Why Dudes Don’t Greet Dudes

My newest Daily Dot piece is about #DudesGreetingDudes.

After that NYC catcalling video went viral online, some men (not all men!) were upset, not because they were trying to defend their right to shout “nice tits” at a random woman, but because even non-sexual comments were being defined as harassment. For instance, Michael Che, co-host of Saturday Night Live’s Weekend Update, wrote on Facebook, “I want to apologize to all the women I’ve harassed with statements like ‘hi’ or ‘have a nice day.’”

In response to comments like these, This Week in Blackness CEO Elon James White created a hashtag called #DudesGreetingDudes:

The #DudesGreetingDudes tweets are hilarious because they’re ridiculous. After all, everyone knows men would never actually talk to each other like that.

But why wouldn’t they?

The common explanation is that street harassment—yes, including the “nice,” non-explicitly sexual kind—is ultimately about asserting male dominance over women, forcing them to give men their time and attention. It wouldn’t make sense for a man to infringe on another man’s mental and physical space in that way.

But I think there’s also a little more going on here, and it has to do with the ways in which men are socialized to view women not only as sexual objects, but as their sole outlet for companionship, support, and affirmation. They’re socialized to view women as caretakers and entertainers, too.

Read the rest here.

Therapists Can Be Wrong

Therapists, like many professionals who work directly with clients, need to present themselves confidently in order to be effective, even when they’re not feeling very confident. It can be difficult for therapists to admit that they have or could be wrong, or that they don’t know everything. Like doctors and teachers and others, therapists worry that acknowledging their own limitations will erode their credibility and trustworthiness. When your livelihood depends on people finding you credible and trustworthy, that adds to the aversion of being wrong and admitting mistakes that virtually all of us already experience.

Yet we have to learn how to admit and accept that we are sometimes wrong–not only because it’s a foundation of accountability and ethical practice, but also because clients can often see through that facade, and they won’t like what they see. It’s difficult to trust someone who will never–can never–admit that they’re wrong.

This was going through my mind as I read one of my required texts for school, Psychiatric Interviewing: The Art of Understanding“Psychiatric interviewing” is really just a term for the process of therapists asking their clients questions, so the book covers a lot of very important ground. While I’ve found it useful so far, a few things irk me about it.

For instance, the author has a strange preoccupation with labeling clients using the article “the” in a way that implies uniformity. The text is laden with references to what “the paranoid patient” may do or how “the guarded patient” may behave in an interview. This type of language is not only dangerously vague (who qualifies as “the paranoid patient” as opposed to “a person who has some paranoid thoughts”? Who gets to make that determination, and using which measure(s)?), but stigmatizing to therapy clients and a potential source of bias for therapists. If you’re a young therapist who reads this book and gets all these ideas about what “the paranoid patient” may do, you may project these assumptions onto every client you work with who struggles with paranoia or expresses thoughts that seem paranoid to you. Assumptions are not necessarily a bad thing–and may even be useful in some cases–but you need to be aware of them as you work. Thus far in my reading of this book, it has not provided any cautionary notes about making assumptions. Even in my classes, in which we are often told not to make assumptions, provide little if any guidance on learning to actually notice these assumptions in practice.

Shea also recommends a few other techniques that I find excessively presumptuous. Take this example dialogue from the book:

Pt.: After my wife left, it was like a star exploded inward, everything seemed so empty…she seemed like a memory and my life began to fall apart. Very shortly afterwards I began feeling very depressed and very tearful.

Clin.: It sounds terribly frightening to lose her so suddenly, so similar to the pain you felt when your mother died.

Pt.: No…no, that’s not right at all. My mother did not purposely abandon me. That’s simply not true.

Clin.: I did not mean that your mother purposely abandoned you, but rather that both people were unexpected loses.

Pt.: I suppose…but they were very different. I never was afraid of my mother…they’re really very different.

A lot of therapists, especially those in the psychodynamic tradition, are understandably attracted to the idea of making this sort of “insight.” As Shea points out, when you get it right, it can build a lot of trust because the client feels understood in a very special way. It feels good to feel “smart” and insightful, to be able to read people like that. It can remind us that there really is something special we can do as therapists that others cannot. It probably doesn’t hurt that this, the therapy-via-Sudden-Brilliant-Insight, is usually the only kind we see represented in the media.

But a lot of the time, there really isn’t enough information to reach this conclusion. Therapists may make these leaps based on hunches, but that doesn’t mean there’s data to back it up. Sometimes the client will tell you so, but I think that a lot of the time, they will say, “Hm, I suppose you might be right,” because you are an authority figure and they want to believe you have the answers.

From the information given, you can’t reasonably jump to the conclusion that the client felt similarly when their wife left them and when their mother died. Those are very different types of loss, and even similar types of loss–two breakups, two deaths in the family–can feel very different.

Certainly there can be conceptual similarities between losing a spouse to divorce and losing a parent to death. It might even be worthwhile to explore them, but the therapist need not assume they felt “so similar.” If I were the client, I would’ve liked the therapist to say something like:

Between this and your mother passing away, it sounds like you’ve been dealing with a lot of loss. I’m wondering if losing your wife is bringing up any memories of losing your mother.

