On Supporting Borderlines

Tags

abuse tw, mental illness, ozy blog post

[content warning for discussion of abuse, self-injury and suicidality]

There is a problem with advice for the loved ones of people with borderline personality disorder.

If you google, you’ll find websites like BPD Family and Out of the FOG. On Reddit, there’s bpdlovedones; on Amazon, one finds books like Stop Walking on Eggshells.

The problem is this: imagine describing the behavior of someone with borderline personality disorder from the perspective of her partner. You might come up with a description like this:

My partner has absurdly huge negative reactions to relatively small triggers. Sometimes it feels like I can’t do anything right; whatever I do, she gets upset. Sometimes she even threatens to kill herself! She’s tremendously afraid that I will leave her, and sometimes that makes her want to kill herself. Half the time she puts me on a pedestal and acts like I don’t have any flaws, while at other times she seems to despise me. When my partner fucks up, she apologizes so much– and, of course, wants to kill herself– that I feel guilty for criticizing her. She has these fits of negative emotions where she seems completely out of control. When it’s good, it’s really really good– she’s tremendously sweet and loving, the most romantic person I’ve ever dated, and great in bed– but I’m not sure if I can put up with the bad times anymore.

You know what that’s also a description of?

An abusive relationship.

Of course, most borderlines are not abusive. But the things that make a relationship not abusive… well, we sort of take them for granted. They’re part of the minimum basic expectation for any relationship. And so you don’t mention “my partner was legitimately horrified when she found out that apologizing so much made me not want to say when something’s bothering me, and while she still apologizes waaaaaay too much I can tell she’s trying”. Or “my partner cares about my feelings and preferences; even when she’s having a bad day, she wants me to be happy”. Or “while disagreeing with my partner involves a lot of giant meltdowns, and that’s a pain in the ass, eventually we come to a compromise that satisfies both of us”. Or “my partner encourages and reassures me when I’m upset.” Or “my partner understands that I have boundaries and would never invade my privacy.”

And so when someone who has an abusive partner reads those descriptions, quite naturally, they conclude their partner has borderline personality disorder. And this is particularly true for people who are being abused by a woman, because the majority of borderlines are female, and our culture still has no concept that a woman can be abusive.

However, a borderline and an abuser are two completely different things. As Lundy Bancroft writes in Why Does He Do That?:

Yet the great majority of my clients over the years have been psychologically “normal.” Their minds work logically; they understand cause and effect; they don’t hallucinate. Their perceptions of most life circumstances are reasonably accurate. They get good reports at work; they do well in school or training programs; and no one other than their partners—and children—thinks that there is anything wrong with them. Their value system is unhealthy, not their psychology.

A borderline may have mood swings, or psychotic episodes, or dissociation issues. A borderline may have truly awful relationship skills: I know I’ve more than once attempted the Telepathy Method of setting boundaries. A borderline may be seen as manipulative: for instance, if she gets so distressed that she cuts, and her partner presumes that this is an attempt on her part to manipulate them into preventing her distress. A borderline may even be manipulative: if the only way a borderline knows to ask for attention is to cut, of course she’s going to cut.

But there is a step you do not cross unless you also have fucked-up values: unless you believe, in your heart of hearts, that you are entitled to certain things, that you deserve to be able to control your partner, that it’s okay to disrespect your partner, that abuse is a good way of expressing love. You might have overwhelming emotions, but you don’t decide that it’s your partner’s job to handle your emotions and keep you from ever feeling bad unless you have a fucked-up value system. You might have poor relationship skills, but that doesn’t mean you have contempt for your partner, that you think of them like they’re dirt. There is an important difference between someone who cuts because they don’t know how else to tell people they’re upset and who wishes they had some other strategy but who doesn’t, and someone who cuts because they’ve figured out it’s a great way to keep their partner from ever sticking a toe out of line.

(This is not to say, of course, that abusive borderlines do not exist. Of course they do.)

I think conflating the two is terrible for abuse survivors, for borderlines, and for the partners of nonabusive borderlines.

The harm it causes to abuse survivors is obvious. Most people feel pretty bad about leaving a partner who’s mentally ill; it feels like abandoning her, like not being supportive. They might also be optimistic about their partner getting better. The rate of recovery for people with borderline personality disorder is quite good: about fifty percent of borderlines recover within ten years, and the rate is higher for people who are in DBT. Unfortunately, while DBT is very good at helping people regulate their emotions, it’s absolute shit at getting people to fix their value systems. If you put an abusive borderline through DBT, you wind up with someone who can tolerate distress, regulate their emotions, and stay mindful– and still believes that she is entitled to you preventing her from ever feeling upset.

A lot of websites provide advice about how to deal with people with borderline personality disorder. Providing advice for dealing with abusive partners is good– not everyone is ready to leave their abusive partners, and harm reduction is important. But by presenting this advice as a cureall, survivors may believe that if they just validate their partner’s emotions enough, if they just set the right boundaries, if they just do everything right, their partner will stop being abusive. And that’s simply not how it works.

The partners of nonabusive borderlines are also harmed. Many people are interested in learning how to better support their partner with borderline personality disorder. However, all of the advice for dealing with people with borderline personality disorder is this cockamamie combination of advice for supporting a borderline and advice for coping with an abuser. In a shocking turn of events, these aren’t actually the same problem, and the same advice doesn’t work for both– meaning that partners of borderlines are left figuring out what works by trial and error.

Furthermore, a lot of the advice aimed at partners of people with borderline personality disorder begins and ends with “leave”. Partners are warned of the dire fate that will happen if they stay with their borderline: physical violence, false accusations of abuse, gaslighting, and on and on.

I want to be clear. Dating a person with borderline personality disorder is not for everyone. In fact, it probably isn’t for most people. The most essential skill for having a healthy relationship with a borderline is the ability to say “I understand that me going to a party tonight makes you want to kill yourself; however, I’m still going to the party, because I want to and it would make me happy.” If you can’t do that, your relationship with a borderline is going to be short and miserable. It is totally okay to decide that you, personally, do not want to date borderlines.

However, some people are okay with that. Some people can feel compassion for their partner’s pain while simultaneously caring about their own needs; some people don’t mind endlessly reassuring their partner “yes, I do still love you”; some people love their borderline partner very much and are willing to do whatever it takes to keep them. And that’s okay.

Finally, this situation is pretty shit for borderlines. First, because no one likes having a bunch of websites devoted to how they are totally awful and all their relationships are abusive. The participants in such websites often conclude that borderlines who get upset are “having rages” and “splitting”, despite the obvious fact that most people get insulted when you say they are inherently abusive. And I worry about the effects such websites have on people I disclose my disorder to– will people conclude that I’m an abuser?

The “just leave!” advice is pretty bad for borderlines as well. If you advise everyone in a close relationship with a borderline to leave, you’re essentially saying that people should not have close relationships with borderlines– which means that you’re saying we should not have a basic human need fulfilled. Humans need socialization, intimacy, and love. There’s a reason solitary confinement is literally torture.

This is different from “leave an abusive relationship!” If you’re in an abusive relationship, you’re being hurt, by definition. If you’re in a relationship with a borderline, you may or may not be hurt. Abusers are capable of being perfectly pleasant to people they don’t feel like they own; borderlines are borderline at everyone. If everyone left abusive relationships, abusers would never date and probably sulk on incel forums a lot; if everyone refused to befriend borderlines, we would be alone for the rest of our lives.

And yet most of the people who give this advice don’t want us to be dead– they often add “be sure to call the hospital if they’re suicidal!” Ought we to struggle through recovery with no support besides our therapists (if, that is, we can afford one– borderlines have sky-high unemployment rates)? You know what the odds are against figuring out how to cope with your mental disorder without any intimate relationships? It’s a setup for disaster.

I suppose in theory borderlines could just be friends with other borderlines– but that kind of screws us over too. While of course borderline/borderline relationships can be healthy, in my experience relationships for borderlines work best with someone calm and low-neuroticism, so you don’t wind up triggering each other or trapped in the delightful “when I’m avoidant you’re anxious, when you’re anxious I’m avoidant” struggle.

