All posts by abby jean

Stigma Hurts Everyone

blaming, disability activism, medical practice, mental health, social attitudes

I read an interesting post recently, from a self-described “functioning alcoholic” discussing the possibility of treating alcoholism with pharmaceutical drugs. While there’s no successful pharmaceutical treatment at this time, there are a few things in development and it’s seeming increasingly probable that the drug companies will focus research and development efforts on coming up with something.

More interesting to me than the potential treatment itself were the issues raised in the post about concerns raised by this treatment possibility – because all of the concerns seem to be based on observations of how psychiatric medications have been implemented and viewed since their development. (These issues also obviously apply to pharmaceutical treatments for other conditions, including fibromyalgia, migraines, etc.)  The issues raised by the author of the original post include:

  • “Is it appropriate to battle a chemical addiction with another chemical?” This is parallel to the often-voiced concern about whether chemical/medication-based treatment is an appropriate response, or if it will just replace the symptoms of mental illness with dependency on psychiatric drugs.
  • “Won’t the pharmaceutical companies “define alcoholism down” in an attempt to get the broadest possible consumer base for their products?” – This is parallel to the concerns about encouragement to overdiagnose mental health conditions such as ADHD and depression in order to broaden the market for pharmaceutical interventions. It also draws from concerns about advertising Abilify and other psych drugs directly to consumers through TV and print marketing.
  • “Is life really worth living if you’re sober all the time?” – while the original author clearly intends this as a joke, I find it similar to arguments I’ve heard that “messing with someone’s emotions” through pharmaceutical intervention will inherently result in significant changes to that person’s personality and identity. This seems similar, in that it questions whether life will be the same if such a fundamental component of their self is being affected by pharmaceutical treatments.
  • “One of the arguments against a medicine-based treatment of alcoholism is that while it may certainly curtail the physical addiction it does nothing to address the underlying reasons why someone might choose to drink—anxiety, depression, an unwillingness to be in the world without some kind of sedating agent to take the edge off of existence.” This idea is often used to argue that medication-based psych treatment alone is insufficient, and must be combined with some kind of psychotherapy to effectively address the underlying emotional issues driving the mental illness. It is also sometimes used to suggest that taking medication alone is “cheating,” by mitigating the symptoms of underlying trauma or disorder without addressing the root causes, allowing the patient to ignore the root causes and eventually causing greater harm.
  • “I’m not unsympathetic to the argument that a certain amount of drinking is just fine. I know plenty of folks who drink almost as much as I do and manage to keep it all together. Why castigate their actions or make them think they need “treatment” for what could be considered just another lifestyle choice?” This parallels many of the discussions regarding what constitutes a mental illness and ties into the ideas of “neuroatypicality,” where a person’s mental functioning is described as different than typical mental functioning, without a value judgment as to whether typicality is better or worse than atypicality. It also references the underlying conception that being labeled as someone who could benefit from pharmaceutical treatment is shameful or stigmatizing, a judgment which would surely spread to those on the borders of atypicality.

I found all this fascinating because, while I’m used to hearing these arguments and issues raised in the mental health treatment context,  it’s clear that they are permeating our society and discourse beyond their direct application to mental illness.  Here, the spectre of passing out ADHD drugs in every elementary school classroom is being raised as a potential concern in the as-yet hypothetical development of a treatment for alcoholism – a serious condition which can lead to significant health consequences up to and including death.

To me, this says that addressing these issues – the misinformation, the stigma, and the bad acts of pharmaceutical companies – is important not only to people with mental illness, but also to the groups who could benefit from pharmaceutical developments and interventions yet to be developed. It is clear that these issues are so significant that they could discourage people from supporting or even considering the possibility of future treatments that could potentially help millions.

