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copperbadge · 1 year ago

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Feeling a little overly perceived by Dr. Dodson right now, not gonna lie.

I'll throw a transcript under the cut, but both reading the transcript and listening to the video can be difficult as it's quite long, so here's some highlights. As always, these are the opinions of a specialist but only one specialist, so take with a grain of salt, and if you have research to add to this, please feel free to comment or reblog with it. I believe this presentation is from sometime in 2022.

ADHD appears to derive from issues in the corpus striatum in the brain. In most people, the corpus striatum filters out all but the most important input AND output; with ADHD, the things normally handled "outside of awareness" must be handled consciously.

People with ADHD don't see their emotions coming. Emotion is immediate, intense, and unfiltered, making therapies like CBT or ACT difficult, because you can learn the technique but you won't have time to employ it. Because people with ADHD have impulse control issues, expressing emotions "inappropriately" is common, leading people with ADHD to believe they can't trust themselves.

One function of ADHD-typical dysregulation is Rejection Sensitive Dysphoria, which nobody understands even a little. People who have it can't even adequately describe it to people who want to study it. It is intense, painful, and apparently impossible to control. Prevention is based in maladaptive behaviors designed to avoid it entirely (perfectionism, people pleasing, generalized withdrawal). The only currently known treatment is alpha agonist medication.

Lastly, by the age of twelve, a child with ADHD has likely received twenty thousand more "negative or corrective" messages than their neurotypical peers. (This isn't relevant to the rest, I just found it sufficiently horrifying to warrant inclusion. Fortunately for me, if I got 20,000 negative or corrective messages, I wasn't paying attention for most of them.)

Anyway, here's the transcript of the first half. I did this by copying and cleaning up the auto-transcript on YouTube, but I stopped at Question Time, so this is only the first half (the presentation). Transcription of the second half is available at YouTube.

There is suddenly a very large interest in the whole subject of emotional dysregulation and ADHD. That has been driven oddly enough by the Food and Drug Administration, which has just opened up several pathways that drug companies can study emotional dysregulation and whether or not their medications can get an FDA indication for emotional dysregulation. So it's sort of follow the money. Up until then, there was not a great deal of interest for ADHD emotional dysregulation.

We have to understand that the ADHD diagnostic criteria were not made for people like you and me, either practitioners or people who have ADHD or their families. They were designed for and made by people who do research and pretty much that's it. People who do research have to have criteria that they can physically see and count. "Little Johnny was up and out of his chair three times in the last hour," and you can write a three on your clipboard. Things which are invisible, not always there, hard to count, or even hidden by the patient, don't lend themselves to research very easily and so tend to be ignored. And so consequently this is one of the main reasons why emotional dysregulation -- until there was some other motive provided -- was pretty much ignored and disregarded.

Consequently ADHD right now, if you look at the 18 diagnostic criteria, are almost entirely behavioral criteria. What is the person doing? Not how is the person thinking, what is the patient feeling, how are they controlling their emotions, how are they sleeping. Things that are all very, very important to the person who has ADHD but which is essentially ignored by the diagnostic criteria.

Why should you care? Who really cares about this? Well, the definition of what ADHD is and isn't defines who and what will be studied. It defines who will actually get into a study and what questions will be asked. It defines who will be diagnosed with ADHD and who will not. One of the most common problems I get is with a secondary referral to me -- somebody clearly has ADHD but they're not pinging off the walls, they can sit and do their work, especially when they get into a hyperfocus, and so they're told they couldn't possibly have ADHD. When really they just have the inattentive subtype and they're not being driven by their behavior, their overt behavior. Therefore it defines who will get treatment, who will get insurance coverage for that treatment, and who will get accommodations in school when they're young and at the workplace when they're older.

Consequently we should also care because the other major components of ADHD get ignored. These are the ones that if you really stand back and look at it cause the greatest amount of impairment, the greatest amount of embarrassment, the greatest amount of just…problems in general. We're talking about cognition and thinking, that people with ADHD fundamentally think in a different way than do neurotypical people. They are able to engage with the tasks of their lives in a totally different way. Their ability to control their emotions and their behavior, control their emotional responses, tremendously affects their self-esteem and their self-definition. Who am I? What am I worth? What am I valued? Why am I valued in a certain way? What do other people think of me?

It affects tremendously the nature and healthiness of relationships. How you respond emotionally to the people in your realm makes a great deal of difference about the healthiness and gratification you get from your relationships. Being highly dysregulated in terms of your energy and emotions also affects deeply how well you sleep, how easy it is to fall asleep and awake refreshed, and of course it affects emotional dysregulation.

And this is probably, when you look at it in the long term and especially with adults, probably the most impairing part of the ADHD syndrome. The vast majority of people with ADHD have found ways around their academic and work performance, but they haven't found their way around their emotional reactions to the people and events of their lives.

At all points in the life cycle -- child, adolescent, adult, and elderly -- people who have ADHD nervous systems lead intense, passionate lives. Their highs are higher, their lows are lower, all of their emotions are much more intense. And that really is what we're talking about: not really the quality of the emotions -- people who have ADHD have the same types of emotions for the same reasons that everybody else does. What we're talking here, in terms of dysregulation, is two things: one, the expression of emotions, being able to choose whether or not you let an emotion out. And then, when you do decide to express it, how intensely that emotion is experienced and expressed by you as a unique individual.