This resonates with me; it might not with other clients. That’s why sometimes the more important thing as a therapist isn’t what you say, but how you respond once you realize you’ve said or done something that strains the connection between you and your client. In this case, a responsive therapist might say something like:

I’m sorry, I didn’t mean to make assumptions about how you’re feeling. Can you say a bit more about how this loss feels different for you?

The client is the expert on their experience.

But instance, in the dialogue, the therapist doubled down on the (mis)interpretation, attempting to justify their response to the client’s disclosure. This leads the client to double down as well, justifying to the therapist why the losses feel different. They shouldn’t have to justify themselves that way.

Here is the thought I had, as both a provider and a consumer of mental health services, when I read Shea’s example dialogue above:

The failure mode of Brilliantly Insightful Therapist is Arrogant, Presumptuous Therapist.

Now, I don’t know if Shea is arrogant or presumptuous; I don’t know him but I would hope he isn’t. I do know that refusing to acknowledge missteps and misunderstandings can lead one to across that way, though. And that’s exactly what Shea refuses to do both in the dialogue itself and when he analyzes the dialogue for the reader:

Needless to say, this attempt at empathic connection leaves something to be desired. The patient’s attention to detail and fear of misunderstanding have obliterated the intended empathic message, leaving the clinician with a frustrating need to mollify a patient who has successfully twisted an empathic statement into an insult of sorts.

This probably infuriated me more than anything else in this text. Here, the failure of the interaction has been blamed entirely on the client. Shea has assumed that the client has taken his statement as an “insult” when there is no evidence of this; the client is merely correcting the therapist’s misinterpretation. It reminds me of how, often when I tell people they’ve made inaccurate assumptions about me, they respond by shrieking about how “upset” I am and how I take everything as an “insult.” Correcting someone is not the same thing as being “insulted.”

If this situation is “frustrating” for the clinician, then, I can only imagine how much more so it must be for the client.

There is no room, in this approach, for any acknowledgment that the therapist’s interpretations might simply be wrong. No room for the possibility that it’s not the client’s personal characteristics (“paranoid,” “guarded,” “histrionic”) that made this interaction fall flat, but the therapist’s presumptions and subsequent refusal to step back from them.

I discussed this particular example because it’s what came up in my reading, but it’s hardly the most egregious thing of this type that happens. Therapists who cannot conceive of the possibility that they’re wrong not only fail to help their clients, but can actually hurt them.

Since there are probably a lot more therapy clients (or prospective therapy clients) reading this than there are therapists, I want to be clear about why I wrote this. It’s not to discourage people from seeking therapy, but to arm them with the knowledge and language to advocate for what they need from their therapists, and to find therapists that suit their needs.

That last part is important. Some people may want a therapist who makes bold interpretations and takes that authoritative, explanatory sort of role. Personally, I think conducting therapy in this sort of way opens practitioners up to all sorts of bias and errors, which is one reason I want to avoid it both as a client and as a therapist. But if that’s the approach that resonates with you, then it’s likely to work a little better for you, because the most important factor is the client-therapist relationship.

Aside from that, the reason I write about problems in mental healthcare is the same reason I write about problems in feminism or atheism–to hold my own communities accountable. Anecdotally, I know that this sort of thing makes it difficult for some people to benefit from therapy, or even to want to access it to begin with. I’m not the only person who dislikes having an authority figure tell me things about my life without bothering to find out if their assumptions are even accurate.

I trust people more when they admit their mistakes.

 

[guest post] Debunking Some Skeptic Myths About Sexual Assault

[Content note: sexual assault]

This guest post was written by my friend HJ Hornbeck and discusses a talk on sexual assault given by social psychologist Carol Tavris at The Amazing Meeting (TAM) this past July. 

Introduction

Carol Tavris’ talk came at the worst time for me, as well as the best. I’m too busy at the moment to give it a proper fisk, because I’m preparing a lecture on sexual assault. I’ll see if I can aim for two birds, but for now her talk deserves at least a point-form response with minimal proof-reading.

Some background first, though. If I can crib from her TAM 2014 bio,

Carol Tavris is a social psychologist and author whose work focuses on critical thinking and the criticism of pseudoscience in psychology, among other topics. Her articles, book reviews and op-eds have appeared in the New York Times, the Los Angeles Times, the Wall Street Journal, and the Times Literary Supplement, among other publications. Many of these essays and reviews are available in Psychobabble and Biobunk: Using psychological science to think critically about popular psychology. Dr. Tavris is coauthor, with Elliot Aronson, of Mistakes Were Made (But Not By Me): Why we justify foolish beliefs, bad decisions, and hurtful acts–a book that has become something of a bible, dare we say, of the skeptical movement.

So she’s a pretty cool, smart skeptic. The title of her talk did raise a few eyebrows, though–why was a conference notorious for havingsexual assault problem hosting “Who’s Lying, Who’s Self-Justifying? Origins of the He Said/She Said Gap in Sexual Allegations”? Still it didn’t attract much attention…

until the live-Tweets arrived.

