Trigger Warnings

This blog post was written to fulfill an assignment for the course Creativity & Community.

Last night my girlfriend had a runny nose, so I went and got a mostly-empty roll of toilet paper and tossed it to them.  I'm one of those funny people who likes bouncing lightweight objects off of others, so it bounced off their chest.  Immediately they started gasping for air like I'd hit them with a fastball.  They dove to the ground and gasped for air, wailing loudly and unnaturally.  Their brother came running and asked what's wrong.  "I'm fine," still wheezing.  "Well, you don't sound fine."  "I'm sorry."  They say that a lot, "I'm sorry," when the PTSD is acting up.

Most people seem not to understand how PTSD really works.  In this case, the glimpse of the toilet paper being casually tossed in the air triggered a physical response, due to its visual similarity to the casual toss of a tear gas bomb that they've previously been exposed to.  As soon as they were hit with a very lightweight TP roll and not a heavy smoldering cannister, they consciously were aware that nothing was wrong, but by then their body had already involuntarily gone into defense mode: restricting airways to keep the gas out.

They apologize a lot, and it makes me sad, because I'm not the one who deserves an apology.  It was a complete accident that I triggered them, and now the best future action is to hand items to them instead of tossing them, to avoid a similar situation.  Even saying "hey, here's your toilet paper" and waiting for comprehension before tossing it would have made a difference (oh hindsight).  This is what's known as a trigger warning, because it is a warning to precede something that would otherwise be triggering without the warning.  That makes all the difference: warning, no trigger; no warning, trigger.

I've seen people get offended by that concept.  It really is a weird thing, as though basic medical facts are something non-medical persons should deny on a whim.  I've seen it framed as "censorship".  I find that odd, because censorship would involve not engaging in the triggering behavior at all, rather than warning about it and then doing it anyway as is typically done.

I've also seen some disagreement between "real PTSD" and "sensitive feelings".  Again I find that odd, because it is a medical fact that abusive behaviors sustained over time are as traumatic as brief life-threatening situations.  This is known as Complex PTSD.  For example, my girlfriend already had sustained trauma from abuse before they ever stepped into a combat zone, and they would never say that the former is somehow more preferable to the latter.

Somewhat more complicated is the issue of exposure therapy, and whether people with PTSD need exposure to recover.  First off, this is not always the case.  Some patients get worse from exposure therapy, not better.  Second, exposure therapy must be supervised by a medical professional!  Trigger warnings are used in non-medical settings because we recognize that we're not medical professionals with the ability to regulate a patent's response to the material, and as a result we could be making their medical condition worse.

So who should be using trigger warnings and for what?  Clearly if I care about my girlfriend, I should take into account their particular needs.  What about my blog?  I try not to get too graphic - I could be wrong, but humans often are, and I'm willing to edit anything to add a warning if the need for a particular one is pointed out.  What about the classroom?  Well, schools are required to comply with ADA accessibility accommodations, and PTSD is disabling, so it's up to the school to work toward making sure everyone has equal access to the same education.  Can we adequately warn everyone about everything?  Probably not, but aim for the moon, and even if you miss, you'll land among the stars.

Does ADHD cause gender dysphoria?

doingthegreatfuckingnorthernrun asked:

Hi! So I posted on addforums, and kind of made a mess of genderqueer/adhd. Basically someone else said that adhd made her gender issues go away, and she said my gender issues sounded similar as did my adhd. however this made me really dsyphoric and I have been out of control. they also were like you cant start T and adhd meds at the same time. they kept pushing adhd meds, saying I won't know my perception of self until I do. you are like the only person I can find that might have some input.

Oh hi!  Ironically I have too much ADHD to regularly participate in ADD Forums, but thanks for looking me up.
I think they're full of shit trying to push any medication regime on you. Sounds like they're trying to "save" you from being genderqueer or something.
I can see how someone having ADHD might misattribute their social/mental dysphoria to gender dysphoria. I've considered it myself, since when I eat right and get enough sleep, my ADHD symptoms are greatly improved, and incidentally I have less gender-related anxiety as well. What if ADHD is causing the dysphoria?
For her, it seems that was the case, and she's managed to identify the correct cause of her problems. For me, it's that I'm managing my gender dysphoria better when I'm taking care of my mental health reserves. I can deal with being GQ better when I don't have to also deal with ADHD quite so much. Balancing all that is exhausting!
As far as you "can't" start T and ADHD meds at the same time... that sounds like something only your medical professionals can advise you. Outside of general concerns monitoring for unpleasant side effects (two new drugs at once may make it difficult to figure out what's caused by which), I haven't heard of any horrible drug reactions between the two that would prevent concurrent use.