SSRIs, Violence, Walking, and Dogs

blaming, medical practice, mental health, policy, shaming, violence

Recently a link was making the rounds on Tumblr about how SSRI anti-depressants caused violent and homicidal reactions in people (h/t to the lovely Cara for making sure we saw it). I was largely ignoring it because, frankly, there’s a lot of unproductive discussions about whether SSRIs, or anti-depressants in general, or even psychotropic drugs as a whole, are teh most awesome things ever! or an evil tool of big pharma or poisoning our children or should be put in the water supply to help the population at large. And my attitude towards psych treatment, whether it be therapy or medication or anything else, is pretty similar to my attitude about religion: everyone has the right to make their own determinations about their treatment and whether they would or would not like to take psych meds, and just as my atheism doesn’t make someone else’s faith any less valid, I can support someone’s decision to reject psych meds without lessening my own right to believe they help me personally. (To extend that, I support anyone’s right and decision to pursue or not pursue any kind of treatment, to identify as they feel appropriate, and to reject the whole framework and basis of psychiatry.)

That said, I thought it might be useful to take a look at this article to discuss some of the issues I see in a lot of these arguments and discussions. The basic gist of the article is to publicize an archive of “3,500 crime related news reports linked to the use of SSRI antidepressants … Pharma and the FDA may still be agnostic about SSRIs causing violence but 700 murders, 200 murder-suicides and 47 postpartum depression cases, including the 2006 case of Andrea Yates who drowned her five children on Effexor, don’t lie.” The article describes the site as “more of a public service than the FDA which has yet to withdraw the drugs named in the 3,500 stories–or even call them dangerous,” so the clear goal of the article is to encourage prohibition of SSRIs as a class.

That’s a pretty broad goal to be supported by such thin and unconvincing evidence – and that’s my problem with these kinds of arguments. Whenever I talk about these kinds of science articles, I often use the same phrase: “correlation does not equal causation.” This means that although two variables may be very closely associated, there’s not enough information to figure out which of them causes the other, or even if the two are related by anything more than chance and coincidence. A simple example is that everyone who orders food at McDonald’s is a human. Can we assume that if a dog walked into McDonald’s and ordered food, it would magically transform into a human because of the correlation between ordering at McDonald’s and being human? No.

To unpack this further, let’s look at the fact that a lot of people who walk in my neighborhood have dogs. I know some people who got dogs specifically in order to encourage themselves to do more walking – so the dog is influencing how often they walk. However, I also know people who do a lot of running or hiking and got a dog to keep them company on their outings – so their walking/running influenced their having a dog. So does being a person who walks outdoors make you more likely to get a dog, or does having a dog make you more likely to walk outdoors? We just do not have enough information to figure that out. This means my observations of walkers and dogs should not justify a public policy to issue dogs to every household to ensure people walk outdoors.

To extend this to the SSRI stories, there’s not enough evidence for us to determine if people who are not violent or homicidal become so when they are given SSRIs, or whether people who are already violent or homicidal are likely to be given SSRIs for treatment. And that’s a very important thing to be absolutely clear on when we’re talking about having the FDA eliminate an entire class of anti-depressants that some (including me) rely on for treatment.

There’s a couple other factors in the dog analogy that I also see at play in this SSRI story:

  • Observer bias: I think dogs are pretty cute, so when I’m out and about, I tend to notice pedestrians with dogs more than I do pedestrians without dogs. So if I see 10 pedestrians and 4 of them have dogs, I’m much more likely to notice and remember the dog people and think that the majority of pedestrians have dogs. Similarly, self described “anti-SSRI advocates” are more likely to notice and prioritize instances where SSRIs occur with violent behavior.
  • Who is observed: I happen to live two blocks from the most popular dog park in town, so people from miles away drive here in order to hike with their dogs. There are a lot of trails that don’t allow dogs and if I lived right next to one of them, I’d likely see a lot more walkers who are dogless. So I’m not looking at the entire population of walkers and dog owners when I’m observing a connection between those two characteristics – I’m looking at a population more likely to suggest to me that the two are connected. Similarly, the SSRI stories are drawn entirely from crime reporting. Stories about people who take SSRIs and do not engage in violent, homicidal, or otherwise criminal behavior are not going to be in a crime story – so the archive is looking at a subset of SSRI-takers that is more likely to confirm their perception that SSRIs cause criminal behavior.
  • Interpreting evidence to fit desired results: when growing up, I tried out the “dogs will make me walk and exercise more” argument on my parents. This is because I wanted to get a dog, and I was trying to put together any argument I could to support that conclusion – I had started with the conclusion instead of with the evidence. Some of the stories mentioned in the article make me wonder if the SSRI stories suffer from the same problem. One of the quoted stories is “Lynyrd Skynyrd harmonicist Mike Caruso’s remark that, ‘the doctor put me on Cymbalta. That turned me manic.'” To me, giving an anti-depressant to someone with undiagnosed bipolar and triggering manic behavior is a very different argument than if taking the SSRI created violent or homicidal behavior that hadn’t previously existed in the person.

