Before You Speculate About Amanda Bynes’ Mental State

[Content note: mental illness, ableism]

I wrote a piece for the Daily Dot about the gleeful speculations about Amanda Bynes’ supposed mental illness.

Former child star Amanda Bynes hasn’t been having a good month. After being arrested for DUI in California, Bynes left her family and made her way to New York City, where she’s attempted to shoplift clothing twice, which she claims was a “misunderstanding.”

Bynes also gave an interview to In Touch magazine in which she apparently said that she believes there’s a microchip implanted in her brain that allows people to read her thoughts. She later made a series of tweets claiming that the interview was fake and that she will sue the magazine for calling her “insane.” Celebrity gossip websites have, of course, taken this story and run with it, speculating about Bynes’ mental health and diagnoses and treating the situation like a spectator sport.

Even if Bynes really did tell In Touch that she believes she has a microchip implanted in her brain that allows people to read her thoughts, that doesn’t mean it’s okay to call her “insane” or “crazy,” and I’m not surprised she’s angry about it. Words like that don’t just mean “displaying symptoms of a mental illness.” They connote ridicule, ignorance, and sometimes even hate.

They also place people with mental illnesses in a category apart from the rest of us, the ones who aren’t “crazy.” In fact, mental illnesses exist on a spectrum. Some people have a a few hallucinations or delusions during a time of extreme stress (or perhaps sleep deprivation). For others, psychotic symptoms are a struggle they must manage for their entire lives.

Are all of these people “crazy?” Is everyone who has ever had a random and totally irrational thought “crazy?” Is everyone who takes medication for anxiety, depression, or bipolar disorder “crazy?” Words like “crazy” and “insane” do not refer to any specific set or level of symptoms. They refer to someone we wish to hurt, ostracize, or laugh at.

How do you report a story like Bynes’ without perpetuating the stigma that people with mental illnesses face?

For starters, recognize that some things are newsworthy whether the person who did them is a celebrity or not; others are newsworthy only when they’re done by someone we’re already paying attention to—or used to pay attention to. People get DUIs and shoplift all the time, but when a famous person does it, that suddenly becomes a reason to write an entire news story. Someone having delusions is also not in and of itself interesting to the public—although, in a way, I wish it were, because maybe then people would know more about it and stigmatize those who struggle with it less.

Obviously, journalists have to make money. Sometimes that means writing stuff that sells, whether or not you personally think that this information is important to collect and provide to the public. However, oftentimes journalists—especially those who cover celeb news—shrug off all responsibility for choosing their subject matter by claiming that it’s “just what sells” or “what the people want.”

Read the rest here.

Promoting Mental Health in the Workplace

[Content note: mental illness, including eating disorders]

This post was requested by Kate [not FtB!Kate], who donated to my conference fundraiser. She wanted to hear my opinion on mental health in the workplace and how employees and employers can foster a culture that values and promotes mental health. She had some of her own suggestions, which I’ve incorporated into this piece with her permission.

Work is often a concern for people who suffer from mental illnesses. They might worry, for instance, that their struggles will impact their work performance, that coworkers or employers will find out that they have a diagnosis and stigmatize (or even fire) them, or that offhand comments at work could trigger eating disorder symptoms.

I wrote about this topic much more generally in this piece, which was about how to prioritize and promote mental health in one’s community. Workplaces are particular types of communities, so a lot of this still applies. At the same time, workplaces present particular challenges to promoting mental health, as well as particular capabilities that might help.

Note that I’m writing this as a person with a mental illness, as a person who works, and as a person who observes human behavior. I’m not writing this as someone who’s ever been a manager or a supervisor, so while I can speak to what I would like to see from managers and supervisors, I don’t have firsthand knowledge of what it’s like to be one. If you have that experience and you’d like to weigh in in the comments, feel free to do so.

For employers/managers/supervisors

1. Ensure that the assignments you give your employees and the culture you foster in the office encourage and allow employees to take good care of themselves.

Every workplace that expects people to skip lunch or sleep less than 7 hours a night is a workplace that is detrimental not only to physical health, but mental health as well. Sleep deprivation can dangerously exacerbate many mental illnesses, and having to skip meals can cause people with eating disorders to relapse. Obviously this is unavoidable with certain jobs or when a big important project is nearing completion, but it’s avoidable with most jobs most of the time.

(At the same time, recognize that this is a problem with American culture at large, and companies feel pressure to pressure their employees in this way because if they don’t, a competitor will, and it’ll reap the profits.)

2. Make sure that new employees understand the health coverage they’re receiving under the company’s benefits plan, especially as it pertains to mental health.

Explain in as little legalese as possible what the coverage includes and doesn’t include, and where they can go to find more detailed information or look up specialists in their area. In my experience, many people are worried that if they see a mental health professional using their employer-provided insurance plan, their employer will somehow have access to their medical records. Emphasize that it’s none of your business as an employer what your employees do with their health insurance and that providers cannot disclose such information to you without a patient’s consent. For extra points, give a short overview of HIPAA.

Going over this information not only improves the odds that employees are able to get the mental healthcare they need, but it shows that you’re comfortable discussing mental health with employees and that your company thinks it’s important.

3. If you choose to have health-related contests at the office, focus them on fitness goals or healthy eating, not weight loss.

Personally, though, I’d avoid these altogether because many people consider health a personal matter and feel pretty uncomfortable about having to discuss it publicly and competitively. Even if the contest is optional, keep in mind that people will feel a strong social pressure to join in. Who wants to be the only person in the office who doesn’t seem to care about staying in shape?