Consequently just about everybody with ADHD, but especially little children, are always at some sort of risk of being overwhelmed by their own emotions from within themselves. This is something that needs to be really emphasized: a lot of people with ADHD grow up not being able to trust themselves.

So why is this happening, especially to people with ADHD? I think that just about everybody now would agree that ADHD is primarily a problem of insufficient inhibition, being able to slow down and keep things from happening. If you look at the mass of the human brain, 85% of all the nerves in your brain and out in your nervous system are inhibitory in function. We happen to be aware of the other 15% because we can see what happens when those nerves are used: they create movement, they create emotions, they create our experience and memory. We have to remember they are a minority of the actual mass of the human brain.

Most of what happens inside the brain occurs outside of awareness. What happens is the brain starts something, it gets it moving, and then uses inhibition to guide that toward the destination it wants. It's like shooting off a rocket -- shooting it off is the easy part, guiding it to where you want it to go is the hard part.

When you look at where stimulant class medications work, they work solely in the deep areas of the brain down in the basal ganglia, and especially in an area called the corpus striatum, which is just Latin for a "striped body". That's how it looks when you look at it -- it's got many very fine stripes in it. This area, the corpus striatum, is almost entirely inhibitory in function. What it does is that it inhibits neurological input and output to just the one piece of information or one action that happens to be most important at that time. Everything else gets handled, but it gets handled out of awareness.

Probably the easiest place to see this in action is when we're driving a car. Driving a car is the most difficult thing that the average human being ever has to learn how to do. It's a very difficult process, if anybody has ever had an adolescent learning to drive. But once we learn how to drive a car we do it largely outside of our own conscious awareness. We can drive along, talk to the person on the seat next to us, think about what we're going to have for dinner, sing along to the radio, and not really pay attention, conscious attention, to what's going on around us. But if suddenly something is out in front of the car, even before our conscious brain can process what that thing is, our corpus striatum has already handled it. Slam on the brakes, swerve to miss it, start to question that person's parentage, in the twinkling of an eye. The corpus striatum has been scanning everything, handling everything.

So basically what ADHD is, is that relative lack of inhibition that should be there. Inattention, which is a cardinal feature of ADHD, is the relative lack of the inhibition of other inputs or distractions. When we look at physiologically what's happening, we don't actually pay attention to one thing. Neurologically, we suppress every other thing we might engage with except the one thing that we want. It is maximally inefficient in that way.

Impulsivity is a relative lack of inhibition, of the expression of actions and emotions before you can think about them and make decisions about that expression. Hyperactivity is the relative lack of inhibition of physical and mental activity. When the physical activity of the hyperactive little boy who's pinging off a wall goes away in adolescence, they're still very much mentally active in their own brains.

So what? The “so what” for most of us is that when this area of the brain is not working as it should, people cannot regulate the experience and expression of their emotions. Emotions are experienced as completely unmodified and unscreened. The word that most people use is that they are raw. They come out without any modification at all, they go in without any modification at all. People can see this in hyperacusis, where somebody chewing or the conversation across the restaurant comes in loud and clear because it can't be screened out.

All this is tremendously overwhelming. We get overwhelmed by entirely too much input, and the impulse to have entirely too much output. It's exhausting, and when it does get inappropriately expressed it's embarrassing, so consequently people with ADHD must always be vigilant of themselves.

Now, when we look at the traditional therapies that have been used, or tried to be used, with ADHD, they have had very very poor track records. They're largely ineffective in helping people control the expression of what they think and feel. The reason for this is that people with ADHD don't see their own emotions, their own actions, coming. They find out about their emotions and actions the same way everybody else does: it's already out there before they even know that it's coming. Consequently they don't have the time and the warning to use the techniques and new skills that they may have learned in behavior modification therapy, or in cognitive therapy. They learned them, learned them perfectly well, but the cat’s out of the bag before they can make use of them.

Right now, as we sit here today, medications are the only thing we have to offer that have a proven track record, because they're there all the time. We have two basic groups: we have the stimulant class medications which are amphetamine, methylphenidate, et cetera, which help directly with inhibition. They help slow things down, they help inhibit both input that would distract us and output. It gives you the same two seconds that everybody else has, to see an emotion or an action coming up, to play it out in your mind. “If this happens then this will happen, then that'll happen. Oh, I don't want that to happen, I'll redirect it.”

The alpha agonist, of which we have two -- guanfacine and clonidine -- inhibit the energy driving the speed and intensity of response. Interesting enough, when we look at just clean effectiveness, when we measure how effective is this treatment, the alpha agonists are significantly more effective than are the stimulants. Usually that's kind of a false choice, because most people end up taking both classes of medication.

A very special type, I think, of emotional dysregulation is -- again a terrible technical term -- what's called Rejection Sensitive Dysphoria. We actually don't know what it is. It's much too early to tell. But it does seem to be a thing with which many people with ADHD identify. There was a brief article from ADDitude that got posted on Reddit, on their subreddit on ADHD; that particular posting got twice as many responses, in less than a month, than any other posting that had ever been put on that subreddit. It really touched a lot of people in a strong way.

In my own checklist, when I'm asking about Rejection Sensitive Dysphoria, the question I have is: “For your entire life, in other words going all the way back into childhood, have you always been much more sensitive than other people you know to rejection, teasing, criticism, or your own perception that you’ve failed or fallen short?” This is directly from a psychiatric textbook, an old one, and it's the definition of a technical term, for psychiatrists called Rejection Sensitive Dysphoria.