The Problem with Armchair Diagnosing Mental Illness

http://www.healthyplace.com/blogs/verbalabuseinrelationships/2013/03/narcissistic-sociopathic-or-plain-abusive/

I have occasionally run into people who are preoccupied with narcissism/sociopathy. They insist that they can spot the tell-tale signs a mile away, and that the only acceptable response is to turn the diagnosed into a pariah.

I have several problems with this. For one, it reinforces the concept of sane privilege, which sets people who struggle with mental health as inferior to those with a mental health status accepted by society as "normal". It also introduces the idea that laypersons should be armchair diagnosing other members of society with mental illness, under the guise of self-preservation. Perhaps there could be a point on the side of such people if mental illness actually were associated with increased rates of abusive behavior, but the facts simply don't support such an assertion.

The end result of this sort of false correlation is a mental illness stigma on those who would seek help. This not only discourages people from getting help who need it, lest they be labeled as a dangerous person; it also diverts mental health resources away from those who don't fit our stereotypes of someone who needs help, when "needs help" is actually code for "is dangerous".

Creating a More Inclusive Humanism in an Ableist World

Warning: ableist slurs.

Humanists generally claim to support creating an inclusive space where people of every background can feel welcome. For example, a web search for “diversity in atheism” returns posts from Daylight Atheism, American Atheists, and Friendly Atheist, among others, all about how to open up atheism to a more diverse crowd. Women, blacks, parents, the poor – these people are traditionally left out of atheist conversations, and there’s a much-needed movement to include them. But one crucial area is still overlooked to an alarming degree: disability.

Unfortunately, the message many of us are sending out (even if unintentionally) is: if your mind or body is configured differently than mine, you’re not welcome here. Which is a shame, because I know many people with autism, hearing impairments, PTSD, reduced mobility, schizophrenia, etc, some of them as good friends and terrific contributors to the community.  Here are a few comments I’ve read recently in atheist spaces.  I’m not interested in mud-slinging, so I’m not linking to the sources, though Google probably renders my caution irrelevant:

• “You are so literal as to be autistic. Are you really that stupid?”
• “PETA is creating the next wave of young adults with scary personality disorders.”
• “Cannibalism is the same as eating a hot dog?  I’ve heard better analogies from people with Down Syndrome.”
• “Instead of writing a new generation of software to circumvent our filters, maybe they should recruit social misfits with obsessive-compulsive disorder, and write software that amplifies their efforts.”
• “I realize that this man-child is a ward of the state. Too “young in the mind” to hold a job or live on his own without assistance. This simple minded man is alone. He is most definitely frustrated. And I feel like in a way, we are one.”
• “[Insert countless remarks equating religion with mental disability/insanity.]“

We as humanists have the opportunity to show everyone that we can have superior ethics and morals without god or religion.  One way we can do this is to stick up for the dignity and rights of all people, regardless of race, gender, class, sexuality, ability, etc.  This includes people with disabilities, both physical and mental (which are really one and the same *glares at dualists*).  It is a basic humanist value that all people, including people with disabilities, deserve dignity and respect.  Not all people have the “standard model” brain, and a lot of those people are proud atheists and need the support of a freethinking community, so here are a few ways we can begin:

1. Recognize and discourage use of ableist slurs.  These include “retarded”, “lame”, “idiot”, “crip”, “insane”, etc.  Why?  Because these words still are being used as slurs against the disabled, and have not been “reclaimed” by the disabled, so they are not our words to use.  To use “idiot” [or any slur] as an insult is to say that this word can be used to degrade you, because being that identity is degrading. In the same way, a slew of all-too-familiar terms have been used to degrade people according to sexual orientation, gender and race.  And in case you’re wondering which words to use instead for biting criticisms, I like to go with “wrong”.  Or when I’m getting creative, “dangerously wrong” or “bogus” or “transparent” or any number of words which don’t equate an identity with an insult.

2. Understand that taking steps to include people with disabilities is good for everyone.  For example, if your local atheist group meets up in a room where the only entrance is up/down a flight of stairs, that is not accessible to everyone.  Anyone who has mobility impairments will have a very difficult time feeling included.  Meeting in a loud or crowded space can be difficult for those with hearing impairments or autism spectrum conditions.  Meeting at an expensive or out-of-the way location can also exclude people with disabilities on a limited income (as they are more likely to be unable to find and keep a high-paying job).  If we keep these things in mind, it improves meeting conditions for people without disabilities as well.  Realistically, we’re all going to experience a disability at some point in our lives, excepting the small chance of flat-out spontaneously dropping dead.

