencing religion in these situations can be self-serving or even passive-aggressive and manipulative, and sure, it’s not ideal, but can’t we just assume good intent and force out a smile and a “thank you”?

Well, assuming good intent and being polite are definitely things I generally encourage because they make social interaction smoother and less stressful, but it’s a heavy burden to place on someone who just lost a loved one or got diagnosed with a terminal illness. I’m glad we seem to have all this empathy for socially awkward Christians who just want to comfort you the best way they know how, but how about some empathy for the person going through the fucking trauma? Maybe they’re not at their best when they’re burying their mother or lying in a hospital bed. Maybe that’s okay.

Further, being able to assume good intent is a privilege. It’s a function of your position in society and the experiences you’ve had as a result. That doesn’t mean it’s bad! It’s great! But not everyone can do it and it’s unreasonable and small-minded to demand that they do.

(This applies along all axes of oppression. When you see a police officer approaching, do you worry that you might die? If not, you’re probably not Black.)

Why might an atheist be unable to assume good intent from a Christian? Religious folks and more-fortunate atheists often erase or disregard the fact that many atheists have had coercive and abusive experiences with religion. Some consider their time in religious spaces to have been traumatizing.

And when you’ve experienced a trauma, little reminders of it can be overwhelming.

Before you rush in with #NotAllReligiousSpaces, remember that it doesn’t matter. Not all religious spaces, but theirs was. It would be good to see more religious folks and more atheists acknowledge this reality. Many are still dismissive or openly contemptuous of the idea that religion can be traumatizing.

Viewed through this angle, a certain amount of snappiness or impoliteness from an atheist being told that “At least your mother is smiling down on you from heaven” makes much more sense. But there’s another way in which Christian privilege plays out in this situation, and that’s in our (yes, atheists’ too) perceptions of tone and “politeness.”

Look at that post again. “Some egotistical shit about being an atheist” often, in my experience, refers to comments like “Actually, I’m an atheist.” Not “fuck you I’m an atheist,” not “take your religion and shove it up your ass,” but “Actually, I’m an atheist.” This is what’s so often perceived as “some egotistical shit” and people who say it are apparently viewed by some as “emotionally inept morons.” (Sorry, the ableist wording was not my choice.)

And while it’s apparently “egotistical” to reference one’s atheism in response to an explicitly religious comment, it’s somehow not “egotistical” to reference one’s religion in response to someone else’s trauma. It’s somehow not “egotistical” to offer unsolicited help that’s not what the person needs, without bothering to ask what they need, and then getting offended when that help is rejected as irrelevant.

This sort of double standard pervades all oppressive dynamics, and religion/atheism is no exception.

When a person with a marked/stigmatized identity does something someone doesn’t like, that identity often gets dragged in to explain it. That’s why an atheist getting snappy about a religious comment following a tragic loss is obviously snappy because they’re an atheist, not because they just lost a loved one and don’t have a lot of emotional energy left to micromanage their responses and perform politeness.

And, look, getting snapped at is an occupational hazard of interacting with someone who’s going through a ton of pain, whether it’s physical, mental, or some combination. If you want to support someone in pain, you need to set a bit of yourself aside and be prepared for some rudeness. That doesn’t mean you have to put up with it indefinitely, and it certainly doesn’t justify anything abusive, but you also don’t get to demand that they be impeccably polite and patient with you while they’re in pain, especially if you’re (unintentionally or otherwise) making that pain worse.

Just as people often try to help others in order to satisfy their own needs, people often reference religion to those going through bad things for the sake of their own coping. Watching someone go through a terrible illness or a painful loss is difficult, and praying or thinking about God’s Ultimate Plan can be comforting for those who believe in such things. So naturally they’d verbalize what they’re thinking. It’s not necessarily the grand selfless act this Tumblr post makes it out to be. Neither is it necessarily a cruel and manipulative act (though it can be); it’s very human to assume that others’ minds work the way ours do.

That it’s human doesn’t make it empirically accurate. It also doesn’t make it kind, let alone the kindest sentiment someone could possibly express. It doesn’t obligate someone who’s suffering a trauma or tragedy to put on a good face to spare that person’s feelings.

The kindest thing you could do for someone in pain is to set aside your own opinions on how they ought to be helped and help them the way they want to be helped.

~~~

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“How can I support you?”

When people share mental health struggles online, well-meaning friends and followers often rush in to give them unsolicited advice. That’s something many of us find irritating and push back on. One of the responses we get often goes something like this: “But I give advice because I need to say something. How am I supposed to know exactly what they need?”

These days my response is usually the same: “Have you tried asking them?”

It’s both surprising and unsurprising how often the response is: “Oh. I didn’t think of that.”

It’s surprising because, rationally, that seems like the obvious thing to do when someone is struggling and you have no idea how to help them. It doesn’t make sense to waste your time and energy and risk upsetting or pissing them off by guessing what they might want and offering that. When you need information to make a good decision, and the information is readily available by asking someone who is as close as it gets to being an authority on the subject, it makes sense to just ask them.

At the same time, it’s also utterly unsurprising that people so rarely do this.

For one thing, we have all these cultural scripts about how this stuff is supposed to go, and one of them is that if you’re really a good friend/partner/family member to the person who’s struggling, you will “just know” what they need and be able to offer it without needing to be told. On the flip side, you might believe that if someone is really a good friend/partner/family member to you, they shouldn’t have to ask you what you need; they should just know. If they do ask, and you tell them, and they do that thing, then that might be nice and all, but it’s not as special as it would’ve been if they’d just known.

You’re probably familiar with these dynamics from discussions of sexual communication and the importance of asking/telling partners what they’re/you’re into, but this applies to so many other interpersonal situations.

That second part is talked about a little less often than the first, because the first seems on the surface to do more immediate harm. But they’re two sides of a coin. We need to get rid of that sort of thinking in order to be able to intentionally create strong, communicative relationships of all kinds.

In fact, I suspect that a small part* of the reason many people are vague about what they need when they let close ones know about their struggles is because they hope that those close ones will be able to help them without being explicitly told how. When you’re neck-deep in some sort of life shit, that sort of effortlessness can be so incredibly affirming. It satisfies a need many people have to feel taken care of.

(*Note I specifically said “small part”; there are many other, probably more significant reasons people do this, such as not knowing what they want, not having the emotional energy to communicate extensively/clearly, fearing criticism or pushback for stating what they really want, etc)

Besides cultural scripts about Just Knowing what someone wants, another reason people might not ask “How can I help?” is that they worry about annoying the person or putting an additional burden on them (that is, making them explain what it is they need). While that’s definitely a risk, especially with someone who expects you to Just Know, it’s significantly less annoying than shoving useless (or even harmful) advice or assistance at someone.

In her article about unsolicited advice online, Katie Klabusich lays all this out in a great way:

“How can I support you?” is a question that works in almost every situation imaginable. It preempts judgement and assumptions while oozing humility. Often the person won’t have an immediate answer—likely because they aren’t used to being asked a question that’s about what they actually need as a unique human being. If they look stunned, I suggest something like: “It’s OK if you don’t have an answer or don’t need anything right now; the offer’s open for whenever. Just let me know.” And then use an emoji of some sort or make a face that conveys warmth so they know you mean it. (This could be a unicorn, the two señoritas dancing, or the smiling poo. Up to you.)

*Here’s the fine print: you have to believe their answer, whatever it is. If they tell you they don’t need anything, you don’t get to push or pressure or demand they give you something to do so you feel less helpless. Remember, this isn’t about you.

Following up a few weeks or months later (whatever equals “a while from now” with the two of you) is totally fine. Asking clarifying questions about what they need if they need something is also totally fine. Being unsure and having to ask along the way if the thing they asked for that you’re trying to provide is helping or being provided in a helpful way is also totally fine.

Telling the person you don’t know if the thing they need is something you can do is also totally fine; no one expects you to be everything they need, and we’d all rather you not promise than drop the ball. These are all honest, humble, supportive responses and, frankly, just being asked “How can I support you?” will make the person feel less alone and more cared for.

 

As Katie notes, the fact that many people won’t have an answer right away doesn’t mean that the question was wrong. It could mean that they’re surprised at actually being asked, and it could also mean that they’re not used to thinking of some of their needs as needs. For instance, we might ask someone for advice or for practical assistance, but it feels a little weirder for most people to ask someone to just listen or to tell them something affirming. Being asked “How can I support you?” can help shift them into that way of thinking about it: “Hm, what would feel supportive for me right now?”

Feeling supported is not always the same as Making The Right Decision or Growing As A Person or whatever, which is another reason people are sometimes hesitant to ask others what they need to feel supported. “But what if they’re making the wrong decision!” they might protest. “I need to tell them they’re Doing It Wrong!”

Yes, there are some cases in which it’s probably a good idea to speak up and rain on someone’s parade because you’re seriously concerned about their safety or wellbeing. But most cases are not that and most people are not the kinds of people you have that relationship with (i.e. children, little siblings, partners with whom you have that sort of understanding, etc). I have watched friends and partners make decisions that I personally thought were bad decisions, but because they were clear with me that they wanted support/affirmation and not constructive criticism, I kept my concerns to myself. For the most part, those people turned out okay, because they are adults and they have the right to make their own decisions.

I’ve written before that self-awareness is really important when you’re trying to help people, because you need to make sure you’re not just doing it to try to relieve your own feelings of helplessness. Even if you are doing it to relieve your own feelings of helplessness, you can still go ahead and try to help, as long as you acknowledge those feelings and understand that they are your responsibility and not that of the person you’re trying to help. Only then can you focus on helping them in the way they need rather than in the way you need.

Asking what they need is a big part of that. Don’t try to show off how amazing you are at magically intuiting what they need. You’re likely to mess up and cause more trouble than you solve. Just ask.

“How can I support you?” is not a magic question. It will not necessarily get you the answers you need or them the help they need. Maybe that phrasing sounds weird and stilted to you; try not to get too caught up in that and find other ways to ask the same essential thing. The point isn’t the exact words, but rather the idea that you should figure out how best to help someone before trying to help them. They might not always know, but they certainly know better than you do, even if it takes them some time to be able to access that knowledge. They are the expert on what they need, or as close to an expert as anyone is going to get.

Be prepared, too, for the answer, “Nothing.” Sometimes people share their struggles not to get help or support but to be heard and witnessed. Sometimes they don’t know why they’re sharing at all. Sometimes they will tell you that the best way you can support them is to hear what they have to say; sometimes they will tell you, “Nothing.” Thank them for their honesty and move along. “Nothing” is a difficult thing to hear, but it is also a difficult thing to say.