It's important to note, this is all a matter of degree. No one likes being rejected or criticized. Everybody hates it when we fail, we fall short, especially in front of other people. Rejection Sensitive Dysphoria is much more intense, and is much more than this universal discomfort.

When they were originally doing the research on this particular idea, 45 years ago, they wanted to get that intensity right up there in the name, and so they chose the word dysphoria -- which unfortunately happens to be Greek -- but it means “unbearable”. Because that was the description they were getting from people over and over and over again. Again, for reasons unknown, people with rejection sensitivity have trouble describing what the intense emotion is all about. They can describe its intensity -- “it's awful, it's terrible, it's catastrophic,” -- but not the quality of the mood. And so, over and over again, these research subjects would finally just tell the researcher, “Look, man, back off. I can't find words to tell you what this awful feeling feels like, but I want you to know I can hardly stand it.” And so that's where the word dysphoria came from. A researcher at Harvard who decided to put it into Greek, but that unbearable quality is very much a part of what's going on, a part of the experience of Rejection Sensitive Dysphoria.

It's extremely common in people with ADHD; my guess is that about 95% of my patients report it as a significant impairment, and about a third of my patients say that it is by far the most impairing part of their ADHD. For the majority of people, and most occurrences, it is not that particularly disruptive, but when it hits, it turns your life upside down.

So how is rejection sensitivity experienced? There's no warning. It hits out of the blue; there's no way to protect yourself from it. It happens all at once, it goes from zero to a hundred percent instantaneously. It is commonly experienced as being physically painful, as if someone just punched you in the chest or punched you in the stomach -- there's an aching in the core of your being.

Once it gets started it seems to be largely uncontrollable until it's run its course, whatever it is. The quality of the mood is indescribable. Most people struggle to find any words at all to describe this feeling, even though it's massively intense. The duration can be a few minutes to several months. It's a very potent experience and can make it very difficult to risk ever being rejected or criticized again.

If this very intense emotional reaction is internalized, it looks for all the world like an instantaneous major depression, complete with suicidal thinking. And so a lot of times people do get a diagnosis of major depression, because the clinician they're working with fails to pick up the triggered, instantaneous nature of the onset of that depressive-looking syndrome. If it's externalized, it presents as a rage that is directed at the person or situation that wounded them so terribly. In fact, being “wounded” is is a very common description. This sort of sudden trigger change, with an intense emotional response, not uncommonly leads to a misdiagnosis of borderline character organization.

So if you can't see it coming, and you can't do anything once it's happened, how do people try and protect themselves from episodes of rejection sensitivity happening in the first place? Some people use perfectionism; they try to be above reproach. They feel driven to be the very best at everything they do. These are the penultimate overachievers. It works, but it's also an absolutely terrible, driven way in which to live.

By far the most common response is that people become people pleasers. They are constantly scanning everybody around them and trying to figure out what that person wants or would approve of, and that's what they give them, so much so that it is the to the exclusion of what they want for their own lives. These are people who take care of others, please others, to the exclusion of any sort of gratification in their own lives.

Another very common way that people try to deal with this is that they give up trying anything new, giving up anything in which they might fail or be embarrassed. I have hundreds of patients who have never been able to apply for a job or ask someone of the opposite sex out for a date. Just the imagination of being told no is so frightening, so devastating, that they just say, “No, I'm not going there. I'll sit this one out.”

One of the most effective ways of dealing with this are the alpha agonist medications, and when they work they can be almost completely effective. Alpha agonist again is a tongue twisting name, but it's not as tongue-twisting as the full name, which is alpha-2 selective adrenergic agonists. So you can see why we shorten it a bit. They were originally blood pressure medications that came on the market in the early 1980s. They worked very poorly -- when they did work, at most they lowered blood pressure about 10%, which was measurable but it still required other things that needed to be done in order to get most people's blood pressure down into a therapeutic range.

We have two of them, guanfacine which was marketed both as immediate release and extended release under the name of Intuniv, and clonidine, which was marketed under the trade name of Kapvay, both as an immediate release product and as a delayed release product. They have been used as a treatment of the hyperactive component of ADHD for more than 30 years, so these are not new medications for the field of ADHD. They're very much the treatment of choice for the “hyperactive, disruptive, and obnoxious little boy” that is what most people have in their minds when they consider the notion of “What does a person with ADHD look like?”

The exact mechanism of action of these medications both in ADHD and especially in rejection sensitivity is highly unclear. We really don't know -- we have a couple of ideas but they are very definitely theoretical. The only thing that we know for sure is that the stimulants don't work by stimulating anything, and that the alpha agonists don't work by being alpha agonists. How they do work is completely unknown.

We have two medications, they seem to work equally well, so there's nothing that would lead you to choose one over the other. The problem is that the robust response that we're looking for that really changes people's lives, is disappointingly low -- at about 30% to either molecule. Luckily that 30% is a different 30% of people, so that 30% of people get a good response to guanfacine but it's largely a different 30% that get a response to clonidine. So if the first medication tried does not work, it makes good clinical sense that that one should be stopped and the other one tried. There was an unfortunately worded sentence in an article I wrote for ADDitude several years ago that gave the impression that you could use the two medications together; they should not be used together. You try one, if that doesn't work you try the other.