In order to convince me that SSRI used caused these behaviors in people who otherwise would not display them, I would want to see a clinical study where people were observed before and after starting SSRI treatment and a control group was also monitored while not having SSRI treatment. Those kinds of scientific studies are the only way to meaningfully determine whether the two variables have any kind of causal relationship.[1] And without that data, this article does a lot more harm than good – by reinforcing existing perceptions that criminals are all mentally ill and by shaming or scaring people who take and benefit from SSRIs.

[1] I should note that requests for data and scientific studies are often used to invalidate or minimize reported personal experiences from marginalized groups, an academic privilege argument of sorts. I do and continue to credit individual experiences where SSRI treatment caused specific behaviors for that individual, but I feel very uncomfortable making blanket decisions about whether or not these drugs should be available at all, for anyone, based on third party descriptions of the experiences of others.

It Will Always Be The First Thing I Think Of

bodies, identity, introspective, mental health, violence

**TRIGGER WARNING FOR DISCUSSION OF SELF-HARM**

I’ve been under some significant emotional stress lately, more so than usual. And I’ve had a couple of incidents when I received some very upsetting news. Of course I’ve cried. Sobbed, even. And reached out to my friends and family and cared for myself in all the healthy and productive ways I learned in my years of therapy. Take a hot bath. Read a good book. Snuggle with the kitty. Get enough sleep. All that kind of thing.

But before that – before the tears even start welling up, much less spilling over – my mind flashes on an image of my left forearm. Sometimes it’s being slashed with a razor blade. Sometimes it’s being burned with a cigarette or the hot metal of a lighter. In one particularly vivid recent image, my left wrist was being smashed with a hammer. This happens in less than seconds, before any other reaction. It’s entirely unconscious and I’m often surprised by how quickly and vividly the images take over my consciousness.

I used to self harm a lot. I thought I’d made it up myself, back when I realized that scratching at one spot on my skin with a thumbnail would peel back the skin to expose glistening wet red pain. I quickly progressed to razor blades and learned the exquisite joy of making a perfectly straight line in my skin, imposing some kind of geometry and order on my out of control body that would hopefully extend into my increasingly disordered mind. I learned how pressing a hot lighter to the inside of my ankle would send a poker of pain straight up my body in a wave so powerful it drove out every other sensation or thought. I learned about long sleeves in summer, the trick of putting a painful cut on the inside of my wrist so it would throb every time I took my mittens on or off. My arms looked so bad people thought I was using heroin. (Even writing this out makes me want it.)

And then I stopped. (Not so easily, of course, lots of safety contracts and lists of health coping activities and techniques and medication and relapsing and all of that. But I stopped.) And it’s been … I don’t even remember the last time I did it. Over 10 years, certainly. Long enough that you can hardly see any of the scars unless you know exactly where to look.

But it is still the first thing I think of. My first unconscious innate reaction to stress or emotional pain or just feeling overwhelmed and drowned by my own emotions. It is always there, just under the skin, waiting for me to be weak enough for it to take over again. That’s why I will never trust myself enough to have a razor blade or an x-acto knife in the house – I know that if they’re there, I’ll lose my way sometime.

