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#in describing the symptoms of functions it's easy not to see the why
whenever talk about level of autism (1/2/3) and support need labels (low/mid/high), see bunch people say how they don’t like levels because can’t be described by single number or single word, and how if someone want know what they need help with, just ask, disabled people know their needs!
by all means, allowed feel this way for self! this post not way say you must like autism levels or support need labels for self.
and yes! ableism & infantization like assume all disabled people not able know self, so it sensitive topic for many, and true that many disabled people do know own self & needs & disability & limits.
but do notice pattern: often, people who say this, more likely comparatively less language & communication struggle, comparatively less intellectual & cognitive struggle, and able be somewhat independent—people who can know and explain their needs in timely manner—which become problem when they go beyond talk about self and try speak for all autistic (or I/DD, or disabled) people. become problem when say “levels/support needs labels useless and gloss over details and ableist, just ask disabled people themselves we can answer for self.”
(human experience complex. no one number/word/phrase/label can perfectly explain all experience. this include levels, support needs, but also diagnoses like autism.)
here only some! reasons why some autistic people cannot explain struggle & what need help with, why need quick short easy remember word like autism level & support needs labels & severity (but other I/DD may feel similar, but wide and am not entire know don’t want generalize. people with dementia and similar may also feel similar) :
1. cannot communicate all
autism impact social communication ability. may not able explain all complex need and how exactly help. may not have language and word for all. may only able say few words. may only able know few words. may not have functional communication. may not have any word communication.
2. cognitive struggle, cannot remember all, cannot understand all
may be too often confused or overwhelm or brain not clear to explain. may not able know what specific need help with, just “need help.” maybe not remember all thing need help with. may not remember need explain. may not able understand need help. may not understand need explain need help.
3. too much, or take too long explain, too private for random internet, but need something
“level 3” “high support need” may not tell you what exactly need, but definitely tell you “will need a LOT more help than most people, need especially watch out for.” because “autism” not specific enough.
mid/high support need, level 2/3, moderate/severe, often struggle with so much and need help on so much, even if able perfect communicate & cognitive, actual explain can take very long, even hours or more and only touch basic. many half joke about name what don’t need help with faster.
during time sensitive emergencies, or “you don’t need all my medical info but you need know” situations, or “no time/space need be short & sweet summary” situations: ambulance, medical ID, lanyard, ER, quick medical intake paperwork, be/about be called police on, be see as suspicious / act “weird.” all no time/space/ability say anything more than few words.
even outside that. it personal medical info. some don’t want name all. for some, say all bring out many emotions and trauma, like embarrassed or ashamed or hopeless.
why do you say autistic instead list all autism symptoms everytime? same reason why many people use & need autism levels and support needs labels.
4. specific for so called “outdated” autism severity: not all able change language. not all want change language. not everywhere have levels. for some, severity most accurate describe how autism symptoms impact.
so, no, not all autistic people, not all disabled people able know & explain self! not all able answer for self! some may only able use quick summary words like autism levels & support needs & severity, some none at all. some need others help explain, some need lanyard or other visual ID for everyone see explanation because we autism visible and everyone already see.
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desceros · 5 months
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Hey, if this is too personal totally feel free to disregard this! But I've seen you mention having adhd more than once, and I know a super common symptom is executive dysfunction. The professionals I see aren't sure if I have adhd specifically, but they agree that I definitely have major executive dysfunction issues. Like... it feels like an actual, physical wall between me and the things I need to do, and even want to do. This wall feels... impossible to scale. I think that's just executive dysfunction in general, though, and isn't really unique to me. I just wanted to know if you have any tips that help you do the things you want to do or need to do even when it feels impossible? I've tried so many of the tips I see online, I've done quite a bit of research into the mental illnesses I do have and even the ones I likely have, and... I don't know. I still just feel stuck. Sorry if my thoughts are disorganized or hard to follow, I'm sorta really going through it right now. I'm fine, just... stressing myself out. Any tips you feel comfortable giving would be so, so appreciated. And thank you for taking the time to read this!
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yes indeed, i am hashtag officially diagnosed with what i like to affectionately call my dumb bitch disease (not that anyone else is allowed to use that term for it.... well. maybe my very close friends. but yeah. gotta laugh at the awful things so you don't cry, right?)
so the thing with adhd (well. any kind of mental health issue) is that it's all a spectrum. every human person on this planet is somewhere on the euclidean axis of how many neurodivergencies they have. some people have no recognizable symptoms in any of the recognized areas we have. some people may have mild issues with things, and it's a bit fuzzy if they "have adhd or not." when you talk to a professional, there's a particular line of demarcation that happens when someone is looking to diagnose you with something.
do these symptoms interfere with your day to day life? are they severe enough to rise to the level of DISORDER?
it's completely possible for you to struggle with executive function and not have adhd. you may have something else, as executive function disorder is not exclusively in the domain of adhd, or it might just be that those particular neurons are cranky in your brain. what you're doing here—recognizing symptoms and looking for ways to address them—is really good, and basically what adhd therapy does, anyway.
all that being said, honk shoo honk shoo, let's get into a What The Fuck Are You Talking About for people who want more information on the subject, and some advice i have for you. i'll start generally, then talk a little bit about the writing thing specifically since it's a bit of a special beast for me.
what you are describing does indeed sound like issues with executive function to me.
first, for those new to the idea, executive function is the fancy term for the "executive" of your brain. the guy in a fancy suit who makes shit happen. when you walk by a dirty plate, you have the thought "oh i should put that in the dishwasher." executive function is the gap between the thought "oh i should x" and doing x.
a lot of the problems that neurodivergent people have, especially those with adhd, is that this function is impaired. some days, it's just fucking impossible to move that plate.
and it's not consistently, or predictably. some days, you will be perfectly able to do the thing. yesterday you put the plate in the dishwasher. today you put the plate in the dishwasher. tomorrow you will put the plate in the dishwasher. but tuesday comes, and you walk by the dirty plate, think "oh i should put that in the dishwasher," and then you stand there and stare at it without moving it. and you're like, c'mon. it's easy. you did it yesterday. all it takes is moving your hand. picking up the plate. walking into the kitchen. putting it inside the dishwasher. isn't that so easy? why can't you do it? why isn't your hand moving? are you lazy? are you stupid? this is infuriating! you literally just did this yesterday! you've done it a hundred times! what the fuck is wrong with you?! and then wednesday comes. now you have two dirty plates. now the task is twice as hard. maybe you can do it. maybe you can't. it's a harder task now. now you have three plates. now you're guilty because you have all these dirty plates, and it's a mountainous task now, and your roommate is giving you stink eyes for leaving dirty plates out, and you're a fucking adult who should be able to take care of some dirty plates, and you want to, you WANT to take care of the plates, but every time you THINK about them you flop into a cold sweat—
this is executive dysfunction. it's one of the more insidious side effects of adhd in my experience. that said, there are a lot of little tricks i've gotten from therapy specific to addressing this problem, so i'll give you a list here.
DO I HAVE TIME? this is best used for small, quick tasks like our plate example. you walk by the dirty plate and think "i should put this in the dishwasher." do you have time, right now, to do it? will it interfere with the thing you were doing? for example, if you're on the way out the door because your ride is honking, the answer is no. if you're on the way to get another glass of water while kicking back and watching some youtube, the answer is yes. if you have the time, do it now. now let's say you bring the plate into the kitchen and open the dishwasher. it's clean. you haven't emptied it yet. now the task has changed. but that's okay; do you have the time to empty the dishwasher right now? maybe you only get an hour a week to kick back and watch the youtube, and it's a special time that you need in order to recharge. the answer becomes no. well the plate is in the kitchen now instead of your room. victory.
COIN FLIP GAME. this one i actually got from the anti-planner by dani donovan, which i can Not recommend highly enough. there is a task you have to do, and you want to do it, but you're having a problem getting started. or maybe you have to do it but it feels icky, but you do really need to do it. the important thing for this trick is that it is not time sensitive; if you don't do it right now, it's okay. so you flip a coin. heads, you do it. tails, you get to wait until you have the thought that you need to do it again. if you get tails, then you are allowed, guilt-free, not to do the thing. if you get heads, sorry champ but you're doing the thing. gamifying it in this manner kind of... cheats your brain into approaching things differently, which can help you get around that brick wall.
TASK INITIATION. sometimes, it's not that the task itself is the problem; it's because you're having problem with what's called "task initiation." getting Started doing the thing is really fucking hard. if this is your issue, you can try and approach it a different way, usually by going "backwards" down the order of operations. so say for example, laundry. i have a lot of trouble with laundry. if i think to myself "i need to do my laundry," i have difficulty with the task initiation there. so what i do instead of "starting" at the shoving clothes into the washing machine part, i'll go into my room and make sure i've picked up all the dirty clothes and sorted them out. check my bathroom for towels and washcloths. sort them away. now i'm standing in front of my dirty laundry, and i'm "doing laundry," so it's easier to pick up one of the organizer bags and take it into the laundry room. i went backwards down the line and found a place in the task list where i could begin without the hassle, then i basically tricked myself into continuing past the point where i was having trouble.
BREAK UP THE TASK. this one is good if you feel like you're looking at a mountain and it's so overwhelming you just. don't do the thing. you'll hear it a lot: "just break it up into smaller tasks!" but. what the fuck does that actually mean? what does it look like? it's going to depend on You, but let's look at our plate example. so we just walked by the plate and we know we need to put it into the dishwasher. well. let me start by looking at the plate. can i do that? can i pick it up? let's say the answer is no. well, why? maybe i'm so stressed from work that this is just one too many things on my, haha, plate right now. okay. maybe don't worry about this right now, then. or maybe i'm having trouble because i know that the dishwasher is full of clean dishes, so it's not really as simple as "put the plate in the dishwasher." so, bring the plate into the kitchen. put it on the counter. maybe that's enough for now. or maybe i can open the dishwasher. look inside. it's full, and i don't really have the energy to unload it right now. ...or maybe i do, but i'm just looking at this huge thing that feels too big. maybe i can put away one plate. okay. that wasn't so bad. maybe i can put away all the plates. plates are easy. my trick is i take all the clean dishes OUT of the dishwasher and put them on my kitchen island without worrying about putting them away yet. then i load the dirty things into the dishwasher. well now i turn around and i have all the clean dishes pilled up nicely here. momentum really is everything. one task leads to two leads to five leads to done.
TASK BUNDLING. this is useful if you're trying to be more consistent about something and you already have something else you do consistently. for example, i have dogs. every night around six pm, i feed them supper. now, historically, i've had problems with remembering to eat/feeling like cooking when i wasn't hungry/being hungry but having trouble cooking. i don't need to tell you how unhealthy that is, hahaha. so what i did is i bundled my supper together with their supper. they will eat every night. they will Not forget to remind me that they want to eat. i make their supper every day. so i make their supper, feed it to them, and bam! i'm in the kitchen. preparing food already. so it's really easy for me to keep going and prepare My food. let's say you want to drink more water. every time you open tumblr, bundle together the task of checking to make sure you have a glass of water with you, and take a sip. let's say you want to take a vitamin. keep the bottle by your toothbrush. and get weird with it! don't let social norms hold you back. i have a toothbrush in my shower. i have medicine on the bookshelf next to where i play video games. these aren't the "usual" places for things, but they Work for ME. find the places that work for you, and bundle things together. you'll be a lot more likely to do them if they're tied to something else.
