cahn: (Default)
[personal profile] cahn
I devoured The Coddling of the American Mind and I have a lot of probably-incoherent thinky Thoughts about it. I read the Atlantic article it was based on and wasn't really expecting much more from the book, but indeed the book is so much better because it's able to expand on and discuss things that an article isn't able to.

I read The Righteous Mind earlier this year and I can't believe I didn't talk about it here; well, I won't talk about it now except to say, I won't say it changed my life but it gave me a framework in which to put a lot of free-floating things I'd been thinking about. (Due to the particular demographics of my life, I know a lot of people from both sides of the (US) political spectrum.) This book is similar, except that it actually did a lot more of changing my thinking than I was expecting it to.

The idea of the book is that the authors (Greg L. in particular -- I will refer to both authors by their first names because that is how they refer to each other in the book) have been seeing a lot of specifically college events that make them believe that campus atmosphere is fostering unhealthy mental habits. In particular, there are three unhealthy mental habits they are seeing a lot more of:
1. What doesn't kill you makes you weaker.
2. Always trust your feelings.
3. Life is a battle between good people and evil people.

Many of the things they cite in the book as examples of this -- trigger warnings, safe spaces, microaggressions, intersectionality, common-enemy identity politics -- are interesting because they're staples of fandom/online discourse as I have seen it over the last several years. Their point is not that these are ethically or morally bad ways of thinking about these things (which they don't think at all), but rather that they can be dangerous to the thinker because they promote specific cognitive biases that can often result in increased anxiety and depression.

For example -- intersectionality. They don't quibble with the principles of intersectionality (I should point out that Greg and Jon -- I call them this because that's what they call each other in the book -- are both liberals (which I think is good because it seems to me there's no way a conservative could have written this book and not got torn apart, which is also a problem but for another time), so although a lot of the ideas they bring up are ideas I associate with liberal spaces, they are careful to say that they don't disagree with the ideas or the principles involved; their whole thrust with the book is different) but they point out that the end result, for the person who is thinking about it in these terms if that is their primary framework for thinking, is an us vs. them, dominant vs. subordinate way of looking at the world, and that this promotes anxiety. That although this can be a useful framework in which to think about various things, if one is always thinking about everything in an us vs. them framework that anxiety and depression is more likely to occur.

(Also: oh God, I need to make that post about my ward and Gospel Doctrine teaching and old ward vs. new ward, and maybe I will... someday?... when I have more time?... it's really REALLY easy to slip into us vs. them in my religion. REALLY EASY. Members vs. non-members. Believers vs. apostates. Righteous vs. sinners. That was one of the spiritual geniuses of ex-Bishop (and also one of our Relief Society presidents (who was actually called by the bishop before him), she was amazing, and I absolutely tried to do this too in my class), that they utterly refused to do that, with at least two major consequences: (a) it promoted not slipping into us vs. them within our ward (which Greg and Jon also cover -- the concept of witch hunts that actually turn on members of the group) which is also a Really Really easy thing to slip into for those of us who are members of the Church of Jesus Christ of Latter-Day Saints, and also made it much more comfortable for those of us who feared we might be on the "them" side if/when this happened (why hello there from person flirting with the apostate line since grad school); and (b) encouraged us to keep open hearts in general, both within and without the church boundaries. And I can testify to you right now that it made us -- both the ward as a whole and all of us individually -- way happier and mentally/spiritually healthier to be doing it like that.)