They’re terrible, by and large, but most of them come from people who are already terrible on this topic. This was a talk given at a conference where the management has historically taken out extra liability insurance to deal with the risk posed by one of its keynote speakers. There’s a certain motivation for the attendees to pull out every dismissive, permissive, victim-blaming message possible from a talk on rape. The tribalism in the tweets is not subtle. I could give a talk on rape myths in front of that audience, and the Twitter feed would still be terrible.

So I’ll wait to see whether the talk is released to a general audience.

I had much the same opinion as Stephanie Zvan; critiquing something you only have a fragmentary record of would only lead to disaster, so it was better to wait and see.

Well, I waited. I saw. And my goodness, what a disaster.

[Read more…]

Open Thread: How Do You Practice Self-Care?

A teapot and a mug that says, "Write like a motherfucker."

90 degrees outside. No fucks given.

I’m going to give open threads a try! The folks who comment here seem to have a lot of interesting things to share, so I thought it’d be cool to have some threads where you can talk about yourself as much as you want.

The topic I’m starting with is self-care. Whether or not you have what could be called Mental Health Problems, everyone needs to calm down, unwind, or get their mind off of things sometimes. Different things work for different people, and sometimes something that seems really weird or counterintuitive will help someone.

Self-care is not a replacement or substitute for treatment (if you need it). It’s a way for people to cope with stress and jerkbrain, maintain recovery from a mental illness, or help manage mental illness symptoms if you have them. So none of these things are intended to cure or treat anything, and a lot of frustration tends to arise when people offer them up as “advice” for those with mental illnesses.

We each know best what helps us best. Here’s how I like to do self-care:

  • Hot tea. (Even in the summer. Must be because I’m Russian.)
  • Writing, even if it’s about something heavy.
  • Taking a hot shower, even if it’s just to have a place to cry in private.
  • Cleaning, organizing, doing dishes. My apartment tends to get cleaner the more life problems I’m having.
  • Going for a walk and listening to music. Unfortunately, I don’t get to do this so much now that I live in the city, where it wouldn’t be relaxing or necessarily pleasant. But my high school years, back in Ohio, were full of leisurely walks around the neighborhood.
  • Playing music. Now that I finally have a keyboard piano, I’ll finally be able to do that again.
  • Reading sci-fi novels or nonfiction articles. For some reason, it has to be one or the other. Nonfiction books don’t work, and short stories or poetry don’t work.
  • Watching something that tells a good story but doesn’t require careful attention. So, Star Trek and Doctor Who are in; West Wing and Damages are out.
  • Talking to a friend about something totally unrelated.

Some things that help lots of people but not me are: YouTube videos, animal photos, talking to someone about the thing I’m upset/stressed about, eating, video games (though I like them at other times), basically anything that’s supposed to be funny/uplifting. The first two are especially frustrating, because the first thing many people will do if I say I’m feeling down is send me YouTube videos and animal photos. Then I have to either pretend that it helped, or tell them that that doesn’t help. (Except sometimes. Hard to predict.)

 

What works for you? What doesn’t?

Towards A Better Conversation About Mental Illness

This is my latest for the Daily Dot, about how we can discuss mental illness more accurately, productively, and compassionately, particularly in the wake of tragedies like Robin Williams’ suicide.

After comedian Robin Williams committed suicide two weeks ago, fans took to the Internet to express their grief, as well as their admiration for his work. Whenever a beloved celebrity passes away, regardless of the cause, social media temporarily becomes a sort of memorial to that person, a chronicle of the ways in which they changed lives.

However, when the cause is suicide, a celebrity’s death also brings out lots of dismissive, inaccurate, or even hateful statements about people with mental illnesses. According to some, Williams was “cowardly” and “selfish” for committing suicide. Last week, Musician Henry Rollins wrote an op-ed for L.A. Weekly (for which he apologized over the weekend) in which he said that he views people who commit suicide with “disdain,” claiming that Williams traumatized his children. There was plenty of rhetoric about suicide being a “choice,” the implication being that it’s the wrong choice.

Comments like these not only misinform people about the nature of mental illness, but they are also extremely hurtful to those who struggle with it. As the Internet continues to respond to Robin Williams’ death, here are some suggestions for a better conversation about mental illness and suicide.

1) Do your research.

We all have a “folk” understanding of psychology, which means that we experience our own thoughts and feelings, interact with other people, and thus form our opinions on psychology. Obviously, noticing things about ourselves and the people around us can be an important source of knowledge about how humans work.

But it’s not enough. If you haven’t had a mental illness, you can’t really understand what it’s like to have one—unless you do your research. Depression isn’t like feeling really sad. Anxiety isn’t like feeling worried. Eating disorders aren’t like being concerned about how many calories you consume. Your own experiences may not be enough.