BODY DOUBLING. this one is HUGE. i've actually infected my neurotypical friends in discord with this one, it's so powerful, hehehe. basically, you externalize the executive function. there are a couple of ways to do this. if you want to do something, ask someone to be in the room with you. they don't have to be doing the same thing, or anything, really. but having another Person there (another BODY, if you will) will make it so you can do the thing. you can also do this over discord. for example, my friends and i will open up a voice chat, and we'll be doing things. i'll be writing, khaya will be drawing, yorsh will be writing or drawing, keisha will be writing or drawing... and because we're all there together, we're super productive! it smashes through that brick wall a bit. there is a whole genre of youtube videos i LOVE that target this thing. find "study with me" type videos where you have someone doing homework or something, maybe they have rain, or lofi music, or just the ambient noises of a coffee shop; whatever you find most helpful. i actually body double with a little fox timer i have on my desk. i turn him on for an hour, and since he's "working," it's really easy for me to be like "ok i gotta work too." silly? yes. does it work? yes!
BULLET JOURNAL/APPS. i don't mean the pinterest pretty things where you end up spending way too much time on making a pretty spread. i mean the actual basic bullet journal that the original creator developed because he has adhd and needed something to keep his shit straight. i did this for a while, and i found it somewhat useful? eventually i found more success with the app TickTick, which is so good for me keeping my tasks straight and accounted for, i pay for the premium bc fuck yeah. if you're the kind of person motivated by streaks (think, like, doing something because you don't want to break a streak. i am very much this person.) then i've gotten a lot of good mileage out of the Today app. i don't use it much anymore, but it's very good if that's a motivating thing for you.
WEAPONIZE ANNOYANCE. i do this one a lot. i have certain things that annoy me a lot. like, being wasteful with water really annoys me. so that means i don't like to wash laundry more than once. which means, if i put something in the washing machine, i WILL move it into the dryer. so if i can put my laundry into the washing machine and get it started, i have defeated the demon of moving it into the dryer by weaponizing my own irritation against myself. same thing with gritty bathroom floors. my cat's litterbox is in my bathroom. i Really hate stepping out of the shower and feeling litter under my feet. so i'm pretty meticulous about keeping the bathroom floor clean, even though sometimes i have a moment of executive dysfunction about vacuuming every day, because whenever i hit that brick wall i think. ok. well. we can look at this brick wall that's here. now think about the sensation of stepping out onto cat litter out of the shower. aofjalsfjadlskfjslakfjsalkfj. and that's enough for me to reach for the vacuum. so you can use your preferences against your weaknesses, especially if they're things that you're Very particular about.
RECONTEXTUALIZE. my therapist will sometimes stop me and say "you are should-ing all over yourself." and this is when i'm saying things like "i should x" or "i should y." i should be able to put away this plate in the dishwasher. i did it yesterday! i should be able to do it today! the moment you catch yourself thinking these things, stop. think about it differently. instead of "i should be able to put this plate away," think "i want to be able to put this plate away." now you can say. well. why do i want to put the plate away? because it's dirty, and dirty dishes will attract bugs. i don't want bugs. i want my room to be clean and smell nice. i want to enjoy being in here. now, instead of a chore that needs to be done, you can think about it as a positive thing you're doing. sometimes this is enough to get around that wall.
now. you've asked me about writing specifically, which is. kind of a special beast for me. you said it seems like i have a compulsion to do it—and it really does kind of feel that way. if i go too long without writing, i feel uncomfortable. antsy. like i'm not doing what i need to be doing in order to be Me. as such, it's usually not that difficult for me to convince myself to write. if i start seeing a brick wall about it, i can go "...but... think about the COOL SHIT that's about to happen in symphony!!" and i'll go "OH YEAH" and break right the fuck through that brick wall kool-aid style.
that said. i do experience executive dysfunction with my writing. there are days when i want to write, i have the scene in my head, i have the time, i'm in my special writing place, and i sit down and—and i can't do it. i can't write. i keep clicking into tumblr. i close tumblr on my computer then pick up my phone. i watch youtube videos. it's like no matter what i do, i can Not focus on writing. even though i am screaming and rattling at the cages because i want to!!! i want to write!!! i want to do nothing MORE than write!!!!
often, one of the tricks above will work for me since i've learned how to use them over the years, and i have practice tricking myself. i find particular success with the body doubling in particular for writing. but some days, it just. Doesn't Happen. and here is the ultimate truth that i will bestow upon you:
it's okay if you don't do the thing.
so you don't pick up that plate today, and tomorrow you have two. so you don't do your laundry, so you have to do it tomorrow. so you miss a meal. you go a day without writing. it's okay. as long as you're safe and healthy, it's okay. tomorrow is another day for you to try and do the thing.
stressing out about how much you want to do the thing is counterproductive. you're just going to make yourself ill doing that, and then you'll be less capable of doing things. just... chill. relax. breathe. do what you can. try the tips i gave, look for some more and see if those work, and if they don't... all right. it just isn't meant to happen today. no big deal. do something else today. maybe you don't pick up that plate... but you do fold that laundry that was giving you a brick wall a few days ago. maybe you don't write that fic today... but you do read that book you've been putting off, and now you have a new favorite author you want to pick apart and study. life is short, and precious. don't should on yourself.
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transmutationisms · 9 months
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Do you have a perspective on why stimulants aren’t currently widely prescribed as weight loss drugs? Im guessing it’s related to it being a ‘controlled substance’ and ‘scary drug’ but drug marketing in pursuit of pharmaceutical profits is pretty powerful… I wonder why I haven’t seen (effective?) efforts to try to ‘overhaul’ the image of stimulants as only associated with “addiction”, “hyperactive children”, finance bros, and “lazy adults”.
I know vyvanse is also prescribed for binge eating but I get the sense most people are unaware of that. I tried many stimulants and I had the most rapid and “easy” (found food repulsive) weight loss on vyvanse. Granted all of the many prescribed stimulants I’ve tried all greatly suppress my appetite.And I’ve seen it described as a benefit by some people who have it prescribed for adhd (I understand why people do and I sometimes see it as a very depressing benefits because lack of food security despite). Binge eating disorder and prescribing for general weight loss aren’t too far from each other in the fatphobic society we live in but I guess I’m curious how it hasn’t had the ozempic treatment already/ when will it happen. People already look down of folks who can’t function by society’s standards in certain contexts and I see that similarity in how people talk about people who take ozempic for weight loss (admonishing and a moral failure).
stimulants absolutely still are prescribed for weight loss lol, in addition to Vyvanse for 'binge eating' (v unreliable diagnosis that many people receive when they are in fact dealing with subjective loss of control around food as a direct result of restrictive behaviours...) there's also Desoxyn (methamphetamine) and Phentermine (a substituted amphetamine), which are both still FDA-approved for short-term weight management. and yes that's Phentermine as in half of fen-phen. you also have to keep in mind that off-label prescribing is hard to track but is probably still occurring at not-insignificant rates (i know it happens with Ephedra and Clenbuterol, for example). and then there are also patients who use stimulants for weight loss without a doctor's knowledge, either by obtaining them on the black market or by simply getting a doctor to prescribe them for something else.
anyway in regards to pharma marketing strategies i think there are a few things going on here:
weight loss has never actually been the sole market for these drugs, nor was it the first. amphetamine was first synthesised in 1929; it was put into asthma inhalers almost immediately and by the late 30s was being sold as a kind of generalised wellness-producing drug, used by, for instance, college students as a 'pep pill'. the Allies used quite a bit of amphetamine in WWII to keep soldiers alert (the US military was still doing this in Iraq and Afghanistan in the 2000s; afaik they have not stopped this practice). by the late 50s stimulants were also marketed as pick-me-ups for unhappy housewives and for a dizzying array of depression 'subtypes' (postpartum, old age-related, disability-related) and 'modern miseries' (atomic anxiety, economic and political unrest). it wasn't until the 50s and 60s that stimulants really started to be marketed as diet pills, with 'overeating' configured as a symptom of depression. even those formulations also had other use markets: professional athletes, for example. i'm sure pharma companies would love to have the stimulant dominance they once did in weight loss, but it's not really necessary in order to move product: these days the ADHD diagnosis will generally do the job just fine. nicolas rasmussen's book On Speed has more on this history.
speaking of the ADHD diagnosis, i have observed that in the last two or so decades, it has increasingly been invoked in bioessentialist narratives of either 'chemical imbalances' (usually dopamine, norepinephrine) or distinct 'neurotypes' that are said to cause, worsen, or be susceptible to 'overeating', which can therefore be treated by the use of stimulant drugs. i strongly suspect an effect here is that 'overeating', weight gain, or 'obesity' are de facto being used as diagnostic criteria for ADHD, or for other psychiatric diagnoses considered to have high overlap in behavioural presentation. this is not dissimilar to the formulation in the 60s of 'overeating' as a result of depression; in both cases the narrative elides the appetite-suppressant effects of stimulants and presents them as aiding with weight loss by treating an underlying bio/psychiatric pathology. an interesting historical note here is that Adderall is simply a rebrand of the second-gen formulation of the weight-loss drug Obetrol.
presently, weight loss is largely marketed using the language of health rather than aesthetics. although pharma companies are certainly not morally above lying, i do think it would be a tough pill to swallow (pun intended) if they tried to convince anyone that a stimulant prescription is part of this sort of 'wellness' scene. that could change in the future, ofc; these perceptions and associations are socially and historically contingent. in the US even as recently as the 90s, people were definitely still presenting fen-phen as health-promoting (tautologically, because it caused weight loss!), at least until the valve disease scandal.
glp-1 agonists like ozempic are, i think, getting a lot of extremely credulous coverage, from both the medical establishment and health journalists, that is obfuscating the fact that they basically also work by suppressing the appetite. whether it is 'healthier' to do this with a substance that alters endocrine function than to do it with a substance that acts on adrenergic receptors is unclear to me. certainly there are many 'side effects' of the glp-1 agonists that are simply the results of rapid / significant weight loss (fatigue, weakness, osteoporosis, hair loss, gallstones, 'ozempic face', &c). that a process that causes these things can be marketed as health-promoting is a whole other topic lol. but i think the perception of the glp-1 agonists as healthful weight-loss agents has to do with certain misunderstandings of diabetes, metabolism, and body weight, as well as a degree of... not quite blackboxing, but something adjacent, on the part of pharma companies in their promotional materials. which is to say, it wouldn't surprise me if, in the future, people looked back at glp-1 agonists as also being risky drugs to use for weight loss, and only being worth using in specific, limited circumstances.
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Text
What’s a CDD?
Easy.
DID and OSDD 1.
Sources?
The authors of the ToSD
People without access to a proper library really shouldn’t be in syscourse, ffs, why are we arguing about this? >:[ stop it
All sources under the cut
According to the Theory of Structural Dissociation of the Personality, trauma-related disorders can be described on a continuum from simple PTSD, to cPTSD, to more complex dissociative conditions such as DDNOS-1 and DID.
Resting‐state functional connectivity in patients with a complex PTSD or complex dissociative disorder before and after inpatient trauma treatment - Nijenhuis, Ellert R S
In the treatment of complex dissociative disorders (i.e., dissociative identity disorder [DID] and dissociative disorder not otherwise specified [DDNOS] it is often unclear if the patient will be capable of integrating the traumatic past).
TREATMENT STRATEGIES FOR COMPLEX DISSOCIATIVE DISORDERS  - van der Hart, O
These complex disorders are considered to be extreme reactions to developmental trauma and require a specific treatment approach. They include Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder-Type 1 (OSDD-1; APA, 2013). OSDD includes a diverse range of four dissociative problems, but OSDD-1 is considered to be very much like DID with less distinct symptoms.
Assessing and Treating Complex Dissociative Disorders - Steele, van der Hart
Various studies found, among psychiatric inpatients, prevalence rates of 421% for these dissociative disorders as a whole and 17% for the most complex dissociative disorder, i.e., dissociative identity disorder (DID) (see Sar, 2011, for an overview). For the complex DSM-IV dissociative disorders, i.e., DID and dissociative disorder not otherwise specified (DDNOS, subtype 1b), as well as for other complex trauma-related disorders such as Complex PTSD, the standard of care is phase-oriented treatment consisting of...