And trigger warnings/safe spaces. I see trigger warnings everywhere now, including, hilariously, in a mom's message board I sometimes read -- those are hilarious because they'll be like "So then Person X *trigger warning* died *end trigger* and..." and it's like... how would that be even at all helpful? But anyway, their contention here is that the idea of, say, safe spaces where ideas that one disagrees with will never be mentioned (as opposed to a safe space where you'd be, well, physically safe, which are noncontroversial) promotes a mindset that people are really fragile and can't take the exposure to difficult ideas. In fact, they contend, people tend to be "antifragile" -- exposure to things that might be difficult and challenging helps us grow and makes us better off than if we hadn't been exposed to those things, and so a mindset that causes people to avoid challenging ideas isn't a healthy one. (Anyone who knows, but specifically I know [personal profile] rachelmanija will know -- they say, "Avoiding triggers is a symptom of PTSD, not a treatment for it... Cognitive behavior therapists treat trauma patients by exposing them to the things they find upsetting. Is this true/not overly simplified? I trust them when they talk about papers in depth, and I mean this sounds good to me, but it only got a paragraph and I don't think either of them are anything like experts on trauma.)

...I have a couple of thoughts about this. The first is that I think it depends? Like, I think there must be an antifragility threshold -- past that line, one is fragile, and before that line, one is antifragile. I think this a lot about parenting... For example, my parents did some things I think were maybe not great choices, but some part of me thinks that some of these things were not that bad for me; it helped me develop skills that I would probably not have otherwise. My sister, I think, may have been fragile on these particular topics, because she had some issues greatly exacerbated (ironically given the subject of this post, often dealing with mentally unhealthy habits) by the same parenting by the same people. (Although to be honest, I also think being the older kid, and having specific character traits that were highly valued in my culture, helped me a lot.) I think to a certain extent one just doesn't know where that line is and so you have to guess, and this is why parenting is So Hard. (Greg and Jon also obliquely refer to this, but they don't spend a lot of time on it.) And also I definitely parent my older one differently than my younger one -- with A. I'm much more likely to be "eh, deal with it" (when something goes wrong) because I know he can, and sometimes E can't -- and I definitely think there are times when I've made the wrong choice there. (For example, when A is hungry he CANNOT deal with it. He just can't. He needs food and until then he can't even come close to dealing with whatever it is.)

That being said, my second thought is that I've seen things like this in my own life. It's become really clear to me, from E's journey and the fact that she's basically identical to me when I was a small person (except rather more so), and also because of one too many canonically-Aspergers people in media that I immediately thought were the Best Characters Ever Can I Be That Person, that I've probably got (subclinical?) Aspergers-ish tendencies. And it's useful and interesting as a way to understand why I think differently and work differently than other people, a lot of the time. (I was totally staggered when D and I were having a conversation when E was young, about eye contact, and D revealed that he didn't think constantly about maintaining eye contact when having a conversation. I legit thought this was a thing all geeky people did!) But if I try using it as an excuse -- "oh, I'm This Way so I don't want to pick up the phone"("I'm too fragile to pick up the phone!") -- I can feel myself giving up, being like "ok, yup, let's not talk on the phone." It's better as an explanation: "ok, I'm This Way and so I don't like initiating phone conversations as much as [e.g. super-Extrovert boss], but I'm going to anyway, and I might use [X] hack to help me do that if I need help with it" is a lot more useful way of framing it, for me.

The last bit of the book is on parenting, and they discuss why they think that the rise of helicopter parenting / resume-building and the loss of play is leading to the rise of anxiety and the rise of these trends on college campuses. Their hypothesis -- and it's definitely not a settled thing, but it seems to me that it could be true -- is that it used to be that kids were just left to their own devices and playing with each other all the time and that served as a sort of laboratory where you could get hurt, both physically and emotionally, and that by and large made kids stronger and more resilient. And now that kids instead have their time filled with activities where one is ferried from one place to another (*raises hand guiltily*) or else screen time (*), and even at school there's less in the way of recess and non-structured time, there's nowhere for them to gain that experience, and they get to college and they don't know how to deal with things like being confronted with someone who thinks totally differently than they do. (I mean -- there are clearly lots of kids who are just fine, but they're specifically trying to address the problem of the ones who are on the edges and maybe falling into anxiety and depression that maybe wouldn't have before.)

Again I wonder if this is a threshold kind of thing... Bullying, for example, is something I imagine there was more of with unrestricted free play than now, and I think is likely to be terrible enough that it is more likely to send one into a tailspin than to make one tougher. But I can see how for smaller bumps and bruises, it would actually make one tougher. And it clearly depends on the kid a lot.