[I just turned my head and saw two straight pins sitting on the desk (I was mending a hem) and *boom* I see them plunging into my wrist, just near the bone. It’s not that I imagine the process of picking them up – my mind flashes straight to an image of me pushing it into my skin, with the idea that “this is right, this is good.” I can almost feel myself relaxing while I visualize it and then I shake my head and it’s gone and I’m disappointed in myself for even thinking of it.]

I’m beginning to think it will never stop. I may never do it again – I hope I never do it again, I intend never to do it again – but it will always be there. It will always be the first thing I think of, before there’s even time to think.

For Cereal, Internet?

disability activism, feminism, For Cereal?, justice, language, media and pop culture, mental health, social attitudes, television

A periodic feature in which we highlight some of the more ableist posts and comments in the blogosphere – the things that made us throw up our hands and ask “FOR CEREAL???” *

Today’s edition: a post at Jezebel titled “Woman, Go Take Your Pills!”: Schoolgirls Respond To Samantha Bee’s Christmas Conspiracies. Which, already – are you for cereal, Jezebel? The post reviews a Daily Show segment in which Samantha Bee meets with schoolgirls and, in the tradition of the Daily Show, presents outlandish and absurd positions to them as serious arguments. For example, she tells them that she doesn’t believe that Obama was born in the United States. The humor in the segment is the shocked and outraged responses from the schoolgirls to these positions and arguments.

At one point in the segment, one of the schoolgirls tells Bee “woman, go take your pills.” Which is problematic for a whole slew of reasons – the assumption that irrational or absurd political arguments are a sign of underlying mental illness, the assumption that medication is an appropriate treatment for all mental illnesses, the assumption that bystanders have a right to dictate the treatment a person pursues or receives for a mental illness. But none of these problems seem to have occurred to Anna at Jezebel, who chose the phrase to title the piece.

And the immediate response of commenters wasn’t to push back against this ableism, or to explain why using such a phrase is problematic, but to embrace the phrase as their “new smackdown,” per boobookitteh, or celebrating the “straightforward verbal beatdown these girls delivered so awesomely,” per BillyPilgrimisnotmylover.

So I award a “FOR CEREAL?” to Jezebel for approving of the phrase and using it to title their post, and a second “NO REALLY, FOR CEREAL?!” to the commenters for enthusiastically embracing this offensive phrase as their new go-to insult.

*(Actually, what I say, and what I considered titling this, is “Are You Fucking Kidding Me With This Crap, Internet?” but I’m trying to use less salty language.)

“Bad Activist” moments

activism, disability activism, feminism, gender, identity, mental health, resistance, social attitudes

I read a blog post recently by a woman with muscular dystrophy and her experiences going out to eat in restaurants. The author mentioned how wait staff rarely give her a menu, or give her a children’s menu instead of the standard menu. When this happens, she often just looks on with her mom’s menu rather than asking the wait staff to give her her own adult menu. She described that as a “bad activist moment.” While I enjoyed and appreciated the rest of the post, and marveled at the ableism she routinely experiences – wait staff giving her a sippy cup to use?! – the idea of “bad activist moments” particularly stuck with me.

A “bad activist moment,” if I understand it correctly, is a potential opportunity to highlight ableism, educate TABs on the abilities of a PWD, and instruct people on the correct way to interact with a PWD. It could also apply in other contexts – the opportunity to highlight and correct patriarchal or sexist behavior, or racist behavior, or ageist behavior, or any number of other discriminatory and oppressive behaviors. In this context, the person experiencing or observing the problematic behavior is a member of the class negatively affected by such behavior, but it could also, for example, extend to me as a white woman observing behavior that discriminates against Latinos.

I definitely think this idea has value and recognize that the term “bad activist moment” is likely shorthand for “an identifiable moment of opportunity for direct personal activism that I didn’t take” rather than a judgment on whether the person is actually at heart a good or bad activist. But I’m concerned that framing it as a “bad activist moment” suggests that to be a good activist, we must speak up and speak out Every Single Time we observe negative behavior, not just that affecting PWDs, but that affecting or oppressing any minority group or marginalized class. I know that I do not do this and if I did, I would likely suffer significant consequences. I feel I’m already on the edge of being characterized (and thus dismissed) as the girl who has a problem with everything and is hyper-sensitive on these issues and cannot in any way ever take a joke ever – and that’s with me pointing out about 1 in ever 10 problems I see. I worry that if I devoted more time and energy to those issues, I’d be pigeonholed as “politically correct girl” and nothing I said would be taken seriously or considered.