~~~

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How Mental Illness Labels Help

I wrote this piece for Everyday Feminism. Please note that it’s based on my own experience and I include a section about how it doesn’t apply to everyone, so please read all the way through before commenting.

When I was first diagnosed with depression as a nineteen-year-old college freshman, I felt an emotion you might not associate with getting diagnosed with a mental illness: relief.

I was relieved that it was actually a real illness and not just a personal fault. I was relieved that there was treatment available for something I thought was just my burden to carry for life. I was relieved to have the language for the background noise of hopelessness, sadness, and pessimism that I had experienced for as long as I could remember.

Not everyone agreed.

Concerned loved ones questioned my decision to accept the diagnosis and use it as a personal identifier when relevant. They worried that thinking of myself as a person who has depression would prevent me from taking responsibility for recovery, or that telling others about it would cause them to judge me and abandon me.

Many people wondered why I needed to concern myself with labels at all. Couldn’t I just go to therapy, take my medication, and leave the technical words out of it?

Actually, I don’t think I could.

Identifying with the label “depression” has helped me in a number of ways, both with recovery and with coping with the symptoms that I still have.

Here’s how.

1. Finding Helpful Information About Mental Illness

The most basic way that mental illness labels have helped me is that they’re a great way to find information about mental illness.

Sounds obvious, right?

But many people who disparage labels don’t realize that you’ll probably find a lot more useful stuff if you Google “how to cope with depression” than “how to stop feeling sad” or “what to do when you feel numb.”

When I was first learning about mental health – both in general and mine specifically – I looked up a lot of things online and read a lot of books.

My searches led me to life-changing perspectives like Andrew Solomon’s The Noonday Demon, which helped me understand different ways in which depression can manifest itself, and Peter D. Kramer’s Listening to Prozac, which helped me feel much less ashamed about needing to take medication.

These books have “depression” and “antidepressants” in their subtitles, and I wouldn’t have found them without knowing what to look for.

Many people first realize they might have a mental illness by looking at simple, nonjudgmental websites like WebMD, Mayo Clinic, or even Wikipedia.

Unlike some of the people in our lives, these websites won’t tell you that “it’s all in your head” or “other people have it worse.” They present scientific information in a way that’s easy to understand and relate to.

But in order to end up on one of these pages, you generally need to have a diagnosis in mind.

Even if you’ve already been diagnosed and started treatment, knowing your diagnosis can help you find information that’ll help your treatment.

For instance, if you’re looking up information about borderline personality disorder, you might learn that dialectical behavior therapy is one of the best treatments for it. This can help you find therapists who specialize in DBT, join groups that use it, and learn some techniques on your own.

Read the rest here.

A Good Critique of the Medical Model is Hard to Find

I was optimistic about reading this critique of the medical model of mental illness by professor of clinical psychology Peter Kinderman, in part because it is written by someone with experience in the field and in part because it is published on Scientific American, which I trust.

However, while the article makes a number of good points that I will discuss later, it starts off immediately with such a tired and oft-debunked misconception that I almost quit reading after that:

The idea that our more distressing emotions such as grief and anger can best be understood as symptoms of physical illnesses is pervasive and seductive. But in my view it is also a myth, and a harmful one.

I’ll say it again for the folks in the back: nobody* is trying to medicalize “distressing emotions such as grief and anger.” They are medicalizing mental patterns (which can include cognitions, emotions, and behaviors) that are not only very distressing, but also interfere with the person’s daily functioning. It’s kind of like how some stomachaches are minor annoyances that you wait out (or take a Tums), and some land you in the ER with appendicitis. Therapists and psychologists are not concerned with the mental equivalent of a mild cramp.

In general, people don’t end up in my office because they get pissed off when someone cuts them off in traffic; they end up in my office because they are so angry so often that they can’t stop physically attacking people. They don’t end up seeing the psychiatrist down the hall because they get jittery and uncomfortable before a job interview; they see the psychiatrist because they feel jittery and uncomfortable all the damn time, and they can’t stop, and they can’t sleep, even though they rationally know that they are safe and everything’s okay.

I understand that it’s more difficult to grok differences in degree as opposed to differences in kind, because Where Do You Draw The Line. Yes, it would be easier if mentally ill people had completely different emotions that had completely different names and that’s how we knew that they were Really Mentally Ill, as opposed to having emotions that look like more extreme or less bearable versions of everyone else’s. (Sometimes, from the outside, they even look the same. “But sometimes I don’t want to get out of bed either!” “But sometimes I feel sad for no reason either!” Okay, well, you might be depressed too. Or you might find that those things have no significant impact on your day-to-day life, whereas for a person with depression, they do.)