So in conclusion, Parenting Is Hard and maybe we parents have a large chance of mucking up the thresholds and all Doing It Wrong but we won't find out about it for another thirty years until our kids go to therapy :) ...In the meantime, I'm trying to bite my tongue when I pick E up from school and the kids are rolling this large plastic tube (I don't even know where they got this from) around the playground with kids inside it! (The kids think this is the best thing ever.)

(*) The authors think that in-person socialization time is in general better than screen socialization time, which in e.g. Facebook can run to carefully curated versions of people's lives that invite negative comparison. I don't disagree with them in general, although more specifically I was kind of like, "but what about having really interesting discussions about books and opera that it's much harder to get in my real life?" :D And they do address that -- they say that in some cases, when screen time results in building real relationships, it can be a good thing. And I vehemently agree. (hi all you guys!) But I think it's also true that (as they say) as human beings we're wired to need actual in-person socialization as well.

Date: 2018-11-20 07:51 am (UTC)
duskpeterson: The lowercased letters D and P, joined together (Default)
From: [personal profile] duskpeterson
From the way you (and others) have described the book, it does sound as though the authors simplify complex issues.

I grew up in the 1970s. We weren't quite as free-range as earlier generations, but my very protective mother would shove me out the door after school, say, "Go play," and that's the last we'd see of each other till dinnertime.

*But* this same mother came zipping to my defense when she learned that my school bus driver was endangering my health by smoking. So it really wasn't a case of "all hands off" or "all hands on" in those pre-helicopter days.

I'm with you concerning fragility thresholds. I see that daily: people who are more fragile or less fragile than I am over the same events. I think the authors are being - I'm trying to think of a polite word but can't - if they assume that, just because *they* wouldn't end up in the ER with a mental health emergency because no trigger warnings were used, that means nobody would.

I like your telephone analogy, because it goes to show that the important thing is having a *choice* whether to do something that might harm you. Without any warning, that choice is taken away. The whole point of a trigger warning is so that the person will know that they're about to enter into territory that is personally dangerous for them. They can still choose to proceed, but at least they won't have a ton of bricks drop on their heads without warning.

The extent to which society is obliged to shape its life to accommodate people with serious health and disability issues is a valid matter for consideration; myself, I haven't gone as far as some other fic writers do in providing specific trigger warnings. But it doesn't sound to me as though these authors have spent much time actually listening to people whose health requires such measures. That has to be the first step.

Date: 2018-11-22 11:27 pm (UTC)
duskpeterson: The lowercased letters D and P, joined together (Default)
From: [personal profile] duskpeterson
My immediate thought is that it would have been nice if the authors had spent a fair amount of time in the fanfic community, because we've spent so many years talking about stuff like this and hammering out possible solutions. (I remember very clearly, at my first fanfic con, a discussion of the difference between wanting warnings because you find something fictional to be icky, and condemning others that want to read about the same topic. "Squick" is such a wonderfully useful word.) I think authors sometimes write about topics that have alteady been much discussed in subcultures or marginalized cultures, without realizing that they're reinventing the wheel.

But it sounds as though you feel this book has contributed to the discussion, so I'll have to search it out!

Date: 2018-11-25 10:10 pm (UTC)
duskpeterson: The lowercased letters D and P, joined together (Default)
From: [personal profile] duskpeterson
I miss discussions like that. It's so hard to find them these days.

Date: 2019-01-16 05:09 pm (UTC)
lokifan: black Converse against a black background (Default)
From: [personal profile] lokifan
YES! Yay "squick", it's so great.

I think your point about the negative effects on YOU of this framing makes a lot of sense, [personal profile] cahn. Especially since "squick" is a MUCH less common term on e.g. Tumblr than it was in fandom in general ten years ago. We need a similar term for the rest of the culture, I guess!