More seriously, though, it is infinitely more risky to raise issues of discrimination and oppression when you are part of the group that is being discriminated against or oppressed. Not only might this require someone who is “passing” to identify and out themselves, but explicitly claiming membership in the targeted group can lead to further discrimination and marginalization. In the racial context, it’s often characterized (and thus dismissed) as someone “playing the race card.” I’m not aware of a similar term in the disability context, but the trope of an “uppity” activist who “thinks they’re entitled to something” extends to all oppressed or marginalized groups. Identifying as such opens a person up to further attacks and discrimination and even physical violence.

Even without these very real risks, I believe that we should all allow ourselves the option to pass up potential opportunities for activism while still considering ourselves to be good and powerful activists. Even if all we did was live our lives as PWDs, that in itself would be an activist act, demonstrating that PWDs have interests, passions, relationships, emotions, LIVES. We would qualify as activists even if we passed up every single potential opportunity to do affirmative activism work.

My ultra-wise co-contributor Chally once told me that taking care of myself was a feminist act. Placing myself at the top of my priorities – even though I am a woman and “should” prioritize caring for others or building a family, even though I am a PWD and thus “have minimal value or worth to society” – is an act of activism. Can I do more than that? Yes, and I do, but I always try to keep in mind that my activism is and should be secondary to my own well being. In part because I’m not going to be able to do any activism at all if I burn out or hurt myself physically or mentally doing activism work. But also because the simple act of prioritizing myself is, in itself, activism.

So take the opportunities for activism that you feel you can. And let the others go by. And remind yourself at the end of each day that you were a good activist that day.

The frustration of incremental progress

activism, identity, media and pop culture, mental health, social attitudes

The place I work does a lot of trainings for other organizations on health care programs. A number of health care programs are available only for people with long-term disabilities, so the trainings always include a fair amount of discussion of what disability is and who is disabled.

My organization is relatively progressive and puts a priority on protecting vulnerable populations. We have a section of the training talking about the government’s requirement to provide translation and interpretation services for people who do not speak English. We discuss programs for minor children who want to obtain family planning or pregnancy services without their parents being notified. We highlight the special rules for homeless people to work around their lack of a fixed mailing address or phone number.

When it comes to disability issues, though, there isn’t always the level of awareness and sensitivity that I would like. Recently, I was sitting with two co-workers talking about potential interactive activities to add to the training. One co-worker suggested making a poster with photographs cut out of magazines that we should show to the trainees and ask them to point out who is NOT eligible for Medicaid (the U.S. goverment health program for very low-income folks).

“We can use the photos to show them that people on Medicaid aren’t just homeless people pushing shopping carts on the street,” she said. “And it’s also good to remind people that you can’t tell someone’s disability status just by looking at them.”

“Yeah,” responded another co-worker. “It’s always good to remind them that someone could have a mental health disability or something like fibromyalgia that you can’t see just from looking at them.”

HURRAH, I thought. People who are aware of these issues of disabilities that aren’t immediately apparent by looking at a photo. People who want to include this information in a training, want to highlight it with an interactive activity, to make sure everyone understands that. This is progress. This is positive.

“We could Britney Spears and Lindsay Lohan on the poster,” my co-worker continued. “Nobody knew how crazy both of them were at first! I mean, who would have imagined that they were so totally loopy and unhinged? They’re SO CRAZY!” And then she and my other co-worker laughed and laughed.

I froze. Do I mention that we don’t actually have access to their medical records or diagnoses so have no idea what’s going on with them other than what’s reported in the not-at-all unbiased mainstream media and gossip columns? Do I mention that if we go by what’s been reported, I have the same diagnosis as Britney and could be considered just as “loopy and unhinged”? Do I distinguish between drug and alcohol problems and mental health disorders? Do I argue that laughing at people with disabilities that way undermines the message they’re trying to convey with the activity?