The typical dose of either one is in the range of three milligrams of guanfacine per day or about three tenths of a milligram of clonidine per day. If you take all the people who get a good robust response to either one of these medications, about 80% are going to end up at these doses, so it's by far the most common dose.

There are of course side effects. Anything that's going to adjust the adrenaline system of the body is going to have the potential for sedation as a side effect, and this does occur for about 25% of people. It's usually mild and it does go away -- over a period of several months. So a person has to be fairly patient with that. It can cause dry mouth, and it's by a different mechanism then the stimulants can cause dry mouth, so the two of them together can really make your mouth cottony dry. And the third one is an accentuation of a universal experience we've all had, when we stand up quickly and suddenly and we get dizzy, get kind of a head rush, vision goes a bit gray. The technical term for it is orthostasis. And this can happen more frequently when you take the alpha agonist medications.

The benefits of the alpha agonist medications take a while to develop. When you change the dose it takes five days for the benefits to develop, so once again they're not like the stimulants where what you see is what you get at one hour. It takes a while for these medications to work and to see all that they can do.

Now just as a side note, Strattera has been looked at in two studies for emotional dysregulation and the results have been what they call mixed. If they did work it was only to a very minimal degree, almost undetectable, so Strattera does not seem to be a medication one could use and expect to have it help with emotional dysregulation.

So in summary, emotional dysregulation is a basic feature of ADHD, is almost universal in ADHD, and it should be considered as a core symptom of ADHD that ought to be evaluated in every initial evaluation. Rejection sensitivity…it's unclear yet -- this is an old concept that has only been brought up in the last couple of years. Its exact nature is still unclear. It does seem to be a specific form of emotional dysregulation, especially in regard that it does respond very well to medication. But again, how it fits into emotional dysregulation is completely unclear at this point. It does seem to be something that's really important, though. It is a thing that resonates with a large number of people with ADHD.

#adhd #sam has adhd #rejection sensitive dysphoria #RSD #emotional dysregulation #Youtube

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fidicusautism · 4 months ago

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drdemonprince · 1 year ago

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Despite how popular and effective body doubling appears to be, empirical research has not tested it as an intervention for people with ADHD at all. It’s a shockingly simple way to address a variety of problems, from a child struggling to complete his homework, to a grown adult who can’t tackle the massive pile of used clothes on her couch. Doctors prescribe stimulants to ADHDers facing “executive functioning” difficulties like these all the time. Yet no clinician has ever examined whether prescribing a body double would be an effective treatment — despite the fact that anecdotally, it addresses the problem more directly than meds do, and it doesn’t come with the risk of building up a physical tolerance or any unwanted side-effects. To understand why body doubling is so neglected by professionals, we have to look at the flawed way that psychiatry and psychology conceptualizes the ADHDer’s experience. Professionals largely view ADHD as a disorder of motivation and attention, a disability located inside the mind that must be solved on a solely individual level. This framing makes it impossible to understand the ADHDer as a unique, neurodivergent social being interacting with a broader cultural and economic context. Every feature of ADHD, as it is clinically described, is one of pathology and lack. ADHDers are “time blind”: they don’t have an instinct for what hour of the day it is, or how long a task takes. Nevermind that humans have relied upon time-keeping technologies for as far back as recorded history goes, suggesting that none of us approach time by instinct. ADHDers lack focus, except for when they don’t, in which case they’re suffering from hyperfocus, and that’s actually a problem too. ADHDers are emotionally volatile — but they’re also too spacy. They dissociate from reality too much, but when they take steps to address this, they are guilty of needing too much stimulation and being too active. And they’re lazy — except for when they’re staying up very late at night working, being most productive during the hours society tells them they ought to be asleep. If the many complex features of Autism can be best summed up by saying that we have a bottom-up processing style in a world built for top-down processors, then the best way to summarize ADHD is this: people with ADHD are highly socially motivated, but they live in a world where independence is prioritized.

Read the rest of this essay for free on my Substack!

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lastoneout · 4 months ago

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It's also like super fucking infuriating to see people continue to argue that generative AI is the best way for disabled and/or poor people to make art because like, you know what helps make art more accessible? Giving poor and disabled people money.

Like take me for instance, I'm disabled. I get severe migraines and intense leg/back pain if I sit at my computer for too long, my hEDS makes holding pens and pencils hard, my ADHD makes it hard for me to start certain tasks and/or stop them before I potentially hurt myself, my neck also hurts if I look down too much, my dyslexia AND my ADHD both make it difficult to keep track of a story as I write and use correct spelling and grammar, plus, I need to prioritize taking care of myself and going to appointments and keeping my house clean and that takes up a lot of my free time. All of these things make creating the kind of art I want to create difficult if not occasionally impossible.

So what do you think would solve my problems better? Giving me money so that I can have a drawing tablet and desk chair that won't hurt my neck or back, another tablet + pen and a lap table and comfortable body pillows for drawing in bed, easier transportation to my doctors appointments, effective treatment for my chronic pain and migraines, the ability hire someone to help me keep my house clean, a spelling/grammar checker that isn't complete ass, and a therapist and psychatrist who can help me manage my ADHD better?

Or an AI program that takes my input and spits out a drawing or story made of stolen content glued together that, in the case of the art, I cannot meaningfully edit without starting over, which also destroys the environment in the process?