But it really doesn’t help when you’ve got mental health professionals obfuscating the issue in this manner.

As I said, Kinderman does go on to make some really good arguments, such as the fact that psychiatric diagnoses have poor validity and reliability. This means that they don’t seem to correspond that well with how symptoms actually look “on the ground,” and that different diagnosticians tend to give different diagnoses to the same cases. However, these are criticisms of the DSM, not of the medical model. I’ve felt for a while that we should move away from diagnostic labels and towards identifying specific symptoms and developing treatment plans for those symptoms, not for some amorphous “disorder.”

For instance, suppose I’m seeing a client, Bob. After getting to know each other for a few weeks, Bob and I determine together that there are a few issues he’s particularly struggling with: self-hatred and feelings of worthlessness, guilt, difficulty sleeping, lack of motivation to do anything, loss of interest in things he used to enjoy, and frequent, unbearable sadness. Traditionally, I’d diagnose Bob with major depression (pending a few other considerations/differential diagnosis stuff) and move on with treatment. But without these often-invalid and unreliable diagnostic labels, I just skip that step (although I might let Bob know that “depression” might be a useful word to Google if he’s looking for support and resources). Instead, Bob and I look at his actual symptoms and decide on treatments that might be helpful for those particular symptoms. Cognitive-behavioral therapy might help with Bob’s self-hatred, feelings of worthlessness, and guilt. Behavioral activation might help with his lack of motivation and interest. Certain dialectical behavior therapy modules, such as distress tolerance, might help him cope with sadness in the meantime. Antidepressants might very well help with all of them!

Because mental healthcare doesn’t treat disorders; it treats symptoms. Whether that mental healthcare is medication, therapy, or some combination, the ultimate goal is a reduction in symptoms.

I can see how the medical model makes this seem bad when it isn’t. In traditional healthcare, treating symptoms rather than getting to the root of the problem is downright dangerous. If someone has headaches and you give them painkillers without diagnosing their brain tumor, they’re in serious trouble.

However, we haven’t yet developed great ways of figuring out what “the root of the problem” is when it comes to mental symptoms, especially since there often isn’t one. It’s almost always some complicated tangle of genetics, early childhood stressors, interpersonal patterns learned from family, sociocultural factors, and so on. All of this affects the brain in fundamental biological ways, which further drives the symptoms.

Thankfully, that’s not as much of a problem as it would be with a physical health condition. If you only focus on symptoms and don’t treat the underlying cancer or diabetes or whatever, it will slowly kill you. But if you successfully treat the symptoms of mental illness, you will make the person’s life much better no matter what originally caused the symptoms. There won’t be anything silently killing them in the background, and good therapy teaches people the skills to avoid future relapses of their symptoms.

Sometimes the root cause of mental illness is, as Kinderman points out, a social problem. Poverty, social inequality, and other issues contribute heavily to mental illness. But since you can’t solve those issues from the inside of a counseling office, all you can do is help your client as much as possible. I do this every day, and believe me, it feels weird and gross at times. But what else can I do? Until our fucked-up society decides to come in and take a seat in my office, I can only work with my clients as individuals. (Otherwise I would have a very different job and it would not be therapy.)

Kinderman argues that treating mental illnesses as diseases is wrong because of these social factors that contribute to them. I understand his concern, because he (and many other people) treat “disease” as synonymous with “thing that is entirely biologically based.” So, the medical model feels like an erasure of the complex and valid social dynamics that contribute to what we call mental illness.

But I don’t think of disease that way at all, and I’m betting most doctors don’t either. Social factors contribute heavily to physical illnesses, too. People who are living in poverty or who are marginalized by the healthcare system in other ways are much more likely to have all sorts of physical health problems, and the results tend to be more severe for them. Stress, which includes the stress of poverty, racism, and other social problems, makes everyone more vulnerable to illness. Eating well and exercising enough, two very important factors when it comes to physical (and mental) health, are not equally accessible to everyone. Heart disease and diabetes may have biological origins, but they do not happen in isolation from societal factors, either. Just like mental illness.

You might argue that physical illnesses and mental illnesses differ in that physical illnesses are more heavily caused by biological factors and mental illnesses are more heavily caused by social factors, and I might agree. But again, that’s a difference in degree, not kind. Both types of illnesses affect us physically and mentally.

Another good argument that Kinderman presents is that the medical model may not help reduce stigma, and there’s research to back this up. Kinderman writes:

Traditionally, the idea that mental health problems are illnesses like any other and that therefore people should not be blamed or held responsible for their difficulties has been seen as a powerful tool to reduce stigma and discrimination.

Unfortunately, the emphasis on biological explanations for mental health problems may not help matters because it presents problems as a fundamental, heritable and immutable part of the individual. In contrast, a more genuinely empathic approach would be to understand how we all respond emotionally to life’s challenges.

So, that’s important and deserves highlighting.

However, I think the issue of how best to reduce stigma against mental illness is slightly separate from the issue of how best to help people with mental illnesses feel better. (There’s a school of thought in the disability community that disabilities [including mental illnesses)] “hurt” only because of the stigma and prejudice against people who have them, and I’m not particularly equipped to engage with that here except to say that it makes me angry in a way I can’t possibly explain. It completely invalidates how awful and wretched I felt because my symptoms hurt unbearably and not because of anything anyone else said or did to me as a result.)

When it comes to what people with mental illnesses actually find helpful, for some it’s the medical model and for some it isn’t. In her piece on mental “sick days,” Katie Klabusich writes about how freeing it actually was to see herself as “sick” when she needed to take a day off due to her mental illness:

I’d realized that not only is it alright for me to think of the dysthymia as the illness that it is, it’s necessary. If it were a south-of-the-neck illness, I wouldn’t have had the conflict about it. Yes, I’ve worked when I had a virus and shouldn’t have. (See the stats on service industry staff who work when they’re sick; we’ve all done it.) But my thought process would have been totally different. I certainly wouldn’t have needed the Ah ha! moment to know I had the flu. So why didn’t I realize I was sick?

Our culture impresses upon us that we SUCK IT UP and GIT ER DONE when our “issue” is “just mental.” Except . . .

MY BRAIN IS PART OF MY BODY.

It turns out that what happens in my head has a real—not imagined or exaggerated—physical affect on my other bodily functions. That list of symptoms from a dysthymia flare? They’re worse than the flu. Full-blown body aches and exhaustion alone are enough to make just sitting up nearly impossible. What work Idid do last week was all done from bed. Including writing this.

Others may not find that way of thinking helpful, in which case, they should absolutely abandon it in favor of whatever does help.

I want to end on a cautionary note about this whole idea of the medical model “pathologizing” “normal” emotions, because the alternatives I sometimes see offered to the medical model seem far, far worse about this. While Kinderman seems to argue sensibly for a more “psychosocial” approach to mental healthcare and a reduction in the use of medication (which I disagree with, but at least it’s sensible), others turn entirely away from scientifically validated treatments into “holistic” or “alternative” treatment. In many of these communities, “positive thinking” is seen as the only treatment you need, and anything that strays from the “positive” (like, you know, the negative emotions that are a normal part of almost any mental illness) is actively preventing you from recovering. There’s a very victim-blamey aspect to all of this: if you’re unhappy or sick,” it’s your own fault for not thinking positively enough.

I’ve had clients from these communities in counseling, and it’s very difficult to get any work done with them because they only ever want to share “positive” thoughts and feelings with me. As it turns out, medical model or no, they have completely pathologized any sort of negative emotion–including, in fact, the totally normal negative emotions that all of us experience all the time.

Yet it’s those evil psychiatrists who don’t want anybody to be sad or angry ever. Okay.

