#I'm a fan of CBT and ACT

[iplaywithstring]

Currently taking a Research Methodology course. The final project is a literature review on a topic of our choice.

My topic is the efficacy of psychological interventions for those with chronic pain.

It's been super interesting. One thing of note is that a lot of the studies show only small improvements, but those improvements are typically in the same range as other common treatments (meds, physio, massage etc.). A lot of what I've read acknowledges that chronic pain is different than acute pain.

One thing I've seen a lot is resistance to psychological interventions (CBT, ACT, mindfulness etc.) because the individual feels a need to assert that their pain is real and not "all in their head" and can't be fixed by thinking (just like positive thinking doesn't change stairs into a ramp). The encouraging thing I'm seeing in these studies is that researchers know this too, and the point of these interventions is how to better live with the pain, not how to make it go away.

A couple of the studies even acknowledge that the stigma around invisible illness and the difficulty patients have getting doctors to take them seriously impacts their openness to psychological intervention.

It's been a really interesting project.

[gxlden-angels]

do you have any thoughts on the story of abraham and isaac? my parents talk about it and praise abraham for being willing to kill his son which..... scares me to say the least, and i'd love to hear your perspective as someone who seems more well-adjusted

Where I am now, it disgusts me more than anything. The interpretation of "I'm willing to sacrifice your life if I was told to" feels like the step before "I put you into this world and I can take you out of it." It's entitlement to a child, who is an independent individual, just because they are dependent on you for survival. I prefer the interpretation of understanding the actions you're taking and the reasons why (like how there's multiple religions that don't eat pork because it was so unsafe to eat at the time), especially if it's at someone else's expense.

Where I was in the thick of it all, it gave me morbid comfort that scares me now. I had fantasies of being a martyr for the church and the idea of being the next Isaac was just so appealing. Being a hand-selected sacrifice chosen by the Good Lord Himself? Sign me the fuck up, babey!

I think if I admitted that to my family, they'd be horrified.

It's another one of those stories or beliefs where I think the majority of christians just regurgitate what they've heard. It's a point of pride and devotion, but there's no personal reflection or cross-cultural awareness of it. Lean not unto your own understanding and whatnot. It's the potential that scares me the most, like the Quiverfull movement with the Duggars or Turpins. I'm sure there's stories now, but I can't remember them off the top of my head

(Also I will be telling my therapist someone on Tumblr called me "more well-adjusted" thank you anon)

[akirathedramaqueen]

CBT and Exposure Therapy: Blitzø Showcase

An important (really, don't skip) disclaimer

If you are contemplating whether or not you would benefit from any kind of therapy, consider consulting with your medical provider first. While I did my best to validate all the points made using publicly available resources, I am not a medical professional. At the very least, I strongly advise that you do your own research and not take some amateur's opinion about a character from a silly demon show for granted.

"Everyone in this show needs fucking therapy STAT!"

We hear fans screaming into the void every now and then. Me too. I plead guilty and I willingly put myself in custody. But I am not taking these words back.

Especially often it is being said with Blitzø in mind, who, as hinted earlier and clearly shown in the latest episode, Ghostfuckers, is not doing okay. Not in the slightest.

Which is . . . yes. Indeed, trauma-ridden Blitzø is a major problem for both him and those around him. Yes, we see him reaching his lowest point now exactly because he left these gaping wounds untreated for so long.

But the tricky question is—how, though? What to do? Will a good talking to a confidante help? Or, maybe, some kind of shock would snap him out of the spiral?

I've been pondering on this topic for more than 4 months, and, as the Ghostfuckers came out, I finally got all the data I need to prove a point. The show did all the job for me and effectively made Blitzø go through improvised versions of two popular therapy techniques. And, before I even start, I want to say—I am so glad with what we ended up with. What they did, and, more importantly, didn't do, aligns well with how it would likely happen in real life.

So buckle up, and let's see where it gets us!

Therapy # 1. Cognitive-behavioral therapy, or CBT

This is, in essence and with some corrections, your good old talking. Here you can find more information about it, so, if you're not familiar with the topic, I recommend following the link first.

But, very shortly: CBT is an extremely common approach to be tried while you're dealing with anxiety, depression, and a number of other mental disorders. What it aims to do is to help you get past unhelpful thinking (distortions) and learn not to act on it.

Looks like it fits the bill, right? Blitzø has a lot of issues with self-fulfilling prophecies, infuriatingly stupid assumptions, poorly thought-out actions . . .

But he's not like, you know . . . w-we're not, like . . . we're not doing a . . . w-we . . . what's betw— It's a transactional fucking, you see.