In any case, framing weight loss as an intrinsically healthy and positive goal is harmful and counterproductive. You can weigh little and be very unhealthy, and if you lose weight in an unhealthy way, you’ll probably gain it back anyway. A better way to structure a health contest is by encouraging participants to achieve goals that are proven to be healthy and doable.

4. Make sure employees understand the policies and processes about taking time off for medical reasons (and remember that mental health is a medical issue).

It’s especially important to find a way to emphasize that mental health is just as important as physical health, and little gestures make a big difference. For example, you could say something like, “If you know in advance you’re going to need time off, like for a physical or a therapy appointment, you can submit the form to me at at least a week’s notice.” That provides important information while also implicitly conveying the fact that you consider therapy to be a legitimate reason to leave work an hour early.

For employees

1. Consider your own mental health when choosing responsibilities to take on at work.

It’s understandable, especially in this economy, to try to impress your boss by offering to do as much as possible and overworking yourself. However, good mental health should be seen as an investment. If you take good care of it, you’ll ultimately be more productive than if you neglect it and burn out.

This applies to all those little volunteer opportunities that aren’t directly job-related, either. If you have social anxiety, it might be a bad idea to offer to organize a social outing for the office. If you have an eating disorder that makes it really stressful to choose food to buy, it might be a bad idea to offer to bring snacks for a meeting. You know yourself best.

2. If you feel safe and comfortable, let your boss know about mental health issues that may affect your performance and how you plan to deal with them.

The “if you feel safe and comfortable” is the key part. I’m absolutely not suggesting that everyone can and should come out about their mental illness to their boss, since I know that in many cases that’s a really bad idea. (It shouldn’t be, but it is.) But personally, I know people who did this and found it really helpful because they were able to work collaboratively with their boss to make sure that they can get the time off they need and that they can fulfill their responsibilities rather than having to keep it a secret and try to solve potential problems on their own. Disclosing also makes it possible to receive any accommodations you may need, which brings me to:

3. Educate yourself about laws related to mental illness and the workplace.

The Americans with Disabilities Act (ADA) is obviously a major one, but so is HIPAA, which I mentioned earlier. The definition of “disability” in the ADA is intentionally quite general, but mental illnesses are included: depression, anxiety, PTSD, ADHD, and so on. Title I of the ADA concerns employment. There’s a lot of useful information in there; for instance, an employer cannot ask you in a job interview whether or not you’ve been treated for mental health problems, or which medications you’re taking. Keep in mind that the ADA only applies to businesses with 15 or more employees, however. Here’s another useful article about it.

For everyone

1. When someone asks you how you’re doing, be honest (within reason).

In the piece I linked to earlier, I wrote:

This is something I’ve been really making an effort to do. This doesn’t mean that every time someone asks me “What’s up?” I give them The Unabridged Chronicles of Miri’s Current Woes and Suffering. But I try not to just say “Good!” unless I mean it. Instead I’ll say, “I’ve been going through a rough patch lately, but things are looking up. How about you?” or “Pretty worried about my grad school loans, but hopefully I’ll figure it out.” The point isn’t so much that I desperately need to share these things with people; rather, I’m signaling that 1) I trust them with this information, and 2) they are welcome to open up to me, too. Ending on a positive note and/or by asking them how they are makes it clear that I’m not trying to dump all my problems on them, but I leave it up to them to decide whether or not to ask more questions and try to comfort me, or to just go ahead and tell me how they’re doing.

At work, there are obviously different standards than in other communities, or with friends and family. But even at work, there’s room for honesty and mutual support.

2. Be mindful of using language that relates to mental illness.

Casual usage of diagnostic terms (“That’s so OCD,” “You’re being delusional,” etc.) hurts people with mental illnesses by trivializing their conditions and turning them into the butt of a joke. It also makes it more difficult for people to disclose mental illnesses because it keeps people from taking them seriously. If “ADHD” is what you call it when you can’t focus on a boring project and someone tells you they have “ADHD,” you’re not going to think, “Oh, this person has a serious condition that makes it neurologically impossible for them to focus on a task unless they get treatment.” You’re going to think, “Oh, come on, they just need to close Facebook and get focused.”

3. Remember that talking about dieting and weight loss can be very triggering for people with past or current eating disorders.

Fat talk (as it’s called) is so ingrained in our culture and communication patterns that it’s hard to imagine that it could be such a serious issue for someone. But anecdotally, it seems that eating disorders in particular are very easily triggered by offhand remarks like “Ugh I need to work off this cupcake” or “My thighs are huge.” Even when not actually triggering, these comments encourage unhealthy behavior and create a social norm of dieting and preoccupation with weight loss.

I sometimes dread being around groups of women who are not my friends because more likely than not, I’m going to hear these comments. And it’s not like you can avoid your coworkers. So if you must do it, try not to do it to a captive audience.

4. Respect others’ privacy when it comes to mental health issues.

Just as you should never out an LGBT person without their permission, you shouldn’t discuss someone’s mental health with others at the office. Although I generally encourage people to be open about mental illness if they feel they can be, that has to be on their terms, not someone else’s. If you’re concerned that someone’s mental health problems are causing them to be unable to do their work, do the same thing you’d (probably) do anytime a coworker isn’t pulling their weight: talk to them about it in a kind and considerate way rather than going straight to the boss.