Seems pretty obvious to me. I don't need AI, I need help to manage the things that are actually stopping me from being able to write and draw.

Or take my mom. She's had severe rhumatoid arthritis since she was a small child, her hands are deformed and she relies on her wheelchair to get around. She doesn't need AI to help her paint, she needs special paint brushes she can actually hold, a table her wheelchair will fit at, and someone to help her with personal hygiene/keep her house clean/take her to doctors appointments so she actually has free time to paint.

Does that poor kid growing up in public housing with parents who are too poor to afford art classes or supplies or to send them to college really need a computer program to draw for them, or do they need support to help them take those classes, buy drawing supplies, and money so they can go to college.

Blind people can paint, deaf musicians exist, people with missing limbs find all sorts of ways to make art, people with parkinson's paint with typewriters, my mother can't hold a normal paintbrush and she makes some of the most beautiful watercolor paintings I've ever seen, Van Gogh had bipolar disorder and only sold like one painting when he was alive, I mean for real how many different artists have you heard of who's biographies start with them being born into poverty?

This is not meant to be inspiration porn, these people are just ones who were able to find ways to make art despite their struggles. They shouldn't have had to struggle at all, but god imagine how many more artisrs and writers we could have had if none of them had to overcome those struggles. It breaks my heart to think of all the wonderful art that never got to exist because no one helped the people who could have made it actually have the time, money, support, and safety they needed to make it. AI would not have saved them because making art isn't the problem, being disadvantaged is the problem. Living in a world that refuses to make room for you is the problem. Being fucking poor is the problem. Humans have always found ways to make art despite huge barriers, the solution isn't a computer that makes art for them, it's SUPPORT AND MONEY SO THEY CAN OVERCOME THOSE BARRIERS AND MAKE THEIR OWN ART.

As a last example: I love watching dancing and I would love to be able to dance, but I'm terrible at it(I got kicked off a dance team for not being able to learn the dance at all despite spending weeks on it, idk my brain wasn't made for dancing) and my disabled body makes it more pain than pleasure if not actively dangerous, anyway. Having a robot dressed to look like me dance next to me while I get to watch would not make me feel like I'm getting to dance. It would actually be extremely fucking demoralizing and frustrating. I would hate that!!

Having an AI spit out a painting or book would not make me feel like I got to paint or write a book. It's a fucking anamatronic doll running on stolen ideas and it will never be the same as getting to actually expirience the joy of creating art first hand. AI is not the solution. Helping people who need it is the solution. And I am CONSTANTLY pissed to think about all the time and money that goes into these fucking AI programs that would be better spent helping disabled and poor people get the help they need so they can make art themselves, all while the people running the nightmare plagiarism pollution machines pretend that their horrible inventions exist to help people like me.

#anti-AI #actually disabled

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ababehaviorservices · 4 months ago

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lostintransist · 1 month ago

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I can't keep doing this to myself...

My brain spit out an idea at me that I don't want to lose so you get to suffer with me under the weight of this idea until I have the time space energy ADHD hyperfocus to start on it.

This is not edited. Goal is to get the thought out of my head, not to make it perfect.

So imagine for me if you will that in some version of the stories for whatever reason I can bullshit into making sense Simon is selected to undergo a new and experimental form of trauma therapy. Used she/her here but when I write it pronouns will be you/yours

He hates it but orders are orders and after losing Johnny (his best mate, his lover, the other half of his soul) he would do just about anything to crawl from under the weight of the grief and guilt. Accepting the assignment means being put under sedation regularly for anywhere from six months to a year. During the sedation your active mind will remian awake and will begin to interact with a simulation that will help deal with the traumas exisiting in his body and mind.

Simon, not 100% on board, accepts the assignment but when he wakes up in some of his worst memorires ignores the woman following him from scene to scene, offering help. Every time he cowers as a child she offers a hand. Each time he bites back the fear flooding his system on a battlefield she offers to take the bullet instead.

For months he ignores her, trying to defeat his demons on his own. This was his mind and his body dammit, he could do this.

She stops offering help but doesn't leave. Trailing behind him in his memories Simon always finds flowers strewn in his footsteps. He never bothered to learn her name. When her laughter starts to haunt his dreams he watches her instead of his memories.

Whoever had programed this simulation had taken great care in creating a realistic interaction point. She makes ugly faces before she sneezes in the barns he has hid in, always complains about hayfever. Her ring finger on her right had been broken before, he can tell from the slight bend between the second and third knuckle. Every time he entered the simulation she wore something different, sometimes tugging on pants as if they wouldn't stay up.

"What should I call you?"

"Mmm?" She looks up from a book she had pulled down from a shelf in a dilapidated kitchen. "Oh, I'm not real so you can call me whatever you want."

He stared at her, frustrations mounting.

"Back to the silent treatment? Okay, this recipe looks actually really yummy," she turns to look back to the book.

Simon stalks up and snatches it from her hands. There is actually handwritten recipes. For some reason this makes Simon's rage double. How? How could this be real? He never opened a book in this kitchen. All that happened here was patching his wounds while waiting for exfil.

Their pattern continues like that until his brain finally spits out Johnny's death. He had been so, so careful to never let that memory come up. When it does Simon is so blindsided that when she offers to help he finally accepts.