Some critiques of the medical model are quite valid and very useful. Others seem to rest less on evidence and more on a general sense of unease about the idea of thinking of mental symptoms as, well, symptoms. Kinderman even implies that it’s unethical. But “makes me uncomfortable” isn’t the same as “unethical,” as we all know. Unless I see evidence that this conceptualization is harmful overall, I see no reason to throw it out.

That said, if you’re a mental health provider and you have clients who are clearly uncomfortable with this model, maybe don’t use it to explain their conditions to them, since it’s unlikely to be helpful. All of these labels and diagnoses and explanations should serve the client, not the other way around.

And if you’re a person who experiences some significant amount of mental distress and you can’t stand thinking of it as an illness, then don’t! You don’t have to think of it in any way you don’t like. I hope you’re getting treatment of some sort that works for you, but at the end of the day, it’s actually none of my business.

~~~

*Yes, there are probably some bad psychiatrists out there who think that grieving at the loss of a loved one is literally a mental illness. There are also surgeons who leave crap inside of people’s bodies or amputate the wrong limb. I see these as roughly analogous.

~~~

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Assorted Thoughts on Self-Care

I have a bunch of complicated feelings on the topic of self-care, but none of them seemed quite sufficient for its own tidy blog post. So I’ll discuss them here and maybe expand on some of them later. Some of them are mostly political, some are mostly personal, and most are a mix of the two.

I. Self-care versus communal care.

Lately I’ve been noticing how often self-care becomes a replacement for care that really ought to be provided by the community: by employers, by mental health professionals, by friends and families, by (dare I say it) taxpayers.

Self-care cannot replace being paid a living wage that allows you to get through the day without breaking down because you’re so stressed about money. Self-care cannot replace effective, accessible therapy and psychiatric medication for those who need it. Self-care cannot replace having love and support from close people in your life. Self-care cannot replace adequate parental leave, sick leave, childcare, elder care, healthcare, and other basic necessities. Self-care will not help when the only way to have a job that pays enough to cover the things that self-care does not magically provide is to put yourself so far in debt for your college education that you spend the rest of your life worrying about money anyway.

Self-care has very important limits, and I think most of us activisty types are aware of that. But it’s jarring to see self-care touted as a solution by institutions that are creating (or neglecting their responsibility to solve) the very same problems they are touting self-care as a solution to. Self-care doesn’t pay my rent, much less my student loan debt. Self-care doesn’t help when an employer won’t give me enough time off to do any damn self-care.

II. Self-care is a harm reduction measure.

Having said all that about the limits of self-care and the responsibilities of people/institutions to step up at times and care for each other, I think there’s another way to think about this that might be helpful: self-care as a harm reduction measure. Harm reduction, as the words imply, suggests that at times when immediately taking all the harm away is impossible, reducing the harm may still be possible (and worthwhile). In its prototypical usage in alcohol/drug treatment, it might refer to giving intravenous drug users free clean needles because, while we can’t magically make them stop being addicted right now, but we can reduce the harm of their drug use by greatly reducing their likelihood of contracting infections by using dirty needles.

Harm reduction in the self-care context can mean that, since we can’t magically create a just society today, we can help people cope with the way things are for now. If you have a mental illness but no therapist or psychiatrist, there are things you can do to help yourself get by in the meantime. If you don’t get paid enough and are constantly stressed about money, there are things you can do to forget your worries for a few hours and give yourself some small things to look forward to. If you are taking care of your aging parent while working full-time because there is no other care available/affordable, there are things you can do for yourself to ease the burden you’re carrying. (The wording here is not to imply that a person who needs care is themselves a burden or that it is wrong to need that care; we all carry burdens of various weights and sometimes that includes caring for someone we love who can’t care for themselves. It should be okay to be honest about the difficulty of that, even if it is a labor of love.)

Of course, one potential concern about harm reduction in any context is that people will get complacent and stop working on the broader, systemic changes that would reduce the harm the rest of the way. For instance, same-sex marriage can be seen as a harm reduction measure against homophobia–it won’t solve the problem, but it will help reduce some of its harms for the time being. (Some people don’t realize that there even is homophobia beyond the marriage issue, but they are wrong.) But some radical LGBTQ activists worry that, having achieved same-sex marriage throughout the U.S., we’ll collectively sigh in relief and say, “Well, that’s good enough, I guess.” And, meanwhile, trans people of color will still be subject to disproportionate violence and discrimination, folks will still be losing jobs, housing, and families because of their sexuality or their gender, trans people will won’t be able to access appropriate healthcare, and so on.

The same thing could happen on a smaller scale with self-care. We might develop our own effective individual self-care practices and decide that, really, it’s okay, we can live with juggling two or three jobs while caring for children and aging parents.

At least, that’s the argument against harm reduction. (The left-wing argument, that is.) But in my experience, when people give up on fighting for systemic change, it’s less complacency and more burn-out or straight-up not having enough time. Burn-out, at least, is the exact thing that good self-care is supposed to prevent. Besides, the argument that harm reduction is actually harmful because it prevents people from staying motivated to pursue more complete solutions sort of implies that people should be expected to suffer even more in the meantime so that they can be better agents of social change, and that’s downright creepy.

III. Everyone’s self-care looks different.

This is an oft-repeated fact, but sometimes it’s still hard to internalize this. I used to get so frustrated with the idea of self-care because all the examples I saw online were like…take a bath! Watch a crappy TV show! Spend all day in your pajamas eating ice cream out of the carton! These are all perfectly valid things to do, but these types of activities make me feel worse rather than better. Taking a bath is nice, I guess, but it’s hard to keep my mind engaged on anything when most of the things that I could engage it on cannot be safely taken into a bathtub. Watching crappy TV and spending all day doing nothing makes me feel like a useless waste of space, so I try to avoid it. (Again, it doesn’t mean you’re a useless waste of space if you enjoy those things. It means I don’t like them.)

So for a while I was all like “what is self-care even” because all the examples I saw failed to resonate with me and seemed more like self-neglect than self-care. As it turns out, for me, self-care usually involves doing the sorts of things that other people need to avoid for self-care: reading articles online, spending time in big groups of people, writing (for public consumption, not in my journal), being with my family, listening to someone else’s problems. Self-care for me looks nothing like sitting around on the couch looking like crap and eating crap.

This is why when people ask me for suggestions on how to do self-care, I don’t really know what to say. I only know what works for me, and I’m starting to pick up on the fact that I’m a little unusual in this way. (For instance, people keep asking me how I manage to write so much despite my depression and despite how hard writing online can be. I find this question confusing. I have depression, so how can I possibly not write? Being online can be shitty, so how can I not use writing to cope with it?)

IV. Self-care versus self-preservation.

I find it useful to distinguish between the self-care we do to replenish and sustain ourselves, and the self-care we do to prevent ourselves from falling to pieces completely. This distinction would help clarify my earlier thoughts on self-care as a form of harm reduction, and it would help explain why some forms of self-care actually seem somewhat harmful, at least in the long term.

Consider these two different situations. One: You’ve had a long, crappy day at work and you’re feeling demoralized about your work and about your value as a person. You’ve spent all day around people who don’t care about you and treat you like shit, and at times like this it’s hard to remember that you do really matter and you’re important to people. You’d planned on going home after work tonight and doing adult things like laundry and making lunch to take to work the next day, but you realize that what you really need right now is to recover from your day. So you message some friends and ask them to meet up with you at a bar, where you drink and laugh and talk about anything other than work.