And then you add in that most borderlines are not abusive. We do not hit, we do not rape, we do not gaslight, we do not isolate our partners from their friends, we do not threaten. Dating us is stressful, certainly. But if someone decides they want to shoulder the burden of that stress– of their own free will, without anyone pressuring or manipulating them– that’s okay.

In conclusion: abusiveness and borderline personality disorder are two different things. While borderlines are more likely to abuse (and to be abused, something that is always lost in this sort of conversation), most borderlines are not abusive and most abusers are not borderline. And while people have a right to refuse to date people for any reason or no reason– and borderline personality disorder is a particularly good reason– the idea that no one should be in a relationship with borderlines is wrong and evil.

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Don’t Use Diagnoses As Insults

Tags

mental illness, ozy blog post

 

I take a very firm line on insults. I think that insults are a form of social punishment, and therefore you should only insult people if the trait is (a) actually harmful and (b) something that might change in response to punishment.

So, for instance, I basically don’t think there’s a good reason to non-jokingly call someone ugly. There is nothing wrong with having a face that doesn’t fit someone else’s standards of aesthetics– prettiness is not a rent you pay for occupying a space marked ‘human’– and most ugly people can’t do a hell of a lot about their appearance anyway. Don’t call people “obsessive”, because obsessiveness shouldn’t be punished; obsessive people are the reason you don’t have to light a candle when it gets dark out. And don’t mock people for having cancer, because while having cancer is bad, mockery will not make people have less cancer.

I’m not a big fan of the concept of “ableist language”. In my experience, what happens is that if you tell people “don’t say ‘stupid’, say ‘foolish'”, they will switch from calling people “stupid” if they can’t do math to calling people “foolish” if they can’t do math, and at no point will it occur to them that maybe having dyscalculia can’t be fixed by insulting people. The problem here is not ableist language. The problem here is ableist beliefs and values.

And it’s absurd to put “moron” in the same category as “retard.” “Moron” has a history of being used as a psychiatric diagnosis, but is not currently associated with intellectual disability. The Google Image Search for “moron” mostly gives you pseudo-clever insults and a man with a lot of tattoos, while the Google Image Search for “retard” gives you this charming picture:

Nevertheless: I don’t think you should use mental health diagnoses as insults. The worst case, of course, is when you genuinely mean to imply that the person has a mental health diagnosis. As a general rule, when someone has a diagnosable mental illness, it is a sign that we as a society have said “this person’s problems cannot be fixed by the ordinary process of social rewards and punishments”. Therefore, it is basically always insulting people when insulting people won’t do any good, which is wrong.

However, most attempts to use diagnoses as insults aren’t meaning to imply people have diagnoses at all; they’re just playing off inaccurate and harmful stereotypes.

Let’s consider the joke “The Republican Party is very diverse this year– there’s two Hispanics, a black man, a woman, and an intellectually disabled man.” Clearly the author does not intend to actually suggest Trump has an intellectual disability; if they did, it wouldn’t be funny. The joke is a humorous exaggeration; but what is it a humorous exaggeration of?

Is the author suggesting that Trump has subclinical versions of traits intellectually disabled people also have? Are they implying that Trump is sometimes nonverbal, or has difficulties with self-care activities, or performs poorly on Raven’s Progressive Matrices, or has difficulty understanding articles unless they’re written in plain language? No. None of these are stereotypes associated with Trump, and his IQ is no doubt (like all presidential candidates) above average.

No, what they mean to suggest is that Trump is ignorant, that he is irrational, that he ignores evidence that’s right in front of his nose, and that he is often wrong. None of these things are necessarily true of intellectually disabled people. There are plenty of intellectually disabled people who cultivate their intellectual capabilities as best they can and who are informed about some topics while readily admitting when they don’t know enough to have a real opinion. Personally, I think it’s a tremendous dick move to insult intellectually disabled people by comparing their rationality to that of Trump.

Moving from the realm of humor: consider the phrase “psychotic killer”. Obviously, if one means to suggest that the killer actually had symptoms of psychosis, that is one thing. But a lot of people describe, say, Ted Bundy as a psychotic killer, even though he isn’t actually psychotic.

When these people use the word “psychotic”, they don’t mean to say that the person experiences delusions and hallucinations; they mean to say that the person is a Monster. Equating psychosis and being a Monster is tremendously harmful to psychotic people. While schizophrenics are at somewhat elevated risk of committing violence, so are other groups, such as young poor men, and yet no one has banned young poor men from purchasing guns or advocated for their preemptive long-term imprisonment. A substantial amount of the stigma against psychosis is exactly the fear that psychotic people will hurt you– a fear that, for the vast majority of psychotic people, isn’t true. And this is a particularly awful stereotype to perpetuate when you are referring to the actions of people WHO DON’T EVEN HAVE ANY PSYCHOTIC SYMPTOMS AND ARE THEREFORE CLEARLY AN EXAMPLE OF NON-PSYCHOTIC PEOPLE BEING VIOLENT.

In conclusion: it is okay to insult people. Do not insult people about harmless traits or traits that aren’t responsive to social punishment or in ways that perpetuate inaccurate stereotypes. Thank you.

DBT Sequence: Assumptions

Tags

dbt, mental illness, ozy blog post, rationality

I’ve recently started going to How Not To Kill Yourself Class, otherwise known as DBT Skills Training. So I thought I’d write up some of what I’m taught in the class, partially for my own reference and partially because I hope it’ll help other people.

So first I’m going to talk about some basic assumptions about how people work.

One important caveat is that all of these assumptions are framing, much more than empirical differences. I tend to adopt the “people are basically good and doing the best they can” framing, while Topher tends to adopt the “people are selfish bastards” framing. But we’ve discovered that we don’t actually predict different things. It’s just that when I see (say) developed countries’ neglect of developing countries, I’m like “oh, stupid scope insensitivity, getting in the way of people’s basic compassion– too bad it’s so hard to get rid of”, whereas Topher is like “ugh, people don’t care about the developing world.” However, some framings are more useful than other framings, and I think these happen to be fairly useful ones.

DBT works from the assumption that people are doing the best they can. No one wakes up in the morning and is like “I know! I’m going to blow off all my responsibilities, piss off all my friends, and do a bunch of self-destructive behaviors for no reason! That sounds great! I love making it impossible for myself to reach my own goals!” No one is like “wow, you know what sounds awesome? Developing an eating disorder!” No one is like “I’m very satisfied by all aspects of my life and there are no problems I’m facing that I can’t cope with. Killing myself sounds like a really good idea!”

Furthermore, everything you do, everything you feel, everything you think, has a reason. You might not know what the reason is; in fact, most people aren’t always aware of the reasons for their thoughts. And even when they are aware, a lot of times they don’t want to admit it to themselves, because it seems petty, or stupid, or not in line with their own self-image. Nevertheless, you do not do things for literally no reason; your behaviors have a cause and it’s probably a sensible cause, all things considered.

So why do people behave in such counterproductive ways? A bunch of reasons. They might not know how to respond in a better way: if the only strategy you have for dealing with sadness is getting drunk, of course you’re going to abuse alcohol, because you– quite naturally– don’t want to be sad. They might have inaccurate beliefs: for instance, that everyone is out to get them. They might have constraints: if you’re tired all the time, you’re probably going to neglect some of the things you ought to do.

The problem is that your best isn’t good enough. I mean, if mine were, I wouldn’t have to be in How Not To Kill Yourself Class, and you wouldn’t be reading this essay. But I think this is pretty much the human condition, actually: pretty much everyone has some dumbass thing that they constantly keep doing even though their life would be 100% better if they stopped– whether it’s skipping workouts, self-sabotaging relationships, or spending too much money.