I didn’t say anything. I’d already used up a lot of my “humorless” allotment arguing against using an example of a welfare recipient as a single mother with 11 kids so felt that to make any inroads on this issue, I’d have to disclose my own status, which I just wasn’t willing to do. So I let it go by.

Incremental progress.

Injury versus disability

bodies, introspective, normality, Uncategorized

I have an injury – animal bites on my face, forearms and hands from a skirmish with a feral cat outside my office building. I’ve got quite a black eye with puncture wounds on my cheek, so my injuries are immediately visible. I’ve also got severe swelling in my left index finger so I can’t bend it or use it for anything, and bumping it against something sends extremely sharp pains through my hand that last for about half an hour.

I am having a fair amount of trouble with it. I can’t open jars or plastic packaging or use a can opener. I can’t hold the steering wheel very well with my left hand. I’m right handed so I can still use a pen and hold a fork and spoon, but my typing is totally jacked up – I can use the other fingers on my hand if I keep the injured finger extended, but that makes my hand go in an unfamiliar position and the rest of the muscles start cramping and aching if I do it for long, making me rely primarily on hunt n peck typing with my right hand. (I usually type over 120 words per minute, so this significantly slows me down.)

When people observe or hear about these functional impairments, they keep saying to me “oh well thank goodness this will heal. Imagine how it would be if you permanently lost the use of your finger!” and “well at least your face won’t be that wasy forever. Let’s hope it doesn’t scar.” They seem to regard these temporary injuries as a disability simulation of sorts and are reassuting me that I won’t continue to be this impaired or have this reduced functionality only because my injuries will heal.

I, on the other hand, feel that if these injuries were permanent disabilities, I’d have a lot easier time dealing with them. The problems I’m having are largely because it is a new situation for me and my habits and unconscious behaviours are all based on my assumption that my left index finger works fine. I haven’t had any time to develop the mental awareness or the physical abilities to compensate for the problems with that finger – if the other muscles in my left hand were more used to typing without that finger, I’m sure I’d be able to type more quickly and without as much pain in my left hand. Similarly, if my brain could remember that bumping left index finger leads to extreme pain, I wouldn’t have banged it against the car door every single time and I’d buy a purse with more organization capacity so I didn’t have to dig through it with both hands to find anything.

This isn’t to say that having this injury be permanent wouldn’t have long-term effects on my functional capacity. It just means that the functional effects of my temporary injury are in no way indicative of my functioning or my abilities were this a permanent disability. And that having this injury doesn’t teach me anything about what it would be like to have this disability.

The one aspect that has been eye opening for me is the demonstration of how entitled people feel to talk to you about visible injuries or disabilities. My finger isn’t that noticeable and I’m wearing long sleeves because of the weather, so only my facial injuries are visible – and boy are they visible. Even when wearing sunglasses to cover the worst of the bruised and swollen eye, the puncture wounds on my cheek are prominent. And in the day and a half since I was injured, I have been asked to explain “what’s up with my face” by virtually every stranger I’ve encountered. So much so that I’ve already started making up stories (my favorite: “I was being attacked by a vampire but I managed to deflect him so he bit my cheek instead of my neck.”). The feeling that my body is fodder for them to gawk at and demand explanations for is new to me, as my disabilities are usually not visible and I’m used to passing in public. While I don’t pretend this temporary experience in any way lets me know what it would be like to live as a person with a permanent visible disability, this is the only aspect of my injury experience that I feel is at all relevant to understanding the experience of disability.

The Brain Is Still A Giant Mystery

mental health, normality, social attitudes

Optical illusions are one of those things that seem fun and frivolous but actually illustrate deep insights into how brains function. I recently saw an illustration of the “hollow mask illusion” over at the Wired Magazine Blog and it made my jaw drop. In the illusion, a person viewing a concave face (like the back side of a hollow mask) perceives it as a convex face, like the front side of the mask. This illusion is so strong that even when a person is aware of the illusion they are still unable to see the concave face because the brain perceives it as a convex face.