3. Be willing to stick your neck out for people with disabilities.  Trying to create change isn’t always easy or comfortable to everyone – if it were, people would already be doing it!  For example, I myself am not disabled and I don’t appear to be disabled.  This means I have the privilege to chose to ignore ableist actions in the world around me without being negatively affected by them.  But to me, humanism is about creating a better world for all of us, even if it involves more of a struggle to those of us with more resources.

Is this list complete?  By no means, but hopefully it is the beginning of a more open and honest look at the inner workings of our communities, both online and in meatspace.

Further reading:

http://disabledfeminists.com/2010/11/19/what-is-ableism-five-things-about-ableism-you-should-know/

http://www.stopableism.org/what.asp

http://www.disabilityisnatural.com/explore/pfl

Communication and ADHD

http://www.psychologytoday.com/blog/may-i-have-your-attention/201102/i-cant-believe-i-just-said

As a person with ADHD, having conversations with single-thought people (my name for all you who only contemplate one thing at a time) can result in frustration and miscommunication, often without an obvious reason why.  My whole life has been trying to figure out why others act like I'm a bad person simply for being myself.  "You're so weird!"  "Don't you know how rude you're being?"  "Sometimes I think you do that on purpose."  Despite all that hostility, I'm still trying to figure out the secrets of so-called normal communication, and I'm getting better every year.

"But Andy!" I'm sure you're saying, "what about the secrets of ADHD communication?  I appreciate that you're trying to learn about us, but I want to learn about you too.  Don't be stingy, now."  I wouldn't dream of withholding such useful information, which is why I'm sharing this link I recently found.  It's the best summary I've ever read, and pretty much describes my experiences spot-on, but I'll go ahead and add my own notes below.

Blurting Things Out - This has nothing to do with how little I respect the person I'm talking with.  Instead, it has to do with the way my hardware runs.  I can't count how many times I was about ready to say something, tried to my tongue for a few seconds, and then completely forgot what it was I was about ready to say (and this has happened for very important issues too). As many people with ADHD are well aware, thoughts are transient things.  Any moment I'm thinking of something may well be the last, before it's lost forever to forgetfulness.  Sometimes I manage to make it to a pen and paper in time.  But often, I just say it, that way it gets out of my brain where I don't have to worry about it any longer.  You may wonder what was so important about squirrels that it couldn't wait a minute?  Well, let's just say that the fear of forgetting often overrides taking the risk to waste precious have decided that understand that yes, this cannot wait, it might be forgotten.  Also, if I'm spending time contemplating what I'm about to say, I'm diverting my attention away from what someone else is saying in a conversation, and I've just completely missed it all.  This is why I often just say what I have to say, then ask my conversational partner to continue where they left off.

Conversations that Go Everywhere - Apparently some people only think about one thing at a time.  I never saw the point.  After all, everything in life is interconnected (6 degrees of Kevin Bacon, anyone?), and drawing those diverse connections out into the open is an exciting way to learn new perspectives on familiar topics.  I you really want to focus on one particular point, let me know.  This doesn't mean I'll sit up straight and refuse to deviate (as if that were possible, ha!), but it does mean that I'll make sure to regularly touch base with that topic as we converse, especially if you bring it up again.

Monologues - If you don't like what I'm talking about, switch the topic.  I probably won't notice if you don't find my thoughts engaging.  I can't notice.  I'm about as useful for reading conversational cues as my tone-deaf father is for reading music.  The good news is, I rarely take a subject-change as a bad sign, and in fact could get excited because something new and different is now happening.

Extreme Defensiveness - I've been told I have this.  Possibly.  The author said it's because of years of being constantly criticized.  I do know I'm tired of being told I'm a bad person simply because I am neurologically different.  The best way to approach me is with the phrase "I know you may not be aware you're doing this..."

Poor Memory of Agreements or Incidents - I do my best, but I already have a long list of things I'm supposed to change about myself in order to fit in.  Your item probably got lost down at the bottom.  Just issue a gentle reminder, and I'll try to bump it up a bit.

Getting Lost in Conversations or Wildly Misunderstanding - I often get blamed as though I do this on purpose.  It helps if you use really specific examples during conversations for me to help define the topic.  In fact, tell stories, so I can form a vivid visualization of people acting out what you're trying to tell me.  Also, ask questions.  I do a lot of question-asking myself, and if they seem to be leading in the wrong direction, it's not because I'm trying to trip you up, it's because I'm trying to rule out what you're not saying to get a better grip on what you actually are saying.

There you go!  Hopefully the article and my comments help you out.  And if anyone has created a similar cheat-sheet for how single-thought people converse that is as good as this one, let me know.  I've been looking for one for over 2 decades.