Tags
drugs cw, martha wells, naomi novik, neoreactionaries cw, neurodivergence, ozy blog post, seanan mcguire, sex positivity
Rising Out Of Hatred: This book– about former white nationalist Derek Black and how he stopped being a white nationalist– takes place at the college I attended as a undergraduate, while I attended. For that reason, I’m not sure I should give much of an opinion on the book; gossip about my college acquaintances is not of public interest, and my book on the story is going to be fundamentally affected by the fact that I took classes with Derek Black, in a way that makes it less useful for other people. I can, however, state that as far as I’m aware its description of events is accurate. There were a couple of places where I’d quibble with the description of New College, but nothing I’d consider generally unreasonable.
The Sober Truth: “There isn’t great evidence that AA works. Despite its pretensions of secularism, AA is a clearly Christian-influenced organization, which makes it problematic for both devout members of non-Christian religions and atheists. AA is prescribed over and over again for people for whom it clearly isn’t working. THEREFORE, we should use the true evidence-based treatment for alcoholism, which is psychodynamic psychotherapy.”
Inside Rehab: I started internally screaming in the first chapter, when someone described how one of their rehabs only gave you Suboxone as a reward for good behavior. I did not finish internally screaming until I finished the book.
Interesting facts: Your chance of receiving evidence-based treatment is generally higher if you’re poor or homeless and lower if you pay for rehab out of pocket, because NGOs and governments have leverage to demand that rehabs implement evidence-based treatment, while private rehabs can just do whatever sounds good (equine therapy, Reiki) even if there is no evidence behind it. Rehabs (particularly for people with mild substance abuse problems and teenagers) can make drug addictions worse by introducing the client to more severely addicted friends and teaching them about new drugs and ways of hiding them. AA specifically leads to binges in some people by teaching them that if they have one drink they might as well go on a binge. Thirty percent of people have had an alcohol use disorder at some point in their lives; this is because alcohol use disorder is defined very broadly and essentially includes anyone whose use of alcohol has ever caused a problem in their lives. As you might guess, most people with mild alcohol use disorders are capable of drinking moderately.
One thing I’m confused about is that the author complained that rehabs are very expensive, and then complained that addiction counselors are untrained people whose only qualification is being former addicts, and then complained that rehabs almost never offer much individual therapy (often less than once a week). Presumably the last two things would make rehabs less expensive? Are rehabs directing money in a useless way (towards equine therapy or administrator salaries or nice bedrooms)? Or are rehabs inherently very expensive for some reason? If it is the second thing, maybe we should transition to outpatient therapy, which is less expensive.
Highly recommended both for people who want to gain a better understanding of the rehab system in the United States and for people considering rehab for themselves or their loved ones. The lists of questions to ask rehabs seem very helpful.
Sex Addiction: A Critical History: I was really excited when I bought this book, because I think sex addiction is a problematic concept and I was really looking forward to an in-depth history of how it came to be, along the lines of (say) David Valentine’s excellent Imagining Transgender. (Incidentally, if you’re interested in the social construction of transness, Imagining Transgender is an absolutely invaluable book and I highly recommend it.)
Unfortunately, the authors have Szaszian sympathies, so instead of enjoying the book I spent the entire time raging about their terrible, terrible politics. “‘Sex addiction’ is bad because it’s another example of the psychiatric industry medicalizing normal human behavior, the way that depression medicalizes normal sadness! You can tell, because there’s a continuum between sex addiction and normal behavior and you can’t draw a non-arbitrary line between ‘sex addiction’ and ‘normalcy.’ How negatively sex addiction affects you depends as much on your environment as it does on your objective symptom severity. In some contexts sex addiction can be neutral or even conducive to your flourishing.”