Before you form strong opinions about mental illness and suicide, you need to know what mental illnesses are actually like, what their symptoms are, what treatment is like, what sorts of difficulties people may have in accessing treatment or making it work for them. If you can make tweets and Facebook statuses about a celebrity’s suicide, you can also do a Google search. Wikipedia, for all its drawbacks, is a great place to start. So are books like The Noonday Demon and Listening to Prozac.

2) Never engage in armchair diagnosis.

Now that you have a good idea of what different mental illnesses look like, you should try to figure out who has which ones, right?

No, please don’t. Armchair diagnosis, which is when people who are not trained to administer psychiatric diagnoses try to do so anyway, is harmful for all sorts of reasons that Daily Dot contributor s.e. smith describes in a piece for smith’s personal blog:

The thing about armchair diagnosis is that it mutates. First it’s a ‘friend’ deciding that someone must have bipolar disorder because of some event or another. Over time, that’s mutated into an ‘actual’ diagnosis, repeated as fact and accepted. Everyone tiptoes around or gives someone sidelong glances and makes sure to tell other people. Meanwhile, someone is completely puzzled that other people are treating her like she’s, well. Crazy.

Whether the person you’re talking about is a celebrity or not, it is up to them whether or not to make public any information about their health. Mental health is part of health. While having a mental illness should never be stigmatized, unfortunately, it still is. People deserve to decide for themselves whether or not they are willing to disclose any mental illnesses they may have.

Even if someone commits suicide, that doesn’t mean we can come to any conclusions on which mental illness they had or didn’t have. First of all, not everyone who commits suicide could have been diagnosed with any mental illness just prior to it. Second, various mental illnesses may lead to suicide. Many online commentators, including journalists, simply assumed that Williams had depression. However, he may have also had bipolar disorder, in which depressive episodes are interspersed with manic ones. Williams himself never stated which diagnoses he had, so it’s best not to assume. Whatever he had or didn’t have, it is clear that he was suffering.

Read the rest here.

“Twitter Psychosis”? I’m Skeptical

[Content note: mental illness & delusions]

Over at the Daily Dot, I did some mythbusting about this alleged “Twitter Psychosis.” For whatever reason, it’s hard for me to pick out an excerpt, so I’ll just go with what I think is the most relevant part of this story, but you should go read the full thing to get the background:

Unlike most other published psychological research, the study about Mrs. C and “Twitter psychosis” is a case study— a type of research in which researchers study one particular person, or case. Something you should know about case studies is that they’re the least scientifically rigorous experimental design possible. There’s obviously only one subject or participant, and a particular person’s psychology is so idiosyncratic and impacted by so many factors that we may or may not even notice that it’s difficult to draw any firm conclusions. Unlike other studies, that compare some group to some other group, case studies don’t allow us to see what happens if certain conditions are different.

This study was further an observational case study, not an experimental one. In experiments, researchers change something or do something to the participants and see what happens. In observational studies, they can only observe what’s already going on. This means that it’s impossible to tell what causes the observed phenomena to occur.

That said, case studies are useful sometimes. When researchers are first discovering a new phenomenon, or when people with a particular condition are very rare, there might be no choice but to study a single individual. Observational studies in particular are useful when it’s unethical or impossible to tweak some variables to see what happens. Twitter psychosis, if it’s a real thing, is probably quite rare. We would have to study thousands of participants to find cases of it. And if Twitter really can cause psychosis in certain people, it’s clearly unethical to purposefully expose them to it to see what happens. So, case studies, including observational ones, are often the first step of studying something new.

My main concern with this type of research—and with other recent warnings by mental health professionals that the Internet (and social media in particular) can cause or aggravate mental illnesses—is that people dealing with mental health problems may be pressured by friends, family, or doctors to stay offline. Of course, sometimes staying off the Internet (or off social media specifically) can be a wise choice for someone for any number of reasons. However, the general trend of anti-tech alarmism makes it likely that “stay off the internet” will be a piece of advice too often and too easily given.

People with mental illnesses can be vulnerable to persuasion and even coercion by those with authority over them, including therapists and psychiatrists. If a person with a Ph.D. says, “I think you need to stay off Twitter,” they may take their advice without any grains of salt.

You might ask why this matters. It matters because the Internet can also be an incredible source of support and information for people with mental illnesses. Tumblr, in particular, is known for its supportive community, but it’s not the only one. Reddit has subreddits dedicated to every major mental illness where users can post stories, ask for advice, and support each other. Twitter’s hashtags make it easy to find tweets about your illness, and mental health organizations and professionals are very active there, posting supportive messages, advice, and news about clinical research.

And Facebook is where many people “come out” about their mental illnesses for the first time, finding it easier to share with many people at once rather than with individuals—but without having to show it to the whole world. (Incidentally, Facebook is also where I run a support group for atheists dealing with mental health problems, which many of the participants have told me has been really helpful.)

It’s possible that Twitter can trigger psychosis in some people with other risk factors, and researchers should conduct more studies to find how whether, how, and why this happens, and how it can be prevented. But we should be careful not to cut suffering people off from a potentially vital source of support.

Read the rest here.