The use of imagery in phase 1 treatment of clients with complex dissociative disorders - van der Hart, O
According to the current standard of care, the treatment of traumatic memories of patients with complex trauma-related disorders – including dissociative identity disorder (DID) and DSM-5 other specified dissociative disorder [OSDD] (DSM-IV dissociative disorder not otherwise specified [DDNOS]) – involves a phase-oriented treatment approach.
The treatment of traumatic memories in patients with complex dissociative disorders - O. van der Hart, K. Steele, E. Nijenhuis
Other sources:
Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1).
Chronic complex dissociative disorders and borderline personality disorder: disorders of emotion dysregulation?
Once there are multiple ANPs and EPs then a complex dissociative disorder is in place, structural dissociation applies.
UNRESOLVED PROBLEMS IN THE THEORY OF STRUCTURAL DISSOCIATION
(reminder of the theory for context)
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The term ‘complex dissociative disorder’ (CDD) used by some authors (see Dell, 2009) refers to the most severe dissociative conditions, that is, the diagnoses Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV/DSM-5 dissociative identity disorder (DID) and DSM-IV dissociative disorder not otherwise specified, subtype 1 (DDNOS-1)/DSM- 5 other specified dissociative disorders-1 (OSDD-1) (APA, 2000, 2013).
Negative affective responses to positive events and stimuli in patients with complex dissociative disorders: a mixed-methods pilot study 
DID and the closely related Other Specified Dissociative Disorders, example 1 (OSDD), where similar disturbances are observed without meeting the full clinical picture of DID, are commonly categorized as Complex Dissociative Disorders (CDD).
Group treatment for complex dissociative disorders: a randomized clinical trial
The participants were all diagnosed with complex dissociative disorders (CDD), that is, dissociative identity disorder (DID) and Dissociative disorder not otherwise specified (DDNOS).
The challenge of being present with yourself: Exploring the lived experience of individuals with complex dissociative disorders
Psychotic symptoms occur in some, but not all dissociative disorders. They are usually seen in dissociative identity disorder (DID) and dissociative disorder not otherwise specified type I (DDNOS-1, according to the DSM-IV), traditionally subsumed under the rubric of ‘complex’ dissociative disorders (Loewenstein, 1991).
Psychosis, Trauma and Dissociation Emerging Perspectives on Severe Psychopathology 
There is a paucity of empirical data to assist clinicians in choosing interventions to use with patients with complex dissociative disorder (DD; i.e., dissociative identity disorder and dissociative disorder not otherwise specified) at different stages in treatment. 
Treatment of complex dissociative disorders: A comparison of interventions reported by community therapists versus those recommended by experts.
This information resource outlines the rationale, response and outcomes required for recovery from complex trauma when there is also a significant dissociative presentation. In particular, when Dissociative Identity Disorder (DID), similar trauma-related complex dissociative conditions or Complex PTSD (as a result of severe, prolonged and repeated traumas - usually abuse - beginning in early childhood) is the most accurate primary psychiatric diagnosis.
ESTD Complex Trauma resulting in Dissociative Identity and similar Dissociative Post-Traumatic Conditions
Most people at the severe end of the dissociative spectrum, living with Dissociative Identity Disorder (DID) or Dissociative Disorder Not Otherwise Specified (DDNOS), have suffered severe, and often organised criminal trauma and abuse in childhood, against a background of disorganised attachment. Complex dissociative disorders including DID and DDNOS are widely understood as complex forms of post-traumatic stress disorder, where some combination of severe neglect, trauma, and abuse has occurred in childhood, against a background of disorganised attachment and across a child's developmental stages.
Medical aspects of recognising complex dissociative disorders
Complex dissociative disorders (CDD) include dissociative identity disorder (DID) and the most common other specified dissociative disorder (OSDD, type 1). One of the strongest predictors of CDD is antecedent trauma, particularly early childhood trauma.
A Schema Therapy Approach to Complex Dissociative Disorder in a Cross-Cultural Setting
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notenderlaith · 1 year
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A rant on ableism
Does anyone else have the problem of "You have everything!" when you use a medical term to describe a state of being or behavior. Like yes, I have heterochromia. But its not a diagnosis, or a disease, or anything of the sort. It just means that I have multiple different colors in my eyes. that's it. just like you likely have monochromia. Which is also not a diagnosis or disease. Or like how I have sensory issues. Which means I'm not gonna touch the dishes that are covered in grease and crumbs from fried chicken. Which I have no idea why its a surprise in the first place seeing how I specifically skipped dinner today because I wanted to avoid that. So when I ask literally everybody in the house if they'd rinse the dishes off and then not one offers, its "well that's your job". no its not. Its literally a rule that you rinse off your own dishes because were not small children and can clean up after ourselves. And even if it was, my sensory issues aren't just gonna pack their bags. All I'm asking is for them to be rinsed off. I will do the rest no problem. I prefer to do it because nobody else can seem to get the job done. As far as I can tell, the neurotypicals in my house (everyone else) are more dysfunctional than I am. And the only reason I seem dysfunctional is because I can't function in the dysfunctional environment they made. So when I tell you about my disability after nicely asking for accommodations, and you tell me that I have all the problems there are to have, what you are really saying is that there's no way I have these problems and I'm making it up. and the only reason one would believe that in the first place is if you consider these things to be very basic and easy to do, and that anyone who can't do it is either a liar, or so incompetent that they are not human. For some reason, I'm not allowed to have disabilities unless I'm completely stupid. I'm not stupid. I'm not a liar. I'm not dramatic. I'm not an alien or an animal. I am autistic. And its really stupid and dramatic of others to have a bigger problem with me have a disability near them, than it is for me to have the disability to begin with. Other people seem to experience so much suffering when ever I ask for accommodations that I need because yes, if I ignore my sensory issues id prolly just be inconvenienced right? wrong. I wont be inconvenienced. I'd be overwhelmed. And even if I suppressed my emotions until I could isolate, one way or another I'd scream-cry my eyes out because it is so consuming that it physically hurts me. I don't stop suffering when I mask, they just don't see it anymore. Just because I don't need leg braces and I can smile and talk like everyone else doesn't mean I'm not disabled. I'm fine with my disability, I really am. It's inconvenient but I play my cards right and make the most out of it. (spoiler alert: I can make a lot of really cool stuff out of it) But what I'm not fine with is playing dress up. I'm not the doll that people project onto. I don't do what you say because you do what you say. You make your own decisions and I make mine. And I make the decision to love and respect myself enough to not put me through a lot of unnecessary stress because "you have everything". And I can see where people are coming from with this. Yeah, I have sensory issues, echolalia, dyslexia, and executive dysfunction, but none of those are on any of my papers as a diagnosis because they are not separate disorders. They are the symptoms of one disorder. Which I am diagnosed and with and had even before the diagnosis. I've always had it and I've always been this way and I always will. There isn't a thing in the world to fix me because I'm not broken. Mental illness and disorders are a buy one get 17 free. I have ADHD and ASD, which greatly increases my chances of being trans. Those three things increase my chances of having anxiety. Those things increases my chances of getting depression.
The trauma I've experienced among my inability to cope makes it really really likely that id get PTSD and a personality disorder. so yeah, its a long list but it wont change its validity. Mental illnesses are not rare. Disabilities are not rare. Trans and intersex people are not rare. they are all around us and we have met so many of them with out even realizing and we might be them with out even knowing. Not everyone is so caught up in their own privilege. I acknowledge my privilege a lot (but still not as much as I probably should). And I try my best to boost the voices of those I have privilege over in an attempt to make change. I'm not the most pathetic person in the world. I have it fairly well. Even if I've had one of the roughest lives I've even heard of (including in realistic media), I have it pretty darn well. and If I don't, oh well idc I'm still gonna be happy when the occasion gives way. There is no amount of disability and disorder that can ruin me. But it does effect me a lot. and I take care of myself because I deserve to be taken care of. When I am on my own, I will not make food that cause sensory issues. And this dysfunction magically isn't a problem anymore because I have given myself the attention I deserve. If there is any instance where I need assistance, I will ask. And I fully intend on surrounding myself with people who are kind and willing and are at least half way decent enough to be able to recognize that disabled people look just like everyone else sometimes, and regardless of the disability or how it may affect our appearances, we are people. And those people would have no problem helping me with things and I would have no problem helping them. I get infantilized and that is why I can't help myself, not because I'm helpless. I'm not allowed to help myself. So until I get recognized as the disabled person that I am, I will forever remain the animal with every disease and disorder know to man kind. Let me do things in a way that works for me, in the only way that I can, or do it yourself. There are an extreme amount of cases where it would be necessary for me to do things in a way dictated by another person. that is incredibly sparse. If you want me to do something, act like it. Why ask me to do something if I can't do it in the only way I know how? If it needs to be done in your way, then you do it. It makes me think of getting a jigsaw puzzle solver to paint a masterpiece. Yeah they make pictures, but they do it with jigsaws, not paint. So why would you ask a puzzle solver to paint rather than a painter?
Just like the puzzle solver can make pictures like the painter can, I can do a lot of the same things people without my conditions do. But It's done in a different way. It takes time and energy and a lot more than everyone. Yeah we all have problems and get tired but I'm tired because I do my hygiene in the wrong order so I think really hard about it and take an hour and you're tired because you've been working all day. I promise it a lot harder for me. Not that abled people don't have valid problems. But they don't have disabled problems. They don't have room in the conversation of validity with disabled folks because they do not have the experience and they will not be affected when we get more and more marginalized. We speak for ourselves because we face the consequences for their mistakes and they wouldn't even notice something went wrong. It does make sense for them to hear us and get to know about different kinds of people, because we should be able to peacefully co-exist and that requires understanding. It will be inconvenient to co-exist with some disabled people, but it is for anyone. It's just inconvenient in different ways. And you wont notice the benefits because you take it for granted. But I promise that I have just as much worth as the next person.
Asking me to not be disabled is so fucking stupid. And I can't believe that I have to say that to begin with.
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donnerpartyofone · 2 years
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so i'm reading The Life-Changing Magic of Tidying Up, a development i never saw coming, because of two things i recently heard about it:
1. that one of its main points is that keeping your space clutter-free is actually a specific skill you need to acquire and not, as is popularly thought, something that you either naturally do because you're a good person, or that you refuse to do because you're a jerk or a failure. 2. that marie kondo found her calling in this area after suffering from some sort of cleaning-related nervous breakdown.
i've had problems with being clean and organized my entire life, and for the most part i just accepted the criticism that this is a matter of personal failing. as a more informed adult, it has become much easier for me to see my disorganization as one symptom among many of a bigger problem that is probably cognitive in nature. as a kid i was depressed and sort of oblivious to the "real world", which could make it easy for adults to assume that i just needed an attitude adjustment. (i don't even blame them, my parents were not psychologists, but anyway) as an adult i'm still depressed and instead of being oblivious, i care profoundly about being more functional, but just wanting to change, and trying as hard as i can, still don't seem to make a difference.
the first time it occurred to me that my problems may be more neurological than intent-related was when a sympathetic listener referred me to this helpful article:
but while i'm reading the kondo book, it also occurs to me that there's this whole ethos around being organized that's really oppressive. there's a feeling that being untidy is sort of a moral failure: that you are being a mess, on purpose or out of willful negligence, because you are disrespectful, inconsiderate, LAZY (is the big one), shortsighted, apathetic, or any number of other indicators of a human being with poor character. my messy room was one of the main points of friction between myself and my family until i left for college. never mind that i was also sleeping all the time, swinging constantly between sadness and outrage, and expressing suicidal ideation out loud from when i was in single digits; my apparent refusal to clean my room was seen as a separate issue, either a bratty behavior that i designed to piss off my parents, or at best, just a failure to learn to follow the rules.