If you don't feel like coming, that's OK! I'm sure I can do without it for one month. :)

Stolas only cares about having a rugged peasant raw-dog him into his matress! It's nothing, ya know . . . it's nothing else.

You . . . no longer have any obligation to see me, to touch me, to bed me . . . You are— you are free of me.

He sees things which aren't truly there.

It's not Stolas giving him space after the disaster in the 'Ozzie's.' It must be Stolas not needing him anymore, getting tired of him.

It's not Stolas caring about Blitzø. He is a royal, why would he care how an imp's day he happened to be fucking was?

It's not Stolas setting Blitzø free and putting an end to a problematic transaction they had with the hope for it to grow into something more. It's him getting rid of Blitzø.

As a result, he ends up hurting himself and the relationship he had with that one sad gay bird he happened to fall deeply for but literally trashed in his own house twice, acting on nothing more than frenetic fear of losing Stolas, but in reality, driving him away even more . . . for good.

I mean, you royal fucks think you can do this every time, like you can just play with our feelings because we're smaller and not as important!

Ha! I'm right, aren't I? You get off getting plowed by people you look down on!

And I can sorry more people, everyone but you! 'Cause I don't owe you dick! Everyone, but you . . .

So, the case's closed? Let someone—say, Millie—talk to him and tell him how wrong he was about himself and the others?

Well, here's the thing. Despite him being infinitely wrong about Stolas's intentions, we can't deny the fact that every one of his beliefs was not, in fact, a distortion. It'd led him to wrong conclusions, yes, but it was built on the information he received and legitimate experiences he had in his life. Here are only some of the facts connected to only this situation with Stolas, but there are other problematic behaviors and other reasons for him acting the way he does.

Fact # 1. The circus fire did happen, and Blitzø was the reason for it. Unintentional, and of course it wasn't his fault, but it still ruined the lives of many people—him included. Blitzø cannot act like it never occurred.

Fact # 2. Hell is divided by class and race. Their situationship with the grimoire was an embodiment of that inequality. A lot of Blitzø's outburst during the Full Moon and later in the Apology Tour was connected to it, to his beliefs that Stolas is the same as the rest of the privileged circle. Beliefs, I stress, justified by the real world. Stolas is more of an exception, and even then, his behavior is only different when it comes to Blitzø. He still acts the same toward other imps.

Fact # 3. We knew about Stolas's intentions all along, but before that fateful Full Moon, what Blitzø saw was Stolas avoiding him and not communicating the issue the Ozzie's date had raised. And before Ozzie's? Stolas did act entitled and inappropriate. He was baby-talking to Blitzø and used derogatory terms while addressing him. The dude literally called him an impish plaything in the Truth Seekers.

Fact # 4. Blitzø's heavily implied (though not officially confirmed by the show) existing conditions—ADHD*, BPD**, PTSD, and dyslexia/dyscalculia***—do affect his life, and while Hell seems to be somewhat receptive of neurodivergence, he still has to deal with it every single fucking day. He is going to be avoidant and afraid to be abandoned at the same time. He is going to hate himself. His learning disabilities are going to make his life harder. No way around it.

Note: *, **, and *** contain links to separate meta-analyses from @timkontheunsure and @tealvenetianmask about the respective conditions and how they show themselves in Blitzø's case.

And my beef with CBT here is exactly that. CBT's goal is to gaslight you into believing your distortions hold no water and suggests you just ignore them. And, as I've shown with Blitzø, these reactions and assumptions aren't baseless. They are legitimate, and, in fact, sometimes help to get by. Even though it's a crooked crutch, you can't learn to walk properly by just throwing that crutch away. You're still going to limp, and oh, will it be painful.

This is oversimplistic and dismissive. Anxiety and depression don't come out of the blue, and with mental disabilities, it's even deeper. The class/disability stigma is alive and strong, and just slapping a "you're fine" bandaid on your traumatized self isn't going to help.

Therapy # 2. Exposure therapy.

Exposure therapy is another approach commonly used while dealing with traumatic past and its aftermath—PTSD, anxiety, phobias, and such. Again, if you're not familiar, there's the link for you, but very shortly—the therapist puts the patient in a safe environment and 'exposes' them to the feared object in question for limited periods of time. The goal is to eventually get rid of the targeted fear and decrease avoidance.

And Blitzø has got some phobias for sure.

The fear of letting everyone down. Again.

And the fear of abandonment. Again.

All of it is a result of self-hatred, sitting so deeply it rules his life and his vision of how others perceive him. Said it himself. Almost.