When we notice that we’re doing some dumbass thing, our natural response is to go “ugh! Why am I such a dumbass? I need to stop doing this stupid shit!” The problem is that this is not actually a good way of solving problems. In my two decades of yelling at myself about what a terrible person I am, I have never not once found that yelling at myself about what a terrible person I am fixed anything. In fact, it usually makes the problem worse.

Instead, you need to figure out why you’re behaving that way. When you pick pointless fights with your partner, is it because you feel like someone being angry at you means they really love you? Because your partner is being controlling and asserting yourself about stupid stuff gives you some sense of power you desperately need? Because you don’t know how else to manage your annoyance (mostly at people who aren’t your partner)? Because you never learned how to handle conflict without fighting? Because your partner gets annoyed at you being upset, and then you’re more upset because they’re annoyed, and they’re more annoyed because you’re upset, and it escalates from there?

The thing is that all of those are solvable problems. You can learn conflict resolution or emotion regulation skills, ask your partner to hide their annoyance better or give you more signs of affection, teach yourself to believe that passion can be expressed through things other than fights, or (particularly in the case of the controlling partner) break up. Conversely, “UGH, why can’t I just go ONE DAY without fighting with my partner? I am a TERRIBLE boyfriend and a TERRIBLE person” is unlikely to solve much of anything.

(The same thing applies to other people, in my experience. An ounce of problem-solving is worth a pound of blame.)

One important thing about changing your behavior is that you have to learn how to change your behavior across a variety of different contexts. A lot of times, people think that if they’re able to control their emotions on the job, they should be able to control their emotions at home. Now, as it happens, I have a variety of different mental health conditions that make it really difficult for me to generalize skills. (Fun fact: when I was in college, every two months I would have an epiphany about being able to buy [insert food here] whenever I want to, because “I can buy gummies whenever I want to” never generalized into “I can buy any food whenever I want to.”) But I think similar things apply to other people: we all know people who can set boundaries with their friends but not their parents, or take criticism at work but not from their romantic partners. This is totally normal and okay and not a sign that you’re broken or anything. It just means that you need to practice your “setting boundaries” or “taking criticism” skills in a variety of situations.

Finally, a lot of people are like “actually, it’s my partner’s fault that we fight all the time. They’re picky and argumentative and can never just let something go. So I shouldn’t have to change my behavior! It’s not my fault!” The problem with this line of reasoning is that you cannot actually control what your partner does. Certainly you can try to influence it– you can be sweet to them, or not bring up topics that set them off, or whatever– but what your partner decides to do is, ultimately, up to your partner. (Attempting to control what your partner does is called ‘emotional abuse’, and is generally not recommended.) What you can control is what you do.

Now, let me be clear about what I’m saying here. It is perfectly reasonable to be like “well, I know that my boss is a lot more likely to listen to my ideas when I bring in donuts, so I’m going to do that.” It is not reasonable to be like “the existence of sugary breakfast food should not affect my boss’s opinion of me, that’s stupid, so I’m not going to bring in any donuts.” It is perfectly reasonable to be like “my partner is a dick, I’m breaking up with them.” It is not reasonable to be like “I am going to stay in this relationship, but I’m also not going to take any steps to fix it, because they should fix it, because it’s their fault.” You can’t make other people do shit they should do. You can make you do shit you should do.

BDSM Questions, Answered

Tags

abuse tw, disability, mental illness, ozy blog post, rape tw, sex positivity

[Commenting Note: I am trying to be as charitable as possible to radical feminists in this blog post and I would greatly appreciate it if my audience would do the same]
[Content warning: extensive discussion of sex, BDSM, abuse dynamics, and sexual violence; brief, approving discussion of self-harm]

I recently read an article by a radical feminist asking five questions about BDSM she had never heard satisfactorily answered. And, you know, how else does one respond to a temptation like that?

1. How would you teach women that they are owed bodily integrity, freedom from violence, and mutually pleasurable activities if they are also taught that it’s normal for sex to be degrading, painful, and non-mutual?

I want to turn this around into another question: how would you teach women that they are owed bodily autonomy, freedom from domination, and activities they find pleasurable, if they are also taught that those rights only extend to activities no one finds sufficiently gross or incomprehensible?

My thoughts here are closely tied to neurodiversity activism. One concept arising from the intellectually and developmentally disabled people’s rights movement is dignity of risk. Even today, a lot of people decide that intellectually and developmentally disabled people should be protected– other people should make their decisions for them, because what if they make the wrong decisions? But if you’re not allowed to make bad choices, you’re not actually allowed to make choices. Actual autonomy involves the ability to take risks, to decide what costs you’ll accept for what benefits, to make decisions your guardians or peers disapprove of, to make mistakes, to fail, to fuck up. Otherwise it’s meaningless.

The policing of nondisabled women in our society is, of course, not nearly as bad as the policing of disabled women. But I still think a lot of sexism takes the form of “don’t worry your head about that, little lady. Just let someone else think about it for you. We’ve already decided what’s good for you.” So I think we should, at the very least, default to the position that, when a person’s choice is not directly hurting other people, you don’t have to like what they choose, you don’t have to understand it, you don’t have to want it for yourself, but they are making understandable choices given their own life circumstances, and you shouldn’t limit their choices without a damn good reason.

“Hey, wait!” you might say. “I have a damn good reason! Those women are hurting themselves!” The Icarus Project, in their excellent workbook on self-harm, gives examples of things that could reasonably be thought of as self-harm: running a marathon; not exercising; getting tattoos; working when you’re sick; skydiving; even undergoing psychoanalysis. The point, of course, is that it’s pretty hard to draw a hard line between the intentional infliction of damage on one’s body that we accept and even approve of, and the intentional infliction of damage on one’s body that we pathologize. Therefore, the line shouldn’t be drawn around acts, but around the relationship people have to particular acts. If someone wants to not work while they’re sick but has panic attacks whenever they try to stop, or it’s making them unhappy or making it harder for them to reach their goals or harming their relationships, then they have a problem. If someone cuts, and it calms them down and is a useful tool in their emotion-management toolkit and generally improves their life, and they’re taking appropriate safety precautions, then they’re fine. The best thing is to provide nonjudgmental, harm-reduction information that allows individuals to make the best decisions for themselves.

The same thing applies to BDSM. If someone wants to stop having kinky sex but feels compelled to do it anyway, or it makes them feel like shit, or it harms their ability to reach their other goals, then we have a problem. If someone is having kinky sex and it makes them feel happy and at peace, or more connected with their partners, or even just gives them some good orgasms and no other consequences– there isn’t a problem. It doesn’t matter what the act is. It matters what the individual’s relationship to the act is.

2. How do you expect to prosecute and prevent domestic violence when you promote controlling relationships, sexualized abuse, and psychological and physical abuse as part of “healthy” relationships?

The Conflict Tactics Scale is a commonly used method of measuring interpersonal violence. It typically finds that men and women are equally likely to abuse each other, and that a substantial number of relationships are “mutually abusive”.

Why? Because the Conflict Tactics Scale looks at individual acts of violence. If a man hits his partner because she burned the dinner, and she hits him back in an attempt to get him to stop, the Conflict Tactics Scale will record it as each partner having hit each other once, and therefore both the man and the woman are abusive and the relationship is mutually abusive.

The context of the relationship is not a minor detail. It is not something you can handwave past. It is not something you can leave out for simplicity. It is literally the entire difference between an abusive relationship and a nonabusive relationship. Abuse is not a particular set of behaviors. You don’t get two abuse points for name-calling and five for gaslighting and ten for shoving and if you get more than twenty-five the relationship is abusive. Abuse is, at its core, the act of maintaining power, control, and domination over your partner; hitting is just a popular strategy for doing so. If no one is trying to maintain power, control, and domination over anyone else, it ain’t abuse.

Now, this does get into the thorny issue of 24/7 relationships. As it happens, I tend to get decision-fatigued very easily. Therefore, I sometimes ask my partner to order for me at restaurants, or decide what task on my to-do list I’m going to do. I feel like this is fine. If I said “partner, I am going to be decision-fatigued for the next while, so just order for me at restaurants until I say for you to stop”, I think that would also be fine. It seems implausible to me that this setup would suddenly become unethical if I added collars or boners.

