Friday, January 6, 2023

All Therapists All Bastards (Wait! Let Me Explain)

Controversial opinion. All Therapists All Bastards (ATAB). Wait. Take a deep breath. Check your professional fragility if you must and let me explain. If this phrase offends you, I ask you to take a moment to introspect and think about why. 

If this phrasing seems like it's coming out of nowhere, it's not. The statement comes from the justice system reform/abolition movement and their slogan of ACAB - All Cops Are Bastards. It's a complex statement and if you're not familiar with the underlying meaning we'll get into it.

To start with, the way I understand the phrase is that (for both ACAB and ATAB) these are not statements about individuals. It is absolutely true that there are some instances where service users have been helped by an individual or set of individuals holding the role of police officer or mental/behavioral health professional. At times, these interactions have been life saving. It is also true that there are instances where interactions with individuals holding the role of police officer or mental/behavioral health have been harmful, abusive, and even life-taking. 

This is not, per se, about individual good faith or bad faith actors. Though that is an issue. This is not, per se, about compassion or discussion of intent versus impact, though that is a conversation that sorely needs having. What this is about is who defined and built these institutions and especially who did not. And it is about what these institutions represent, which is control. These institutions are often framed and labeled as "help", "assistance", and "protection". And especially are frame as help and protection for you. For some instances, as mentioned above, that turns out to be the impact. But it's not the underlying structure. The underlying structure of psychotherapy, psychiatry, and behavioral health has, both historically and currently, been one of control.

Underlying both of these professions is a set of rules. Rules for how to behave and, in a very real sense, how to exist. They dictate what behavior is (under their framing) "good/productive" for society, and "healthy" for the individual. And a key question and concern is who was allowed in the room to determine these notions of what "good/productive" and "healthy" is, and who was not allowed in that room.

Put simply, cops and therapists represent rules systems not in alignment with the people they have power over. Cops have the power of direct monitoring under threat of confinement (and therapists do as well, through so-called "involuntary commitment"). But therapists also have a less obvious second as being placed in the role of sole systemic responsibility for the mental health of our population. It is true that you have the freedom to not use their services. But you do not have the freedom to hold them accountable for their services. If what they call "help" isn't help to you, your only other option is to be left unhelped. That is not any true sort of freedom.

And make no mistake, much of the help is not actually help. The field of mental health has taken empowered ownership of what mental health is and isn't, and it is not in alignment with the people they have power over. 

Mentalism or sanism is defined as the systemic discrimination against or oppression of individuals perceived to have a mental disorder or cognitive impairment. And I put forward that modern mental health has and remains intensely sanist in many ways.

The institution of therapy and behavior analysis serves as cops of the mind, enforcing what behavior and thoughts are deemed permissible and healthy, and with handy explanations of why they occur. At best, a therapist or behavioral analyst will genuinely let the service user self-authenticate and be given empowerment over what "healthy" means to them. Modern therapy will claim that it 100% knows and does this now. And that it has always tried to do so.

I don't think that's true. I think, by any reasonable measure, we can look at modern dialogue around mental health and see that is filled with examples of control (whether intended or not) over the definition of health, what behavior is okay, and control over the narrative of why a given cognitive/emotional experience is occurring. Which then directly leads into conversation over who is and isn't responsible for changing behavior in attempts to relieve unwanted cognitive/emotional experience and behavior.

Any everything within that carries astounding issues of the individual being judged both...

1) Not being allowed to have their own opinion on the matter
2) Being heavily and consistently fed messaging that is often untrue, ableist, and sanest

The work continues, here on this blog and elsewhere, mapping out the extent of both those points. I will highlight one specific story below, but there are thousands of examples. I endeavor to document these instances and keep forcing to convince you that the above points are true. And I would hope you give me the benefit of doubt, and start by assuming I might be right rather than assuming I might be wrong.

Who knows better? The service provider or the service user? And if your answer is the former, you've missed the entire point of this post.

Example of ableism in the field of disability services (excerpt from Gregory Tino's article Being Held to A Higher Standard)

"It took me 25 years to find a way to communicate. It then took me another year to become fluent with my mother. Why does it take 5 minutes for a critic to decide that I am not capable of communicating my thoughts?

For some unfathomable reason, spellers like myself are held to a higher standard than everyone else. Spelling on a letterboard is hard work for our apraxic, disobedient bodies. I need constant reminders to point accurately. I am able to spell for quite some time, but if I become fatigued, my accuracy with my pointing goes down. I feel like that is probably true of most anyone, autistic or not, but if WE mis-poke or make a mistake, people begin to question our authorship. YOU are allowed to make mistakes, but WE aren’t. 

Tell me what is fair about that?"

Some people even think we shouldn’t be able to use word prediction on the keyboard because it may influence what we want to say. But everyone else is able to use it to make typing easier.

Seem fair to you?

Follow Gregory on his blog, The Autistic Mind Speaks, and read more of his work in his 2020 book, The Autistic Mind Finally Speaks: Letterboard Thoughts

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Tuesday, January 3, 2023

A Condition I Have - Hyper Semantic Sensitivity / Semantic OCD

January 3, 2023

To be continued. Leaving here to show I coined the term.

July 16, 2023 Update

Since I linked this from another article, will try to explain a bit that I invented this set of terms as a way to explain that I, as a condition, become intensely uncomfortable with words and cannot help but sense and see how they're imperfect tools. This also does not mean that I need the world to be perfect. That's, of course, an unrealistic ask. What it does mean is that it's much harder for me to "just let go" or ignore issues semantics and wording cause, especially the more glaring and problematic they are.

I also do incredibly poorly when others wave away the issues versus trying to respect and at least slightly accommodate it, similar to any other disability. Even just acknowledging "oh, true, words are imperfect and wow does that cause problems" is super helpful. Demanding that your word use is correct, or that it's "not a big deal" is intensely disabling and triggering for me. I literally cannot unsee or "just let go". If you can, that's a privilege and possibly even a blissful ignorance? I'm not mad at that, but I am mad when I'm held to your standard versus trying to meet halfway and accommodate my condition, versus asking that I conform to your personal comfort level of how to use language.