i haven't finished kondo's book yet (because i'm still working on the exercise i'm about to describe), but it starts to become clear that there are important psychological underpinnings of one's hygiene-related behavior. kondo doesn't come right out and describe her own personal problems (not yet anyway! don't spoil it for me if she does!), but you start to realize a few things from her snippets of biographical information: for instance, she makes it clear that she was alone a lot as a child. she seems to have lived a very separate existence from her siblings, and instead of socializing with schoolmates, she spent all of her time researching and implementing new ways of cleaning and organizing both her home and her school rooms. she describes this as an all-consuming compulsion that had a deleterious effect on her grades, and something is surely implied by her revelation that when a person switches from a pressing task, like studying for an exam, over to compulsively cleaning their space, they're being overtaken by a subconscious drive to Put In Order something that is bothering them deep inside. (when i was trying to get through my final year of college i started taking several showers a day, but ANYWAY) and then of course, there is what i read elsewhere about how she was eventually so overwhelmed by her sisyphean struggle with clutter that she had some sort of collapse, after which she gained clarity on why disorder happens and what to do about it...
kondo reiterates the old pop psychology truism that for a person to change, they have to really want to change, and she has a smart way of getting the reader to access their own obscure but potentially powerful motivations for wanting to get organized. she gets you to ask yourself why you want to "tidy up", but you're not supposed to stop at pat answers like "i want more space" or "i want to entertain at home" or whatever. you're supposed to then ask yourself what you want that cleanliness and space FOR, and as you keep asking yourself "why?" for every answer you come up with, you eventually start producing really detailed personal information about what kind of life you actually want to be leading. i suppose it's true that you could do this for any aspect of your existence, e.g. "why do you dress like that" or whatever, but there is something about starting with the basic issue of how and where you live that seems especially liable to make you face yourself. the whole "clean your room" thing is so loaded with psychic material related to family friction, intimacy issues, social prejudices that assign a moral quality to neatness/messiness, etc, that something deep is bound to come up. like when i start trying to answer marie kondo's question about why i'm even reading her book, two things come up: one answer relates to my sunniest aspirations about what kind of life i want to lead, to have the kind of future i want. the other answer is something more like, "i want to tidy up because once upon a time, grownups made me feel like i was actually a bad person for having a messy room/desk/locker/etc."
so my point is that even though The Life-Changing Magic of Tidying Up is mainly aimed at practical, cosmetic changes to your lifestyle, under the surface there's this really deep psychological thing going on that's as potent to me as any of the more spiritual, personal, new age-y type of self-help material that i've encountered. like, you could pay thousands of dollars to let tony robbins put you up on a stage in front of screaming crying strangers so you can give them incredibly intimate details about the worst thing that ever happened to you...or you can do some basic exercises from this book about how to clean your room, and you might wind up with the same kind of startling clarity about yourself without even realizing that that's what you were about to do.
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Okay so. This gonna be long. But dean headcanon.
This is a bit of a stretch and not one that I think a lot of people lean towards (either that or I'm just not in a circle that talks about it) but. Dean has autism? Maybe not super obvious signs, and I'm much more familiar with the signs in afab than amab, but it feels REALLY similar to myself.
I realize that cptsd has really similar symptoms as low-support-needs (high functioning??? Someone please tell me what term to use I cant figure out if it's problematic or not) late diagnosed autism, as well as several other neurotypes. But a lot of it feels really familiar, and in some of the distinguishments between cptsd and autism, dean leans toward the autism side.
Anyway, a list in no particular order:
Knows a lot about random topics -- that one case where he knew the guy used the wrong country for a proverb to come from, mentioning vonnegut, possible hyperfocus on weapons and fighting
Seems to have a fairly good musical understanding despite having little to no experience -- you're telling me John taught him how to sing? And he picked up on guitar as quickly as was implied? I think the fuck not
Hyperfocus on a TV show/genre -- Scooby-Doo, dr. Sexy, westerns
Perfectly happy driving for hours on end listening to the same tracks on repeat -- apparently this isn't normal???
Seems to dissociate really easy -- he could be desensitized to violence, and probably is at least a little. But when he's already emotional, or caught by surprise, he's immediately horrified, almost like he's not as careless towards it as normal.
Described as having too many emotions. Very much cannot communicate them. Seems overwhelmed.
Very much likes blankets, hot showers, massage bed -- sensory issues. Also, that could be why he wears flannel and jeans all the time. Yeah, it's practical, but the clothes don't bother his sensory issues.
Also, sensory stuff could be why he's constantly chasing sex. If your constantly feeling everything, why not make the everything be mostly good? People with asd also typically are either on the grey scale of sexuality or hypersexual.
He clearly understands communication, but masking. Also, he's fairly social. The puzzle of human communication may be a hyperfixation of his. Not to mention that a few of the times people say things he isn't expecting he gets flustered and confused.
He seems to see grey points in a very black and white way, and black and white as grey. I don't know how else to describe that.
The thing with asd people typically struggling more than nts to understand things like capitalism bc why WOULDNT you give up some fancies if other people can eat enough -- that's literally why he can't get himself to leave hunting.
Not willing to change the impala or his music.
Had the whole dean cave put together without Sam knowing (I think? Correct me if I imagined this)
Routine. He's impulsive when it's his decision, but if someone else decides, he wants nothing to do with it -- getting up in the morning, I swear there's more but my brain is getting tired
Struggles to make close connections. Very few actual friends (especially compared to sam) and very few actual relationships.
The close friends he has are not nt. Charlie most likely has adhd or asd, cas acts very similar to someone with asd, Sam's at least really traumatized. This is common with nds.
He has different personalities depending on who he's with (masking) -- cas vs Charlie vs Sam vs Donna vs Claire vs Benny... etc
Prone to addiction -- the need for routine and chronic stress from masking makes this true for asd people as well.
I think it was called existential suicidal ideation or something like that? Doesn't want to die necessarily, but doesn't really want to be around but does, but doesn't really care. It doesn't seem like a big deal so he's sorta apathetic to it.
I think there was more, but I cant remember right now. Am I crazy???
Sorry is asd autocorected to sad. And yes I did hyperfocus on this for a week and a half.
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sonneillonv · 2 years
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yea you're right with everything. i guess eddie sometimes takes the special k when he needs to escape too. what most people criticise is that he could have made her addicted to it because that happens when you take drugs to escape
Yeah, that can definitely happen. And who knows? He might take it. We don't really know whether he self-medicates with anything (besides alcohol, and very mild alcohol at that). He's definitely not getting any actual medication for his obvious ADHD 😅
Talking about addiction is thorny and difficult for a number of reasons. Classism, ableism, general anti-drug attitudes, and hell, even racism all play a part in how addiction is viewed in American culture. Addiction is hard to define - a lot of people in this fandom have pointed out that K is about as harmless, and only slightly more addictive, than caffeine and marijuana. But when people are dependent on caffeine, we typically don't describe that as an 'addiction', or if we do, we don't attribute the same stigma to it as we would if someone was addicted to Ketamine.
This is especially funny to me because I have ADHD. People with ADHD notoriously self-medicate with caffeine because it has the opposite effect on us that it has on other people. It's incredibly easy for someone with ADHD to develop a caffeine dependency that can actually affect their health in many ways (not just the withdrawal headaches but blood pressure and heart problems that can be dangerous), but we don't get stigmatized for that: we get stigmatized for taking Adderall, which basically does the same thing for us. Adderall is a controlled substance because it's SO popular on the street. It is, essentially, a legal dosage of Speed, and because it's associated with recreational drug use, it's heavily regulated - which means I have to overcome hurdles to get my prescription that a lot of other people don't. Since ADHD makes remembering to do stuff and forming habits really difficult for me, extra barriers result in frequent medication lapses - I can't get a 90 day supply, so I have to do a special song and dance to get my meds every single month, and I have to keep seeing my GP so she can keep prescribing it to me in case I'm suddenly 'cured' and don't need it anymore, and she has to put a special call into the pharmacy so they know a real prescriber actually wrote the prescription she transmitted electronically from her office, etc, etc. Those medication lapses fuck with my health because you're not supposed to just 'stop' Adderall. It's addictive, and you will have symptoms if you go cold turkey. Not to mention, if I have a lapse for more than a few days, my life starts heading down the tubes because I need my medication to function enough to do basic tasks like, y'know, dishes. Laundry. Vacuuming the floor.
So I depend on Adderall, which is addictive. Am I an addict? Is there a difference between me, a person with a prescription, and the kids who are buying it off their local pill guy to help with 'academic performance'? If so, WHY? Why is it different that I need a drug to perform, and they need the same drug to perform? Or, if we flip it around, why is the idea of children taking Adderall to focus better in school such a threat that the system needs to make it nearly impossible for me, an adult with a medical disorder, to have consistent medication? Many, MANY disabled and mentally ill patients face systemic barriers to getting help because people are SO scared of enabling 'addicts'. Pain management in America is utterly fucked because people are so scared of (and disdainful toward) 'addicts'. At some point, we have to recognize that our culture uses the word 'addiction' as a boogeyman. It's meant to create fear and demonize individuals, and that is NOT a constructive way to talk about or address dependency.
Other countries have begun to recognize and treat addiction as an illness (or a consequence of treating an illness which can be managed with professional assistance), and they are seeing a LOT more success in harm reduction and addiction recovery than the US. I don't want to type another five-page essay here, so I'll just say that a lot of people get addicted because they self-medicate. They self-medicate because something in their life is intolerable to them. They may choose more harmful or dangerous methods of self-medicating if they're unable to fix the bad situation or alleviate the pain/stress. A long-term, unhealthy, and degenerative 'addiction' the way that we typically think of it has two factors - the chemical addictiveness of the drug itself, and the threat of the environment you're trying to escape. American rehabilitation suffers because even if you can break a person's chemical dependency on a substance, we don't have the social programs in place to fix the shitty situation that caused them to self-medicate in the first place. Once they're 'clean', they have to go right back to being broke, jobless, unloved, ill, stressed, abused... and if that's too much, and they turn back to substance abuse again, most of us get on a high horse and go, "Tsk tsk, well I guess you never deserved my help in the first place. Never trust an addict!"
To continue my personal example... evidence-based research proves that if you want kids to stop abusing Adderall, it's not effective to put it behind a bunch of legal barriers. What's effective is asking yourself, "Why are kids feeling such immense pressure in school that they need chemical assistance to meet standards? What could we do to alleviate this kind of pressure on students while still helping them learn?" Then addressing the root problem, which removes the need to self-medicate.
'Addiction' isn't a monster in the closet. It isn't some kind of looming evil. Lots of people need a particular substance to live and function. The diabetics in my family are utterly dependent on insulin to live, and I'm dependent on Adderall to do dishes. They need one kind of help, I need another. Someone who's become dependent on heroin needs a different kind of help to thrive. But it's all HELP. It's all NEED. With Harm Reduction, we focus less on demonizing the fact that people have needs, and more helping people meet their needs without destroying their lives. In the case of heroin that would mean breaking their chemical dependency, but it's not because "OMG it's bad that you need this". It's because the heroin is killing them and we want to find a way to alleviate their suffering that doesn't also kill them.
So when people are like, "OMG Chrissy could have got addicted!" I'm over here like "Yeah she could have got 'addicted' to pseudoephedrine or adderall or prozac too, so what?" (in the sense that none of the above are 'addictive' on par with, say, opioids but can create dependency in the long-term.) Nice upper-middle-class girls take that stuff all the time. If people care about Chrissy avoiding addiction, the solution is to address the problems in her home life, not to clutch pearls over a tranquilizer she was offered once.
That's why it seems pretty obvious to me that people who demonize Eddie for selling her K don't actually care about Chrissy (or real people with chemical dependencies) at all, they're just trying to feel superior. Just another expression of modern puritanism in fandom and I'm over it. 🙄
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drunkenelfmage · 1 year
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ADHD and Gender
Nowadays, one of the first things You'll find out about about me is my ADHD. Probably mostly through just context clues of me rambling in your face, topic bouncing around in very long sentences without punctuation or pauses, talking exitedly about every topic like a 6 year old that was just asked to describe why Charizard is awesome.