The important difference here is between my partner taking power and control and me giving power and control. In a healthy 24/7 relationship, the submissive is deciding, of their own free will, to do what their dominant wants; if they decide that they don’t want to do that anymore, then they can just stop. If you could stop abusive relationships by going “nah, I don’t want to be abused anymore”, there would be a lot less need for domestic violence shelters.

Look, I agree with you that consent is not enough. Consent is the bare minimum standard. “Enough” is that the sex contributes to the happiness and flourishing of everyone involved. But I don’t think you can strip a particular act from the entire context of the relationship and the people involved and be like “that! That is clearly harmful to the people involved!” People are more complicated than that.

3. How would you teach men to respect women and want to engage in mutually pleasurable activities if they are also taught that it is sexy to hurt, dominate, and coerce women?

Well, uh, to begin with, I don’t support teaching men that it’s sexy to hurt, dominate, and coerce women. I think one of the great things about the Internet is how polymorphously perverse it’s allowed human sexuality to be. I want there to be balloon fetishists and dragons fucking cars and knotting and Comstock Films and dendrophiles and transformation fetish and inflation and wetlook and feederism and giantesses and 200,000 word fanfics where they don’t fuck until word 180,000 and the Hydra Trash Party. The faster we get out of this vanilla/BDSM binary where the only alternative to cunnilingus and cuddles is bondage and flogging, the better, I say.

But even in that polymorphously perverse world some people are going to be enjoying the Hydra Trash Party, and therefore some men will get off on the idea of hurting, dominating, and coercing Sebastian Stan their sexual partners. However, in my experience, this is not related to actual abuse.

People in the BDSM community are probably at higher risk of experiencing sexual violence, although it’s confusing. However, the BDSM community also has a lot of casual sex. In a monogamous community, Jane Rapist will get married and rape her wife; in a casual-sex-heavy community, Jane Rapist will rape three, or four, or a dozen sexual partners– greatly pushing up the percent of people who have survived rape. In addition, the plausible deniability offered by such communities makes them extremely attractive to rapists. Does the BDSM community have a higher rate of rape than, say, the vanilla bar scene? I don’t know. But I suspect the answer is “no.”

To be honest, this is a hard question for me to answer, because of how absurdly distant it is from my own experience. The sex partner I’ve had who fantasized about the most objectively horrifying things is also someone I’ll be forever grateful to, because they were the first person to notice that I had a hard time setting sexual boundaries and deliberately teach me how to say “no” to things I didn’t want. My current primary is pretty fucking kinky, and also tremendously understanding about and patient with my disabilities in a way I’d never expected a neurotypical to be. Conversely, the partners I’ve had who most blatantly disrespected my preferences, limits, and boundaries all fantasized about sweet, loving sex with attractive women. I admit I am only one person, and this is only anecdote, but you understand why this question is much less satisfying than the others. I have no experience to draw on.

4. How do you expect to teach men about affirmative consent when BDSM practices themselves do not embody affirmative consent — including situations where consent is physically impossible?

I want to emphasize that we’re on the same side here. I agree that the BDSM community all too often fails to embody affirmative consent, and I agree that we should work on fixing that. In fact, the author’s very own FAQ quotes from an extended series of essays by a kinkster about preventing rape in the kink community.

If we applied the same standards to non-BDSM sex that this question applies to BDSM, we are all going to be celibate for the rest of time. The vast majority of rapes are not BDSM-related. The vast majority of rapes are oral sex, manual sex, anal sex, and PIV, because of the simple fact that most sex is oral sex, manual sex, anal sex, and PIV. Forced electricity play is essentially a rounding error.

Earlier in the FAQ, the author gives a more extensive idea of what she means by the BDSM community’s poor consent practices and situations where consent is physically impossible. She says, describing the former:

The author described the rapist’s grooming behavior (subjecting his victim to other forms of penetration and lying about what he was doing) thusly: “It’s not a bad way, this sort of mind game, to move towards opening up a limit.” [emphasis mine]. Respecting a boundary is to take the boundary as an absolute limitation on behavior; not something to be pushed, or worn down, or (euphemisms again!) “opened up.” The author condones the grooming because the victim “didn’t say no,” in spite of the fact that the victim was uncomfortable with the perpetrator’s behavior. Insofar as they condone grooming, manipulation, and coercion to violate boundaries (and this author apparently does), BDSM practitioners cannot claim that they respect consent.

On the same blog, this author dismisses unwanted torture and assault, as well as resulting permanent trauma, as “shit happens” (which sounds disturbingly like the oft-cited dismissal that various forms of sexual violence or abuse are simply “bad sex”). Some of this, he claims, is due to “miscommunication” and the fact that a “good top” is not going to do simply what has been explicitly discussed. A very flimsy excuse — if there is the slightest ambiguity about whether a partner is uncomfortable with a sexual activity, one can always ask.

I think these passages greatly misrepresent Millar’s points. First, it is a very unusual definition of “lie” which includes “I am going to put my fingers inside you and claim that it’s a knife. Is that okay?” Normally, “lie” implies that you are misleading people about facts. Do you also think that reading fiction to your partner is grooming behavior?

Second, I think this passage confuses you pushing my boundaries and me pushing my boundaries. If I say “no, I don’t want to do that” and you say “please please please please”, you are clearly being an asshole. However, if I say “I’m uncomfortable doing that, but I’m going to do it anyway. Can you help me work my way into becoming more comfortable?”, that is perfectly ethically fine. If it wasn’t, I would be morally obligated to never leave my house. (It’s true that Millar’s essay leaves it ambiguous which one is happening, and if it’s the former it’s obviously unconscionable.)

Third, the author fails to mention that what Millar calls “shit happens” are technical errors and emotional landmines. While those may have awful emotional and physical consequences, they are clearly not the same thing as actual rape. Millar does not dismiss the consequences of those acts; he compares the effect of an accidentally tripped emotional landmine to a tsunami. He simply points out that it’s no one’s fault, which is true.As someone with a hell of a lot of emotional landmines, the idea that my partner accidentally triggering me is the same as rape is absurd. And both of those are also issues in vanilla sex: the broken condom, the rape flashback.

I agree that people don’t check in enough during sex; a “can I pull your hair?” saves a lot of trouble and guesswork. However, people are still not perfect at reading each other’s signals. The problem comes exactly when from one person’s perspective there isn’t any ambiguity and no need to check in. Fortunately, most cases of miscommunication aren’t particularly disastrous, because in a healthy sexual relationship you can just say “actually, that’s not my thing”; legitimate sexual-violence-by-miscommunication is probably even less common than forced electricity play.

Next, she discusses cases when, to her mind, people cannot consent:

A submissive may be in such a state of fear, pain, or disassociation she is unable to give or withdraw consent: “Lots of bottoms, especially subs, are not really in a state of mind mid-scene to advocate for themselves… Some folks just can’t use safe words at all because they can’t access them in scene: they have to negotiate up front and then trust.” But if there is no consent if someone is in such a state of pain, fear, or disassociation — or for any reason feels unsafe expressing her feelings — that she cannot withdraw consent or communicate (certainly no one could claim that someone in such a state is actively giving consent).

First, this is clearly a misrepresentation of Millar’s point. Millar is not talking about “feeling unsafe expressing her feelings”– he would most certainly agree that making someone feel unsafe expressing their feelings so they can’t say “no” to sex with you is an act of sexual violence. What he’s talking about is that for many people BDSM induces an altered state of consciousness. For many people, altered states of consciousness make them vulnerable– think of it like having sex with someone who’s drunk.