 

Debunking Four Myths About Polyamory

I just went through a frankly hellish transition of ending my Midwest trip, saying goodbye to my family yet again, coming back to New York, and moving into my new apartment in Brooklyn. Predictably, all this led to an inordinate amount of emotional turmoil, but I somehow managed to write this piece for Friendly Atheist about some polyamory tropes.

Polyamory — the practice of having multiple sexual/romantic relationships with the knowledge and consent of everyone involved — is currently going through that stage that all “alternative” lifestyle practices must go through: the one where journalists discover their existence and have a field day.

Luckily for them, more and more people are willing to openly talk about their open relationships as the stigma of being non-monogamous diminishes. Journalist Olga Khazan interviewed quite a few of them in this article for The Atlantic. While the article is well-researched, balanced, and accurate overall, it (probably unintentionally) repeats and propagates a few tropes about polyamory that aren’t always accurate.

Note that I said “not always”; tropes are tropes for a reason. There are plenty of people whose polyamorous lives resemble them, and I mean it when I say that there’s nothing wrong with that (as long as it’s all consensual!). But I think that the (presumably non-poly) audience these articles are aimed at might benefit from seeing a wider variety of poly experiences and opinions, so I wanted to add my own voice.

With that in mind, here are a few dominant narratives about polyamory that aren’t always true, but that crop up very often in articles about polyamory.

1. Polyamorous people don’t feel jealousy.

It’s right there in the title, “Multiple Lovers, Without Jealousy.” Although the article does later go more in-depth about the ways some poly couples experience and manage jealousy, the headline perpetuates the common myth that polyamory is for a special breed of human (or superhuman, perhaps) who just “doesn’t do” jealousy.

Some do, some don’t. For some poly folks, jealousy is a non-issue. For others, it’s an annoyance to be ignored as much as possible. For still others, it’s a normal, natural emotion to be worked through and shared with one’s partners. There are as many ways to deal with jealousy as there are to be polyamorous — and there are many.

The reason this matters is because framing jealousy as a thing poly people just don’t experience drastically reduces the number of people who think they could ever be poly. I’ve had lots of people say to me, “Oh, polyamory sounds cool, but can’t do it because I’d be jealous.” Of course, dealing with jealousy isn’t worth it for everyone, so I completely respect anyone’s decision to stick with monogamy because of that. But I think it’s important to let people know that you can experience jealousy — even strong and painful jealousy — and still find polyamory fulfilling and completely worthwhile.

Read the rest here.

Depression and Self-Gaslighting

Gaslighting is a term you probably know, but if you don’t, it refers to the act of telling and convincing someone that their feelings or perceptions are not really true. In the context of interpersonal relationships, gaslighting is considered to be an abusive behavior, as it can render people incapable of trusting themselves and their own judgment, instead placing an undeserved trust in the gaslighter.

Cognitive distortion is also a term you probably know. It refers to a set of maladaptive mental habits that people with mental illnesses tend to have. (The Wikipedia list is useful, and I discussed some specific examples in this post.)

A cognitive-behavioral approach to mood disorders involves teaching the client the difference between thoughts and feelings. A lot of people will say things like, “I feel like a failure.” The therapist’s role is to remind them that “I feel like a failure” isn’t actually a feeling, but a thought. “I feel like a failure” is really “I think that I’m a failure.” The therapist may ask, “How do you feel when you have the thought that you are a failure?” The client may say, “I feel hopeless,” or “I feel miserable.” Hopefully, the therapist can help the client see that a lot of their thoughts are actually cognitive distortions, and that there are more helpful and realistic ways to think about the same things.

That’s the standard CBT frame that’s used in all the training videos I watch in school. But the reality, at least for me, is a little less tidy. Sometimes feelings come seemingly out of nowhere, and while I know there is a reason for them (and I usually know what the reason is), there was no proximal cause for the feeling. There was no maladaptive thought.

Sometimes I see a partner with someone else and I just feel awful. I don’t think, “I bet they’re going to leave me now,” or “That person is way cooler than me,” and then feel awful. I just feel awful. Is it because I trained myself to feel awful on cue, as a conditioned response? Maybe. Others would argue that feeling awful is a “natural” response to seeing a partner with someone else, though I disagree. Regardless, the feeling comes immediately and without any stimulus other than seeing the thing.

Sometimes I have to leave my family after a visit and I become extremely depressed. (I will have to do this in a few days. I’ve already had a few breakdowns about it.) I don’t think, “I WILL NEVER SEE MY FAMILY AGAIN” or, slightly more realistically, “It is Terrible and Bad that I have to leave my family.” I just think about the mere concept of leaving and instantly collapse in tears. (To wit: there is nothing less undignified than collapsing in tears while sitting on the toilet, but that just happened to be when I remembered about my flight home. It happens.)