Date: 2018-11-20 08:46 am (UTC)
rushthatspeaks: (Default)
From: [personal profile] rushthatspeaks
But trigger warnings aren't about avoiding ideas one disagrees/might disagree with? They're about avoiding things one already knows produce a PTSD response. And to these guys saying, oh, cognitive scientists advocate exposing people to their triggers... sure. In a controlled setting. With a lot of one-on-one preparatory work and careful work afterwards. At a preset, pre-planned time. In measured amounts. Over the course of years.

Which is a kind and amount of attention and responsibility that is quite rightly beyond, say, a professor in a pedagogical context.

A professor has the capacity to inflict real damage in this direction, but does not have the capacity to fix it.

A lot of people who object to trigger warnings in classroom settings seem to me to be objecting to the idea that professors have any responsibility whatsoever towards their students' emotional health, especially if their students might be having emotional reactions to coursework. This is partly because of the academic ideal of 'objectivity' and the idea that emotional reactions can somehow be left out of academic work, and partly because many teachers, well, do not consider themselves to have this responsibility.

I'm not going to go into why I believe them to be wrong here, but I will point out that a macho, only-those-who-can-stand-the-heat-allowed attitude is one of the main mechanisms academia has used to weed out persons who do not fit into certain categories, and that that kind of macho is frequently expressed through content as well as through things like amount of homework.

I am suspicious of people who write about trigger warnings as though they are ways to avoid seeing content one disagrees with, as it takes very little study of the subject to discover that that is not how it works.

Date: 2018-11-20 09:00 am (UTC)
rosefox: Green books on library shelves. (Default)
From: [personal profile] rosefox
Ah, I see we are comment twins today.

Date: 2018-11-20 12:00 pm (UTC)
the_rck: (Default)
From: [personal profile] the_rck
The syllabus for my 15 year old's English class this fall included Octavia Butler's Kindred. I emailed the teacher and my daughter's counselor to ask what supports they were going to offer for kids who found the book upsetting/triggering. They didn't answer me, just changed the syllabus so that the kids read a different book.

I didn't want them not to read the book, and I said that specifically. I just wanted them to pay attention and provide help for students who needed it. Butler's work is visceral and important; it might be a way for some kids to understand things they hadn't before and for others to see things from their own family history that aren't normally acknowledged in the schools.

It's also potentially like asking the kids to run 10 miles with no lead-in training.

Date: 2018-11-20 08:59 am (UTC)
rosefox: Green books on library shelves. (Default)
From: [personal profile] rosefox
they say, "Avoiding triggers is a symptom of PTSD, not a treatment for it... Cognitive behavior therapists treat trauma patients by exposing them to the things they find upsetting." Is this true/not overly simplified?

This is EXTREMELY oversimplified. Exposure therapy for trauma is done specifically within a safe context, with a lot of patient control over the degree and type of exposure, and discussion before and after. Being abruptly, nonconsensually exposed to a trauma trigger in a place where you aren't prepared for it, can't deal with it in the moment, and can't necessarily process through the experience afterwards is the opposite of therapeutic.

"Difficult and challenging" and "triggering" are also not synonymous. For something to be triggering, there needs to be a chronic ailment to trigger. Some people have those ailments. Others don't.

I sometimes use physical examples because they can be easier for people to viscerally grasp than psychological ones. It is not difficult or challenging for most people to write a postcard by hand, but it will trigger my chronic tendinitis and leave me in pain for 24 hours or longer, depending on whether the injury has been aggravated recently and how much I can rest it and take care of it. That's what chronic injury means—being prone to both sudden and lingering pain after doing activities that physically hale people find unremarkable. PTSD is a chronic injury of the mind—it means you are more prone to be in (mental) pain after exposure to something that ordinary people might find slightly unnerving but quickly move on from.