(Tangent: nonverbal people are capable of communication. Everyone is capable of communication. When I go nonverbal and point to something, or make an upset noise, or bring someone a movie I want to watch, that’s communication. All you need to be able to communicate is the ability to move at least one (1) muscle. The idea that nonverbal people can’t communicate is regularly used to ignore the preferences and consent of disabled people, and you should not put it in your feminist blog post.)

Now, it is a defensible position that it is unethical to knowingly have sex with someone in an altered state of consciousness. Indeed, many people have a similar position with alcohol: if your partner is sufficiently drunk, you shouldn’t have sex with them. In that case, you don’t have to condemn all BDSM, you just have to condemn BDSM that puts people in an altered state of consciousness such that they are more likely to agree to sex acts that, in the cold light of morning, they wouldn’t approve of. However, I disagree. I believe that if I say to my partner “honey, when I’m really drunk, you can have sex with me if you want”, and my partner respects my limits and my drunken “no”, then this sex is ethically fine. And I believe that if I say to my partner “honey, I get very deep into subspace, but I’m okay with doing a scene with you”, and my partner respects my limits and my subspacey “no”, then that sex is also ethically fine. Riskier? Perhaps. But I don’t think it’s a risk that it’s wrong to knowingly take.

5. How would you prevent emotional and social coercion into these practices?

Now that’s one difficult as hell question!

I don’t think anyone has come up with a satisfying answer about how to prevent emotional and social coercion into sex. But that’s the thing– there’s nothing special about BDSM. The feeling of being socially coerced into a flogging you didn’t want is really not a whole lot different from the feeling of being socially coerced into cunnilingus you didn’t want. If you rule out BDSM but allow cunnilingus, you’re not going to solve the problem of social and emotional coercion into sex, any more than you’re going to solve it if you rule out cunnilingus and allow BDSM.

One important step, I think, is to get rid of the bullshit status games around sex. The quality of your sex life is measured in how much enjoyment you and your partners get from it– whether that means celibacy, missionary-position penis-in-vagina intercourse once a week, quadruple penetration while being suspended, or all of the above at different points in your life. Not being into kink doesn’t make you a prude. Not being interested in penis-in-vagina sex doesn’t mean you’re being unreasonable. Not wanting to orgasm doesn’t mean you aren’t liberated. And not wanting sex at all is perfectly fine– for whatever reason you don’t want it.

We should also get rid of the idea that certain sex acts are something we ‘owe’ our partners. Of course, we should strive to find partners we’re sexually compatible with: it’s tremendously convenient to have a partner who isn’t interested in the sex acts we aren’t interested in. And there’s nothing wrong with trying something out if you’re not sure if you’ll be into it, or doing a sex act because you like making your partner happy. But in the event that your sexualities change, or you discover new things about your sexuality, or perhaps you or your partner were not quite as open in communication as one would hope– you don’t have to engage in any sex acts you don’t want to. Period. End of story. If you decide to let your partner finger you, or fuck you bent over the desk, or diaper you, when that’s not your thing, it’s a favor you’re doing for them. There is nothing your partner is entitled to.

Finally, in a linked article, a person argues that widespread BDSM creates a form of social coercion. A woman who doesn’t like BDSM may have a choice between BDSM and celibacy. However, ending BDSM does not solve this problem. I myself have a hard limit around receiving oral sex. Let me tell you: there are a lot more people who will sulk when you say “please don’t touch my genitals” than people who will sulk when you say “please don’t tie me up.” I think there are about three solutions here. First, you can argue that being socially coerced into bondage is far, far worse than being socially coerced into a sex act that makes me dissociate from gender dysphoria, in which case, uh, good luck with that. Second, you can support mandatory celibacy for everyone. Third, you can support a diversity of sexual preferences, so both I and people who aren’t interested in BDSM can find sexually compatible partners.

You Don’t Have To Be Good At Relationships To Be Poly

Tags

mental illness, ozy blog post, polyamory

A lot of polyamory advice books are, frankly, terrifying. They make it sound like to be poly you have to be Emotional Competence Georg, who lives in a firm boundary adn negotiates with his partners about 10,000 emotional needs each day.

So I would like to say something reassuring to my crazy friends: you don’t have to be good at relationships to be poly.

It helps! It definitely helps! The advice in More Than Two or The Ethical Slut is good for people of all relationship styles, monogamous and polyamorous.

However, I am needy, whiny, insecure, and approximately as good at communication as a potted plant. I have a diagnosis that got a reputation as being absurdly manipulative, and then it turned out the reason we were all being manipulative is that none of us have any idea how to ask for things from our partners other than “cry a lot and cut yourself.” (I don’t recommend this as a communication strategy. For one thing, while it adequately conveys ‘I am upset’, it totally fails to convey any ways to solve the upsetness.) 

And I have been poly for several years and it has worked out fine.

That’s for a bunch of reasons. Polyamory is sometimes easier. I have hypersexuality symptoms which, for those of you not up on your borderline lingo, means that sometimes I am like “I am sad! Clearly the correct response is to go out and fuck someone I actually don’t like that much and then never call them!” If I were monogamous, this would cause tremendous strain on my relationships and hurt for my partners in a time when I couldn’t really use the strain. Since I’m poly, I’m pretty sure it qualifies as a healthy coping mechanism. (Social model, bitches.)

A lot of times your problems aren’t polyamory-specific problems, they’re problems you’re going to face in every single relationship, mono or poly. For me, the specific insecurity of my partner sleeping with someone prettier than me barely registers next to the all-encompassing background insecurity about why my partner is dating someone as terrible as me in the first place. I might feel abandoned when my partner goes on a date with someone else, but I also feel abandoned when they go hang out with a friend. I have to deal with this shit either way, so I might as well deal with it in the way where I get to kiss pretty girls.

A lot of the problems that are created by poor communication are solvable. So your partner gets jealous, so you get your feelings hurt, so your partner feels like you don’t love them, so you and your partner get into a fight and storm off into separate rooms, so you have utterly failed to tell your partner your kinks. It happens. Is it good to put effort into avoiding those things? Of course! I don’t think anyone wakes up in the morning and says “today I want my feelings to be hurt!” But they’re also survivable. Nothing will explode. In five years, it will be funny, or cringeworthy, or regrettable, or something you look back on that made your relationship stronger, or something you look back on with relief because you finally dumped that person– but it will be fine.

And a lot of times your partners are willing to work with you. If you’re bad at setting boundaries, your partners can check in when they’re doing something they think might make you uncomfortable. If you’re insecure, your partner can reassure you. If you can’t deal with your anger without yelling, get a partner who can yell back. For a lot of people, that sort of stuff is a hard limit: I personally could never date someone who yells. But there are lots of people for whom it is not a hard limit, and who are happy to pay the price of putting up with your shitty relationship skills in order to date you.

I am not saying it is okay to have shitty relationship skills. By all means, try to improve your communication! What I am saying is that it is okay if you’re doing the best you can, and if the best you can is seriously suboptimal. You can still be sex-positive and poly if you want to.

Depression Is Weird

Tags

mental illness, ozy blog post

Depression is the most common mental illness, which is unfortunate, because it’s also one of the strangest, and I think this fundamentally fucks up people’s intuitions about neurodivergence.

First: according to the research on DALYs, severe depression is worse than any mental disorder other than at this very moment being psychotic. Depression is worse than intellectual disability; it’s worse than autism; it’s worse than personality disorders; it’s worse than schizophrenia in the stages when you aren’t psychotic.

(This is confounded because many of the above conditions make you be depressed sometimes. However, in that case, the problem is still depression, and not the root condition.)

If you think about it, that totally makes sense. Other impairments are bad because they usually make you less happy. Depression is an impairment in your ability to feel happiness; it causes directly what other impairments cause indirectly. You can say “well, I can’t walk, but I’m happy anyway”, but you can’t say “well, I can’t experience pleasure, but I’m happy anyway.”

Take it from a borderline: if I had a choice between “your child will have borderline personality disorder but be magically protected from major depression” and “your child will be neurotypical except for recurring depressive episodes”, I would pick the former. No question.