Last year I wrote about some things I had learned from depression, including two slightly/seemingly contradictory maxims: “Not everything your brain tells you is accurate,” and “Your feelings are valid.” You can read that post to see what I meant by these things, but the jist of it is that depression can teach you to be more skeptical about some of the stuff going on in your brain, but also that you get to feel how you feel without passing judgment–or having others pass judgment–on it. Some would say that feelings can’t be “wrong.” They can be crappy, or not useful, or distracting, or whatever, but they cannot be empirically inaccurate or morally wrong.

However, this is where reality gets murkier than these convenient teachings. Feelings aren’t wrong, per se, but they can be premised on exaggerated or inaccurate fears or worries. I feel bad when my partners like people who I think are Better than me. But what is “better”? Can I really accurately say that someone is “better” than me, rather than maybe better at certain things and worse at others? And isn’t the whole point of polyamory that nobody has to leave anyone just because they’ve found someone “better”?

I feel depressed when I have to leave my family and go home to New York. But I know I will be just fine and quite happy when I get there. I know this because I’ve gone through it many, many times now. There is no reason to feel so depressed I can’t get out of bed for two days. Yes, it’s sad to say goodbye to your family. To me, personally, it is slightly tragic, even, that I can’t live close to them the way people usually do in our culture. But it is not that sad. It is not weeping-on-the-toilet-bowl sad. Few things in my life are objectively that sad.

These are far from the only situations like this that I experience; it happens all the time, every day. I get very frustrated. “No feelings about feelings,” a friend of mine says, not as a rule, but as an aspiration. I can’t make it work.

So I start gaslighting myself. “That’s not true.” “That perception is just wrong.” “That’s false and you know it.” “There is no reason to be upset right now.” “Your hypothesis that that person is somehow objectively better than you is premised on nothing but a pile of turds.” “THAT FEELING IS WRONG AND YOU SHOULD IGNORE IT FOREVER.”

Cutesy slang about jerkbrains and badfeels aside, what I’m now doing is very serious. Now I have abandoned a defensive stance and taken up an offensive one, with which I will battle the Wrong Feelings and vanquish them in a burst of light. Gaslight.

What happens when you teach yourself not to trust your own perception? How many toxic people become “just difficult for me to deal with because I’m so insecure and oversensitive”? How many untenable situations become marginally acceptable because “I’m only miserable about it because my brain lies to me”? How many injustices become annoyances to shrug at because “I’m just pessimistic about everything and don’t realize how good life is”?

People tell me that I’m so good at setting boundaries, but sometimes I wonder how much shit I have patiently accepted because I thought my brain was lying to me. In any case, I’m very glad I discovered feminism at the same time I discovered that I have depression.

Somewhere between “Your feelings are bad and you should feel bad” and “Your feelings are an accurate barometer of external reality” lies a vast unexplored land of feelings that are excessive but useful, of feelings that don’t make any sense but that alert you to an issue that needs to be explored, of feelings that can be discussed with a partner to build trust and intimacy, of feelings that have been spot-on many times before but have simply outlived their usefulness in this new and happier life you have built.

I wish I could really believe that feeling things is okay.

A Primer On Atypical Depression

At CONvergence two weeks ago, I and a few other people did a panel on myths about mental illness. It was really great, and I hope that there will be a video of it up eventually. At one point, I tangentially mentioned atypical depression, a type of depression that is sometimes contrasted with melancholic depression, or the “typical” kind.

Atypical depression is the type that I have, and that might be part of the reason it took me something like seven years to realize that I had depression at all. A few people have since told me that they didn’t even realize atypical depression was a thing. So I decided to write a brief overview of it in the hopes that more people who don’t have a name for what they’re going through might find a name for it.

There are some “classic” depression symptoms that most people think of when they think of depression: being numb or sad most of the time, being unable to take joy in things you used to like, insomnia, and loss of appetite and weight. You think of the person lying in bed unable to care about or take pleasure in anything.

Atypical depression has a rather different set of features. Instead of insomnia, you may have hypersomnia (oversleeping). People with atypical depression might regularly need to sleep 10 or 12 or even more hours. Instead of loss of appetite, you may overeat and/or gain weight. Instead of being numb or just uniformly sad, you have high mood reactivity, or mood swings. You may find that you’re able to enjoy things and feel happy when things are going very well, but as soon as things are neutral or even just a little bit bad, you feel horrible again. There are two other symptoms that are sometimes present: leaden paralysis, or the feeling that your limbs are very heavy and difficult to move, and high rejection sensitivity, which means being overly concerned about people not liking you or rejecting you, to the point that it impairs your social functioning.

Unsurprisingly, these different sets of symptoms mean that different types of antidepressants may work best for each type. I will quote Wikipedia here, since it’s sourced and there’s no good reason to rephrase it:

Medication response differs between chronic atypical depression and acute melancholic depression. Some studies[4] suggest that the older class of antidepressants, monoamine oxidase inhibitors (MAOIs), may be more effective at treating atypical depression. While the more modern SSRIs and SNRIs are usually quite effective in this illness, the tricyclic antidepressants typically are not.[1] The wakefulness-promoting agent Modafinil has shown considerable effect in combating atypical depression, maintaining this effect even after discontinuation of treatment. [5]

I don’t know how useful this information is to you if you think you may have atypical depression, but at least now you know that if your symptoms fit this pattern but your psychiatrist prescribes you a tricyclic antidepressant without further explanation, it might be worth bringing up this research. In addition, if SSRIs haven’t been working for you, you might ask your psychiatrist about trying MAOIs rather than a different SSRI or a higher dose of the same one.