Two: You’ve had a long, crappy day at work. Things just keep piling up and by the end of the day, you’re an inch away from ending up in the bathroom sobbing. You can’t stand the thought of talking to even one more person today. Although you had plans to go out with your friends after work–something you normally love to do, something that normally helps you recharge from days like today–this time you just can’t bring yourself to go. You message them to let them know you can’t make it this time and head home, where you lie on the couch, pet your cat, and watch Gossip Girl because you have no energy left for anything else. It’s not like you even enjoy it, really, and you wish you could’ve gone out with your friends, but at this point you just can’t.

I’ve been in both of these situations, and for me, the difference is agency. In the first situation, I have chosen to do something that will restore a sense of worth and joy to me, and that is self-care. In the second situation, I have “chosen” to cancel my plans in order to do something that I need to do (that is, nothing much at all), but it doesn’t feel like a choice. Yet this second scenario often gets labeled as “self-care.” “It’s ok,” my friends will say when I cancel. “You need to take care of yourself.”

But that doesn’t feel like caring for myself. That’s just preserving myself so that I don’t burst out crying at the bar with my friends or sit there staring catatonically into space. I didn’t go out because I couldn’t, even though I wished very much that I could’ve because that would’ve made me actually feel better.

At the same time, though, it’s still self-care of a sort. Given that I already felt so awful, choosing to stay in rather than try to force myself to go out undoubtedly makes my life easier in some ways. It prevents me from burning out further. It prevents potential damage to my relationships with others. It prevents me from embarrassment if I don’t feel comfortable being my burned-out self in front of my friends (and, although this is a hypothetical, I actually don’t).

That is a harm-reduction sort of self-care, whereas my first example was a more positive form of self-care. It wasn’t about preventing things from getting even worse so much as it was about making things get better. Both of these forms of self-care have their place, as painful as it is when one gets confused for the other.

V. Self-care should fit the situation.

Just as different people find different forms of self-care helpful, different situations might call for different forms of self-care. I touched on that in the previous section, but it goes further than that. At the Secular Women Work conference this summer, Hiba Krisht did a workshop about burn-out and self-care in which she made the point that effective self-care needs to restore whatever it is you’re lacking in that moment. If you’re lacking energy, self-care should restore energy (or at least conserve it, when restoring it is impossible). If you’re lacking connection, self-care should restore it. If you’re lacking peace and quiet…you get the idea.

While that sounds totally obvious in retrospect, I never thought of it that way before, and that was why, as I mentioned above, most suggestions for self-care techniques fell flat for me. Lounging around in a bubble bath is great for when you need calm and solitude, but that’s not what I usually need. I need intellectual stimulation and connection with people.

Unfortunately, that makes self-care even more difficult than it already is for most people, since feeling intellectually understimulated and disconnected from people also usually goes along with lots of sadness, fatigue, and other shit that makes it really difficult to achieve intellectual stimulation and connection with people. What then complicates matters further is that most people, including most of the friends I’d theoretically be connecting with, conceptualize self-care more as sitting in a bubble bath or watching Gossip Girl than being out at a loud bar with friends yelling about recent psychology research. So when I tell my friends I’m feeling shitty, they’re much more likely to say, “Aww, it’s okay if you need to just lay around on the couch and watch TV” than “Oh, sounds like you need to head out to a crowded noisy bar with a bunch of us to yell about research.” And when I’m in an especially shitty state, I can’t always access my memories of things that have helped in the past, so I’m unlikely to draw the “feeling shitty? go hang with friends!” connection on my own. Plus, I feel awkward asking people to hang out with me when I’m feeling shitty, because they might not realize that I’ll probably stop feeling shitty as soon as we start hanging out (but also, I can’t necessarily promise that’ll happen 100% of the time, you know?).

And sometimes it admittedly feels really weird how fast my friends jump to saying “it’s okay to just cancel our plans and be alone!” when I mention I’m having a hard time. At that point, the crappy part of my brain is thinking…do they want me to just cancel and be alone? Would they rather not deal with me when I’m down? Is it bad to want to be cheered up by people when I’m sad?

Ultimately I try not to ascribe such negative motives to my friends and try to trust them to just set their own boundaries. But regardless, it would be so helpful if people would more often ask, “What do you think would be helpful for you right now?” rather than reminding me (with the best of intentions) that I have the option of doing something that would make me feel much, much worse.

Self-care, both as a concept and as a practice, is not a panacea. We shouldn’t try to make it do more work than it’s capable of. But I’m definitely not ready to throw it out, either.

On “Obvious” Research Results

There is a tendency in my social circles sometimes to dismiss social science results that seem “obvious” and aligned with our views with, “Well, duh, why didn’t they just ask a [person who experiences that type of marginalization/trauma/adverse situation].”

I’ve seen it happen with studies that show that fat-shaming is counterproductive, and studies that show that sucking up to abusers doesn’t stop abuse, and probably every other study I’ve ever written about here or posted on Facebook.

To be honest, I’m often having to suppress that initial response myself. It is infuriating when we’ve been saying something for years and now Science Proves It. (Of course, science doesn’t really “prove” anything.) It’s especially annoying when some of the some of the same people who deny my experiences when I share them are now posting links to articles about research that says that exact thing, without any apology for disbelieving me.

At the same time, though, I try to separate my frustration from my evaluation of the research. In reality, the fact that a result seems “obvious” or “common sense” doesn’t mean that the study shouldn’t have been conducted; for every result that aligns with common sense, there’s probably at least one that completely goes against it. Considering the fact that negative results have such a hard time getting published in psychology, there are probably a ton of studies sitting around in file drawers showing no correlations between things we assume are correlated.

Moreover, research is important because it helps us understand how prevalent or representative certain experiences are, and listening to individuals share their stories isn’t going to give you that perspective unless you somehow manage to listen to hundreds or thousands of people. (Even then, there will probably be more selection bias than there will be in a typical study, in which the subject pool at least isn’t limited to the researcher’s friends.) I will always believe someone who is telling me about their own experience, but that doesn’t mean that I will assume that everyone who shares a relevant identity with that person has had an identical experience. That would be stereotyping.

So, sure, to me it might be totally obvious that people who make creepy rape jokes are much more likely to actually violate boundaries–because I’ve experienced it enough times–but my experience may not have been representative. It is very much still my experience, and it is very much still valid and I have the right to avoid people who make creepy rape jokes since they make me uncomfortable, but it isn’t necessarily indicative of a broader trend. (Of course, now I know that it probably is, because multiple studies have strongly suggested it.)

The weirdest thing by far about the “Why didn’t they just ask a [person who experiences that type of marginalization/trauma/adverse situation]” response is that, well, they did. That’s literally what they’re doing when they conduct research on that topic. Sure, research is a more formal and systematic way of asking people about their experiences, but it’s still a way.

And while researchers do tend to have all kinds of privilege relative to the people who participate in their studies, many researchers are also pushed to study certain kinds of oppression and marginalization because they’ve experienced it themselves. While I never did end up applying to a doctoral program, I did have a whole list of topics I wanted to study if I ever got there and many of them were informed directly by my own life. The reason researchers study “obvious” questions like “does fat-shaming hurt people” isn’t necessarily because they truly don’t know, but because 1) their personal anecdotal opinion isn’t exactly going to sway the scientific establishment and 2) establishing these basic facts in research allows them to build a foundation for future work and receive grant funding for that work. In my experience, researchers often strongly suspect that their hypothesis is true before they even begin conducting the study; if they didn’t, they might not even conduct it.

That’s why studies that investigate “obvious” social science questions are a good sign, not a bad one. They’re not a sign that clueless researchers have no idea about these basic things and can’t be bothered to ask a Real Marginalized Person; they’re a sign that researchers strongly suspect that these effects are happening but want to be able to make an even stronger case by including as many Real Marginalized People in the study as financially/logistically possible.