(An exception to this is if you’re worried that someone may harm themselves or someone else. In that case, please call 911. )

When it comes to structural issues like ableism and stigma, no community can be an island, unfortunately. There will not be stigma-free workplaces until there is a stigma-free society. But the more power you have in a workplace, the more influence yo have over its culture.

Thank you to Kate for her donation and for this prompt. 

~~~

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Your Uninformed and Incorrect Opinions About Psychology

[Content note: PTSD, online harassment & bullying]

This is going to be a little different from most of my posts because I’m angry about a number of things, most of which boil down in one way or another to this: I am tired of people with no experience or education (whether through formal schooling or one’s own research) presuming to condescendingly (and, at times, abusively and violently) talk down to those who do have that experience and education. I am tired of being presumed incompetent by default unless I laboriously prove my qualifications, knowledge, and skills, while older men get to prattle on about fields they have no apparent experience with without ever needing to qualify their unasked-for lectures with proof of their competence. That’s all for that.

Now. Apparently a bunch of Skeptics™ don’t know what posttraumatic stress disorder is, but insist on lecturing those diagnosed with it (or those who have studied it) without ever bothering to educate themselves about the disorder, its symptoms, and its etiology. Because nothing says skepticism quite like blathering on about what you have no evidence for!

This is nothing new, of course. Some other entirely unsupported claims related to psychology that I have heard from Skeptics™:

  • Religious belief qualifies as a delusion.
  • Having a delusion qualifies as a mental illness.
  • Religion is a mental illness.
  • Cognitive dissonance is a mental illness.
  • You can instantly stop yourself from feeling upset or angry about something “irrational.”
  • It is “irrational” to feel pride about one’s minority identity because you didn’t “do anything” to have that identity.
  • Sticks and stones may break my bones but words will never hurt me.
  • It is “irrational” to fear strange men coming at you in the dark because most men are not violent.
  • It is “irrational” not to want to get the police involved after a sexual assault for fear of retraumatization.
  • If you feel traumatized by online harassment, then you are “weak.”
  • And, apparently, only war and similar experiences can cause PTSD.

Look, I could present you with shelves full of books and articles that refute all of these points. I could. Or, you could actually consider doing some research before you opine on subjects you’ve never studied and issues you’ve never personally faced. You could.

I understand that psychology is a unique discipline in a few ways. Unlike with other sciences, everyone has experience forming hypotheses about psychology, observing psychological phenomena, and analyzing those phenomena. We all do it every day whenever we try to figure out if someone is lying, whether or not a crush likes us back, how to help a friend who’s feeling really sad, how to appeal to an interviewer, what caused our parents to act the way they do, and so on.

There’s nothing really like that with, say, physics. The most interaction most people have with physics on a daily basis is just understanding that you probably shouldn’t leap off a building to try to fly. The most interaction most people have with chemistry on a daily basis is bemoaning the fact that some item that got left outside in the rain has gone all rusty. The most interaction we have with biology on a daily basis is remembering that our bodies need food in order to continue functioning, and that’s mostly automatic anyway thanks to our sense of hunger. The most interaction we have with computer science on a daily basis is maybe formatting an HTML tag on Tumblr.

There’s no reason for people to assume they are qualified to lecture others on physics, chemistry, biology, or computer science. There are many reasons for people to assume they are qualified to lecture others on psychology.

And to a certain extent, our individual experiences with human psychology are valid and real in a way that our opinions on other scientific topics might not be. We rightfully mock Jenny McCarthy for claiming that vaccines cause autism and creationists who claim that the earth is 5,000 years old because that is demonstrably false. But when someone writes one of those useless books on How To Get All The Women To Have Sex With You, we think, Well hmm, if it worked for him… When someone says that antidepressants are unnecessary because doing yoga made their depression better, well, maybe yoga really did make their depression better.

Think of the platitudes that are often proclaimed regarding human psychology. “Opposites attract.” “Relationships are ultimately about a struggle for power.” (Note: do not date anyone who says this.) “You can’t truly be happy unless you have children.” “Homophobes are just secretly gay and acting homophobic so that nobody guesses.” (Fuck that Freudian bullshit.) All of these statements have a little bit of evidence supporting them but a lot of easily-findable counterexamples, and yet people repeat them because they feel true to their experience and their understanding of the world. These opinions come from real experiences that really happened and can be interpreted in a multitude of ways. But that doesn’t mean that they are supported by research.

So, onto our Skeptics who think themselves qualified to determine who has PTSD and who doesn’t based on their own random little criteria. First of all, if someone has the symptoms of PTSD, then they have the symptoms of PTSD. You can’t Logic! and Reason! your way out of this.

But second, to anyone who claims that only things like combat, assault, or natural disasters can cause PTSD, maybe you should see what actual researchers in psychology have to say about that. Namely:

Research on online bullying and harassment is, unfortunately, still sparse. But given the dismaying way in which interactions online can incite the same strong emotions that interactions in person can, I fully expect this area of research to fill up quickly. We’ve already seen in several high-profile cases that technology-based bullying and harassment can provoke someone all the way to suicide. That they might also experience PTSD is not a huge logical leap at all.

As far as the official diagnostic criteria for PTSD go, here we have a further gap. There are several sections and subsections of the criteria, which I will attempt to summarize:

  1. Exposure to actual or threatened death, serious injury, or sexual assault. This can be your own or someone else’s, and it can include exposure to traumatic details (like you might experience as a police officer or doctor).
  2. At least one “intrusion symptom,” which includes symptoms like flashbacks, nightmares, intrusive memories, and strong unpleasant physiological reactions to stimuli that remind you of the event.
  3. Persistent avoidance of things that remind you of the event. This can mean trying to avoid memories, people who were there, and so on.
  4. Negative effects on mood and cognition, such as forgetting important parts of the event, distorted and negative thinking (such as blaming yourself for what happened), persistent negative moods like sadness or anger, and feeling detached from other people.
  5. Negative changes in arousal and reactivity, such as recklessness, angry outbursts, trouble concentrating, insomnia, and so on.
  6. The usual DSM-type caveats: it has to be longer than a month (these time frames vary for different mental illnesses, by the way); it has to cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning”; and it cannot be attributable to the effects of a substance like alcohol or medication, or to another medical condition.

So. You can see that where we run into trouble is with that first criterion, which attempts to define the types of events that may cause PTSD. This is unusual. Diagnostic criteria for other mental illnesses rarely include etiology as part of the diagnosis, because it’s understood that various types of life stressors, environmental factors, and genetic/biological predispositions can combine to cause problems like depression, anxiety, substance abuse, ADHD, and even schizophrenia.

Notably, the International Statistical Classification of Diseases and Related Health Problems, which is the diagnostic manual used by the World Health Organization, does not attempt to stipulate which types of trauma cause PTSD. It just states that the first criterion is “exposure to a stressful event or situation (either short or long lasting) of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone.”

I can easily see bullying and harassment falling under that category, as the only people I have ever seen claim that bullying and harassment are not traumatic are people who have not personally experienced it.

The key is this: it’s called posttraumatic. Stress. Disorder. If trauma has occurred, and is now causing all of these symptoms, then it makes sense to refer to the illness as PTSD. I’ve written before that I think it’s harmful to refer to clearly non-clinical problems with mental illness terms, because that really does dilute the meaning of words like “depression” and “OCD.” However, if your psychological experience literally looks like the psychological experience of someone who served in combat and now has the same symptoms as you, I’m absolutely comfortable with calling that PTSD whether or not the DSM strictly agrees or not. Then it’s less appropriation and more self-diagnosis, which is often the only option for some people. The DSM is constantly evolving, and I predict that as more and more research is published that examines PTSD symptoms in victims of sexual harassment, bullying, and online abuse of various kinds, the DSM criteria will accommodate this evidence. Which, as I said, is already appearing, just not in huge numbers yet.

Now. I want to validate the discomfort or anger people may feel when they see that a diagnosis they have because of a horrifically violent experience, like military combat, is suddenly being used by people who receive abusive tweets online. It’s okay to be upset because you feel like your experiences are being minimized. However, it’s also important to try to look at it skeptically. Your military-caused PTSD is no less difficult and painful and legitimate just because someone who got bullied in school also has the same diagnosis, just like the fact that someone as privileged as I am still has depression does not minimize the fact that some people have depression because they grew up abused and in poverty. This is not a zero-sum game. It is not any type of game. There is not a limited number of diagnoses that can be meted out, such that if too many victims of online harassment get diagnosed with PTSD, some of your fellow vets will get a shrug and a “Sorry man, we’re all out.”

And those of us who care for and about people with mental illnesses do not have a limited and quantifiable amount of empathy to give out. I feel empathy for my clients who lost their entire families to the Holocaust, and I feel empathy for my clients who are upset because their children live far away and never visit. I feel empathy for my friends who are worried about getting a job after graduation, and I feel empathy for my friends who are worried about making it out of an abusive relationship. I don’t need to try to rank their problems from least to most severe. That is not what mental healthcare is about.

But now I’m angry again, because you don’t get to tell people what mental illness(es) they do and do not have. You especially (and yes, I’m back to all you Skeptics™ now) don’t get to speak authoritatively on topics you have no authority to speak on. I don’t subscribe to the elitist notion that a PhD is the only way to make your opinions matter, but I do subscribe to the notion that you should learn about the things you want to talk about before you talk about them.

Psychology may be something we all have experiences with and opinions about, but it is still a science. It’s a science with thousands of research journals and departments. It’s a science with good methods and not-so-good methods. You have libraries and Google Scholar available to you. If you’re confused about something, you can avail yourself of the opinions of people who study, research, and practice psychology.

I’m tired of hearing complete and utter bullshit from Skeptics™ about psychology, spoken without even a hint of caution, with nary a “I think that” or “Isn’t it the case that” or “I might be wrong, but.” Instead I hear, “Cognitive dissonance is a mental illness.” I hear “You can’t possibly have PTSD from that.”

Stop that.

Yes, I’m talking to you, dude who memorized a list of cognitive biases and thinks that counts as knowledge of psychology. And yes, you too, dude who memorized a list of logical fallacies and thinks that counts as an understanding of good argumentation. And you as well, dude who read some crap blog post about Top Ten Ways Religion Is Like A Mental Illness and thinks that counts as a clinical license to diagnose people.

Your opinion does not deserve respect if you haven’t bothered to do even the most basic research to support it. Take a fucking seat. Preferably in a Psych 101 lecture.