So, where and how does the show expose Blitzø to his traumatic past?

First, the most recent, and the most obvious one—Rolando and his slideshow of all traumatic events Blitzø ever had in his life.

Second—Blitzø's drug trip in the Truth Seekers. While it does not contain the events of the past as they were, it does force him to face his fears.

Are you worried I might have enough of it one day as well? . . . You're going to die alone! . . . You're going to die alone, Blitzo!

With some stretch, the third one is Verosika's 'Blitzo sucks' party. Where Blitzø was forced to see the consequences of his avoidance and rejection.

Note: to be clear, I do think the party does not show the true extent of Blitzø's actions and how much he'd hurt people. It was exaggerated by Verosika, and here I explain why this is the case.

So, what gives? Or, rather, what gives it not?

It might sound funny now, considering I brought it up myself, but I, once again, say this is not therapeutic, just as CBT kind of 'talking.' If anything, all these three events did more harm than good.

The D.H.O.R.K.S.'s goal in the Truth Seekers was to torture the information out of Blitzø. He was not supposed to overcome it. He was supposed to crack.

The Verosika's goal was to ruin Blitzø's reputation. She was working her ass off to prove he's just a heartless freak.

The Rolando's goal was to fucking kill Blitzø.

And okay, their motivations had nothing to do with helping him, but maybe it did, in its own twisted way?

No. The writers added this to push Blitzø past the breaking point, not to heal him, and to show us more of his lore. Each time he was forced to face his past or fears or consequences, he was only spiraling more.

The only thing which did him some good was . . . well, Millie finally seeing his bravado mask falling off. But the cost of it was way too high. Not worth it.

To the therapy's defense, some points why it would never work in the way it was done in the show:

Blitzø had never given his consent and was not ready to face it. I might be very rude right now, but go and try producing some explosion-like sounds in front of war veterans without letting them know first and see what happens.

The amount of fearful experience exposed was way too overboard. He couldn't possibly digest it in a healthy way.

The environment was not safe. It was straight-up retraumatizing, an intentional one.

So there's that.

But what helped then?

We've briefly brushed over the fact Millie did talk to Blitzø. While I did imply this might be an example of CBT, here are some key deviations from the classic therapy which made all the difference.

Millie didn't sugarcoat all the shit Blitzø did. He was hurting their business. He didn't pay her. He was reduced to Bethanie. It showed her opinion can be trusted.

Millie apologized for not being there for him sooner. She admitted she relied too much on Blitzø being bulletproof, unbothered by everything. She admitted she didn't support him in a way he always did.

While proving she could never hate Blitzø, she used their common story, one he knows and can recall. She used evidence to prove him wrong, not a "it's all in your head" bandaid. And more than that, later she proved it with action—not for one second did she believe Rolando and his shittalk about what Blitzø supposedly was thinking about her. Her unwavering faith spoke more than any words ever could.

Getting back to exposure therapy . . . Metaphorically, she reminded Blitzø he can handle a beating or two. And physically beat the infestor demon out of him, which, as we can see later, didn't really affect Blitzø that much. He wasn't even battered. So, apparently, when the said exposure is done by someone who genuinely tries to make you feel better and knows your limits well, it might just work?

And finally, Millie acknowledged Blitzø's pain. She didn't brush it away. She validated him.

What all of this is about?

Like every treatment, too much of a medicine can become poisonous. So are CBT and exposure therapy.

They might help, and lots of research shows they do in certain cases. But there are limitations to what they can and cannot achieve, and they have to be adjusted to each individual story, to each trauma, and they should not be applied as a way to mend the outcome of the trauma without taking into account the story it comes with. Again, legitimate concerns and experiences cannot be brushed away or ignored.

Actualy . . . we've seen where it leads in the show too. In the beginning, Millie was quite dismissive of Blitzø's worries—all of this over a . . . breakup?

And here it comes full circle.

Only when Millie started taking Blitzø seriously, did it help them progress. And look how quickly we've switched from a complete despair to a glimmer of hope! Isn't that a beautiful closing scene?

As a closing note—we do not need to 'fix' Blitzø. After all this shit he went through, there won't be a day where he wakes up and be like, "Hey, I don't hate myself anymore! And look, I'm not afraid to be abandoned or misunderstood!"

I'm sorry to break it to you, but this is a lifelong battle. Being mentally whole, healthy, and constantly happy is no more than a myth, and everyone has their own demons and skeletons to deal with.

What Blitzø needs is some good support system to pull him back when he's down.