Arguments that one position is less oppressed than another position are always fraught. I would like to emphasize that this is contextual; it is perfectly possible that one depressed person has experienced more oppression than another autistic person has. I want to be clear that I am not saying that depressed people do not experience ableism; of course they do. As an assigned female at birth trans person, I experience less transphobia than an assigned male at birth trans person, but my experiences of transphobia are still very real and hurtful. And I’d like to say that this is based only on my observations, which are necessarily limited.

But: I’ve noticed that it is relatively common for people who don’t have depression, or people who have depression and other comorbid conditions, to try to pass as depressed people when it comes up. Conversely, it’s relatively rare for a depressed person to try to pass as, say, a schizophrenic person who’s currently in remission.

I think, in general, depressed patients tend to be treated better by the psychiatric system. As a borderline, I am likely to get psychiatric care from someone who thinks of borderlines as manipulative, treatment-resistant, and attention-seeking. Autistic children are routinely subjected to therapies intended to normalize them, often using unethical treatment methods. In general, depressed/anxious people seem to be the most likely to assume that the only problem with therapy is that not enough people are getting it.

Looking at this post about kinds of stigma neurodivergent people face: depressed people are almost never considered Monsters, which both means that other people are less likely to consider them inherently evil and that locking them up for other people’s protection is safely out of the Overton window. Victim is also relatively uncommon in my experience: while depressed people’s lives are often presented as miserable, people don’t usually seem to use this to erase their personhood or other interests.

So I think in general depressed/anxious people will have more accurate intuitions about other neurodivergences if they assume that the experience of the neurodivergence itself is less awful than they would naively assume and that how people treat you is worse.

Against Tell Culture

Tags

mental illness, not like other ideologies, ozy blog post

A little more than a year ago, Brienne invented the idea of Tell Culture, a variation of Ask Culture and Guess Culture.

The two basic rules of Ask Culture: 1) Ask when you want something. 2) Interpret things as requests and feel free to say “no”.

The two basic rules of Guess Culture: 1) Ask for things if, and *only* if, you’re confident the person will say “yes”. 2) Interpret requests as expectations of “yes”, and, when possible, avoid saying “no”…

The two basic rules of Tell Culture: 1) Tell the other person what’s going on in your own mind whenever you suspect you’d both benefit from them knowing. (Do NOT assume others will accurately model your mind without your help, or that it will even occur to them to ask you questions to eliminate their ignorance.) 2) Interpret things people tell you as attempts to create common knowledge for shared benefit, rather than as requests or as presumptions of compliance.

Let me place my biases upfront: the concept of Tell Culture makes me go AAAAAAAAAAAAA and want to hide in a corner and never talk to anyone ever again. (This is not meant as criticism of anyone I know who practices Tell Culture in general or of Brienne in specific; Brienne and all other Tell Culture practitioners I’ve interacted with are lovely people.)

The difference between Ask, Guess, and Tell Culture is essentially how much is left in subtext. In Guess Culture, the request is left in subtext; in Ask Culture, the request is text, but the reasons for the request are often left in subtext; in Tell Culture, there is no subtext.

The problem is that you can’t eliminate subtext from human interactions.

I bite my boyfriend Mike Blume’s nose; his wife Alicorn says I should not eat her husband; I say I will get her a new one. The actual interaction is somewhat pointless. Instead, what matters is the subtext: “we like each other; we are comfortable enough together to countersignal our affection; we are all clever enough to find a witty new thing to say in response to the previous statement.”

It seems like about half of human interaction is this sort of signaling and social grooming; the idea of removing it would probably make everyone quite unhappy.

And a lot of requests also take this form. There’s a reason that flirting is full of subtext and ambiguity: it’s because a lot of people find subtext and ambiguity fun. I agree that “don’t ever ask someone for sex explicitly!” norms are bad for people who are bad at reading subtext, because it means that getting a basic human desire met is dependent on your ability to play a stupid social game that not everyone likes. But think of it like a literal game: surely it would be bad if someone said “you have to win at Arkham Horror or you don’t eat!”, but it would also be bad if someone said “no one can ever play Arkham Horror ever again.”

“Okay, Ozy,” you might say, “but Brienne clearly did not suggest using Tell Culture all the time and replacing our countersignal-y flirting with endless repetitions of ‘I like you.’ She suggested using Tell Culture when you have needs or requests; you can Tell Culture your important requests, and leave subtext for things you don’t mind someone misunderstanding.”

The problem is that you can’t actually stop people from putting subtext in their interactions.

To pick a personal example: I have suicidal fits. While I am very open about being suicidal, I am very private about when I am currently acutely suicidal. (People who read my tumblr: posts about wanting to kill myself are usually an expression of low-grade/chronic suicidality, rather than the acute kind. If I’m coherent enough to post a Tumblr post, I’m not acutely suicidal.)

This is for a couple of reasons. I am worried people will think “Ozy is suicidal! This overrides all my preferences and boundaries!”, even though that is not a healthy or sustainable way to react to someone as often suicidal as I am. Many people will freak out and start crying and then I have to comfort them about the fact that I want to die. Many people will behave according to their models of how to help a suicidal person (calling the cops, telling me people will be sad if I die, being extremely earnest about how I am Beautiful and Good), which cause me harm. And I have enough experiences with the first three that the idea of telling someone when I’m acutely suicidal when I don’t trust them a hell of a lot is liable to cause me dead panic. Being panicked is not very helpful when you already want to die.

On the other hand, I actually do have needs while I am acutely suicidal: I commonly ask for food, for tea, for distraction, or for a safe person to take me someplace private where I can freak out.

So I feel like with Tell Culture I have four options. First, obviously, I can say “I need to watch a movie right now because I’m suicidal” and just deal with the fact that this consistently hurts me and my conversational partners. Second, when I think there is a fairly high risk I’ll be suicidal, I can refuse to interact with anyone whom I don’t trust.  Third, I can violate the rules of Tell Culture and conspicuously not mention my reasons for needing to watch a movie right now. Fourth, I can say “I need to watch a movie, but I am not going to tell you the reasons because I don’t trust you.”

The first strategy involves me sacrificing my emotional needs for deontological Tell Culture points. The second strategy is somewhat impractical, because I’m borderline so my moods change very very fast, and the list of people I trust is like ten people and doesn’t include two of my roommates, so it would essentially mean confining myself to my room, which is also sacrificing my emotional needs for deontological Tell Culture points. And the second two involve me signaling that I don’t like someone.

Yes, of course under Brienne’s rules of Tell Culture people should interpret “I don’t trust you” as neutral information about my relationship with them and not as an insult or a sign that I don’t like them. It’s just that I think we would both not benefit from you having this particular information! Of course this shouldn’t impact our relationship in any way.

I am certain that is how everyone reading this blog post would respond to someone telling them that they don’t trust them.

In general, in our culture, people don’t say negative things about other people. That means that when you do say “your hair looks like a rat’s nest”, people don’t just get the information “I should go to a different barber”, they also get the information “this person doesn’t like me and wants me to be sad”. And I am not sure that this is shiftable by saying “in this subculture, everyone interprets ‘your hair looks like a rat’s nest’ like it is totally irrelevant to everything except choice of barber.” You can’t make people’s emotions go away by telling them that they shouldn’t have them.

It’s possible I could phrase my request in a tactful, respectful way, probably similar to how I’m writing this blog post. Suicidal people are, of course, known for their immense powers of forethought and self-control.

It gets worse. Tell Culture is the death of plausible deniability. Imagine someone on the stand who says “no” when asked if she’s ever murdered, assaulted, or stolen from someone, and “I take the Fifth” when asked if she sold drugs. It’s pretty obvious she sold drugs, because she only refuses to give information if she is trying to conceal something important. On the other hand, if she took the Fifth on all crimes, it wouldn’t be any evidence one way or the other.