Not knowing what to expect from this interaction did not prevent Simon from being surprised at how she handled it. She started to hum as she froze the memory, touching and moving pieces and people until everything had rewound a few moments.

"You have to sit it in, this pain. Talk to him. Tell him everything you didn't get a chance to. The longer you can sit in the agony the sooner it will find peace." She takes him by the hand and pulls him to his love.

Simon cries, like the young boy who needed safety and only found hate or indifference. Through blubbering sobs he tells Johnny every word he regretted hording. When Johnny hugs him back, mouth moving and voice saying things Simon had only dreamed of he found a semblenece of peace.

When his heartrate returns to normal and the only proof this interaction happened is the hollow space in his chest where Johnny will continue to exist his compaion steps back from Johnny, appearing as if from the dust.

"I think that is enough today. You did good." Turning on her heel she walks away, disappearing into the folds between memories.

Simon had never seen her leave before, he always ended the sessions before she had a chance.

He lets her help then, this nameless woman. They conquer every memory and the vaguest notions of memories that bother him. This intensive work paired with his weekly therapy leaves his with the skills to deal with the nightmares, the PTSD, and the trauma that still manifests from time to time.

Can one fall in love with a figment of imagintion? Simon thinks he might have. The final session he confesses, brushing his lips against hers as she sobs.

"But I'm not real. Simon, you can't love me I'm not real."

"Johnny's not real either anymore. I still love him. I'll keep you in my bones next to him, both of you keeping me safe."

She runs then, between memories and fears until she disappears and ends the sesion.

Simon, upon requesting more sessions, is informed that he has completed the program and all his care is being turned over to the non-intensive team that his therapist is a part of. Oh she shouldn't have argued with him or cut off their sessions. Now he knows she is real, the woman the knocked around his brain and fought back the demons for him.

Now all he had to do? Find her.

For anything I am currently working on check out my masterlist. This is getting dropped into my drabbles for later.

#cod #fanfiction #cod x reader #ghost x reader #simon riley x reader #ghost cod

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bahablastplz · 4 months ago

Text

All in | Chapter 12.5 (Jisung & Minho)

pairing: Lee Felix x f!reader (mafia au)

summary: You didn't know what you were getting yourself into when you started dating Yang Jungwon, notorious mafia boss. Your life gets flipped upside down when you're found beaten and bloody by SKZ, the rival mafia group, and you're quickly integrated into their lives. What will happen when you try to leave your old life behind and start anew?

chapter summary: Jisung has always been overlooked. Minho has been invisible in his own ways. The two have become inexplicably linked; how did Jisung and Minho come to join SKZ?

warnings: please see series masterlist for all warnings.

series masterlist ~~ series taglist ~~ main masterlist

Jisung

When I was in third grade, I could not pay attention for shit.

It annoyed the Hell out of my teachers—I would lean back in my chair, I would distract my classmates by talking to them, and I would even intentionally mess up my assignments as a way to cull the boredom. In reality, I was lost in my own head. My own thoughts were my downfall, even though I was just a child. Full of thoughts, worrying about what my classmates thought of me, whether or not my parents would yell at me, and even coming up with long, convoluted scenarios about all the worst ‘what-ifs.”

When I was in the third grade, I started missing assignments. I would lose them in my backpack that was always a mess; I couldn’t keep track of my assignments like I couldn’t keep track of those thoughts. One day, my mother got called into the principal's office to talk about my behavior. They suggested signing me up for counseling, that my behavior could have been due to an underlying and untreated disorder.

That night when we got home, my mother beat me. She scolded me for bringing unwanted attention to our family, for causing a scene and making up issues that didn’t exist. I didn’t need counseling, she told me, I was just stupid. Stupid, idiotic, good-for-nothing child that can’t even pay attention in class.

The thoughts got worse after that.

When I was in the fifth grade, I started meeting up with the school counselor in secret. I told her about my mom’s adversity toward me going to therapy, though I left out the details—that sometimes, she would beat me or call me names, that some nights she took pills when she thought I wasn’t looking. I didn’t know a lot at that age, but I knew those were things I was not allowed to share.

The counselor told me I likely had some academic confidence issues. No shit. But one day, she called up my mother and told her all of her suspicions about me: That I likely had ADHD, ODD, and generalized anxiety. It would explain my lack of attention, my blatant disrespect toward the teachers, and the thoughts. I didn’t want her to tell my mom. Didn’t think she would, because of confidentiality and shit. But my mother was surprisingly receptive to the idea, especially when she found out that I would be starting medication that could fix me.

That was the first time I felt hope. Hope that I could be better, that maybe she would see me as more than just her stupid son that had no life ahead of him.

I never started treatment for my problems. It fell through, more or less, though I found out years later it was because my mom started taking the medication prescribed for me. In seventh grade, after a particularly hard night that my mom had beaten me, I left the house. I was only gone for a few hours, hanging out with people that were certainly no good for me way past my curfew. It was only a few hours, but when I returned home my mother was dead. In her hand was a bottle of adderall prescribed to Han Jisung. Me.

Grief is a funny thing. No, maybe funny isn’t the right word. Because when you’ve never known grief, it runs you over like a stampede, suffocating you until it’s all you know. In the seventh grade, grief was all I knew. Unsettled were all of the questions I had for her; Do you really think I’m stupid? Do I have any sort of potential, or am I just a waste of space? Am I worth anything? But now that she was dead and I was unable to ask her, it was like all of those statements just became the truth. If she was unable to refute them, then they would simply become a fact of life.