And boy, do I hope that one particular owl will fill in that role of unyielding pillar for Blitzø each time our lizard will fall into that pit again. Look, I love Millie, but there's only so much she can do. She can't be always present, she has her own life . . . and her own disaster of a husband to look after (affectionate <3). Here and here @lost-romantique talks about Stolas's capacity of loving, with me occasionally nodding, ha-ha. But to be short—it's fucking immense. And since he loves words, I do believe he has all the energy to tell again and again and again how awesome Blitzø is. Even if Blitzø wouldn't believe it himself.

[superfallingstars]

Re: your recent canon vs fanon post, and the ATYD timeline:

I appreciate that the ATYD timeline seems super useful to any fans writing fics based off that story. And to be fair, it's labeled fanon (f) or headcanon (hc) where possible. It's awesome that the author did that; there's a lot of ATYD that most people just accept as "basically canon", and it's nice that the creator at least took the time out to note that it's not really.

My biggest issue with it is the descriptions for canon events that are incorrect or not labelled appropriately. For example, Regulus's death is labelled "Regulus and Kreacher go to the cave late and Reg sacrifices himself for Kreacher after destroying the original horcrux". In canon, Regulus doesn't destroy the locket. That's kind of a big plot point of the seventh book...

And for another example: in the timeline, Snape's Worst Memory is labelled: "despite the fact that they were not talking anymore the mars hear Snape saying some shit about Remus and spreading 'rumors' that he is a werewolf. They immediately decide that they need to put a stop to that shit, snape's worst memory ensues. Snape had already told lily that R is a werewolf but L played dumb, however after hearing him call her a literal slur she is over his shit and friend dumps him". In canon, SWM happens because Sirius is bored, not because Snape plans to "out" Remus... he's actually sworn to secrecy at this point, and neither Sirius nor Remus ever give this as an excuse for their behavior during SWM; all they say is that they were young and acted like arrogant berks sometimes.

Idk. I appreciate the effort that went into the timeline but... I think calling it "accurate" is a bit of a stretch. Accurate to the fic, sure. Canon? No.

wow i very much appreciate that you took the time to write all this out, go off. i imagine the calendar is indeed a helpful resource for atyd marauders fans and also can very much see it as like a "hey guys i made this thing for myself and i'm super proud of it! maybe you'll like it too!" kinda thing... like it's not the end of the world if somebody's personal canon ("canon") reference is inaccurate and says snape is homophobic. it's just a pain in my world and i'll complain about it for a while

but also yeah you're very much right about the canon events. i guess it must be referring to events that are technically canon but happen differently in atyd? benefit of the doubt? also i genuinely can't believe that atyd changed snape's worst memory from snape getting bullied to... snape getting righteously bullied for being a bad person? the prospect of this is so funny to me that i'm legit cry laughing over it. tho it's also nearly 4am where i am. strange emotional reactions happen during the witching hour

idk i'm going to say that maybe op posted it for their circle of atyd fans and didn't expect it to break containment to the larger fandom, so didn't feel the need to say "accurate (to atyd)." admittedly i'm cbt-ing myself here but whatever, my sanity requires it. thank you for the ask and for your diligent corrections <3 now time for bed

[altheterrible]

I said to @wardinpanties this morning that I wasn't a fan of antipsychotics, and when you considered the risk:benefit ratio, I wasn't even sure if they held up in the treatment of psychosis, let alone the 679646 other indications they're used for off-label.

As a pharmacist, I saw Seroquel prescribed exclusively for insomnia regularly, and it was rage inducing. Seroquel is not a benign drug; as far as the 2nd generation antipsychotics go, it's one of the worst for weight gain and metabolic disturbances. Why not just prescribe Ambien? Oh, right, Ambien is a scary controlled substance. Better use this other drug that can give you diabetes and a permanent movement disorder instead, that's much safer.

I've been reading a bit about managing psychosis with CBT. Therapy can reduce the distress associated with psychotic symptoms significantly and increase a patient's ability to cope with psychosis, even in the absence of medication.

Maybe like, we should give lower doses of medication and prescribe concurrent therapy? Nah, too much work, better just nuke psychotic symptoms into oblivion, along with the rest of the patient's cognitive function.

Antipsychotic use should 100% always be voluntary. No starting long acting injectables during involuntary hospitalizations. No chemical restraints with haldol. God. When they sedated me with Haldol I was furious. I was already taking an antipsychotic, I'm lucky my whole body didn't lock up. No making antipsychotic compliance a requirement for parole. No court ordered antipsychotics.

Some people may not even want their psychotic symptoms treated, period, and that's a valid choice.