In terms of therapy, I can’t seem to find any studies on the effectiveness of different types of therapy on the different types of depression (that may be because Google Scholar is actually a terrible search engine), but my educated guess would be that dialectical behavior therapy (DBT) would be extra helpful for atypical depression as opposed to melancholic depression. DBT is a type of therapy developed specifically to treat borderline personality disorder, which involves lots of mood swings, rejection sensitivity, and general troubles with managing emotions. DBT contains a lot of the same techniques as cognitive-behavioral therapy (CBT; the standard of evidence-based treatment), but it also emphasizes mindfulness and learning to cope with strong emotions. Atypical depression, with its mood swings and interpersonal issues, might be especially amenable to it.

To the extent that psychodynamic therapy is effective (actually, plenty of studies suggest that it might be), it might also be more effective on atypical depression than other approaches. Atypical depression tends to have an earlier onset, and people may experience it as an aspect of their personality that is rooted deeply in their life experiences. When practiced well, psychodynamic therapy may be useful for resolving these issues. But none of this is to say that standard CBT should not be tried.

During my senior year of college, I asked a professor who studies the neuropsychology of mood disorders whether or not he knew of any research on neurological differences between atypical and melancholic depression. After all, there’s been plenty of research on how depression affects the brain–in terms of active brain regions, neurogenesis (growth of new neurons) in various regions, and so on. Were all these studies really done using patients who might’ve had what looks like two nearly-completely different illnesses? Apparently. My professor wasn’t aware of any such studies, and I’ve only found one myself: some research that examined which hemisphere of the brain responds more to a particular face test, and in atypical depression patients, the right hemisphere was much more active than it was in melancholic depression patients and in non-depressed controls. The authors write, “This is further evidence that atypical depression is a biologically distinct subtype and underscores the importance of this diagnostic distinction for neurophysiologic studies.”

There also seems to be some evidence that atypical depression in particular is linked to thyroid dysfunction, which may explain some of the physical symptoms. However, the results seem to be rather complicated and confusing, and it’s definitely not a simple causative link.

Although the diagnostic criteria for depression contain both sets of symptom patterns and there’s even a special indicator for “atypical features,” the popular conception of depression is of the melancholic type, not the atypical type. This means that many people, believing that depression necessarily means “being completely miserable all of the time always,” may not realize that they might have depression and can benefit from treatment.

Atypical depression presents a classic boiling-frog problem. Because you are in fact capable of feeling happy for short or medium stretches of time, it can take a serious increase in symptom severity to realize that there’s anything wrong. Incidentally, as I mentioned, atypical depression also tends to have an earlier onset than melancholic depression, which means that you may spend your entire post-childhood life that way. For some people, certainly for me, it felt like it was “just my personality.” To make things even more confusing, the rejection sensitivity tends to be present even during periods of time when the rest of the symptoms are in remission. But when it comes to mental health, nothing is ever really “just your personality” if you don’t want it to be.

Hopefully, this overview will help people–at least the people who read this blog–broaden their awareness of what depression is. If there’s anything I missed in terms of research, by the way, please let me know. As I mentioned, my Google Scholar-fu is much worse than my Google-fu.

Of Ethics, Feelings, and Skyrim

I’m currently visiting my family in Ohio, which means catching up on all the gaming I’ve been too busy for during the last five years. My 12-year-old brother and I have a nice symbiosis going: he has a Windows machine, which meant I could install Skyrim on it, and I have a purchased copy of Skyrim. So we take turns watching each other play.

Kilkreath Ruins. Creepy, yeah? Well, maybe you just had to be there.

Kilkreath Ruins. Creepy, yeah? Well, maybe you just had to be there. Credit: Ekulylnam

Last night, while I was adventuring through the Kilkreath Ruins on a quest from the Daedric Prince Meridia, my brother remarked that he found the cave scary–the creepy noises, the unidentified black mist near the ground–and that started off a discussion about the emotional effects of games and how we feel about them.

My brother said that he’s actually glad that the game is making him feel things again. He has previously played it on Xbox (claiming, in fact, that he “beat the game”), but he said that after a while, he stopped feeling bad when people died or feeling scared by the parts that were meant to be scary. But he prefers to feel those things even though they don’t feel good, because otherwise he worries that he’s becoming unempathetic, somehow cruel. This, he said, is why people should be careful about letting little kids play games: you need to make sure they don’t get used to not feeling things.

I hadn’t actually thought of it that way before, though it seems obvious now. I had always been frustrated by how deeply I felt things that happened in games, and how much that actually restricted my gameplay. My ethics as a game character are not very different from my ethics as a real-life person: I don’t steal (unless, hypothetically, it’s vitally important), I don’t fight anyone who doesn’t fight me first, I try to avoid injuring innocent people with splash damage unless it’s totally unavoidable, I try to persuade people rather than bribing or threatening them, and I don’t hunt wild animals (except the ones that attack me).