In Ask Culture, people are constantly going about not giving information about their emotional needs. If everyone says “can we watch a movie?” without adding “because this would be an excuse for me to snuggle you”, “because I really want to see Winter Soldier”, or “because I need to relax”, it’s not conspicuous if I just say “can we watch a movie?” However, if everyone else gives information about their desire for snuggles, relaxation, and Steve’s gay love affair with Bucky, it is really obvious that I’m refusing to give the information because I want to keep it secret– which means that other people work out that I’m suicidal, which means all the disastrous effects I talked about before, plus they’re upset because I didn’t tell them.

I agree that probably a lot more interactions would go better if people talked about the needs they wanted to get met rather than just the requests they were making. However, I think making doing so a rule of etiquette risks hurting people.

Faker, Monster, Victim, Mad Genius

Tags

disability, mental illness, ozy blog post

If you’re neurodivergent, you get to be one of about four things, and all of them suck.

The Faker. Fakers aren’t really neurodivergent. They’re making it up! Probably for attention, or to get accommodations so that they don’t have to study so much. They are taking normal life problems that everyone has and pretending that they’re some kind of ‘disorder’, and they definitely shouldn’t seek accommodations or therapy or medications for it.

A more subtle form of the faker archetype is the idea that neurodivergence doesn’t exist and people who claim to be neurodivergent should have their experiences rounded off to the nearest neurotypical’s. For instance, think about “in my day, we didn’t call that ADHD, we called it lazy!” or “how can you be depressed? There are people out there with real problems!” A lot of advice along the lines of “why don’t you cure your depression by eating oranges and doing yoga?” falls into this category (the rest, unfortunately, comes from depressed people who haven’t quite grasped that not everyone’s brains work the same way).

Complaints about overmedication are usually playing into the Faker archetype (although not always; see Mad Genius). This archetype is one that’s very commonly internalized: many neurodivergent people (including those who are, say, having psychotic episodes) are convinced that they are actually secretly making it up and not neurodivergent at all.

The Monster. Monsters are Chaotic Evil. They are no longer able to tell apart right and wrong, and instead actively value other people’s suffering. This usually results in murder.

In fiction, the Monster is common in bad horror and thrillers whose authors don’t want to have to bother to motivate their villain. The explanation that terrorists and shooters are “disturbed” is an example of the monster archetype. On a more prosaic level, female abusers are often pathologized as having borderline personality disorder. If someone is talking about a disorder leading to lack of empathy, they’re probably using the Monster archetype.

The Victim. Victims are endlessly suffering, endlessly pitiable. Everything about them boils down to their pain. They don’t have preferences or thoughts or hobbies or facts about themselves other than their neurodivergence. They certainly aren’t happy.

I think this archetype drives a lot of “you’re not like my child.” My child is a victim! But you are blogging, you crack jokes, you have opinions, and you generally do things that are totally unrelated to how miserable you are. Therefore, you can’t be as bad as my child– even if you have meltdowns, even if you aren’t cognitively capable of working, even if you can’t speak sometimes or all the time, even if you were exactly like their child when you were five. You are not The Victim; therefore, of course, you must be The Faker.

When the victim sees fit to actually do something, they turn into their cousin, the inspiration. You think you get away from being an endlessly suffering, endlessly pitiable person whose entire existence boils down to their pain because you’ve “gotten a job” or “had a life worth living” or “climbed Mount Everest.” But don’t worry! We will frame all of your achievements as being about Your Noble Struggle To Overcome How Disabled You Are.

The Mad Genius. The mad genius is pretty much the best option you can choose and still come off as neurodivergent, which is maybe why so many people try to pass as it. The mad genius is neurodivergent, true. But they’re also talented, they provide value to other people, and their neurodivergence is intimately connected to their ability to provide value.

The archetypical example is, of course, the great artist who is Nobly Suffering For His Art. But think also of the stereotypical STEM person so consumed with great thoughts about important issues that he can’t be bothered with little things like social interaction and remembering where he put his lunch. Manic Pixie Dream Girls are a common female variation of this archetype: they might be weird, but they’re weird because they’re authentic, and their authenticity allows men to connect more deeply with their childlike selves.

Mad Geniuses are the archetype people are most worried about getting rid of through medication or eugenics– the common worries that antidepressants or ADHD meds turn people into zombies or prevent the existence of the next Sylvia Plath are a product of this archetype.

In Praise of Self-Diagnosis

Tags

mental illness, ozy blog post

The problem with comparing self-diagnosis and professional diagnosis is that both categories combine a wide variety of different things with hugely varying levels of accuracy.

Self-diagnosis can be thoughtful research, using both the experiences of other neurodivergent people and professional journals and books, taking advantage of your devotion to figuring out your own case and your privileged vantage point about how your own brain works. Or it can be someone taking a PsychCentral quiz and diagnosing themselves with twelve personality disorders.

Professional diagnosis can be someone with years of training and clinical experience across a wide variety of neurodivergences who listens thoughtfully to the patient’s experiences, uses medical tests to rule out possible physical and neurological causes, and understands how the patient’s culture and social experiences affect their neurodivergence. Or it can be a general practitioner saying “are you sad? Tired a lot? Here, have some antidepressants.”

Now, the best professional diagnosis is almost certainly better than the best self-diagnosis. And the worst professional diagnosis is probably better than the worst self-diagnosis, if only because there’s a higher base rate of depression than there is of twelve comorbid personality disorders. But these two categories overlap a lot, and I think a thoughtful, careful self-diagnosis should be considered far more credible than our friend the Indiscriminately Antidepressant-Prescribing GP.

Fun fact: according to one study, 38% of people currently using antidepressants have never met criteria for a disorder that antidepressants are prescribed for. This might be a reasonable state of affairs– after all, antidepressants are pretty safe drugs, depression is awful, and even under current standards about half of depressed Americans get no treatment— but it does suggest that professional diagnosis of depression is not great evidence that you were actually, at any point, depressed.

One thing that often gets conflated with self-diagnosis but should, in my opinion, be thought about separately is peer diagnosis: people who have a particular neurodivergence– particularly if they’re also a member of the community of people who have that neurodivergence– and who know you well suggesting that you have that neurodivergence. One of the biggest problems with self-diagnosis is that just reading the DSM symptoms doesn’t let you know what a neurodivergence looks like in the same way that interacting with a lot of people with that neurodivergence does. You might not know what “often has trouble organizing activities” looks like unless you know a lot of ADHD people. Clinical experience solves that problem, but so does knowing a hell of a lot of autistic people.

The other problem is that some neurodivergences are much, much easier to self-diagnose than others. Gender dysphoria is probably Self-Diagnosis Georg, insofar as the diagnostic criteria are basically:

1. Says they have gender dysphoria
2. Repeats that they have gender dysphoria in a very loud and emphatic voice
3. Gets agitated at the suggestion that they don’t have gender dysphoria
4. Demands hormones to treat their gender dysphoria, which they have

But even neurodivergences where the criteria aren’t purely self-referential can be pretty easy to diagnose. “Hm, I’m not eating very often because I’m afraid of getting fat. I wonder what I could possibly have.” “Huh, I experienced a traumatic event and now I’m on edge all the time and sometimes things remind me of my trauma and I have flashbacks. What could it be?” Similarly, people who suspect they have depression can find out pretty accurately if they’re depressed by taking the Beck Depression Inventory.

On the other hand, something like autism or borderline personality disorder has more complex symptoms, and someone who isn’t familiar with what they look like can be seriously misled. And some conditions like schizophrenia, while often pretty obvious to an outside observer, tend to leave people unable to figure out that they’re schizophrenic. In those cases self-diagnosis is going to be unreliable.

However, one thing that is usually easy to figure out (schizophrenia aside) is that something is wrong. Once you get beyond the PsychCentral quiz level of self-diagnosis, most people who consider the possibility that they’re neurodivergent are going to have some sort of problem. It might not be the problem they think they have! If someone self-diagnoses as having generalized anxiety disorder, they might actually have another mood or personality disorder, they might be in an abusive relationship or social group, they might be autistic and continually in a state of proto-meltdown, or they might just be under inhumane levels of stress.