But Im also hyper conscious of how my ADHD affects my day to day life, so you'll hear me talk about the various symptoms and deficiencies that come with it (and of course the latest tactics Im using to combat all of its problems). I was diagnosed as a child, but only in the past year I have actually acknowledged its existence, understanding my symptoms, seeing a therapist, and taking meds. FOr a long time, I thought it only affected me a little bit, and since I knew so many other people with it that seemed to be functioning well without therapy and meds, I thought I didn't need it either, which is possibly one of the worst decisions I have ever made in my life.
I got ADHD and I have it BAD. According to my therapist, it is NOT a light case of the forgetsies that I can just muscle through. Dude said I should be on meds the second session we ever had lol.
So thirty years of untreated ADHD brain has lead to some bad habits. Its a common symptom of ADHD to start projects or big changes and never finish, and after so many years of failure, I've developed a fear of even starting anything to avoid the disappointment. So when I finally started to confront my feelings on my gender, there was always this fear under it all, not just of transphobia, but of an inability to follow through, to end up stopping at some point far behind an imagined "finish line".
The initial glee has definitely slowed down. Its a little hard to experiment living in a transphobic household. Any makeup has to be wiped off after a few moments in front of a mirror, and even when the clothes come from goodwill, the costs add up. The only thing I have been able to consistently do has been wash my face and shave and experiment with pronouns online. Just have to be satisfied with just that for a little while.
I was worried that my ADHD had tricked me, got me excited at just the idea of exploring my gender and now that it wasn't novel or easy, it was going to be another thing to add my list of failures or impulses that I never engage with.
THat was until I had a conversation with someone today, talking about how much I shave and I realized that the idea of stopping was just not an emotional option for me anymore. I can't go back to lazily using trimmers once every week, I need the hair on my face and chest GONE, the same way someone might feel if they suddenly found their body covered in spiders. Shaving was the least permanent change I could have made regarding my gender, but now I know it was incredibly permanent, because now I know exactly when Im feeling dysphoria.
So maybe ADHD was what helped me pull the gender trigger, but now I know these desires won't fade away after I find another hyperfixation. I just hope I can stay focuses long enough to actually deal with them.
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The Parkinsons Protocol PDF, eBook by Jode Knapp
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theblogs2024 · 2 years
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3 Tips to Recover Your Gut and Lose the Weight for Good
Weight reduction is as basic as eat much less and exercise a lot more, right? That is definitely the particular messages we listen to in the mass media. And it sometimes might appear like a good easier solution. But unfortunately, it doesn't always work. The surprising weight reduction trip Janet (not her real name) is a client associated with mine who emerged to me in order to lose weight. She had tried everything and currently had been exercising intensely twice per day to try out to make the scale budge. And it wasn't budging!
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Janet's friend, Claire, came to myself months earlier to deal with her symptoms associated with joint aches and pains and digestive issues. Though weight reduction wasn't her goal, by creating an eating plan regarding maximum nourishment and gut healing Claire healed the pains, pains and digestive issues and dropped 15 lbs. Therefore Janet came in order to me searching for a option to weight reduction and considered that perhaps her belly was part associated with the problem. In addition to Janet's struggle in order to acquire a weight she felt good regarding, she was also experiencing chronic exhaustion, heartburn, stomachaches, obstipation, diarrhea, gas plus bloating. Her concentrate was on bodyweight loss, but there was so many various other symptoms all tied together! Within 1 month of making a good eating plan particular for nourishing her body and healing her gut, the girl had lost 10 lbs. and mentioned her stomach experienced amazing - better than it had within years. Neither Jesse nor her buddy tracked their calories or counted grms of fat or even carbohydrates. Janet got actually decreased the girl exercise because I believed the strength to be the stressor on her behalf system. So, why did they describe the particular weight loss success to be easy? Heal your belly, lose the bodyweight There are a lot of components to attaining and maintaining the healthy weight. Not only do feelings be involved, but the particular current environment postures a significant problem towards healthy residing. In addition, optimum functioning of the particular human body such as the very important gastrointestinal system or "gut" is vital. In latest years, research is definitely giving attention in order to the impact that will the trillions associated with microbes in the particular gut play within health, illness and weight management. In the particular future, we can be capable to determine specifically each individual's microbiome and the way to promote optimal gut bacterias. The ability to manage and avoid illness is going to be afflicted tremendously! Research published in the United states Journal of Gastroenterology in 2012 looked at the belly microbiota and its impact on the growth of obesity in animals. Researchers mentioned that evidence highly suggests that the particular bacterial balance from the gut may enjoy an important function in energy stability and weight. Within research published within Nature in 2006, scientists focused upon two specific groupings of bacteria in the gut - Bacteroidetes and Firmicutes showing that the percentage of the two groupings of beneficial germs were different in obese versus lean individuals. We are going to continue to learn the particular clinical relevance within weight management of the bacterial balance associated with the gut. Yet what we perform know is the fact that developing a healthy gut microbiome is however another reason behind adding nourishment to your body nicely each and every single day. Steps in order to take today Within my practice, I actually see clients who may have damage to their gut and ensuing symptoms for the number of reasons including medication use, poor diet or excess stress. Therefore what can you perform to heal that damage which may be happening each and every day or might have occurred several years before? Eat genuine food I believe one of the greatest challenges dealing with us in attaining an optimal diet plan today is not really necessarily a lot of carbohydrates or excessive body fat or all of the twists that have been described to make the "right" diet. The challenge with regard to so many associated with us truly comes down to real food vs. meals which are highly processed. Take a seem at your diet plan. How many times per day do you consume a food that will has strayed considerably from it's natural source? Once, two times, ten-twenty times daily? If you perform one thing these days it is reduce out an alternative that will is highly prepared and substitute this for any real, entire food - fruit, vegetable or slim way to obtain protein. Give food to your gut exactly what it requirements Your own gut needs good bacteria also it requirements food for germs - probiotics and prebiotics. People might often reach for the supplement, but there are also great food choices. Probiotic foods include fermented foods such since yogurt or kefir, sauerkraut, kimchi or even kombucha. Prebiotic meals include foods wealthy in fiber -- think fruits, vegetables, nuts and seed products. And remember - true food! Look intended for these options that also have small to no digesting. Fresh or iced (without added ingredients) fruits and vegetables, nuts and seed products with at most minimum salt added, yogurt with little additional sugar and artificial ingredients. Rest plus relax We live in a extremely stressful environment. A person can't always remove the stressors within your life, yet consider where a person can minimize tension and find methods to manage this better. Are you able to state "No" to some associated with the commitments that are filling up your schedule? Can a person take 5 mins every day to merely breathe - near your eyes, close off your mobile phone and buzzing email and let your body and brain rest? And keep in mind - sleep is usually important for stress management plus a healthy body too! Persistent sleep deprivation which usually so many Us citizens live with nowadays is a significant stressor within the body. Obtain at least 7 hours every night intended for your best wellness! To know more details visit here: abdomax review
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hello-chloe · 2 years
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Hula hoops for exercise at home
Hula hoops have a magnetic vibe that attracts people from all walks of life, and for good reason. This is not only an artistic, free-flowing form of expression, but also a movement that burns heat and regulates muscles. Honestly, it's just the obvious stuff. Relieve anxiety and depression This is the most useful weighted hula hoop benefit I have ever experienced. The world is not an easy place to live sometimes, and we all face mental health challenges. For me, hula hooping gives me a sense of calm and clarity. It's just me and my smart hula hoop and my favorite music. In this moment, I am free to exist without expectations, without fear. It was the most healing experience. It was a relief. Improve the love we have for our bodies exercise hula hooping does a lot to help you get fit. First, I think it's more important to talk about how much hula hooping actually helps you love your body, no matter your size, fitness or age. Before hula hooping, I never really knew my body, and being fat prevented me from really loving my body. I didn't like the way I looked, and what was worse, I didn't feel healthy. I don't know what my body can do, but I don't think it's that big. I have no idea how to change any of this. The hula hoop weight loss changed my life. Within the first few days, I began to feel excited. I'm excited to exercise! This is new. When I started using workout hula hoop for women to lose weight, I got a sore feeling in my muscles that I didn't even know I had. I could feel my whole body tightening. My balance is better. My energy levels shot up. I started to feel a connection to my body. It was like I understood for the first time that my body was me and deserved my attention, love and respect. There's a wonderful sense of accomplishment in learning new moves with a hula hoop. In my first few days, being proud of what I was doing with my body was a whole new feeling. It's been an incredible journey and I don't want to leave. Hula hooping makes me see myself as graceful, strong, beautiful, even powerful. In my opinion, this is a great benefit. It really changed my life. When you are comfortable with yourself both inside and out, achieving your dreams will suddenly appear in your sights. It's a creative channel That's because hula hoops turn on the part of our brain that fosters creativity. Your own unique talents will shine through in everything you do with the hula hoop. You might start making a list of your favorite songs that you'd like to try hula hooping. You might want to consider the different sizes and colors of hula hoops you want to try. You can use more different hula hoops for exercise, not only for weight loss, but also for smart hula hoops, beginner hula hoops, etc. We can enrich the use of exercise hula hoop through the understanding of the sport and the progress of technology. Creativity is a hula hoop benefit, not only because it produces beautiful art in the form of your unique hoop dance, but also because creativity itself has a multitude of health benefits. There are dozens of studies showing that creativity can increase positive emotions, reduce depressive symptoms, reduce stress, reduce anxiety, and even improve immune system function. This creative addition is something that most exercise and fitness programs simply don't have. Be in good health First of all, I want to acknowledge and honor that we all come from different places on our journey of physical health and all of our bodies are unique. We're tall, we're short, we're thick, we're thin and everything in between. Some of us were athletes in high school, and some of us never felt that the word "athlete" could describe us. That's why size inclusion is so important to me and our brand. Because we are all unique, we all deserve this transformative hula hoop experience. While physical fitness is the most obvious benefit of hula hooping, many people don't realize how healthy hula hooping can make you. Hit with a weighted hula hoop in a variety of ways, and there's no muscle you can't beat. You can use hula hoops to work your arms, legs, core, back, shoulders, chest, hips, neck, and even every inch of your body. It turns out that hula hoops can burn up to 600 calories per hour even when they're around your waist, which is interesting. I hope this article helps you understand not only how much hula hooping has benefited my life, but more importantly, how much it has benefited yours. https://www.amazon.com/gp/product/B09TF1JTG2
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tbh-entp · 6 years
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kernunnos replied to your post
“Hey! So ENFP here and I’m creating some OCs, and one of them is an...”
This looks like a description of my ESTP boss and friends. Same social and planning stuff but very different topics of interest. Isn't Ne random data, connecting the dots and creating patterns? Apart from watching historical documentaries, the other stuff like carrot flute, playing in a band, cooking, fixing a gutter, etc seems more like physical, body, Se stuff. Why would be the point of doing that except when we definitely need to learn it, like for fixing sth?
Hey! 
Yeah so honestly, the Ne can be about body... anything really. Typically, I find the skills we pick up are simply for acquiring a new skill when it interests us-- and the interests may come from like, seeing someone else do it in real life or on TV. So it’s not often about being more healthy, and instead about learning the trade just enough before moving on to a new interest. So the difference is that the Ne is taking in the external cues to understand them, and the Se is taking in the external cues to react to them. 
For example, I don’t really like cooking for myself. I know I should because health and eating and all that is important, but most of the time I can eat a row of oreos and call it a meal. However, I got super into The Great British Bakeoff and then I taught myself how to bake and now I’m great at it. I only get the urge to bake again after watching a baking show or seeing a cool pic on a blog, but I’m actually a really good baker. It’s not about making myself baked goods for nourishment (which, debatable); but instead, it’s about the fact that baking is an art that I want to (kinda) master. Same with cooking, I got into this documentary called Ugly Delicious and I learned how to cook some really cool stuff-- but again, it’s not about health or taking care of myself, it’s about the act of cooking and understanding it. 