As I said, I do completely empathize with the frustration of feeling like nobody takes our experiences seriously until they are officially Proven By Science. I also wish that people didn’t need research citations before they are willing to accommodate an individual’s preferences for the sake of inclusivity or just not being an asshole. (For instance, if I ask you to stop shaming me for my weight, you should stop doing it whether or not you have seen Scientific Proof that fat-shaming is harmful, because I have set a boundary with you.)

However, if we take individual experiences as necessarily indicative of broader trends, we would be forced to conclude that, for instance, there is an epidemic of false rape accusations or that Christian children are overwhelmingly bullied in the United States for their religious beliefs. Certainly both things happen. Certainly both things happen very visibly sometimes. Both are awful things that should never happen, but it is, in fact, important to keep in perspective what’s a tragic fluke and what’s a tragic pattern, because flukes and patterns require different prevention strategies.

I’ll admit that a part of my discomfort with “well duh that’s obvious why’d they even study that” is because I don’t want the causes I care about to become publicly aligned with ignoring, ridiculing, or minimizing science. We should study “obvious” things. We should study non-“obvious” things. We should study basically everything as long as we do it ethically. We should do it while preparing ourselves for the possibility that studies will not confirm what we believe to be true, in which case we dig deeper and design better studies and/or develop better opinions. I find Eliezer Yudkowsky’s Litany of Tarski to be helpful here:

If the box contains a diamond,
I desire to believe that the box contains a diamond;
If the box does not contain a diamond,
I desire to believe that the box does not contain a diamond;
Let me not become attached to beliefs I may not want.

Even if your experiences turn out to be statistically atypical, they are still valid. Even if it turns out that fat-shaming is an effective way to get people to lose weight, guess what! We still get to argue that it’s hurtful and wrong, and that it’s none of our business how much other people weigh. Knowing what the science actually says at this point is the first step to an effective argument. Knowing what the possibly-faulty science is currently saying is the first step to making better science.

Being Extra Nice To Abusers Doesn’t Stop Abuse

[CN: abuse]

So I’m reading this Washington Post article about some recent research on abusive bosses and come across this perplexing bit:

But the researchers also found something they didn’t expect. They predicted that acts of compassion and empathy—employees who assist bad bosses by going above and beyond, helping bosses with heavy workloads even when they’re not asked—would be negatively linked with abusive behavior. In other words, such acts of kindness might help lessen future rude or abusive behavior.

The study, however, found that wasn’t true. “Abusive supervisors didn’t respond to followers being positive and compassionate, and doing things to be supportive and helpful,” said Charlice Hurst, an assistant professor at Notre Dame’s Mendoza College of Business who was a co-author on the paper. Their findings, she said, seem to “clash with common sense.”

To put it mildly, these findings only clash with common sense if you’ve never been abused or bullied. If you have, then you know that abuse is not about persuading people to do nice things for you. It’s about controlling them: their feelings, their thoughts, their self-esteem, their experiences, their behavior, even the course of their lives. It is also about asserting power publicly to control bystanders as well.

That’s why bullies and abusers “win” almost no matter how you respond. If you lash out in anger, they get to use their higher status to get you in trouble for your anger. If you cry, they get to ridicule you. If you ignore it and walk away, they get to paint you as a coward–and, regardless, they still get to influence bystanders even if they haven’t influenced you. If you start being extra nice to them, then they reap the benefits of your niceness while reinforcing their dominance over you. The only way to “win” in an abusive situation is to find a way to get out of it entirely and never look back, and that’s exactly what abuse is designed to prevent you from doing.

And in the event that a boss is deliberately choosing to be abusive in order to elicit “supportive and helpful” behavior from you, then behaving in a supportive and helpful manner would only reinforce the abuse*. It would be like feeding scraps to a dog that begs at the table, except that dogs that beg are at worst annoying and bosses that abuse are at worst life-ruining. I am absolutely horrified at the idea that people are advising victims of workplace abuse to perform “acts of compassion and empathy” towards their abusers, because if anything, that’ll only teach the abusers that abuse is an effective method of getting people to kiss your ass.

The article continues:

In the paper, the researchers say one explanation may be that bosses just see all that extra work as part of the job, something academics refer to as “organizational citizenship,” and therefore don’t feel the need to treat their employees any better because of those efforts.

I submit that it’s not that at all, but rather that people who abuse, whether they do it in a school or their home or their office, do it because they reap some psychological reward from it. Why would they give that reward up just because you did some of their paperwork?

One might protest that this is making it seem like there’s nothing that victims of workplace abuse can do to stop the abuse. Indeed, the article notes that the researchers have so far “only discovered what not to do” to stop abuse, and nothing to do to stop it.

While that might aggravate those who believe strongly in a just world, it makes complete sense. Abusive situations are abusive precisely because they involve a significant imbalance of power. The person with less power does not have the capacity to influence the situation significantly. If they did, they probably wouldn’t have been abused in the first place. And the thing about having relatively little power is that you can’t just decide one day to have more power. That’s not how power works.

That’s why telling victims of abuse and other power-based acts of violence (such as sexual assault) to prevent that violence is not only hurtful and condescending, but also totally useless. That’s why comparing abuse and sexual assault to other situations, like stolen bikes, doesn’t work.

The researchers in this particular study seem to have wised up a lot about abusive dynamics over the course of their research. Co-author Charlice Hurst says that in order to prevent workplace abuse, “Companies have to create cultures where abusive supervisors are not acceptable, and they have to implement policies for employees to report being bullied.” In other words, the responsibility for preventing bullying rests on the shoulders of those who have more relative power within the workplace, not those who have less. The way to stop bullying is to implement reforms at the systemic level, not at the individual level.

(And no, before anyone jumps in with “but some employees are just terrible and rude and bad at their jobs, so shouldn’t they improve,” that’s completely irrelevant. The solution to a bad employee is to tell them how to improve and if they don’t, fire them. It’s not to abuse them.)

While victims of abuse do not have much control over the abuse itself (unless they manage to extricate themselves and leave), they do have some control over their emotional reaction. It is very important that I said “some.” I didn’t say “complete,” or “a lot.” And that control can include, for instance, going to therapy to learn coping skills. But the reason I bring this up is that “passive-aggressive retaliation,” one of the reactions the researchers showed to be ineffective in terms of stopping abuse, was also shown in a different study to be effective for a different purpose: helping employees cope. In sum, “Employees felt less like victims when they retaliated against their bad bosses and as a result experienced less psychological distress, more job satisfaction and more commitment to their employer.”

Of course, retaliation of any sort can be dangerous, you know your situation best, take all psychology reporting with an appropriate grain of salt, et cetera. I’m hesitant to do some sort of “coping with abuse” advicepost because I don’t want to come across like I’m condoning abuse or being fatalistic about it, but on the other hand, 1) abuse happens and 2) it’s already been demonstrated numerous times that you cannot prevent your own abuse. Using whatever coping strategies work for you seems like a good idea.

I hope that studies like this one bring more awareness to the psychology community about the dynamics of abuse. Too often, psychologists fall into the trap of focusing overly on individual factors (like what abuse victims can/should do) as opposed to structural factors (like what communities/systems can/should do). This causes them to make ridiculous assumptions like “it’s just common sense that being nice to an abuser would make them stop abusing!”