Check out this video and see if you perceive the concave face as concave or convex, or both:

Description of video: hollow Charlie Chaplin mask is attached to a rod, rotating slowly. As the mask rotates and the concave inner side of the mask comes into view, it seems to pop outwards, becoming convex.

I have watched this video upward of ten times, and no amount of anticipation, concentration, stern looks, putting hands on hips, or even cursing has allowed me to see the concave side of the mask as concave. Every single time, the visual information goes into my brain and some filter is applied to the raw information and POOF it’s convex again. It seems that this illusion works only for human faces, as “it doesn’t work well with other objects, or even with upside-down faces.” This suggests that there is a program in the brain trying really hard to find face-like patterns in visual information – this is why we see faces in clouds, or snow covered mailboxes or even grilled cheese sandwiches. We can also recognize faces when they are distorted or compressed or otherwise obscured:

The New York Times > Science > Image > Distorted or Blurry, the Face Shines ThroughThis is likely a developed ability to allow us to recognize faces quickly and unconsciously instead of having to consciously process the facial features and determine that it was a face. It was helpful to humans to be able to recognize faces of other humans, both to determine that they were human and to distinguish them from other humans.

The results of a recent study strengthen the suggestion that this is a process applied by the brain on received visual input. Two researches in London found that people with schizophrenia did not experience the illusion and reported seeing concave faces. When they used an fMRI scanner to measure brain activity on people with and without schizophrenia while viewing the rotating mask, there was a significant difference between the brain activity of people with and without schizophrenia:

[The researchers] analyzed the fMRI data using a relatively new technique called dynamic causal modeling, which allowed them to measure how different brain regions were interacting during the task. When [neurotypical] subjects looked at the concave faces, connections strengthened between the frontoparietal network, which is involved in top-down processing, and the visual areas of the brain that receive information from the eyes. In patients with schizophrenia, no such strengthening occurred.

Dima thinks when [neurotypical] subjects see the illusion, which is somewhat ambiguous, their brains strengthen this connection such that what they expect — a normal face — becomes more influential, overpowering the actual, though unlikely, visual information. [People with s]chizophrenia , meanwhile, may be unable to modulate this pathway, accepting the concave face as reality.

What I think is most interesting about all this is the clear illustration that the functioning of the brain is still largely a mystery to us. This illusion basically exploits a processing error that occurs in neurotypical brains and, incidentally, is used in a lot of the illusions at Disneyland’s Haunted Mansion ride. But there are so many other processing glitches that instead of being seen as an amusing and harmless byproduct of a neurotypical brain, are seen as problematic and annoying if they are credited at all. I work and concentrate better when I play music or I take a three minute break to play Bejeweled. Why? I have no idea. But I doubt that any supervisor asking me why I’m playing Bejeweled could explain to me why their brain perceives the concave mask as convex. Or could stop doing it if they just tried a little harder. Maybe if we had a better understanding of how brains worked it would be easier for people to understand and credit the reality of mental disabilities.

Note: clearly, this illusion is not a diagnostic test for schizophrenia and should not be treated as such.

Hate Crimes against PWD

justice, normality, politics, violence

The FBI recently released the 2008 Hate Crimes Statistics report, summarizing hate crime data from over 13,000 law enforcement agencies in the United States. The Attorney General is required to compile and report on this data yearly. Although the majority of hate crimes are based on race, it includes reporting on crimes “motivated by disability bias,” which made up 1 percent of the reported incidents.

Of the total 9,168 hate crime offenses in the report, 85 were on the basis of disability: 28 against a person with a physical disability and 57 against a person with a mental disability. The most common offenses were “Simple assault” and “Intimidation,” with a number of “Vandalism” incidents also. The vast majority of incidents took place in the victim’s residence or home. This mirrors the overall data – the majority of all hate crimes regardless of basis were assaults and intimidation taking place in or near the victim’s residence or home.