Like my chronic injury, PTSD and other mental illnesses that can be triggered in the literal sense require cautious, targeted, specialist care for recovery to be possible. Every time I've tried to go to a gym and work with a personal trainer who isn't a specialist in injury recovery, I've been reinjured—no matter how slowly they go or how little they push me, it's more than my body can handle. But when I work with my wonderful occupational therapist, I get stronger and am less prone to reinjury when I inadvertently encounter a trigger (like trying to pick up something that's unexpectedly heavy) or am required by circumstances to do things that are damaging (like needing to drive a long distance or complete a big work project on a tight deadline) or get careless and don't pay attention to my body's signals that it needs rest and care.

A random college professor assigning a reading that contains material someone finds triggering can be as harmful as a random personal trainer telling me to "just" do five push-ups. You bet I avoid those triggers. Do I work toward being able to someday do five push-ups? Of course! (I can't tell you how much time and money I and my various insurance companies have spent on occupational therapy and personal training and workout equipment and gym memberships and anti-inflammatories and supplements and icyhot and kinesiotherapy tape and...) Does believing that I'll be able to do five push-ups someday mean that I can do them right now? Absolutely not! "Avoiding triggers is a symptom... not a treatment" is technically correct, but it misses the part where you avoid triggers while in treatment, until the treatment gets you to the point where the triggers are less triggery and you don't have to avoid them anymore.

Much of the treatment for my injury is not about the tendon directly—there's very little you can do for an inflamed tendon other than put ice on it and bathe it in NSAIDs or steroids. It's about making the surrounding muscles stronger so they can take on more of the load and relieve the tendon of its burdens. But the tendon is inevitably involved in working out the muscles to strengthen them, so there's a very delicate balance to be maintained, and it's a slow, slow process. Psychotherapy works much the same way; it can't take away trauma, but it can strengthen the parts of your mind that are healthy, so you rely more on those than the parts that are constantly screaming about danger.

Trigger warnings make space for preparation. I'm using a workout app now that tells me all the day's exercises in advance; I can go through them and swap out potentially harmful ones for ones that will help me get stronger without making me hurt, or adapt them with different positioning (doing those push-ups against a wall is much easier than doing them against the floor), or just brace myself and be sure to keep checking in as I go, even if I think I can handle it.

As for identification with injury leading to avoidance: yes, absolutely that can happen and is a problem. But the solution to that problem is to treat the injury, not to act as though people with injuries are whiny babies who need to suck it up. And some degree of avoidance is necessary—there are things that chronically ill and injured people simply cannot do. I miss knitting terribly, and have signed up for a knitting ergonomics class in hopes of figuring out a way to do it that doesn't hurt... but an hour of knitting can leave me in pain for a week, so I don't knit. The other day I glanced at a website for helping women get into the construction trades and then closed the tab, because my body cannot ever become strong enough to work in construction. It's no different from being "chronically short" and therefore not trying out for the basketball team.

Everyone has different capabilities, and there is a sweet spot between cocooning yourself in anxiety and flinging yourself against the ceiling of your limitations. That might look like improving your capabilities with the help of a professional, or finding clever workarounds (I've started dictating a lot to spare myself typing), or simply being slow and cautious while you figure out what you can and can't do. It does not look like throwing a snake at someone with a snake phobia and then being surprised that it didn't help them become less phobic.

None of my strong feelings on this topic are directed at you—I appreciate that you caught that and went "Hm, this doesn't sound right". They are entirely directed at people like these authors who blithely dismiss an entire field of psychotherapy as unnecessary because all you really need to do is scold injured people until they stop being so fragile.
Edited Date: 2018-11-20 09:01 am (UTC)

Date: 2018-11-20 09:04 am (UTC)
rosefox: Green books on library shelves. (Default)
From: [personal profile] rosefox
One additional comment:

I think there must be an antifragility threshold -- past that line, one is fragile, and before that line, one is antifragile.

You are correct, in that this is essentially a definition of chronic injury/illness.

Date: 2018-11-22 06:09 am (UTC)
rosefox: Green books on library shelves. (Default)
From: [personal profile] rosefox
Thanks for clarifying! I have different issues with the term trigger warning, and I'm generally in favor of more neutral terms like content notes or tagging. My knee just jerks awfully hard when I see what looks like blanket dismissals of the concepts of warnings/notes or safer spaces, especially in the context of the word "coddling"—all of that is very often used as a way to invalidate and dismiss people's genuine needs, even though hardly anyone is advocating for "safe spaces where ideas that one disagrees with will never be mentioned" (especially in larger contexts like schools rather than in more personal spaces).