I don’t mean to say that it isn’t important to figure out which you have. If you’re anxious, you might want to try exposure therapy, while if you are autistic and in a state of proto-meltdown, you probably want to remove stimuli that cause you to melt down from your environment. However, this does mean that a lot of self-misdiagnosis isn’t a problem of special snowflake fakers: it’s a problem of people who legitimately have something wrong with them but are mistaken about what.

Finally, I found in my own case that just having a professional diagnosis wasn’t very helpful in understanding myself. I had to go through something a lot like a self-diagnosis process– researching my symptoms, understanding coping mechanisms, talking to other people with similar brain issues to mine. So even if you have a professional diagnosis, you might be advised to research your diagnosis yourself or talk to someone who has. It pays off.

Towards a Transhumanist Model of Neurodivergence

Tags

disability, fuck the natural order, mental illness, ozy blog post

[Previous: Models of Neurodivergence.]

Materialism. The first principle of the transhumanist model of neurodivergence is that there is no soul. There is no distinction between my brain and my me. There is no homunculus floating somewhere around in my head making decisions that aren’t a product of my brain chemistry. Everything we feel, think, say, or do is a product of the interactions of neurons and, ultimately, of atoms banging into each other.

This means that, contra the medical model, there is no difference between mental illness and character flaw. You can’t be like “well, it’s a mental illness if it’s because of your brain chemistry”. Every emotion– from the most functional or typical to the least– is a product of brain chemistry.

It’s no secret that a lot of mental health diagnosis is sort of arbitrary. Look at the Beck Depression Inventory. There’s no particular reason why, if Alice and Bob are identical except that Alice circled “I cry more than I used to” and Bob circled “I cry all the time now”, Alice should be classified as “borderline depression” and Bob “moderate depression.” But you have to draw the line somewhere, and that’s where they chose to draw the line.

Even more so, it seems probable to me that some disorders, such as generalized anxiety disorder, actually are the extreme end of normal human variation– a quantitative difference rather than a qualitative difference. Some people are very easy going and don’t worry at all; some people worry sometimes and not other times; and some people worry constantly. But the thing is that worrying constantly usually makes people unhappy and makes it harder for them to do things, so we have decided that worrying way more than average is a mental disorder and gives you access to therapy and medication. This is not exactly what one would call a well-grounded distinction.

The materialism point is not to say that we shouldn’t criticize people for character flaws. Sometimes criticism is an effective way of changing behavior. However, criticism is also an effective way of changing some behavior caused by neurodivergence: I myself am a lot less likely to get depressed when I’m going to be criticized for not doing the self-care things that prevent depression. And it is an ineffective way of changing a lot of behavior not considered mentally ill: yelling at someone for being normally forgetful often doesn’t help them be less forgetful.

Fuck ‘normal function’. Transhumanism is based on the recognition that just because an impairment is common doesn’t mean it’s good. Perhaps the worst impairment of all– death– is one every human will face. (So far. Growth mindset!) Normal humans can’t spin off subagents to work on particular tasks, add twelve-digit numbers in their heads, avoid confabulating memories, or change their minds as much as they should in response to new evidence. These impairments are just as important as more uncommon impairments such as ADD.

All too often, the impairments that are medicalized are not the ones that are the worst: they’re the ones that are the least common. If everyone could avoid memory confabulation, the people who confabulated would be considered psychotic. Since everyone does it, it is a normal part of life. But I see no reason that the morally relevant criterion for whether an impairment should exist should be popularity.

Morphological freedom. Eliezer writes in Prolegomena to a Theory of Fun:

In the era of my foolish youth, when I went into an affective death spiral around intelligence, I thought that the mysterious “right” thing that any superintelligence would inevitably do, would be to upgrade every nearby mind to superintelligence as fast as possible.  Intelligence was good; therefore, more intelligence was better…

But the real break came when I naturalized my understanding of morality, and value stopped being a mysterious attribute of unknown origins.

Then if there was no outside light in the sky to order me to do things—

The thought occurred to me that I didn’t actually want to bloat up immediately into a superintelligence, or have my world transformed instantaneously and completely into something incomprehensible.  I’d prefer to have it happen gradually, with time to stop and smell the flowers along the way.

I mention this not to make any point about intelligence increase after the Singularity, but to point out that people can, in fact, value being weaker than they could otherwise be. Eliezer Yudkowsky (at least) doesn’t want to immediately bloat up into a superintelligence. And by the principle that all impairments are equal, this means that some people can value having the suboptimal brains they currently have. I value my strong emotions; this is no different than Eliezer valuing his sub-superintelligence IQ.

So, therefore, the transhumanist model of neurodivergence embraces “morphological freedom.” Morphological freedom means that I decide how I want to change or not change my own body and brain; my informed consent is all that is required to cause a particular change.

This means that if you have a normal-human brain and want to have a better one, it is okay for you to use medications and other interventions to get there. If you want to take modafinil so you sleep less or work better, you have a perfect right to do so. Similarly, if you think therapy will help you understand yourself or deal with some subclinical issue like procrastination, there is nothing wrong with seeking therapy.

On the other hand, it means that I have a right to refuse intervention. You can refuse intervention because the side effects are too bad: for instance, not taking antidepressants because you dislike sexual side effects. You can also refuse it because you value your brain being a particular way: for instance, many autistic people genuinely don’t want to be nonautistic, and it is morally wrong to make them such.

Morphological freedom does permit stabilization. If someone is disconnected from reality and hasn’t left a mental illness advance directive, then it may be justified to give them medications until they’re connected to reality enough that you can ask what their preferences are. (However, if someone in sound mind prefers to be psychotic, they should be allowed to do so.) In addition, morphological freedom may permit discouraging people from using addictive substances (including by making them illegal): if a substance is addictive, then people may be using it for reasons other than their own best interests.

Finally, morphological freedom does not mean that doctors can’t help: I might know that I want to have a particular brain state, but I don’t know how to get there, and psychiatrists, psychologists, and so on may play an important role as expert consultants.

Accommodation. The transhumanist model of neurodivergence accepts the social model’s distinction between impairment and disability. If no one can spin off subagents to work on problems, then (for obvious reasons) you aren’t going to have a society that requires people to be able to do that. But if people could, then the hypothetical person who couldn’t would suddenly have a lot of difficulty finding a job.

Our society should strive to accommodate everyone’s impairments as best it can given current technology. There are two reasons for this. First, we cannot fix every impairment, and since there is no moral difference between uncommon impairments and common impairments, there is no reason that common impairments should be more accommodated (beyond the ordinary considerations of tradeoffs).

Second, the right to change your brain in any way you like is not a particularly useful right if, when you change your brain the way you like, you proceed to starve to death.

As I previously wrote in a tumblr post justifying anti-ableist activism:

when the posthumans come— when there are beings that think faster than us, know more, can alter their preferences and share their source code and branch into a thousand selves and merge again—

would you want them to change you, against your will, no matter how painful the changing is or what you value about yourself you would lose?

and if they couldn’t change you, would you want them to abandon you, lost, in a world full of signs you can’t see (everyone sees in ultraviolet) and conversations you can’t comprehend (everyone knows as much as Wikipedia) and sensations that overwhelm you (everyone likes noises as loud as a jet airline taking off), a world you can’t function in and can barely comprehend?

or would you want them to be kind?

and if you hope the posthumans— creatures unimaginably alien, unimaginably superior— would be kind, then how can you not justify being kind to those a little less optimal than you, right now?

And that is where I stand, as a transhumanist and a disability rights advocate.

Further Reading

Nick Bostrom, Transhumanist Values
Scott Alexander, Diseased Thinking: Dissolving Questions About Disease
Sarah Constantin, Errors vs. Bugs and the End of Stupidity
Liz Tarleton, Transhumanism and Disability
Ron Amundson, Against Normal Function

Feel free to share more resources you believe belong on this list!