~~~

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Religion vs. Mental Illness, A Bit More Concisely This Time

Chris Stedman, author of Faitheist and blogger at the Religion News Service, asked me to comment on why atheists should stop calling religion a mental illness for a piece he published today. I ended up giving him a way longer comment than he necessarily wanted or needed (#bloggerproblems), so I thought I’d publish the full thing I sent him since it’s nevertheless a way more concise explanation of my views than my huge post on this was.

Equating religion with mental illness is harmful for a number of reasons. First of all, when done to make fun of or put down religion, it also puts down by association people struggling with problems like depression, anxiety, eating disorders, or schizophrenia. People with these serious mental illnesses already face plenty of stigma and discrimination, so derogatory remarks about how religious people are “all crazy” or “belong in a mental institution” are harmful.

Second, this comparison ignores the fact that religion and mental illness are different psychological processes. Religion largely stems from cognitive processes that are essentially adaptive, such as looking for patterns, believing in things that are comforting, and getting joy out of connecting with others and feeling like a part of something larger than oneself. Mental illnesses, by contrast, are fundamentallymaladaptive. People who cannot leave the house without having a panic attack, who feel a compulsion to wash their hands hundreds of times a day, or who are convinced that everyone hates them and they are better off dead, are experiencing symptoms that interfere with their ability to go about their lives. Except in extreme cases, religion does not operate this way. It is important to point out when religious beliefs and observances reach a level at which people cannot function normally, but we do the secular movement no favors by focusing on these instances to the exclusion of the vast majority of religious people who are healthy, happy, productive members of our society.

Third, calling religion a mental illness keeps us from asking serious questions about what actually does attract people to religion. Often, it’s the sense of community, the support available to people who are struggling financially or emotionally, the quick way to make friends, and the opportunity to mark important life occasions such as births, marriages, and deaths using traditions that feel meaningful. Although some of us are trying, atheists are still not that great at providing these types of communities. Many refuse to even acknowledge that most people value–even need–such communities. Calling religion a mental illness is a convenient way to avoid thinking about what we could actually be doing to make the secular community more welcoming and inclusive, and what sorts of resources we are lacking that people can find in religious communities.

Finally, claiming that religion is a mental illness obscures the fact that we all–yes, atheists too–regularly engage in irrational thinking. Religion is a type of irrational thinking, but it is not the only type; introductory psychology textbooks catalog dozens of biases, fallacies, and other ways in which our minds trick us. While it’s impossible to become entirely free of cognitive bias, we can become more free of it by learning to notice it. If thinking irrationally is a mental illness, then we are all mentally ill, and the term loses its meaning. As a survivor of mental illness myself and as someone who plans to work as a therapist, I think we should save that term for situations in which people are truly suffering and having trouble going about their lives.

Don’t forget to go read Chris’s piece!

And incidentally, I’ve been quoted by journalists a bunch of times and it has almost always come out sounding weird and out of context and not like what I meant at all. Chris avoided this issue entirely and even let me see a draft of the piece to make sure he wasn’t misrepresenting what I said or getting anything wrong. If he ever asks you for a quote, say yes!

The Law is Not on Our Side

[Content note: sexual harassment and assault]

Many brave writers have described what happened to them when they reported gender-based threats and violence to the police. Occasionally the outcome is positive, but often nothing at all happens and often something terrible happens.

Here are two recent examples I’ve read. The first is by Heina of Skepchick:

When the officer called me in, I was shaking a bit, but spoke as clearly and calmly as possible, presenting my evidence and voicing my fears. He responded with laughter.

Taken aback by his trivialization of the situation, I asked him if he could look at my evidence. I knew who the guy was, I pleaded. Couldn’t he, as an officer of the law, do something? Take the guy to task for threatening me somehow? At least take down a report so that if something happened, there was a record? He replied with an incredulous no to all my inquiries.

Out of the blue, he asked me if my picture included my face. I said no. He asked me how I expected to attract responses with a picture that didn’t include my face. Before I could respond, he answered his own question: it was a sexy picture, was it not? Feeling shamed, I was unable to speak and merely nodded.

“Don’t worry about it, then,” he chuckled. “Go home.”

What choice did I have other than to begin to gather up my things and prepare to leave? Before I could make my exit, though, he told me that he often visits women-seeking-women for the pictures, winked at me, and expressed his hope that he would see me on there sometime. Taken aback by the lechery in his tone, I half expected him to take a swat at my ass as I walked out the door.

The second example is even more jarring and painful to read, and deserves a strong trigger warning. It was a comment by EEB on a post of Jason’s, and Stephanie reprinted it with permission:

Two male detectives arrived at my house. I stammered out a request for a female detective; it was denied. (I learned later that they violated procedure by not accommodating the request.) They made me go through what happened. I was in excruciating pain and dripping blood but they didn’t want to take me to the hospital just then, and said the hospital “wasn’t ready” anyway. So I described the rape. Then they asked if I was taking any drugs. Well, just my medication. I thought it was strange that they literally spent more time asking about my mental health history and the types of medication I took, instead of the rape, but at the time, again, I was in shock, and not thinking much.

[…]Over the next few months, I submitted to multiple, horrific “interviews” that really felt like “interrogations” as time went on. I was also dealing with a serious medical condition at the time (I almost died; my intestines ruptured, but was almost certainly not a result of the rape, just bad timing). But I still believed in the system. I still didn’t want the man who raped me on the streets. I did everything they requested, answered every invasive question (the were really focused on my mental health history!), even got on the ground and acted out the rape for them, with the head detective on top of me acting out the part of the rapist. Not only was I absolutely hysterical by the time we were done, I’m positive that aggravated my PTSD for a long time after.