On the surface Ne can be mistaken with Se, but Se is more about the ability to immediately react and physical impulses. When things happen, those with an active Se can interpret, absorb, and respond to external cues and context. Whether or not it’s just making food for oneself upon hunger or capitalizing on a romantic moment or quickly deciding to travel to another country, ESTPs (if you ask me) are a little bit better at acting when they want something-- even if they don’t understand why they wanted it until later. 
ENTPs are much more cautious and have to think things through before following even the biggest events(aka overthinking). Once, I got my fingers crushed in a garage because we were putting it down by hand and my fingers were in the cracks, and I was quiet because I thought that if I yelled or overreacted, the people pulling the garage down would freak out, making it worse--- I was like 10 at the time, and genuinely, my natural response here was to think and not react. 
So the Ne can pertain to learning things that may promote health, but it’s not about health... if that makes sense. One thing about my cooking ventures is that I will skip meals to prepare the most extra desserts... I will be on my feet all day making sure my black forest gateau is perfectly frosted. It’s not about fulfilling my hunger as much as it’s about the understanding of the action.
This is actually why ENTPs often think they’re ESTPs and vice versa though! 
Sorry this is so long. 
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mbti-notes · 3 years
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hi i’m an istj. i fear the problem im going to describe is resolved by being more Te proactive and taking on more leader responsibilities and failing. just typing that out makes me feel burned out and miserable. anyway i get involved with groups that align with my values to get things done but it always feels like i somehow join things that aren’t as efficient as i’d want them to be or stagnate. at the same time that i have strong opinions about what to do i resent having to take on more responsibility to enact it. i want to be part of an established, moral, process/group but it seems like everything is in flux all the time. just making sure: is this Te-Ne dysfunction ?
Your question is about type development. An important aspect of type development is understanding the weaknesses and flaws of your type, in terms of the ways that your type tends to misuse functions. You seem to believe that your problem boils down to a simple lack of desire to lead in group situations (weak Te?), but it probably goes far deeper than that.
Si-Ne problems often manifest as a general aversion to change, specifically, unwillingness to change how one looks at a situation, which would then significantly alter one's approach to it. Imbalance between Si and Ne becomes a very unhealthy stubbornness when one is also prone to Si-Fi loop that thinks in terms of pure absolutes. In essence, you believe what you believe and you want what you want, and nothing and nobody can break through that mental wall. Perhaps not even you.
Auxiliary development is meant to help with Si extremes and Si-Fi loop stubbornness by making you care more about empirical facts (Te) than your frustration (Fi). It isn't always easy to develop the auxiliary function when you come to believe that it interferes with what makes Si feel most comfortable (e.g. "just typing that out makes me feel burned out and miserable"). If using the auxiliary function feels so "tiring", it doesn't mean that you should avoid using it. Quite the contrary. It's an indication that you haven't yet learned to use it properly, which means further development is necessary.
Te wants efficiency, that much is true. However, what separates immature Te from mature Te is how exactly one conceptualizes "efficiency". When Te is immature, one has a very rudimentary understanding of how to be efficient. For example, one is likely to believe that efficiency is achieved through assertiveness or even brute force, i.e., "making" things happen despite all the obstacles in the way. Is it any wonder that using Te feels tiring, then? You're essentially forcing yourself to swim against the current. Si doms are painfully aware that their energy is finite, so they quickly run out of steam.
However, Te isn't really about mustering up energy. This is not what makes TJs smart, strong, and formidable. Mature Te conceptualizes efficiency as reducing the amount of energy required whenever possible, which is why they have a lot of energy to take on very heavy workloads - some people call it "working smart". This is done through facing the empirical facts of a situation head on and learning to work closely with them, which makes it far easier to make them work in your favor.
Your problem requires a two pronged attack:
Are you able to change how you look at situations in order to improve your approach (to address Si-Ne imbalance)?
Are you able to face the empirical facts of the situation and work with them rather than against them (to develop better use of Te)?
Wanting to be part of a process/group that aligns with your values in order to enact some good in the world is an admirable thing to strive for. Presumably, the other people involved in the group have the same sense of mission, otherwise, they wouldn't have joined. However, what you fail to take into account is that people aren't generally single-minded.
Human beings are complex because they are motivated by a multitude of factors, whether they realize it or not. They are full of psychological conflicts, contradictory desires, irrational impulses, old baggage, and unconscious bad habits. And when you bring people together, all that stuff comes out and creates complicated entanglements. A "group" only becomes a "team" when it is able to overcome those psychological obstacles together, and it can be a very long process of learning how to maximize strengths and mitigate weaknesses in every individual member. That's why a lot of groups simply fall apart. While your intention to join the group seems simple and straightforward (because Si-Te is admirable in its ability to keep things simple and straightforward), other people's intentions might not be so simple. If you fail to take into account the irrational aspects of human nature, you will cause yourself needless suffering.
Your frustration with people is likely a manifestation of your unrealistic expectations of them. Perhaps you aren't able to understand people who don't resemble you, let alone work with them. And you will certainly be doomed to fail if the only way Te knows to deal with individual differences is to force everyone to become more like you. That's an impossible task, not because it requires the energy of a thousand suns as you assume, but because you're choosing to fight against reality. Mature Te would advise that you should first face down the empirical facts of how people operate if you hope to discover the most effective way to influence them. Your repeated experience of feeling disenchanted with groups tells you that you're missing an important piece of knowledge about groups and how they operate.
I'll give you a very simple example from my own life. I used to gather with a group of 30-50 people once a week to conduct planned discussions. The discussions never really started on time despite everyone being in their seats because people weren't focused enough at the start of the session. There was often whispering and sidetalking and such that would go on for about half an hour before the room felt settled and focused.
One method of addressing the problem arose organically. Whoever was the main speaker simply started shushing people and it became a thing. Sometimes, it would even escalate to calling people out, like a teacher scolding a student in a classroom. This definitely made the social atmosphere less inviting and more tense. Sure, people would shut up after being called out, but they became less focused due to seething with resentment. Power struggles aren't great for group morale, especially if it's supposed to be a group of equals coming together for a common cause.
It all sounds quite childish, but these kinds of judgments are useless. You can call people childish, inefficient, incompetent, etc etc, but it doesn't solve the problem. And, worse, being judgmental blocks you from understanding people better and working with them. Perhaps an ISTJ would see this as a "mess", an "inefficiency" that wastes time, and evidence of bad character when people break the rules.
However, if you change the way you look at the situation, you might not be so quick to make such judgments. Actually, it's kind of weird for a bunch of people who know each other well to enter a room and immediately sit down quietly. Humans have a natural tendency to socialize as a way to strengthen interpersonal bonds. Isn't group cohesiveness a good thing, since it encourages better cooperation? If you are able to see the benefits of their chatty behavior and how it contributes to group cohesiveness, then instead of fighting against it, you would think of ways to harness it.
The real problem wasn't inefficiency; inefficiency was merely the symptom. The more primary problem was that a lot of people joined the group not just to "get things done", but also to make friends. The structure of the event denied them from fulfilling that important need and then they were more likely to act out. This problem was discovered when people had a chance to talk about what was frustrating them, which meant that the group had to make space to conduct some uncomfortable conversations.
To address the problem, the group eventually decided that the first 15 minutes would be devoted to socializing and allowing people to catch up, with the explicit promise to get down to business when the time was up. Some people brought drinks, others brought snacks. Some even showed up early to have more time to socialize. It enlivened people and enriched their relationships. Being "officially" allowed to get the chattiness out of their system, they were better able to sit down and focus on the planned agenda. The meeting felt like fun rather than a chore. And if you're interested in a cause, don't you want to recruit more people to support it? Making things more fun is one good way to attract support. You can look at it as wasting 15 minutes OR you can look at it as a 15 minute investment.
Solutions to human problems require:
cognitive empathy: figuring out what's really going on inside people's heads (in Te terms it means working only with the empirical facts of the situation, rather than indulging negative Fi judgments)
strategy: taking the time to work with people and figuring out the best way to help them get over obstacles (in Te terms it means investing energy early and wisely to maximize your returns later, rather than putting effort into the wrong places or only stepping in to tackle mere symptoms of the problem)
creativity: harnessing natural human tendencies to produce something useful or worthwhile (in Te terms in means taking what's already there and transforming it into a NET positive, rather than getting too fixated on every little negative detail and losing sight of the bigger picture)
Te can be a great function for dealing with human problems as long as you overcome the immature aspects of it, such as impatience, bluntness, or inflexibility. Every person is unique, so every group is different. Let go of the idea that there is only one way to approach a problem/conflict and you will start to be more creative in your approach. By accepting the fact that things are always in flux and using empirical evidence to understand and predict how change works, TJs become much more effective and efficient at everything they do. When it comes to people, meeting someone different from you is an opportunity to learn how to deal with that kind of person. The more knowledge you have of human psychology under your belt, the better you get at dealing with people's weird or negative tendencies. If a strategy works, use it again. If it doesn't work, adjust it to fit their psychology better.
In your situation, you see the problem as people being inefficient, so your inclination is to step forward and do something to "make" them more efficient. Humans aren't built with the prime directive to be efficient. They're not machines. Their psychology is messy, so trying to force them to behave like a machine is to force them to go against their psychology. In other words, you're choosing the least efficient approach. The more efficient approach, though it requires more intelligent thinking on your part (you want to become more intelligent, right?), is to properly understand the more primary problem of what's really causing them to be so inefficient in the first place. That is the way to discover the right strategy. If you are able to target those obstacles at the very root, efficiency improves more naturally.
Oftentimes, working smart doesn't require you to step up and be THE leader for everyone. As an introvert, it's probably more comfortable for you to work behind the scenes to talk to people, get a better idea of what they need and/or what problems they're experiencing, and incrementally remove the obstacles that are preventing them from focusing on what they should be focused on. You can't fix everything all at once, so just do what you can to fix what you are able to fix at any given point in time. It's a process and some progress is better than no progress.
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scripttorture · 3 years
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My setting is like the real world but with various mythical otherworlds secretly connected to ours. One character with powers of psychic illusion was raised by an MiB-style intelligence and/or secret police force (tasked with keeping otherworldly beings from causing trouble in our world) that trained her to mentally torture people. I want to make this character somewhat sympathetic, so it is plausible for her to be indoctrinated as a torturer from childhood? Does it depend how young they start?
Anon I don’t think this is a good idea. There’s an awful lot to unpack here about why that is so I’m going to start off with a simple question that effects how you move forward: what’s most important for you about this character?
 Is it that she’s sympathetic? That she’s effective at her job? That she’s highly skilled and trained? That she’s part of a productive organisation that can actually do the tasks it sets out to?
 Because if she’s a torturer then realistically she would be none of those things. And making her any of them is (in my opinion) torture apologia: because it is portraying a torturer in an extremely unrealistic way that favours the torturer and excuses the abuse they carry out.
 You would, literally, be repeating lies popularised by real life torturers.
 Torture does not work. It is impossible to get accurate, timely information by using torture. Here’s an introduction to why. Here’s a post on what torture does to investigations. Here’s a guide to writing what torture does to interrogations. Here’s a list of investigative strategies that actually work. Here’s a post on the damage torture does to human memory. Please read these masterposts and take a look at my sources as well.
 Torturers are not indoctrinated radicals. The organisations that torturers are part of actively try to screen out anything they see as radical, deviant or a product of illness. There aren’t enough studies on torturers for me to give you a break down of their politics but my impression from the anecdotes and interviews I’ve read? Their politics is ‘normal’ and mainstream for the organisation they are part of. Whatever that organisation is.