It makes sense that only someone with more power (whether individual or collective) than an abuser can make them stop abusing, although that may not always be sufficient. If an abuser holds such absolute power in your workplace that nobody and nothing can hold them accountable, you’re going to have issues with abuse no matter how nice the abuser’s victims are.

~~~

*I want to be very clear here that sometimes being extra nice to an abuser feels like the only safe thing to do, in which case you should do whatever makes you feel safe first and foremost. I will never pass judgment on the ways in which individuals choose to cope with their abuse. However, I also don’t think we should advise people to do things that seem like they’d make abuse worse, so, that’s what I’m getting at here.

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Brains Lie, But So Do People

[CN: mental illness, gaslighting, abuse]

For those of us with mood disorders to manage, learning and understanding the fact that brains often lie was a revelation. Suddenly we had an explanation–and not a BS, pseudoscientific explanation–for why we think and feel things that don’t make sense and that make life unbearable. We learned that feeling like everyone hates you isn’t actually a feeling; it’s a thought, and the thought isn’t based in reality. We learned that we have a much easier time remembering the bad than the good, which leaves us with the skewed impression that everything is awful and must always continue to be awful.

And so we adopted a new language. We talk about jerkbrains and depression!brains and all sorts of other brains, and we teach ourselves to constantly question and second-guess the negative things we tell ourselves.

For the most part, this is how mood disorder recovery happens. Once you develop the awareness that many of your depressive or anxious thoughts are not based in reality, you are able to develop coping skills to stop these thoughts or minimize their impact. This is CBT, in a nutshell. CBT is not a panacea–some people, especially those whose disorders started early in their life (or seem like they’ve been going on forever) don’t find this sufficient to actually stop the thoughts. But recovery can’t happen until you internalize the fact that brains lie.

Here’s where I worry, though. When I start hearing this:

“My friends are always making jokes at my expense and it makes me feel hurt. But that’s just my depression, I know they don’t really mean it.”

“I know I should be ok with my partner wanting us to be poly. It’s just my anxiety, it’s not a rational thing.”

“It’s not that I don’t want to have sex with him, it’s just that I don’t really have a sex drive because of my medication. So I do it anyway because I mean, I don’t mind.”

Sometimes we overcompensate. We get so used to these tropes–depression makes you feel like people hate you, anxiety makes you freak out that your partner’s going to leave you when there’s no evidence, medication makes you lose your sex drive–that we assume those causations. If you’re diagnosed with depression and your friends are making mean jokes and you feel hurt, it’s because of your depression. If you’re taking medication and you don’t want to have sex, of course it’s the medication.

Obviously these things are all true in many cases. It could very well be that all evidence suggests your friends love you and assume you’re be okay with some good-natured teasing. It could very well be that all the evidence suggests that your partner is committed to you, poly or not, and that your anxiety contradicts your other beliefs about the relationship and your preferences. (For instance, polyamory often makes me very anxious, but I’ve decided that it’s nevertheless what’s best for me and so that’s what I’m doing.)

But sometimes, your “friends” are being callous assholes and don’t care that their jokes hurt you. Sometimes, your partner is pressuring you to try polyamory even though it just doesn’t work for you, and everything about this is (rightfully) freaking you out. Sometimes, meds or no, you’re just not attracted to someone and haven’t internalized the fact that you don’t owe them sex. Sometimes the reason you don’t want to have sex with someone is because they’re giving off a ton of red flags and you should pay attention to them.

This gets even worse when close people, well-meaning or not, start pulling out these sorts of phrases in order to “help” you: “Oh, that’s just Depressed Miri talking.” “That’s your jerkbrain.” “This isn’t who you really are, it’s just your illness.” “Did you take your meds today?”

The message? “That’s not based in reality.”

Don’t get me wrong. When used by a kind, perceptive, absolutely not abusive person, these responses can be incredibly powerful and helpful. Sometimes we really do need that reality check: a partner who helps you draw the connection between skipping meds and feeling bad; a friend who patiently reminds you that sometimes depression feeds you lies.

When used by someone who wants to control you, though, they become very dangerous.

Upset that your partner keeps canceling your plans to see their other partner? That’s your depression, of course they still love you, it’s only natural that they’d want to see their new partner a lot. Scared to have sex without a condom? That’s just your anxiety, they already told you they’ve been tested, so what’s the problem? Annoyed that your friend keeps cutting you off in conversation? You know that irritation is a depression symptom.

I’ve written before that attempting to treat your depression or anxiety by invalidating your feelings can lead to a sort of self-gaslighting; even more harmful, I think, is when others do it to you. I have to admit that I start to get a queasy feeling when I see someone trying to manage their partner’s mental illness for/with them. As I said, sometimes this can be a great and healthy situation, but never forget that in a relationship between a person with a mental illness and a neurotypical person, the latter holds privilege. With privilege comes power, and with power comes responsibility.

The problem here, obviously, is not with CBT or the term “jerkbrain” or even the idea that thoughts/feelings can be irrational; the problem is abusive people learning this terminology and taking advantage of it. To a lesser extent, too, the problem is with ourselves over-applying these concepts to situations that are legitimately unhealthy, unsafe, or just straight-up unpleasant.

I don’t have a solution to this, but I do have some suggestions if you worry that you might be in this situation:

1. If you have a therapist, ask them to work with you on (re)learning how to trust your gut when appropriate. Most of us have a spidey sense when it comes to abusive people and dangerous situations; the problem is that our culture often trains us to ignore that sense. “But he’s such a nice guy, give him a chance!” “But it’s not your friends’ job to make sure none of their jokes ever offend you!” and so on. For many people, especially marginalized people, a crucial task is to remember what that sense feels like and to feel comfortable using it.

2. When an interpersonal situation is making you depressed or anxious, ask for a reality check from more than one person, and make sure that none of those people is directly involved in the situation. If you’re sad because your partner hasn’t been spending as much time with you as you’d like, that’s obviously an important conversation to have with your partner at some point, but the reality check part has to come from someone else, because your partner probably has a vested interest in keeping things as they are. (Not necessarily a bad thing! Maybe your partner has already patiently explained to you many times that they love you and wish they could see you more, but this year they need to focus on completing and defending their dissertation. Or maybe your partner is neglectful and stringing you along in this relationship that they’re only in for the sex and not being clear with you about what they actually want.)

It helps to find people that you can trust to be kind and honest. In many social circles I’ve been in in the past, there was a tendency to support your friend no matter what, and “support” meant agreeing with them about all interpersonal matters. If I’m upset at my partner, my friend agrees with me that they’re a jerk who doesn’t deserve me. If another friend is angry at me for missing their birthday party, my friend agrees with me that they’re obviously overreacting and being so immature. That’s not helpful for these purposes. You need someone who will say, “That sounds really rough for you and I’m sorry, but the fact that your partner has been busy lately doesn’t mean they hate you and don’t care if you live or die.”

3. Remember that feelings don’t have to be rational to be acted on. While it’s good to treat feelings with some amount of skepticism when you have a mental illness, that doesn’t mean you have to just ignore those feelings unless you can prove to yourself that they’re rational. There are many interpersonal situations that trigger my depression or anxiety for reasons I’ve determined aren’t rational, but I still avoid those situations because, honestly, life’s too damn short to feel like crap all the time, and I can’t will myself out of my depression and anxiety.

For example, here’s a meme I come across often:

Yes, rationally I know that sarcasm doesn’t mean you hate me, that that’s a perfectly valid way of expressing yourself and interacting with people, that for many people that’s part of their family culture/subculture, etc. etc.

But this interpersonal style interacts really badly with my depression. It makes me feel insecure and small. It is disempowering. It makes my brain go in circles about What Does This Person Really Think Of Me Do They Hate Me Or Not Did I Do Something Wrong.

(A part of me wonders if the reason people do this isn’t so much because they enjoy feeling relaxed enough to just be their snarky, sarcastic selves, but because they enjoy making people feel the way I just described. I’m not sure.)

So I decided at some point that I just wasn’t going to put up with it. When someone treats me this way, I remove them from my mental list of people I trust or want to get closer to. I minimize my interactions with that person. I prepare myself to set specific boundaries with them if that becomes necessary, but it usually doesn’t because distance does the trick.

At no point do I have to convince myself that, yes, all the available evidence suggests that this person hates me or is a cruel, bad person. I’m sure they don’t hate me. I’m sure they are a decent human being. For my purposes, though, it doesn’t really matter.

You are allowed to act in ways that minimize negative emotions even if those emotions are mostly being caused by mental illness.