And of course there is the thing where schools were traditionally "safe spaces where ideas that one disagrees with will never be mentioned", as long as the "one" in that sentence is coming from a position of relative power and societal privilege. See the endless stories about students who were shut down by teachers for saying things like "I think our textbook glosses over the extent to which the Civil War was about slavery" or "why are all the books for our English class written by white men". Part of what's playing out in these arguments about safe spaces and freedom to speak out against the mainstream view is the leftward shift in education, especially college-level education, that's been going on since at least the 1960s–70s and has scared the shit out of a lot of people on the right. All this language about "don't you want to be exposed to new ideas, it's good to be tolerant of difference, there's value in being shocked out of complacency and familiarity" gained momentum with hippies and second-wave feminists and is now being weaponized against us because it was so effective, a tactic that's used so often by far right and fascist commentators and internet argumentators that "So much for the tolerant left!" has become a joke.

(But I digress.)

(Except that I think you really can't effectively talk about this stuff without context that goes back further than the Clinton administration.)

Anyway, no apologies needed and no worries. Your summary looked an awful lot like an argument I've seen made very badly many times, and I'm glad the book is not that bad.
Edited Date: 2018-11-22 06:10 am (UTC)

Date: 2018-11-20 05:36 pm (UTC)
ase: Default icon (Default)
From: [personal profile] ase
Disclaimer: in my opinion, the antifragile guy is unreadable. The concepts behind antifragility might be more palatable than the execution, but that's another topic.

...and now I'm going to delete a bunch of stuff because I'm trying to argue with the authors instead of ask about your responses to their book. (Though I am sad to delete the side anecdote about This Guy in the elevator. He managed to make a hilariously terrible impression in the thirty seconds he occupied with his self-centered small talk.)

...I have a couple of thoughts about this. The first is that I think it depends?

Some of it yes! I'd ask about the intersectionality example: did the authors have suggestions about using intersectionality in a useful way, or how to promote its concepts to people who Do Not Understand?

Speaking of useful application, I think your example from the mom's message board is an example of a trigger warning not being done well. Do you think something like a header, "hi folks, I talk about a death in this post" would have been more helpful, or appropriate to the venue?

I wonder if the difference between trigger warnings, intersectionality, safe spaces, and microaggresion education done poorly and done well might also be an issue? As you summarize, the principles of intersectionality, versus the execution, might have some divergence. (...now go look at teen/early tween tumblr. There may be some bias in the sample, but oh dear, I am so glad sixteen year old me's uneven grasp of progressive concepts was not immortalized in reblogs.)

I also recognize some of the trends the authors speak of. I have to ask, how much is me as a Grouchy Older Person With Life Experience, and how much is this a genuine trend? How much should it be a trend? Are we now more formally codifying parts of our social values that have historically been softer - be kind to people, including people not like us - are we swinging into orthodoxy as a consequence? If that's the case, how do we swing back toward a more resilient middle ground? (I am not a fan of antifragile, but I am a fan of resilient. Antifragile doesn't seem like a teachable skill, but getting back up after going boom? Or saying, "yes, I'm going to pick up that phone, and here's the tools I have to do it" is something that can be taught.)

Parenting is hard. People are different, small people are different from each other, we all try to do our best with incomplete knowledge (who knew both your kids would be afflicted with the hangries? Until experience demonstrated that).

Date: 2018-11-23 12:53 am (UTC)
ase: Default icon (Default)
From: [personal profile] ase
People I respected recommended Antifragile and I bounced off it so hard. Maybe I am misunderstanding Taleb's ideas and works, but... no, I'm trying to revisit these concepts and I couldn't get my brain around antifragility in a positive light.