I'm just. I really do NOT like antipsychotics. I don't like taking them. I don't like giving them to other people. And I refuse to be involved with any situation where antipsychotics are being given involuntarily. I ain't your girl for that shit.

[goosegoblin]

Do you have any advice for handling ADHD and generalized anxiety together? My brother has ADHD and recently has started having anxiety attacks. Since I don't have ADHD and my anxiety is social-related, I'm not sure if I'm able to give him the most applicable advice. So I thought maybe you could offer some tips to help him handle his newfound anxiety issues.

(I’ve published this to see if anyone wants to add anything in- let me know if you’d rather I deleted it and sent you the content privately)

I really like ACT. I use thought defusion and deep breathing to handle my anxiety, and I find it works better than say, CBT. ACT has helped me fear my anxiety less- I know it will happen to me throughout my life, but I feel more equipped to deal with it when it does happen. The aim of ACT is not to get rid of negative feelings, but to learn to accept them and deal with them in the moment.

One thing to be aware of is that lots of anxiety stuff involves distraction, which is useful, but he needs to make sure what he’s doing is actually fully distracting. With ADHD, you’re very accustomed to doing multiple things simultaneously, so it’s possible to be seemingly fully engaged with a TV show or game and to actually still be freaking out internally. Different things work for different people, so it’s worth experimenting a little. I like walking while listening to audiobooks or playing a video game with my partner that requires concentration. I also do maths problems, especially when my anxiety is quite high- I multiply numbers together that are big enough to be difficult, but small enough to be do-able.

When I’m in actual panic attacks, I’ve found the DARE technique to be really helpful. There’s an app, and the free version is useful- it has the audio I use (‘I think it’s something like ‘help! I’m having a panic attack!) and it also has some nice deep breathing stuff. Using this method has helped me stop panic attacks and prevent them from escalating.

Be careful with caffeine, especially if he’s already on stimulants. Too much can put even healthy people into panic attacks!

It’s useful to come up with a type of ‘panic attack plan’, as it were. I get very hot when I’m anxious and that triggers me, so for me it’s important to keep cool. I use a fan, or wet cold cloths, or I put my face into cold water (also triggers the diving reflex, which is helpful). I find deep breathing audios on Youtube because I find it a lot easier to focus on my breathing when someone else is telling me to. If I feel it’s escalating or not going away, I use the DARE technique. 

I haven’t had a full panic attack in a while, and I think that’s partly due to working on accepting the panic for what it is. Panic can’t hurt you. It’s just your body misunderstanding the situation and thinking there’s a risk when there isn’t. If you fear panic, then you end up in a cycle where your body views panic as a threat, so it puts you further into fight or flight and makes you panic even more. It’s sometimes known as ‘meta-anxiety’- anxiety about anxiety- and tackling that has made the actual anxiety seem a lot easier to handle.

With ADHD, his brain will go a lot faster than a normal brain. That’s a blessing and a curse. It’s worth trying to harness that brain energy into something more useful when panic strikes, because otherwise it absolutely will dwell on the current situation and make it worse. Lots of people with ADHD struggle with anxiety, so he’s absolutely not alone. Checking out online communities of people with ADHD on Tumblr and Reddit has been really helpful for me, as it’s helped me to understand that I’m not mad or broken or lazy. The subreddit /r/panicattack isn’t used much, but reading through that really helped me too.

Feel free to message me any time, or pass my info onto him. I’m rooting for you guys

[goosegoblin]

hey jess! a while ago you rec'd the 'couch to 2k' podcast, i couldn't get through to half of week 1, but now i wanna give it another shot! i've been having some health issues for a while now tho, and i'm most likely on my way to getting diagnosed with IBS, so i was wondering, how do you combine exercise with IBS? becuae i'm afraid of going anywhere that doesn't have a bathroom close by in case it starts acting up

Hey love!

That’s definitely hard, and I know you aren’t the only person to struggle with it. There are apps that show local public toilets- you could check those out and plan a route through them? If you have access to a gym you could also try and do it on the treadmills there. 

The good news is that exercise has been shown to often help IBS! So you might find that as you start moving more, you struggle a bit less. Getting a diagnosis and figuring out your triggers will help too, as you can start working on a plan to minimise symptoms. 

Anxiety is also a huge thing with IBS. The fear of ‘what if I have an IBS attack?’ can sometimes prompt an IBS attack, which is just... the worst. CBT and ACT skills are useful here- I’m a big fan of thought de-fusion. Counselling can be really useful for coming to terms with having a chronic illness, and managing it moving forwards.

Good luck!