But the problem is that all those things are true of literally every psychiatric condition. Psychosis is on a continuum with normal hallucinations that ordinary people experience, and it’s hard to draw a non-arbitrary line between psychosis and normal voice-hearing. How negatively psychosis affects you depends as much on your environment as it does on your objective symptom severity. In some contexts psychosis can be neutral or even conducive to your flourishing. Either you bite the bullet and go “psychosis is fake, the homeless schizophrenic guy is exactly like everyone else”– which, to his credit, Szasz does– or you realize that we have to have a way to think about psychiatric conditions that features the social model of disability and the fact that psychiatric conditions are all on a continuum with normal human behavior.
Unfortunately, the authors are so busy having stupid opinions about psychiatric diagnosis that they didn’t do anything more than touch on the genuine incoherency and thorny ethical issues associated with the ‘sex addiction’ concept.
The behavior highlighted by the PATHOS screening for sex addiction– preoccupation with sexual thoughts, hiding some sexual behavior from others, seeking treatment for sexual behavior, sexual behavior that hurts others emotionally, feeling controlled by your sexual desire, feeling depression after sex– just doesn’t have one simple set of causes. Some people might have hypersexuality symptoms associated with mania or a personality disorder. Some people might be closeted gay people in a homophobic environment, or kinky people in an environment where kink is stigmatized. Some people might use sex as a quick source of pleasure when they’re depressed. Some people might have a history of sexual trauma. These are all different problems with different solutions and I don’t think it makes sense to treat them all as one thing.
(And what’s with that “hiding sexual behavior from others” thing. I hide sexual behavior from others because I have boundaries.)
The concept of ‘sex addiction’, I think, highlights a particularly thorny ethical problem. If a system of sexual ethics is particularly demanding– in particular, if it demands that a person not masturbate, or not masturbate when in a relationship, or not masturbate using porn or erotica or sexual fantasies of people other than their partner, or only have sex with people they aren’t oriented towards– a certain percentage of the population will find themselves engaging in sexual behavior they don’t endorse. But those people are not going to have sexually compulsive behavior in general. If they stop believing that gay sex, pornography use, or masturbation is wrong, they’ll probably use porn, have gay sex, or masturbate a perfectly reasonable amount that is in balance with the rest of their lives. They certainly won’t escalate to nonconsensual behavior, adultery, or pedophilia (as is sometimes implied by sex/porn addiction discourse).
I’m not sure what we should do about that. On one hand, some part of me says that the problem here is clearly not the masturbation or porn use or gay sex, the problem is the stigma, and the therapist should destigmatize the sexual behavior in question. On the other hand, it seems to me that therapists should not impose their ethical beliefs on their patients. I certainly wouldn’t like it if a therapist tried to do CBT to my demanding ethical beliefs! The therapist should let the patient set their own goals according to their own values instead of imposing the therapist’s values. I think this is a legitimately complicated ethical issue, and saying “if you masturbate when you don’t endorse masturbating then you are a sex addict which is exactly the same sort of thing as an alcoholic” elides it. This is exactly the sort of issue I hope would be addressed by a critical history of sex addiction, and exactly the sort of issue that was not addressed.
Artificial Condition: Murderbot is back! Murderbot is on a quest to figure out whether, last time he’d hacked his governor module, he’s committed mass murder instead of his current occupation of binging TV shows. He stumbles across some humans he feels like he has the duty to protect, and much to his grave irritation has to stop watching TV in order to protect them from their own suicidal tendencies. Murderbot is one of the most likeable and engaging protagonists in recent SF, and every novella he is in is a delight. ART, a television-obsessed spaceship, is equally likeable and a delightful foil. Pick up the series next time you have a bad day and need something fun and not too deep.
Spinning Silver: A fast-paced and page-turning fantasy novel. A moneylender boasts that she can turn silver into gold catches the attention of a gold-loving fairy, who threatens to kill her if she doesn’t turn his silver to gold and marry her if she does; a noblewoman uses the fairy silver, which makes others see her as beautiful to marry the tsar, but there is more to him than it seems. Lots of fascinating plot twists; it manages to be very gripping without having any fight scenes, which is always something I like in a novel. The secondary world is Russian-influenced, which is an interesting variation on the stock European fantasy novel. Highly recommended.