I dropped out of highschool after my first semester. I ran away from the shitty foster home they had placed me in, though ‘placed’ is sort of a kind word. When you’re a teen in the system, you don’t really tend to stay in one home. You bounce around, one after another, reminded that you’re nothing, nobody, and that you will never be wanted. You’ll never stay in one school district, never get to keep in contact with your friends, and never get to keep any of your possessions that you hold dear. So, the first night in foster home number ten, I ran away.

When I was fourteen years old, I joined a gang.

They were entertained by me. One thing I found out was that they were amused by how reckless I was. That I would do just about anything they asked. Because when you have nothing to lose you can raise the stakes—and if you make people laugh in return, even better. I lived off of their praise, which was maybe why I was more willing to do things that were… well, stupid, so to speak.

I’m not sure what my life would have looked like if I hadn’t met Lee Minho, my partner in crime.

─ ⋅ ⋅ ⋅ ──── ♡ ─── ⋅ ⋅ ⋅ ──

Minho

Invisibility. I always knew what that was like.

I didn’t exactly realize that I grew up in a gang, at first. I knew that I wasn’t like my peers, that I should stay quiet and stay to myself, to not draw too much attention. There were just certain qualities of my life that were different–my parents would never come to parent-teacher conferences, I would never have a sleepover or birthday parties with my classmates, and I should never talk about what happened in my home.

These were just things that were always a part of my life. I never really made any friends, but I was good at school. Most people never even knew my name, but that was just how I liked it. Once I got to a certain age I really started realizing what was going on in my house–the robbing, the selling of drugs, the violent crimes, but I turned a blind eye. Always doing homework in the background of my house where these things were taking place, I got very good at listening. So even if I wasn’t involved, I always knew what was going on. And for some reason, my mother and my father, who knew that I was too unnaturally intelligent to be their child, never forced me to participate in anything. I’m not sure they ever knew that I knew more than I was supposed to.

One day when I came home I could tell that something wasn’t quite right. As soon as I walked through the door I was met with silence, not the usual commotion that I would try to avoid. As I walked through the house I found the gun that I knew was hidden in between the couch cushions, turning off the safety. Though I was only a junior in high school I knew there was a silent, unspoken responsibility to be upheld, to protect the same way I had been protected. I held the gun close to my chest, listening closely as I stood against the wall of the kitchen listening to a near-silent conversation.

“We don’t have your money,” my father confessed. A pair of footsteps walked around the room impatiently, a breath hitching as someone cocked their gun. “We never even gave them the cocaine, it was a bad deal!”

The person scoffed, clearly unamused. “You’re really going to lie to my face? The issue here is that you ratted us out to the police after selling Mark the coke.”

I heard what sounded like my mother’s voice beginning to protest, and though I didn’t know nearly enough of the situation I rounded the corner and pulled the trigger twice. Two bodies I’ve never seen before fell dead on the kitchen floor, limp with their own guns in hand. My parents were relieved, though I had never really cared how they felt towards me one way or another, I turned and put the gun back where it belonged. I let them deal with the mess of the dead bodies and the cleanup. It was the first time I ever allowed myself to intervene, and while I wasn’t exactly sure why I did it it wasn’t the last.

I was glad I was able to take advantage of my invisibility, of the people who had never heard my name, who never knew my parents even had a child let alone that he knew how to shoot a gun. That he knew the intricacies of the gang business at the age of sixteen years old.

When I was a senior in high school I graduated near top of my class. I had a perfect GPA, missing the extracurricular activities that my peers had to help them succeed on their applications, but I exceeded in every subject I ever tried in. I even got accepted to a great school in statistics and business with a full ride, but I never told my parents. I thought I was going to enroll, but then somebody new joined the gang.

We hadn’t had someone new join the gang in over two years, since I killed the two opposing members. Of course, this spiked my curiosity, but I heard that this new guy was more popular with the younger members. Han Jisung was his name, and he wasn’t quite like anybody else I had ever met before.

Some of our younger members were surprised that I had any investment in their sakes, but I was genuinely curious about this guy. Fourteen years old, dropped out of school, willing to do just about anything that anybody had ever asked of him. He seemed to be in it for shits and giggles, thriving off of the attention he got whenever he did something particularly spontaneous. Stealing from an old woman, selling drugs to a police officer’s girlfriend, he seemed to do just about anything if he could get a laugh out of it. It seemed like bad news–for everyone. If he did something particularly stupid, he would get us all fucked.

He was assigned to his first real mission–robbing a bank, and for some reason, I decided to tag along too. I’m not sure if it was because I was concerned about the future of the gang–that wasn’t necessarily something I had ever worried about before, but something told me that leaving this guy all by himself was bad news. My parents had been slacking on their leadership of our gang for years, so it was just about time before it fell apart for good.

Han Jisung didn’t quite seem to like me. Maybe that was unfair to say, because it was just that he didn’t really seem to talk to me at all at first. I think I had a tendency to over-explain things, to be protective and tell him to stand up for himself. He was no longer in high school, he told me, and so I taught him all of the things he needed to know along the way of our mission. I skipped the first day of my college orientation.