And after all that, I was called in for an “interview” to discuss “a new lead in your case”. They didn’t let my rape counselor in the room–again, against the law, I found out later! For about an hour (I think; my sense of time was not that great) they were no longer even pretending to be supportive. They accused me over and over of making it up. They had very flimsy “evidence” (which I won’t go into because it’s both complicated and ridiculous) but mostly it was their “instinct”.

Because I have a mental illness. Because I was hospitalized after attempting suicide. Because I “claimed” I had been sexually assaulted in the past. Because I was crazy, and he was sure I was just looking for attention. He had a bipolar ex-wife, you see, and she made his life a living hell. He told me how he understood mentally ill women, and how we need to create drama. How we’re liars, and we crave attention.

And over and over they accused me of lying. Alone in this tiny room with two large, angry men, I was doing everything I could to keep from having a panic attack. I couldn’t respond to what they were saying; again, I think I was in shock. And they threatened me with jail time, with a felony on my record, destroying my family, public humiliation (he threatened to call the papers–something he did anyway, because, quote, “the community needs to know there was no threat to public safety”). They said I would be charged with a false report, with terrorizing the public (there was a public awareness campaign initially after my attack, though I didn’t have anything to do with it. After the rape, I did everything I could to maintain anonymity, and only told two people–beyond my family and the cops–hat I was attacked. But…I did it for attention, which was why I didn’t tell anyone? I’m just sneaky like that, I guess!). Accusations, threats, anger, pounding the table, over and over and over.

The detective looked at me. His whole demeanor changed; he tried to seem kind, avuncular. “Tell me you made the whole thing up. This whole thing will disappear. Nothing will happen to you. You can leave, if you just tell me you made it up. Tell me you made it up and you’re sorry for lying, and I’ll let you leave.” I tried to hold out–but I didn’t last long. Honestly, at that point, all I wanted in the entire world was just to get out of that room. There are very few things I wouldn’t have done, if I could only leave. So I looked at him and lied. I said, “I made the whole thing up. I’m sorry.”

Through both of these examples, we see that women who are marginalized along other axes besides gender face additional injustice–cruelty, even–by law enforcement officials. Heina’s sexual orientation was used against her both by the man she reported for threats and by the cop who was supposed to be helping her. EEB’s mental illness was used as an excuse to abuse her, accuse her of lying, and ultimately coerce her into recanting her accusation despite overwhelming physical evidence that it was true.

The more intersecting marginalizations you have, the less likely you are to be treated fairly by the police. This is, sadly, nothing new at all, and it’s not limited to sexual violence (see: Trayvon Martin, stop and frisk, queer people being arrested for being queer). So why do people still insist that 1) survivors of sexual assault have a moral duty to report it to the police, 2) if the police do not prosecute a rapist, that means that no rape occurred, and 3) if a survivor chooses not to report, then they do not deserve any accommodations from their communities, and those communities must pretend that nothing ever happened?

EEB’s story, in particular, suggests that at least some false rape accusations are not actually false rape accusations. More research is urgently needed to determine how common this is, but my fear is that it is not uncommon. This story also shows how ableist ideas about mental illness–that people with mental illnesses are just “crazy” and “delusional” people who make shit up to ruin people’s lives–prevented a survivor from seeking justice and allowed a rapist to go free.

I used to be sympathetic to the idea that people should report sexual assault to the police, but I’m becoming less and less so. While I think we have an imperative to reform this system and make it work, for now, I don’t think it’s at all unreasonable for a survivor to choose not to report. If I were advising a survivor, I’m not even sure that I would feel comfortable encouraging them to do so.

And, dudes, next time you show up demanding to know why so-and-so didn’t report if they were “really raped,” I’m going to link you to this post. Remember that feeling safe around police officers is a sign of privilege, as is the belief that they will treat you fairly.

A Handy List of Everything Wrong with Creating a Database of People with Mental Illnesses

It’s not like anyone expected the NRA to say anything intelligent during its long-awaited press conference on Friday, so I’m not exactly disappointed by what they said. I am, however, completely appalled at the NRA’s ignorance of mental illness and insensitivity to those affected by it.

Along with a few other laughable suggestions, like putting armed security guards in elementary schools, Wayne LaPierre, the NRA’s Executive Vice President, said this:

“How many more copycats are waiting in the wings for their moment of fame from a national media machine that rewards them with wall-to-wall attention and a sense of identity that they crave, while provoking others to try to make their mark.

A dozen more killers, a hundred more? How can we possibly even guess how many, given our nation’s refusal to create an active national database of the mentally ill?”

Now, I’m not sure to what extent LaPierre actually believes that this is a realistic and ethical goal as opposed to a throwaway remark intended to deflect responsibility from his organization and the products it defends. It’s also unclear how much the NRA’s leadership has discussed and promoted this idea.

However, I think it’s still worth using this example to show how ignorant these people are about mental illness, because I’m quite certain that they are not alone.

So, here’s everything I can think of that’s wrong with the idea of creating a national database of people with mental illnesses.

1. It’s redundant.

As Kate explains on Ashley Miller’s blog, mental health professionals are already required to break confidentiality and report when patients pose a clear threat to themselves or others. Rather than putting this in some sort of “database,” they report it to the people who know best how to use this information–the police. I’m not sure if LaPierre is suggesting that we create a public database of people with mental illnesses so that armed vigilantes can take matters into their own hands or what, but I think most reasonable people agree that dealing with people who have expressed the intent to harm others is best left to the police.