 Torturers are not taught from a young age because torture is not complex. It does not take months to learn how to hit someone. Torturers learn on the job by assisting other torturers.
 Torture is simple. It is functionally easy. I really can’t stress that enough. The most common tortures globally right now are: hitting people, depriving them of food and depriving them of sleep. I don’t think it’s an exaggeration to say that six year olds could come up with that list.
 Hurting people is not complicated. It requires no skill and no training.
 The evidence we have suggests torturers lose skills as they turn to torture, a process Rejali calls ‘de-skilling’. The basic idea is pretty simple: if you spend all day hitting people instead of practicing what you were trained for (gathering evidence for example) you get so out of practice that you start to forget how to do those things.
 And then there’s the effect that torture has on torturers. They get symptoms. They develop lasting, serious, mental health problems which directly effect their ability to do their jobs.
 I have a list of the common symptoms here as well as a rough guide for how many symptoms you should be considering for torturers and torture survivors.
 Separate to the symptoms is the general pattern of behaviour torturers exhibit. We don’t have a lot of high quality studies on torturers and there are a lot of questions we do not have clear answers to. However the studies and the anecdotal evidence of survivors, witnesses and torturers themselves points to some consistent behaviours.
 Torturers don’t work alone. They form little sub-cultures within larger organisations. These groups are incredibly aggressive, competitive, self-important, hyper-masculine and violent. Torturers look down on everybody else. They are convinced that they are the most important people in their organisation, the only one’s doing ‘real work’. They have an arrogant, puffed up pride that combines with mental illness and seeing their colleagues as competition to create the worst asshole you’ve ever had the misfortune of working with.
 They do not cooperate with other people. They use abuse as a pissing contest, competing to see who can be the most brutal in order to try and ‘impress’ fellow torturers.
 They define strength and group loyalty by hurting other people.
 They have a fracturing effect on organisations, because they don’t obey orders and see their colleagues as competition or useless. At the low end of the scale this means cliques, secrets from the larger organisation and a terrible working environment as they bully and belittle their colleagues. At the high end of the scale there are cases where torturers have attacked and murdered people within the same organisation.
 Does any of that sound sympathetic?
 I like a challenge when I write. I’ve described my writing style as ‘hold my beer’ because I tend to take ideas other people dismiss as impossible to pull off and try my best to make them work. I do this because I love exploring human complexity through fiction.
 A torturer who is currently torturing is not a sympathetic person. They are a bullying, violent, arrogant brute who contributes nothing useful to the organisation they latch on to, sucking up time and resources like a tick. They see other people as garbage. And they lack insight into their own crimes. Which means they do not appreciate or acknowledge the pain and damage they cause.
 Now I have written a character who is an ex-torturer who I think is sympathetic in some ways. But getting to the point where they could be sympathetic meant them having to leave the organisation they were part of on a stretcher.
 Their fellow torturers turned on them. They lost a leg. They changed sides and in the middle of a messy civil war they dedicated themselves to keeping their friend’s children safe.
 And I had to set the story twenty years after these events to get that character out of their own ass enough for them to be sympathetic.
 Even then, I’d say they’re sympathetic in spite of having been a torturer. Because they’re still clinging to that insistence that they did something meaningful. They still can’t accept the extent of their own crimes or the effects those crimes had.
 But their pride broke. And they did keep those children alive. They helped raise them. And the tie to those children is what makes them sympathetic by the time of the story.
 Torturers are not sympathetic people. They are self absorbed abusers who bend over backwards to downplay the harm they did to their victims and to justify their crimes.
 Is that really what you want to write?
 I say that, not to be harsh, but because it sounds to me as though what you actually want to write is a genuine investigator with psychic powers.
 It sounds as though you want to write a character who is good at her job. Who is skilled and dedicated and a great person to work with.
 If that’s the case my advice is to ditch the torture entirely. Look at the masterpost on genuine investigation instead and write a character who is good at interviewing people.
 Have her use her psychic powers to present herself as sympathetic to the criminals she’s interviewing. Because she can walk into a room and know their politics, their religious beliefs, their internal justifications for what they’ve done. And she can use that, may be even manipulatively, to seem like someone the prisoner would like, someone they’d agree with.
 That gets people talking.
 And if you want to show her as ruthless, as having an edge to her, that can still work.
 Imagine someone sitting down across from a suspect, holding their hands, smiling, talking to them gently. Imagine them gradually, kindly, getting this suspect’s life story. Imagine them being sympathetic about the reason the suspect murdered someone, validating the murder’s feelings and may be even actions… Right up until they have the information they need.
 Then they turn on a dime. The persona drops, the false-sympathy drains away. They stand up with a sneer and say they hope the murderer never sees the light of day again. And walk out.
 Think about what you want from the story Anon. A character who tortures, or a character who is competent, smart and sympathetic.
 Because it really is one or the other.
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fortunatelyfresco · 3 years
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A Holistic Integration of Type 1 Narcolepsy into the Reading of Moist von Lipwig
Literary Interpretation, Disability, and Finding Yourself Between the Lines
As it goes, "I wrote this for me, but you can read it if you want." It might be a fun ride for anyone who is very interested in Moist von Lipwig, or narcolepsy, or both, and/or anyone who enjoys collecting small details from within a body of work and arranging them into threads that are supportable by the text, without being actually suggested by it.
Personally, I find it very interesting to read the meta behind different headcanons, and see how creators can unintentionally write a character who fits certain criteria. There are only so many traits, after all, and some of them tend to travel in groups! Humans are pattern seekers, etc etc.
The first step of reading Moist von Lipwig as narcoleptic is wanting to read Moist von Lipwig as narcoleptic. Being narcoleptic myself and relating heavily to Moist, this step was very easy. I invite you to take my hand and come along, at least briefly, if you were interested enough to click the readmore.
Once you have taken that step, things start falling into place. At least they do if you're intimately familiar with narcolepsy, or if you first learn about it in detail through, for instance, a Tumblr post with an agenda :)
I'll break this down symptom by symptom, citing only the ones I both have personal experience with and see textual support for.
I'll be using OverDrive's search function to catalogue "evidence" in (the American editions of) Going Postal, Making Money, and Raising Steam, so I might miss passages that don't use certain keywords.
Please take any statements along the lines of "being narcoleptic means X" with a huge grain of salt. Sometimes it's just more succinct. Narcolepsy can manifest in many different ways, and is still being actively studied. Don't base your entire understanding of it on a fandom essay I wrote to cope with the crushing pressures of capitalism. I have not even fully read the scientific studies linked here as sources.
Here we go! Spoilers abound.
I. Excessive Daytime Sleepiness (EDS) and sleep attacks.
Being narcoleptic means (salt now, please) that your brain does not get adequate rest while you sleep, no matter how much you sleep. This is because of a disturbance in the order and length of REM and NREM sleep phases. This leads to constant exhaustion. Some sources describe narcoleptic EDS as "comparable to [the sleepiness] experienced by a healthy individual who has been sleep-deprived continuously for 48–72 hours."
(Source.)
Sleep attacks can come on gradually or suddenly. In my case, I become irritable and easily overwhelmed, and nothing matters except finding a place to lie down. A more severe attack, under the right circumstances, can put me to sleep while I'm actively trying to stay awake and engaged.
Moist refers to 6:45 am as "still nighttime." He is "allergic to the concept of two seven o'clocks in one day" and is "not good at early mornings," and the narration even cites this as "one of the advantages of a life of crime; you didn't have to get up until other people had got the streets aired."
In Going Postal, he repeatedly falls asleep at his desk. I can only find two instances, but the first one describes it as having happened "again," so it happens at least three times over the course of one week. Both of the times I found were after Mr. Pump cleared his apartment, giving him access to a bed, and I can't find any reference to the fire destroying it—just that his office is "missing the whole of one wall." His presumably wooden desk is still intact, even, just "charred."
There's also no build-up either time. No direct narration of the time right before he falls asleep, just retroactive accounting for it.
Which is primarily a function of stories not showing us every boring second, and secondarily one of the smaller ways we're shown Moist being overwhelmed and racing to keep up with himself, but tertiarily it's a great set dressing if you've already decided he's narcoleptic. Sometimes sleep is just a thing that happens, without any deliberate transition. Sometimes you sit down to catch your breath or get some paperwork done, and wake up several hours later.
I've found only one example in GP of Moist waking up in his actual bed at the post office: the morning after being possessed by all the undelivered letters. Presumably either they put him there, or Mr. Pump did.
There are two points in Making Money where Moist, in an effort to be a comforting and/or guiding hand, advises people to get some sleep. First Owlswick Jenkins, and then one of the clerks (Robert) who is worried about Mr. Bent.
I take the optimistic view that this is Moist genuinely caring about these people, not just trying to get them to do what he wants. He has always done some combination of those things (GP opens with him having befriended his jailers, after all), but there's definitely a thread of him learning to treat both himself and those around him more like real people. (See also.)
Looking at this thread through narcolepsy-colored lenses, you get Moist perhaps drawing from his own experiences in an effort to be helpful. In Owlswick or Robert's position, what is something he would want to hear from the man currently in charge of his fate, or at least his job? "Get some sleep."
If we accept this as a pattern, it culminates in Raising Steam, when Moist starts to worry about "Dick Simnel and his band of overworked engineers," fixating particularly on their lack of sleep.
What sleep they got was in sleeping bags, curled up on carriage seats, eating but not eating well, just driven by their watches and their desire to keep the train going.
[...]
"People are going to die if we push them any further," he said to Dick. "You lot would rather work than sleep!"
[...]
The young man swayed in front of him and Moist's tone became gentle. "And I see now that part of my job is to tell you that you need some rest. You've run out of steam, Dick. Look, we're well on the way to Uberwald now, and while it's daylight and we're out of the mountains it's going to be the least risky time to run with minimum crew. We're all going to need our wits about us when we get near the pass. Surely you can take some rest?"
Simnel blinked as if he'd not seen Moist the first time, and said, "Yes, you're right."
And Moist could hear the slurring in the young man's speech, caught him before he fell and dragged him into a sleeping compartment, put him to bed, and noted that the engineer didn't so much fall asleep as somehow flow into it.
Moist then recruits Vimes to help him talk the rest of the engineers into getting some rest. The two of them briefly commiserate about people not realizing how important it is.
"I have to teach that to young coppers. Treasure a night's rest, I always say. Take a nap whenever you can."
"Very good."
II. Insomnia.
This is a lesser-known but very common symptom of narcolepsy. Or a comorbidity, depending on how you look at it. It seems counterintuitive if narcolepsy has been presented to you as "sleeping all the time," but it makes sense once you know it's really a matter of disruption in the brain's ability to regulate sleep cycles.
The case for this symptom is flimsier, and I fully admit I'm just reading my own experience into it. But here are two excerpts from Going Postal that I find quite suitable for my sleepy agenda:
1. "A man of affairs such as he had to learn to sleep in all kinds of situations, often while mobs were looking for him a wall's thickness away."
I latched hard onto this detail the first time I read GP.
At my worst, I could not get more than a couple hours of sleep in my bed. I kept taking naps in the bath because it was one of the few places I could sleep. It seemed to fulfill some of the criteria (isolation, temperature control, etc) that my brain demanded in exchange for playing nice.
We're told over and over again, throughout Moist's books, that he functions best under pressure.
(Brief aside: This is often cited as a reason to interpret Moist as having ADHD, which I'm also fully on board with. Not coincidentally, narcolepsy and ADHD share a few symptoms, have a notable comorbidity rate, and are treated with some of the same medications. Source.)
So again, if you're already inclined to read Moist as narcoleptic, the following is an easy jump:
"Moist thinks he's good at sleeping in strange places under strange circumstances. This is because A) his basis for comparison is a disordered attempt to sleep in normal places under normal circumstances, B) something about danger satisfies his brain into running more smoothly, and C) he's a resourceful person who is 'not given to introspection,' and so is less likely to wonder why his body demands sleep at strange times and more likely to focus on finding a place for that sleep to happen, and chalk this up later as a skill."