What I wasn’t expecting was for things to work out as perfectly as they did. Jisung was an amazing listener. He rarely needed to be explained to twice, and for some reason his brain had a perfect understanding and explanation of blueprints. Once being taught a weapon he was a certified master of it, and though I had shot a gun and had killed people before I was more confident in his abilities, his way around a dagger or a pistol.

Han Jisung was quite literally made to work with me, I concluded, as our heist went off without a hitch. What had started off as a mission that was a joke in order to get Jisung incriminated was more than a success, as we accumulated thousands of dollars without the authorities ever knowing it was us. And though the younger boy was apprehensive towards me at first and I had spent years telling myself I would never get involved in my parent’s business, it was obvious that we were… well, partners in crime, so to speak.

I found out more about Han Jisung. His mother was just recently deceased and he was very clearly being taken advantage of by the other members of the gang. He was willing to do anything for the attention, when all he needed was someone to believe in him.

Jisung was my very first friend. I wasn’t willing to call it that at first, but that’s what it was. I was willing to finally tell someone what it was like to grow up in a gang, to work hard to be the top of your class but get no recognition for it. I thought that maybe I would go to college just to be far away from here, just so I could be somebody else, but I was never even sure if that’s what I wanted.

Jisung told me that he has always been seen as less than, as stupid. No matter how hard he worked, nobody would ever see him for his efforts. He would always, always be dismissed.

I didn’t want to be invisible. He didn’t want to be dumb. It seemed like for the first time, we each saw each other as more than what we had always been. And we worked exceptionally well together, even if neither of us necessarily wanted to be involved in crime.

I started to think that maybe I could end up like my parents. Maybe I could see a future in this gang, that I could be someone to professionally carry out crimes and get away with it like nobody else ever had before. That maybe there was a future for me and Jisung to be out there, on top and well-known. Though, I unfortunately caught my parent’s negative attention, and with Jisung still known as ‘the boy that would do just about anything,’ it didn’t come of any good.

We were told we needed to infiltrate another gang. The opposing gang whose leaders I had killed two years ago were still out for vengeance and it was nothing more than a death wish. Even we could realize that, but there was no getting out of this.

Jisung and I were walking the streets, looking for new weapons and discussing infiltration plans when we were approached by an unfamiliar stranger.

“Are you the two that carried out the infamous robbery on main street two months ago?”

Jisung and I had both frozen, reaching for our guns in our pockets as we eyed the mystery man. He had a large nose and wide lips, dark eyes with longer black hair to match his dark ensemble. He gestured us toward an alleyway, and with knowing side-glances, Jisung and I cautiously joined the man for some privacy. Bang Chan, he had introduced himself, one of the most well-known mafia leaders in this area. That was not something to be taken lightly.

“That infiltration was not something to be executed by beginners,” he laughed, whistling as if to show us just how impressed he was. “You would need to be someone seriously smart, to really know what you’re doing.”

“And your point is?” I had asked, crossing my arms and looking at him with trepidation. I ignored the way that Jisung’s eyes had lit up upon being called smart, the way that Chan had taken notice of this and used this to his advantage.

“The point is, I want–no, need people on my team that are as smart, as capable as you two. The Lee family has been a part of this city for years, very well-known. But you, Minho, you don’t like to make yourself known, do you? You would prefer to keep yourself in the shadows, to focus on your studies. And you, Jisung, you just need somewhere to belong, don’t you? Aren’t you tired of not fitting in?”

Okay, so this guy seriously knew what he was talking about, how to use his words to take advantage of a situation. It was as if he saw the way that Jisung reacted and easily maneuvered his plan to work in his favor. I tried to look away from the way that Jisung tensed up, visibly excited when Chan spoke. I even had to calm my own nerves. I was sure there was nothing he could offer us, nothing that could persuade me, but I was wrong. Bang Chan already had his victory written in stone.

“Come, work for me instead. I’m sure your talents could be properly used. They’re being exploited right now, aren’t they? Don’t you want to get away? Minho, don’t you want to forget the Lee family, let your intelligence be acknowledged for what it is? I promise that we won’t throw you into any known danger for our own amusement at SKZ. You can’t tell me it’s not tempting, no?”

And no, I couldn’t say it wasn’t tempting. Though I had no more chance of escaping through means of a college degree, I could still get away through other means. I could be useful in ways other than people throwing me head-first into a suicide mission. It seemed more sustainable for me and Jisung both, and I could tell I wasn’t the only one considering it.

We had two days before we were expected to take down the opposing gang.

“The only catch is you need to come with me right now and never look back.”

One glance at Jisung and I could tell that our decision was already made. My partner in crime, now at a different location to work with me within reasonable means. It was strange, wasn’t it? To want to keep my first and only friend, to be willing to continue the life of crime in a way that was more organized and deliberate?

But on top of that, even moreso I felt this innate desire to protect Jisung, my only friend. I couldn’t let him go by himself either for fear that he would be easily exploited by this powerful man.

And even though I had become well-known as the ‘master of infiltration’ I wasn’t sure how much longer I wanted to be invisible for, not when I found the one person who had made me feel seen. I could either send us both into a death trap and Jisung would never be recognized for his talent, risk the only thing I’ve ever cared about dying before my eyes, or I could take Chan up on his offer.

“We’re in.”

─ ⋅ ⋅ ⋅ ──── ♡ ─── ⋅ ⋅ ⋅ ──

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