Furthermore, as Sarah Kliff writes in the Washington Post, 38 states already require or allow the use of mental health records in background checks for people trying to purchase guns, and the Gun Control Act of 1969 bans the sale of guns to people who have been committed to a mental institution in the past. However, that act is difficult to enforce because state reporting laws vary so much, and unfortunately for LaPierre, it is unconstitutional for the federal government to require states to report mental health records for a national database.

2. It violates existing laws.

As Kate also mentions, HIPAA (the Health Insurance Portability and Accountability Act) requires that people’s medical records be kept private. (So strict are medical confidentiality rules that when I saw a psychiatrist as a 19-year-old dependent on my parents’ medical insurance, the psychiatrist had to ask for my consent before she explained to my mom why she thought I needed antidepressants.) Creating a national database of people with mental illnesses would mean repealing or amending this law. Can the NRA summon up enough support in Congress for that?

If LaPierre intends to use this database to restrict the ability of people with mental illnesses to access to resources they need, such as jobs and schools, that would also violate the ADA (Americans with Disabilities Act), which bans discrimination on the bases of mental and physical disability. And, regardless, as mentioned in #1, creating a national database would probably not be constitutional because the federal government would have to force states to report mental health data.

3. It’s probably impossible to determine which diagnoses should be included.

Repealing or amending HIPAA would also mean deciding which diagnoses would suddenly not be subject to confidentiality. People like LaPierre seem to think that schizophrenia and bipolar disorder are the most “dangerous,” but what about substance addiction, which is highly correlated with violence? Would every alcoholic have to be registered? What about autism, which many people falsely associate with violence? And, if yes, then what about Asperger’s Syndrome, now considered a “mild” version of autism that’s on the low end of the spectrum? What about depression, which can sometimes involve psychosis?

Or, since LaPierre simply called it a “national database of the mentally ill,” should we include everybody with mild depression, social anxiety, a phobia of elevators, an eating disorder? Should we include people whose mental symptoms are caused entirely by another, purely medical illness? Should we include people who develop depression as a result of, say, cancer?

4. The list of ethical ways to use this database is very short.

Seriously, what would you do with it? Deny these people access to employment, education, and housing? Then you’d have to repeal the ADA. Surveil them? That’s a violation of civil liberties (not that our government’s great about that). Bar them from purchasing guns? As mentioned above, that’s already going on in the majority of states, and it’s one of the reasons “liberals” are trying to pass stricter gun regulations. But this is where the common argument against such regulations–that criminals will find a way to get guns anyway–can be turned right back on those who tend to spew it. It’s worth noting that Adam Lanza did not purchase his guns; he got them from his mother, who bought them legally and is not reported to have had any mental illness.

5. Most people with mental illnesses do not get treatment.

And you can’t register them in a database unless they do, obviously. One study suggests that over 60 percent of people with serious mental illnesses, such as schizophrenia or bipolar disorder, do not receive consistent treatment. This means that a majority of the people who should be in the database wouldn’t be in it, anyway.

Although the association between mental illness and violence is tiny, people with untreated mental illnesses are more likely to be violent than those whose illnesses are being treated properly (although the link between mental illness and violence is still very small). This means that the people who would be on this database are the ones who are least likely to cause anyone any harm.

In any case, the percentage of people who don’t get the treatment they need would probably go up, because:

6. It would discourage people from seeking treatment.

The stigma of mental illness and treatment already keeps many people from reaching out for help. If you know that going to see a therapist or psychiatrist could put your name on a national registry of people to be feared, stigmatized, and discriminated against, why would you do it?

Even if most of what I’ve said above about misuses of this database turns out to be a huge strawman–which I don’t know, because LaPierre hasn’t specified how he wants this database to be used and it’s important to consider the potentially dangerous ramifications–people will still worry. Even if the only purpose of the database is to prevent people with mental illnesses from purchasing guns, people will still be worried about that information falling into the wrong hands.

This, of course, is the final nail in the coffin of LaPierre’s idea. Even if nothing else that I’ve said about it were true, this point would be reason enough not to do it. Anything that prevents people from getting treatment is, by default, the wrong solution.

I already know many people who refuse to seek treatment for a mental illness because they are worried about being discriminated against if the wrong person finds out. Although the ADA supposedly protects them, it is difficult if not impossible to prove that discrimination has occurred. Those fears could grow much more urgent if simply going to a doctor and receiving a diagnosis puts your name and medical information into a national database accessible to god-knows-who.

This is what tells me that not only is LaPierre scapegoating people with mental illnesses to divert opprobrium from his own organization, but he also completely misses the point and fails to understand the first thing about mental health and treatment.

He gives away his views on people with mental illnesses when he says this: “The truth is, that our society is populated by an unknown number of genuine monsters. People that are so deranged, so evil, so possessed by voices and driven by demons, that no sane person can every possibly comprehend them.”

We are “genuine monsters” to him.

He’s wrong, of course. There are plenty of “sane” people who comprehend those with mental illnesses–researchers, therapists, psychiatrists, social workers, friends and family of those affected, and people who have recovered from those illnesses. That LaPierre personally fails to understand them says more about his own lack of both empathy and research in the field than about the supposed need to stick them all in a national database for the perusal of bigots.