What is most clear from the report is that the majority of crimes committed against people with disabilities are not considered or categorized as hate crimes on the basis of disability. The US Department of Justice released a 2007 report on crime against people with disabilities finding that in one year, approximately 716,000 nonfatal violent crimes and 2.3 million property crimes were committed against people with disabilities. Even considering that only one in five PWD crime victims “believed that they became a victims because of their disability,” these numbers are an order of magnitude larger that then total crimes against PWD listed in the hate crime statistics.

Whether crimes against people with disabilities should be considered hate crimes is a difficult and complicated question. One on hand, the DOJ report demonstrates that the rate of nonfatal violent crimes against PWD was 1.5 higher than the rate for TABs, with the rate of crimes against women with disabilities almost twice the rate for TAB women. It is hard to imagine that disparities this significant are unrelated to disability status.

At the same time, I am concerned about giving more power to the criminal justice system. I read a compelling piece at The Bilerico Project recently which, while focus on trans issues, seems relevant to this discussion:

No one can deny that particular groups are in fact treated with discrimination and even violence. But rather than ask how about how to combat such discrimination and violence, we’ve taken the easy route out and decided to hand over the solution to a prison industrial complex that already benefits massively from the incarceration of mostly poor people and mostly people of color. It’s also worth considering the class dynamics of hate crimes legislation, given that the system of law and order is already skewed against those without the resources to combat unfair and overly punitive punishment and incarceration.

What do you think – should crimes against PWDs? be punished as hate crimes? Is that an effective way to address and prevent continued crimes against PWDs?

I Don’t Trust Myself

identity, introspective, mental health

One of the aspects of my bipolar that I find the most exhausting is the need to constantly monitor my own moods. Even though I am medicated to the hilt and haven’t had a manic episode in 5 years or so, I spend at least part of every day worrying that I am edging too far towards mania or depression.

Part of this is good – I’m attuned to my moods, I know if I’m experiencing a big swing, I can immediately address it with my psychiatrist and adjust my meds or go back into therapy or whatever needs to be done. That has served me very well in the past, allowing me to catch hold of a rope before I slide so deep into depression I can’t manage to do anything to help myself.

But it also means that I have what I think of as a dual consciousness. One part of me experiences things, reacts to them, has emotions. And the other part of me sits back and watches and worries. Is that a reasonable response to the external stimuli? Is that within the normal range of emotion? Am I just a touch too upset about something? Is that bouncy happy feeling I have because it’s a sunny day, or because I’m starting to verge into mania?

This means I’m not sure I fully experience any of my emotions, because a portion of me is always reserved for this meta-cognition, this constant monitoring and evaluation of how I feel. And ironically, it’s the strongest or deepest emotions that cause me the most concern and trigger that meta-cognition the most, meaning it’s those emotions I experience the least. I’m not sure I have any idea what it feels like to be happy without that edge of worry. I’m not sure I have any idea what it feels like to be sad without part of my brain running through my recent sleep schedule and medication dosages.

This is why I value so highly the experiences that force my meta-brain to shut the hell up. The most recent example was a Nine Inch Nails concert where I was pressed between the bodies of strangers, drenched in sweat, with aching feet and legs, but the music and the beat were so loud they filled all available space and my brain was thinking of nothing but screaming along with the lyrics I’ve heard so often they seem like a part of me. I couldn’t feel anything but music and the bass running through my body, couldn’t keep hold of any thought except the words of the song. They filled me up so much that my meta-brain had no room to be separate. And I got some time to simply experience things, to just feel, without that separate evaluation and judgment going on.

I don’t know how to create those experiences for myself – when I’m so overwhelmed by sensory input that the meta-brain that usually sits in the balcony and comments on everything going on gets forcibly dragged to the floor to experience things with the rest of me. But at the same time, I credit that meta-cognition with keeping me safe and protected and getting help when I desperately need it, so I don’t want to turn it off entirely.

I just wish the checks I put on myself to keep myself safe didn’t lead so directly to feeling dissociated from my own emotions and experiences.