(Also, he's done at least two TED talks. I am irrationally suspicious of Team TED Talk, blame Elizabeth Holmes.)

...in addition to doing it poorly and doing it well (which is also a concern!), there's the question (which I articulated Extremely Poorly in the post) of the kinds of assumptions and culture that are being made by choosing various language.

Ohhh, the language and embedded assumptions of language discussion is the sort of thing that's right up my alley. Which might tie back into what you were saying about Us vs Them mentalities, in your original post. The New York Times actually posted a "How To Talk To Your Angry Uncle" interactive feature leading up to the holiday. It leads readers through a hypothetical conversation with Angry Liberal Or Conservative Uncle, with a final summation of techniques for increasing rapport. It's interesting to me that the Us vs Them issue is currently so prevalent that a major newspaper has created a piece to help people avoid a family meltdown around the holiday table. I may be feeling this one, I voted to watch Lady Bird or Solo while the turkey cooked and lost out to the Mission: Impossible -- Fallout bloc.

I'm glad E. is starting to grow out of the hangries. As another afflicted person, I am not sure have ever completely lost them, and it took me until I was a lot older than E. to put two and two together and take appropriate actions.

Date: 2018-11-23 01:48 am (UTC)
mildred_of_midgard: (Default)
From: [personal profile] mildred_of_midgard
Holy cow, I'm 35 and I just realized that hangry was a thing a year or two ago (from seeing a 'I'm sorry for what I said when I was hungry' t-shirt)! I'm still struggling to realize when it might not be that the person I'm talking to is stupid, it might be that I'm hungry and I need to Not. Snap. At them.

I feel so developmentally delayed!

Date: 2018-11-23 04:25 pm (UTC)
ase: Default icon (Default)
From: [personal profile] ase
We all come to knowledge at different times and through different paths. One's thirties are a great time to learn new skills, like not biting the head off people who are between you and your dinner! (Cough.)

In my experience, tossing a snack in my purse is useful both as a booster if I get caught out on the road, and as a psychological tool ("I know I have the hangries, and as soon as I wrap up this two-minute thing I can wolf down my snack"). The snack bar / energy bar that sits acceptably in the stomach is a great prepackaged go-to. Some walntus and raisins or almonds with a few dried apricots are pretty tasty to me. I also have known one young woman who tossed a jar of peanut butter in her bag and called it good.

Date: 2018-11-22 12:39 am (UTC)
mildred_of_midgard: (Default)
From: [personal profile] mildred_of_midgard
I'm glad other people are replying, because of my limited ability to type right now, but yes, WAY oversimplified. In particular, a good therapist (like Rachel) will ASK you what kind of exposure you think you could handle at each step, and work with you on developing a plan for the agreed-upon next step (with you in total control the whole time), not randomly expose you to reminders of your trauma without warning! That's called retraumatization, not exposure therapy.

I have a whole bookful of opinions on exposure therapy and the B aspect of CBT, which comes down to "you ignore the C part at your peril," meaning "behavior/exposure alone rarely if ever works, even if you ramp up gradually, because you need to make sure that the individual has the cognitive tools to make sure that their small doses of exposure trigger a 'this isn't so bad' response, instead of an 'OH GOD that was awful NEVER AGAIN' response."

I've seen too many therapists think that because CBT is "manualized," they can just give their patients activities to do in increasing doses, and that will magically fix everything from phobias to depression, with minimal effort on the therapist's part.

Also, +1 for whoever said "triggers" =/= "challenging ideas." The biggest problem with trigger warnings is that a real trigger is not something you disagree with, it's an often random object that got associated with trauma for a particular person. Could be as innocuous as scrambled eggs.

That said, yes, I have seen people insist a safe space is one where no one says anything they disagree with. Which, sure, if it's your personal blog, you can lay down any rule about comments you like, down to "Kirk obviously >>> Picard, do not come here talking up Picard to me." But to me that's distinct from "safe space."

Okay, I have to stop. But interesting post, thanks for sharing!