Beneath the Sugar Sky: Down Among The Sticks And Bones was so good! And this was so not good! WHY.
The protagonist’s sole personality trait is being fat. She is insecure and feels bad about her body because she is fat. She is bullied because she is fat. She is an endurance athlete because fat athletes exist. She is magically transported to an alternate world and turns into a mermaid, and suddenly becomes an athlete because being fat is actually helpful in ultraendurance swimming. (This is legitimately pretty cool and I would have hella appreciated it if the character had had at least three non-weight-related personality traits.) She expects to be bullied for being fat, but everyone is tolerant. She has to go to a magical world made out of candy, where the villainess surrounds herself with candy and never eats any of it in order to stay thin, and talks to her about how if she diets she will be thin. Every five pages we get some “and Cora was tired but she couldn’t ask for a rest because people would assume it was because she was overweight.”
I get it! I’m on board! We should be nice to fat people! PLEASE GIVE YOUR FAT CHARACTER ANOTHER PERSONALITY TRAIT.
At one point Cora is like “the only thing people see in me is fat fat fat” and I was like “yes! that’s so true it’s even affecting your author!”
There were some really interesting ideas. The “nonsense world” made out of candy felt like a real world from a genuine children’s portal fantasy novel. Kade, a transgender male side character, had some really lovely and interesting characterization (which is unfortunately a spoiler). But overall this is a very weak entry in the series.
I don’t think that this is universally true. If the patient has obviously and perfectly diagnosable epilepsy but believes that they’re possessed by demons and wants the therapist to help them build up determination to whack their head with a cross each time they have a seizure (instead of every other time, like they, being an imperfect sinner, do now), it’s the duty of every medical professional to call bullshit.
LikeLike
Pingback: Rational Feed – deluks917
“The Sober Truth” and “Inside Rehab” are interesting complementary reads, because by the capsule reviews here, it looks like Dr Dodes may be pushing a treatment regime every bit as flawed as the AA regime he critiques, if we accept the overview of the state of ‘the rehab industry’ – it’s a big business now and everything can be abused so rehab is full of flaws, honest zealots promulgating the system that worked for them (be it prayer or yoga or drinking nettle juice standing on one leg), the assorted ‘hey there’s money in catering to people who need to dry out/get clean’ profiteers who follow after them, and something works for somebody but nothing works for everyone so nobody knows what will 100% work for 100% everyone.
(I’m snickering a bit about the “gasp! AA is *RELIGIOUSLY INSPIRED!*” tone of shock, horror! revelation because no, really? who would have thought? and also because of the “let’s replace one faith system with another, only SCIENCE!!! this time”).
Re: sex addiction, I think it’s possible because some humans do get addicted to sources of pleasure – food, alcohol, drugs and so forth. People using it as an excuse to dodge responsibility and making restitution – like the original celebs who ‘came out’ as sex addicts and used that as an excuse “It’s not my fault I wrecked three marriages and had affairs while having affairs, I can’t help it, I’m addicted” – are abusing the term. Some people are poly or kinky or whatever. Some people genuinely are addicted to sex, to the extent that it’s hurting them and others. And some people are just selfish and greedy.
Re: Cora the fat person did you know she was fat have I mentioned that she’s fat – yeah, how you feel about that is how I feel about all the earnest “my characters are all genderfluid pan trans aliens of colour and the one (1) cis het white guy is the villain”. I
I’m fat myself, I know all about it, and I’m not going to read a book simply because the main character is a fat person and that’s the whole of it. Nero Wolfe is fat, and this is often mentioned in the stories and novels, but he’s also super-smart, sneaky, likes running rings round the cops while never moving from his chair if he can possibly help it, and has a lot of character quirks that add up to a lot more than “here’s a fat guy who’s a detective”.