But despite everything my brother said, we soon discovered that our styles of play are actually quite different (besides the fact that I play slowly and deliberately whereas he tries to get through quests as fast as possible, a difference that he had already remarked upon in frustration many times). After the Meridia quest, I ended up doing another quest in which I was falsely accused of multiple murders and ended up in a prison mine with people who had attempted (and failed) to recapture the city from people they thought were oppressing them. Together with them, we escaped from the mine, since they all turned out to be very capable mages.

Outside the mine, the escaped prisoners were confronted by prison guards. I had planned to fight alongside them, but here my brother started insisting that I kill the prisoners instead. Why? Because they have really good armor, I wouldn’t get a bounty, and I could kill them easily now that I had my own armor and weapons back. I said, “But they already gave me a set of that armor as a gift.” My brother said, “But it’s really expensive and you could make 10,000 gold just from selling all of theirs.” I said, “But I have other ways to get gold.” He said, “But it’s so easy! Just kill them!”

I knew one thing for certain: I had absolutely zero desire to make 10,000 gold by killing these men. At that moment, there was nothing I wanted to do less than to kill them. The idea just felt bad.

And so I told my brother, “Remember how you felt so scared of the cave you asked me to turn the sound down, even though you knew it was irrational? That’s how I feel about killing the men. It would make me feel bad. The point of playing a game is to have fun. That would make it very un-fun for me.”

He immediately stopped trying to convince me to kill the men and never brought it up again.

It’s true, refusing to kill the men was an irrational choice. Within the game, there were no disadvantages to killing them, and one huge advantage to killing them. But outside of the game, the advantage seemed so small–what’s 10,000 gold, really?–and there was also one glaring disadvantage–the fact that I would feel crappy and uncomfortable, partially defeating the entire purpose of playing the game to begin with.

Earlier I might’ve found this frustrating. I thought that I let myself get way too affected by virtual things. I’m the sort of person who would treat even a fairly rudimentary robot as I’d treat a human or a non-human animal.

Now, having had the first conversation with my brother and the subsequent moral dilemma with the prisoners and the guards, I started to think differently about it.

After all, we (I include myself in this) are more likely to think of it as a feature, not a bug, when we experience emotional reactions to things like films and shows and novels. (That, in fact, is what I reminded my little brother when he called me crying after finishing The Little Prince, and again when he called me crying several years later after finishing Flowers for Algernon.) Playful teasing outside, feeling terrified or very sad during movies is pretty standard. Why not in games?

Maybe it’s because we assume that the point of film and literature (as a fan, not a scholar) is to be absorbed into a story. The point of games, some might argue, is more tangible: to shoot stuff, to solve puzzles, to build cool things, to become the best. Stories may matter in games, but they don’t matter the way they matter in films and novels.

And there are definitely games I would play purely for those tangible aspects. I don’t get emotionally invested in the story of my SimCity creations (though maybe some do). I care slightly for the plight of Fez’s Gomez, who has literally had his entire world as he knew it torn to bits, but mostly I’m just there for the cool puzzles.

Persuade, intimidate, or bribe: Skyrim's eternal moral dilemma.

Persuade, intimidate, or bribe: Skyrim’s eternal moral dilemma.

But with games like Skyrim, I come for the fighting and stay for the interesting narrative, and that generally means starting to feel immersed enough in that world to feel bad when people die needlessly in it. The experience of considering (and strongly rejecting) the idea of killing the escaped prisoners for their valuable armor reminded me of something I think I already knew: that much of ethics, at least for me, is based on automatic emotional responses. Stealing feels bad. Threatening feels worse. Killing needlessly feels even worse.

There must be ethical systems out there that rely on something besides emotion and that still result in minimal harm to other people, but they feel alien to me. In any case, I doubt that those systems would transfer over to virtual worlds. Why bother?

Sometimes I wonder if other people feel that way, and if other people end up playing about the same way that they live (give or take a few magical abilities and badass warhammer techniques, of course). If there are gamers who feel bad when they kill NPCs, I wouldn’t expect them to ever say so, because nobody seems to talk very much about the emotional experience of gaming in general, and because of the hypermasculine culture of it.

But for me–someone who has no interest in participating in or belonging to any sort of “gaming community” and who wouldn’t even take up the label “gamer”–it doesn’t feel like a big deal to say that games make me feel things. Not just general things like excitement or fear, but specific things, like I feel sorry for that man who died even though he’s just a bunch of 1’s and 0’s. Or I wish I didn’t have to kill that dragon; it would feel much better if we could just be friends. (That one might be influenced by the fact that I recently saw both How To Train Your Dragon movies and really liked them.)

And now I’ve finally decided that I like it that way. It’s more rich and fun that way, even with the bad feelings too. Like my brother, I like myself better when I feel those things. Embracing that irrationality feels more human to me.