Date: 2018-11-25 10:18 pm (UTC)
duskpeterson: The lowercased letters D and P, joined together (Default)
From: [personal profile] duskpeterson
I'd love to learn more about the cognitive part of CBT. Can you recommend any books?

Date: 2018-11-25 10:47 pm (UTC)
mildred_of_midgard: (Default)
From: [personal profile] mildred_of_midgard
Hmm, good question. It's been about 10 years since I was reading books on CBT. These are the two that came to mind as helpful at the time, with the caveat that I haven't reread them recently, so I can't say whether my thinking has evolved such that I would still recommend them:

Essential Components of Cognitive-Behavior Therapy for Depression, by Jacqueline B. Persons, Joan Davidson, and Michael A. Tompkins.

Mindfulness-Based Cognitive Therapy for Depression, by Zindel V. Segal, Mark Williams, and John Teasdale.

A lot of my thinking has been influenced by [personal profile] rachelmanija's blog, and somewhat less but still usefully [personal profile] staranise.

In the last several years, what I've been doing, instead of studying specific techniques, is the kind of reading that's allowing me to slowly build up my own mental model of how the brain works and how it responds to trauma, and arriving at my own opinions on what you should do clinically about it. It helps that I have exactly one "patient": my wife. Who has been massively failed by therapists for thirty years, including cognitive behavioral therapists. I know good people in the therapy world exist because I keep finding their blogs, but my family have yet to find them in real life. Then again, Rachel's a life coach these days, because the world of therapy is so messed up it doesn't allow her to do what she's good at...so maybe it's not surprising there aren't many like her out there.

Date: 2018-11-25 10:58 pm (UTC)
duskpeterson: The lowercased letters D and P, joined together (Default)
From: [personal profile] duskpeterson
Every book I've ever encountered on mental health assumes one is in therapy, which is . . . not very helpful to those of us who aren't. For the past two decades, I've been too busy tackling my Internet addiction to address my other issues, but *one* of these days I'll find a book on mania that doesn't assume I'm also depressed, and next on my list after that is tackling my phobias. So thanks much for all your recommendations.

Date: 2018-11-26 01:03 am (UTC)
mildred_of_midgard: (Default)
From: [personal profile] mildred_of_midgard
Np! Both those books are aimed at clinicians, not clients, which is part of why I've found them more useful than most self-help guides.

I know virtually nothing about mania, and slightly more about phobias. Depending on the phobia, CBT (as you may know) has a good track record for treating them. The more behavior-focused approach is most successful when the phobia exists in isolation, like "I'm afraid of spiders for no reason," and isn't inextricably tied in with trauma, depression, self-esteem, etc.

The problem is when people decide that the behavioral approach that works for spiders works equally well for more complex issues like "social phobia due to childhood bullying and low self-esteem." That's when, in my opinion, you need to lean heavily on the cognitive side and make sure the patient has some tools before they leap into trying out the behaviors that are scaring them to death.

Good luck to you! I'll let you know if I run across anything on unipolar mania. Googling suggests that it's not recognized by the DSM-V, which would explain why you're not finding anything. My sympathies! I'm still waiting on a DSM-V that recognizes complex-PTSD, because it's very hard to find material on recognizing and treating that condition.

Date: 2018-11-27 03:41 am (UTC)
duskpeterson: The lowercased letters D and P, joined together (Default)
From: [personal profile] duskpeterson
"Googling suggests that it's not recognized by the DSM-V"

(*Rolls eyes*.) And yet again, psychiatry misses the obvious.

Date: 2018-11-22 05:40 am (UTC)
thistleingrey: (Default)
From: [personal profile] thistleingrey
Reading and thinking--I'm phone-only for a few days. I agree with rosefox's remarks in particular.

Date: 2018-11-25 07:08 am (UTC)
thistleingrey: (Default)
From: [personal profile] thistleingrey
Agreed, definitely, especially "when one really is fragile and when one is resilient." Sometimes one is both at once for different sectors of one's life, which can be especially confusing. :(

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