~~~

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Other People Have It Worse

[CN: bullying, sexual assault]

I had a client recently who spent most of his childhood as a target of relentless bullying and physical violence at school. Now, he says, “It’s not that big of a deal. I had a home and a loving family. Some people had it much worse.”

I said, “The worst thing you’ve ever gone through is the worst thing you’ve ever gone through.”

What I mean is that whatever it is that happened to you that still makes you burst into tears or wake up from nightmares or shudder in horror, that’s still (one of) the most difficult thing(s) you’ve ever lived through. The fact that the things that make other people burst into tears or wake up from nightmares or shudder in horror seem worse to you doesn’t change that.

Besides, it’s not so easy to rank suffering. Even if you could rank potential traumas from worst to least worst, someone else’s ranking might look totally different. (There are people who feel that they’d rather die than be gay, and there are happy gay people.) And the ranking might change completely if the hypothetical becomes real. Many people might think, “I could never live through ____,” until ____ happens. Then it sucks, and yet they live. Often they even thrive. And something else becomes The Worst Thing.

So, in fact, one of the people who’s survived one of the things you think about when you think “other people have it worse” might be thinking the same about you. Who’s to say who is right?

When I worked with survivors of sexual assault on a hotline, I noticed that almost every single one of them expressed the belief that others were the “real victims” while they didn’t really have it “that bad.” The women who had faced “attempted” rape said that the women who had “actually” been raped had it “worse.” The women who had been raped by partners or friends said that the women who had been raped by strangers had it “worse.” The women who had been raped by strangers said that the women who had been physically injured during the rape had it “worse.” The women who had been physically injured during the rape said that the women who had contracted an STI or become pregnant had it “worse.” And on and on it went.

In fact, some women who had been raped by strangers thought, “At least I didn’t get raped by someone I loved.” Some women have found it less traumatic to be raped by someone they hadn’t wanted to have sex with at all than by someone that they agreed to have sex with, who then violated their consent by lying about having put on a condom or by doing something else that they hadn’t consented to.

Everyone seems to think that 1) someone else’s experience was objectively worse, and 2) that this means that their own experience “shouldn’t be that big of a deal.”

So either everyone’s trauma is valid, or no one’s trauma is valid. And the latter doesn’t make any sense.

The purpose of reminding yourself that “others have it worse” is ostensibly to build perspective and remind yourself that yours aren’t the only problems in the world. That’s an admirable goal and a worthwhile perspective. However, I think that a certain amount of healing needs to happen before that’s feasible or healthy. It’s okay if there’s a period of time during which you feel absolutely certain that nobody has ever suffered as you’re suffering. And it’s okay if the cause of that feeling is a broken-up relationship or a failed class or even just a spectacularly shitty day. It doesn’t have to be a Real Approved Trauma™.

I think many people feel that they have a moral imperative to always Keep Things In Perspective and make sure that their feelings are in line with some objective ranking of bad things. But the way you feel in the aftermath of a bad thing doesn’t have to be your final say on the matter. It doesn’t have to Mean Anything besides the fact that your brain is doing brain stuff. It doesn’t have to be a feeling you “endorse.”

Of course, many people also believe that if you can somehow fully convince yourself that others do in fact Have It Worse, it will hasten your healing. I’m sure that’s the case for some people, but it doesn’t really seem in line with what I’ve observed in my own experiences, friendships, and professional work with people. Rather, it seems that people heal through acknowledging what happened to them and feeling the feelings that it brings up. There’s a reason why “Wow, that sounds really hard, I’m sorry” does a better job of comforting people than “You know, others have it worse.”

If there value in contemplating the struggles of others as part of your own healing process, I’m convinced that it doesn’t lie in chastisingly reminding yourself that Others Have It Worse, but in letting yourself see how similar those struggles really are. Don’t jump to the classist assumption that people in the “Third World” are necessarily dying of AIDS or hunger while silly privileged you is crying over a breakup. Read some lovesick poetry written by a teenage boy in Ethiopia. And, not but. Replace “This sucks but others have it worse” with “This sucks and I bet other people have to deal with it too.” Countless other people have survived this and you will too. Doesn’t make it suck any less, but it does mean there’s hope.

Emotions are relative, which is why the worst thing you’ve ever experienced feels like the worst thing in the world. But that’s a feature, not a bug. The fact that emotions are relative is what allows us both to cope with persistent adversity and also to keep reaching higher for happiness rather than becoming complacent.

It also means that there isn’t much use in trying to figure out who’s suffering more. Rational!You can choose to care more about global poverty than rare feline diseases that kills some pet cats (I think that would be a wise decision), but the rest of you is still allowed to grieve when your cat dies because of a rare feline disease, and while you’re grieving, you’re allowed to care much more about rare feline diseases than global poverty. If nothing else, think of it this way: the sooner you let yourself feel your feelings, the sooner you can be back to your rational, poverty-prioritizing self.

But besides that, I think that allowing ourselves to feel our own feelings also helps us to be more compassionate to others, including all those people we think are suffering so much more.

~~~

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What We Can Learn From the Reproducibility Project

I have a new piece up at the Daily Dot about the Reproducibility Project and why psychology isn’t doomed.

The Internet loves sharing psychology studies that affirm lived experiences, and even the tiniest ticks of everyday people. But somewhere in the mix of all those articles and listicles about introverts, extroverts, or habits that “make people successful,” a debate still lingers: Is psychology a “real science?” It’s a question that doesn’t seem to be going away anytime soon. Last week, the Reproducibility Project, an effort by psychology researchers to redo older studies to see if their findings hold up, discovered that only 36 of the 100 studies it tested reproduced the same results.

Of course, many outlets exaggerated these findings, referring to the re-tested studies (or to psychology in general) as “failed” or “proven wrong.” However, as Benedict Carey explains in the New York Times, the project “found no evidence of fraud or that any original study was definitively false. Rather, it concluded that the evidence for most published findings was not nearly as strong as originally claimed.”

But “many psychology studies are not as strong as originally claimed” isn’t as interesting of a headline. So, what’s really going on with psychology research? Should we be worried? Is psychology a “hopeless case?” It’s true that there’s a problem, but the problem isn’t that psychology is nonscientific or that researchers are designing studies poorly (though some of them probably are). The problem is a combination of two things: Statistical methods that aren’t as strong as we thought and a lack of interest in negative findings.

A negative finding happens when a researcher carries out a study and does not find the effect they expected or hoped to find. For instance, suppose you want to find out whether or not drinking coffee every morning affects one’s overall satisfaction with their life. You predict that it does. You take a group of participants and randomly assign half of them to drink coffee every morning for a month, and the other half to abstain from coffee for a month. At the start and at the end of that month, you give them a questionnaire that assesses how satisfied each participant is with their life.

If you find that drinking coffee every day makes no difference when it comes to one’s life satisfaction, you have a negative result. Your hypothesis was not confirmed.

This result isn’t very interesting, as research goes. It’s much less likely to be published than a study with positive results—one that shows that drinking coffee does impact life satisfaction. Most likely, these results will end up gathering figurative dust on the researcher’s computer, and nobody outside of the lab will ever hear about them. Psychologists call this the file-drawer effect.

Read the rest here.