This is what I dislike about the whole representation argument – sure, some fat people may *love* a book like this about “hey, did you know how tough it is to be fat?” And yes, seeing “people like you” as main characters is important. But not all fat people want to read about a fat lead character whose main reason is to be A Moral And Improving Lesson In Tolerance, and when I get the obligatory “you HAVE to read/watch this because it has Representation!” kind of hectoring lectures from online social media, I want to know “Yes, but does it have a point besides A Moral And Improving Lesson In Tolerance? Does it have a story? Will I care?”
If I don’t want to read the stunning work of genius about trans queer beings of colour in space maybe it’s not because I’m a homophobic racist, it’s because there isn’t any story there to entice me to read it.
LikeLike
Is this really an argument against representation in fiction, or is it just an argument against doing representation half-assedly? Like, I agree with you that characters whose only character trait is that they’re [queer/non-white/disabled/whatever] are annoying and token-y to read, but I also think that representation in fiction is good and important – it’s just not an excuse to write shitty one-note characters. It sounds like Ozy feels the same, thus the critique of this character whose only trait is being fat.
LikeLike
I think (but am not 100%) that Ozy at some point in the past during one of these reviews was like ‘an identity is not a personality’, and that seems about right.
Like, I get why it can feel that way, to an author, though. The point of giving characters personalities (waves hand furiously) is so the reader identifies with them, and wants to see them win or lose as appropriate. Being like ‘she is double gay and comes from the Indian analogs’ can feel like cruise control to this. Just pick someone marginalized enough and blammo, all the benefits of personality with a tiny fraction of the work.
I’m not trying to defend the practice, just to explain where it comes from. I’ll beg a bit for some charity towards authors. I dunno if you’ve stared into the the Amazon Market with an eye towards making it as a content creator, but it is a monstrous void. I can’t find it in me to blame them for anything they do to try and streamline their process.
LikeLike
That would be great, and I have no objection to that. My quibble is with the messaging about “You HAVE to like/support/spread this around, it’s got [X marginalised group] character in it!” which all too often turns into bullying and hectoring; any “Yeah but it’s not really any good” gets the “Oh so you’re some racist phobic bigot, huh? Go die in a fire!” response.
And often it’s overdone – the cast of characters who are all of them, every one, queer trans differently abled non-white non-this that and the other. That’s just as artificial as the 50s style of “everyone is white, cis, het, middle-class American”. It takes a lot of skill in world-building to pull off a convincing “this is how and why this is”, and often the skill is not there. Samuel Delany can pull it off but not everyone is Samuel Delany.
Plus the recent kerfuffles in YA about eating their own for being insufficiently woke/pure enough – that’s not about representation, that’s about signalling your superior virtue.
LikeLike
@Walter
I don’t identify with people who frame everything in their life in relation to a single trait, though. In real life, I consider those people to be obnoxious, walking stereotypes. In writing, the same.
LikeLike
I notice that I am surprised and confused.
LikeLike
While many people go through their lives without ever hallucinating or hearing a voice, many people have hallucinations sometimes. For example, when I’m in a very quiet room, I sometimes hear someone calling my name, even though there’s nothing that could have possibly made the sound. Grieving people often hear the voice of the dead person or see them out of the corner of their eye. Some severely sleep deprived people have brief hallucinations. Having this kind of experience sometimes is normal and common and doesn’t mean anything is wrong with your brain.
(I realized the way I phrased it was ambiguous between “every day, at least one ordinary person experiences a hallucination” and “the same person hallucinates every day and they don’t have any weird brain things”– I meant the former! I edited the post to make it clearer.)
LikeLike
It’s not actually true that being fat is helpful in ultraendurance swimming–your link says that successful ultraendurance swimmers have body fat higher than the average athlete, but that’s still below the American average, and not equivalent to being overweight or obese.
LikeLike
Sober for Good is the result of interviewing a number of people who’ve solved their drinking problems.
It turns out that every premise of AA is wrong for people in general. There are people who find they can learn to drink moderately, people who make the decision once and for all, people who don’t have a higher power…..
The one thing people who solve their drinking problems have in common is a year of abstinence.
*****
There are athletic fat people. It’s quite possible to be athletic without winning competitions.
LikeLike