It is also worth noting that in this emotionally charged statement, LaPierre fails to distinguish between people who commit acts of violence because of an illness they cannot control without proper treatment–which LaPierre wants to make it even harder for them to get–and people who commit acts of violence because they have no respect for human life and are seeking to make a political point, get personal revenge, and so on. Although violence and death, especially of children, is tragic regardless of the cause, that doesn’t mean that all violence is caused by the same type of person.

If I could make a suggestion to LaPierre, I would tell him to talk less, read and listen more. There’s reasonable disagreement to be had about how to prevent further mass shootings, but his suggestion was not reasonable. It was ignorant, offensive, and probably dishonest.

Please Sign My Petition to Remove the “No Respect For Suicidal Teens” Facebook Page

[Content note: suicide]
Yup, I’m using my blog to promote something. But it’s a very important something.

In my blog post earlier today I mentioned this atrocious Facebook page, which cruelly mocks suicidal teenagers by calling them “selfish” and “ignorant” and inciting them to kill themselves. I had reported it to Facebook, and I just received this email in response:

“Thanks for your recent report of a potential violation on Facebook. After reviewing your report, we were not able to confirm that the specific page you reported violates Facebook’s Statement of Rights and Responsibilities.”

Now, clearly, this is some bullshit, because Facebook’s terms include the following:

“6. You will not bully, intimidate, or harass any user.
7. You will not post content that: is hate speech, threatening, or pornographic; incites violence; or contains nudity or graphic or gratuitous violence.”

This Facebook page is violating these terms by bullying, intimidating, and harassing teens who are suffering from mental illness and are considering taking their own lives. Furthermore, it certainly qualifies as hate speech against people with mental illnesses. The page also attempts to incite suicidal teens to kill themselves with posts that say things like “go drink some bleach,” and, unsurprisingly, it also contains racist material.

So I started a petition to get Facebook to take the page down. Please sign it here and share it.

The thought of a struggling teen stumbling across this page makes my stomach churn. I don’t care if it’s a “joke” or not; it should be taken down.

This is a small thing, but change begins by refusing to allow hatred and ignorance like this in our society, including on the websites we use.

Update: Thanks so much to everyone who signed the petition! The page is now gone. However, its creator left some comments over on Greg Laden’s blog and has made it clear that they intend to bring it back. Pretty unfortunate how vested in their hatred some people are.

Faith is not a Mental Illness

I’ve been seeing a disturbing tendency among atheists to compare religious belief to mental illness. Sometimes this comparison is made explicit, as in this article. Other times, however, the comparison is more implicit–for instance, when words like “crazy” and “delusional” are used to describe religious people or their beliefs (hi Dawkins).

These comparisons are inaccurate and offensive to both religious people and people with mental illnesses.

First of all, being religious is a choice. Being mentally ill is not. While it’s a bit arguable whether or not faith itself is a choice–I certainly can’t make myself believe in god, but perhaps others can–the existence and success of religious proselytism proves that choice is at least part of the equation. Only a completely ignorant person, on the other hand, would attempt to proselytize mental health (although it obviously does happen).

Regardless of whether or not you can choose to believe in god, you definitely get to choose whether and to what extent you observe a religion (unless you’re a child, but that’s different). People with schizophrenia don’t get to choose which hallucinations they have and how often. People with OCD don’t get to choose their compulsions. People with phobias don’t get to choose which phobias they have or how they manifest themselves.

Second, suggesting that religious people are mentally ill is sanctimonious and offensive. It insinuates that they are incapable of consciously and purposefully choosing to be religious, and that their religious beliefs are just as meaningless as a symptom of mental illness. It reminds me of when I used to bring up concerns with friends who would respond, “Oh, that’s not such a big deal, you just feel that way ’cause you’re depressed.”

As I mentioned, being religious is a choice. For most people, it’s a choice made with one’s own best interests in mind. Comparing that to a schizophrenic delusion is a wee bit condescending.

(Of course, delusions that are religious in nature do exist. Some people with schizophrenia believe that they are possessed by religious spirits of some kind, that they have spoken to god, or that they are the messiah. However, this is vastly different from the way most religious folks experience their faith, and is obviously a symptom of mental illness.)

Although I’m an atheist who kinda sorta wishes religion didn’t exist, the fact is that it does, and I refuse to believe that all of the billions of religious people in the world are just mentally ill. No, they’re onto something. It’s just not something that I’m interested in myself.

Finally, these comparisons trivialize the suffering that people with mental illnesses experience. The distinction between mental health and mental illness is not that mentally healthy people do not believe in supernatural things and mentally ill people do. The difference is that (most) mental illnesses interfere with the person’s functioning and make them feel, well, bad.

Religion, for all its flaws, often does the opposite–it provides people with community, teaches them to behave morally and charitably, and helps them cope with illness, death, and other challenges in life. (A caveat: I’m talking about religion at its best, not at its worst, and these same effects can be found elsewhere.)

So when you imply that the definition of mental illness is believing in things without evidence, you miss a lot about what it’s like to be mentally ill. Namely, you ignore the emotional pain, cognitive distortions, thwarted goals, ruined relationships, physical fatigue, and all the other things that are part of the experience of mental illness.

There are many interesting, intelligent, and non-offensive ways for atheists to argue against destructive religious ideas (for instance, here’s an example I read today). Calling religious people mentally ill is not one of those ways. Let’s put that kind of useless rhetoric back on the shelf where it belongs.