And returning briefly to EDS: Why would someone like Moist waste time finding a safe place to sleep while people are actively trying to kill him? At the beginning of GP, he leaves Vetinari's office and immediately goes on the run. In multiple books, when he feels threatened, his brain instinctively launches into complex escape plans. We see him successfully blend into an Ankh-Morpork crowd at least once after becoming a public figure.
So why bother? After all, a safe place to sleep is also a safe place to change clothes, or at least remove whatever distinguishing features he's given himself. Why wouldn't he just become someone else and leave town immediately?
The obvious answer is that sometimes things just happen, and an author doesn't need to know or explain every single detail of a character's past.
I would suggest, though, that one of those things might be Moist reaching a point where sleep is just not optional. A point where he not only doesn't, but can't, care about anything else. Where he is too tired to think straight, too tired to talk his way out of trouble, too tired to even contemplate the long journey from one town to the next.
2. "Moist knew he ought to get some sleep, but he had to be there, too, alive and sparkling."
Sometimes (especially in combination with underlying mental health issues) narcoleptic sleep deprivation can bypass everything I've described so far, and lead straight into a manic state. You won't necessarily find that on Google, but it's been my experience.
That's obviously not what the text is implying. "Alive and sparkling" is just a very relatable description. And we do often see Moist getting away from himself, speaking without thinking, making absurd promises that he justifies immediately afterwards as Just Part Of Being Him, always raising the stakes.
And here are a couple of excerpts from Raising Steam that could be interpreted as Moist being a light sleeper, AKA struggling to get deep sleep:
1. "And slowly Moist shut down, although a part of him was always listening to the rhythm of the rails, listening in his sleep, like a sailor listening to the sounds of the sea."
2. "All Moist's life he'd managed to find a way of sleeping in just about every circumstance and, besides, the guard's van was somehow the hub of the train; and although he didn't know how he did it, he always managed to sleep with half of one ear open."
Moist is exactly the kind of opportunist to see that as a useful tool, isn't he?
III. Hypnagogic and Hypnopompic Hallucinations.
These are hallucinations that come on as you're falling asleep or waking up. They can also happen during REM intrusions while you're awake. My most memorable ones include piano notes, someone calling my name, being trapped in the waves of a large body of water, and a huge truck going over a guard rail and tumbling down a hill. These are often, but not always, accompanied by sleep paralysis (and sleep paralysis is often, but not always, accompanied by hallucinations).
In GP, Moist casually cites his own hallucinations as proof that what is happening at the post office is not one.
"They're all alive! And angry! They talk! It was not a hallucination! I've had hallucinations and they don't hurt!"
Obviously that's not true for everyone, but it's true for Moist, and he has enough experience that he immediately recognizes the difference.
At one point while awake, Moist "[snaps] out of a dream of chandeliers" to realize someone has approached him to talk, while he was busy having visions of what the post office used to look like/could look like again.
Now, that's cheating, because we're probably supposed to assume it's a side effect of being possessed, but... I'm putting it here anyway.
There is also perhaps a case to be made for the tendency of Moist's internal monologue to lapse into extremely specific and prolonged hypotheticals. The lines between hallucinations, waking dreams, and "regular" daydreams have always been very blurry to me. I'm especially curious about the example at the end of Going Postal, which goes like this:
"Look, I know what I'm like," he said. "I'm not the person everyone thinks I am. I just wanted to prove to myself I'm not like Gilt. More than a hammer, you understand? But I'm still a fraud by trade. I thought you knew that. I can fake sincerity so well that even I can't tell. I mess with people's heads—"
"You're fooling no one but yourself," said Miss Dearheart, and reached for his hand.
Moist shook her off, and ran out of the building, out of the city, and back to his old life, or lives, always moving on, selling glass as diamond, but somehow it just didn't seem to work anymore, the flair wasn't there, the fun had dropped out of it, even the cards didn't seem to work for him, the money ran out, and one winter in some inn that was no more than a slum he turned his face to the wall—
And an angel appeared.
"What just happened?" said Miss Dearheart.
Perhaps you do get two...
"Only a passing thought," said Moist.
In-universe... what is Adora reacting to? What did just happen? The fact that these incidents are not isolated to Going Postal is a point against it being some sort of literal timeline divergence caused by The Spirit Of The Post.
So maybe Moist visibly zoned out. Maybe he had some kind of minor but noticeable cataplexy attack (more on those later) as part of a REM intrusion, brought on by the intense emotions he's currently struggling with.
IV. Vivid Dreams.
Again, at least some of this is probably supposed to be part of the possession, but I've been professionally projecting myself onto the surreal dreams of magically afflicted characters for years. Do try this at home.
1. "Moist dreamed of bottled wizards, all shouting his name. In the best tradition of awaking from a nightmare, the voices gradually became one voice, which turned out to be the voice of Mr. Pump, who was shaking him."
2. Moist is uneasy about the Smoking Gnu's plan, and then he has an extremely detailed dream about the Grand Trunk burning down.
This culminates in "Moist awoke, the Grand Trunk burning in his head," followed by a paragraph of him thinking things through and starting to form his own alternative plan, followed immediately by "Moist awoke. He was at his desk, and someone had put a pillow under his head."
So he fell asleep at his desk, woke up from a vivid nightmare, was awake just long enough for a coherent train of thought, and then passed back out. Which once again is not "proof" of anything, but fits the predetermined interpretation like a glove.
V. Cataplexy.
Cataplexy is a sudden loss of muscle control, usually triggered by strong emotions. This is thought to be a facet of REM intrusion—waking instances of the atonia that is meant to stop us from acting out our dreams.
The most well-known manifestation is laughter making your knees buckle, but it's not always that severe. My own attacks range from facial twitching, usually when I'm angry or otherwise extremely upset, to all-over weakness/immobilization and near-collapse when I laugh. My knees have fully buckled once or twice.
This is the biggest stretch. This is the one that is absolutely only there if you've already decided to read entire novels between the lines. It's also not even necessary for the broader headcanon; plenty of people have narcolepsy without cataplexy (or such mild cataplexy that it's never noticeable, or very delayed onset, etc).
However. I am doing this for fun. So I want him to have it. It's also become a major part of how I imagine Moist engaging with emotion, and I'd like to make a case for that.
There are a few scattered references to Moist's legs shaking, or being unsteady, or outright giving way, but there's usually an external physical reason, and/or enough psychological shock to justify it without a medical condition.
The most compelling example I've found so far comes from Moist and Adora's conversation about people expecting Moist to deliver letters to the gods.
"I never promised to—"
"You promised to when you sold them the stamps!"
Moist almost fell off his chair. She'd wielded the sentence like a fist.
"And it'll give them hope," she added, rather more quietly.
"False hope," said Moist, struggling upright.
"Almost fell off his chair" at first sounds like casual hyperbole, but then "struggling upright" implies it was a bit more literal. It's also an accurate description of me recovering from my more severe attacks, supporting myself on a wall or my spouse, or pushing myself up if I've fallen over in bed.
That happens to me multiple times per day, by the way. It doesn't bother me, and I didn't realize there was anything unusual about it for a long time. I barely think about it, except to fondly note that my spouse is good at making me laugh.
Which is to say, even severe cataplexy is not always noticeable or debilitating. Sometimes it absolutely is! It can be downright dangerous, depending on where you are, what you're doing, and whether you have any other conditions it might exacerbate. I don't want to undermine that.
I am just hell-bent on justifying the idea that this fictional character could have repeated attacks throughout the canonical narrative that are so routine they don't merit an explanation, or even a description. Especially for someone who is used to hiding his few distinguishing features behind false ones that are much more memorable. (See also.)
(That link goes to my own fanfic. Sorry.)
On the milder side, between Going Postal and Making Money, there are three instances of Moist's mouth "dropping open" when he's shocked, upset, confused, or some combination of the three. This is the kind of thing that shows up a lot in fiction, but rarely happens so literally in real life.
(There's technically a fourth instance, but I'm not counting it because it seems to be a deliberate choice on his part to convey surprise.)
And then there's laughter. Or rather, there isn't. I could be missing something, but I've searched all three books for instances of laughter and various synonyms (not counting spoken "Ha!"s), and what I've come up with is:
Moist laughs once in Going Postal, when he receives the assignment for the race to Genua.
Two packages were handed over. Moist undid his, and burst out laughing.
There's also an instance earlier in the book where Moist nearly "burst[s] out laughing."
I find the specifics here interesting, and, for our purposes, fortuitous. Cataplexy is complicated and presents differently for everyone. In my case, when laughter triggers an attack, one of the effects (which is sometimes also a cause) is that I laugh very hard, with little or no control. "Burst out laughing" is quite apt.
Let's move on to Making Money, and start with a quick tangent:
Mr. Bent explains that he has no sense of humor due to a medical condition, and that he isn't upset about this and doesn't understand why people feel sorry for him.
Moist immediately starts in with "Have you tried—" before getting cut off by the frustrated Bent.
Out-of-universe, "Have you tried" is such a well-known refrain to anyone with an incurable condition, I'm not at all surprised to find it in a book written by someone who had at least begun the process that would lead to a diagnosis of early-onset Alzheimer's. And Pratchett has certainly never shied away from portraying ignorance in his protagonists.
In-universe, it feels a little odd. Moist's tongue runs away from him all the time, but usually in the form of making ridiculous claims or impossible promises. Moist's entire stock-in-trade is People Skills, and it feels strange for him to make this kind of mistake immediately after being told Mr. Bent is not looking for solutions.
But if one were reading with, for instance, the idea in mind that Moist himself has an incurable condition related to laughter and is enthusiastic about, but still relatively new to, the practice of drawing on his own experiences to help people... it is easy to imagine the gears in his head turning the wrong way, superimposing those experiences over the tail end of Mr. Bent's explanation. Disabled people are not immune to these well-meaning pitfalls.
There is another Mr. Bent moment that I want to discuss, but we'll circle back around to it later.
I found two instances of Moist himself laughing in MM.
1. "He said it with a laugh, to lighten the mood a little."
This is deliberate laughter, employed as a social tactic. A polite chuckle, probably. Not the sort of thing that generally triggers cataplexy.
2. "Moist started to laugh, and stopped at the sight of her grave expression."
The first and only involuntary laugh in MM. It doesn't always trigger attacks...
Which brings us to Raising Steam. Compared to the first two books, Moist laughs a lot here. I count nine instances. Two of them are "burst out laughing"s, a couple include him as part of a group, some of it comes off as deliberate, and some of it doesn't.
I've always seen a lot of... rage in Raising Steam. Combing through it for laughter, I realized Moist's emotions in general are much closer to the surface here, and he's much less concerned about letting people see them. He laughs with friends and acquaintances, he cries in front of strangers, he shouts at Harry King, he has that entire conversation with Dick that boils down to "I'm very worried about you," etc.
Opinions vary wildly and sharply on Raising Steam. I have my own hangups with it, as I do with most books in the series. (Every time I make a new Discworld post, Tumblr passive-aggressively suggests the tag "my kingdom for a discworld character who is normal about women and other species.")
But I like this particular change in Moist, and I choose to see it as character development. He's trading in the professional detachment of a conman for the ability to grow into himself as a person and make meaningful connections.
So, what does that have to do with cataplexy? A lot.
I don't want to get too maudlin, so I'll just say I have plenty of personal experience with emotional repression masking cataplexy symptoms. And so, I believe, does the version of Moist we've put together over the course of this post.
Which brings us back to Making Money, and Mr. Bent. He says something about Moist that I find very interesting: "I do not trust those who laugh too easily."
Unless I've missed something, at that point in the book, Moist has never actually laughed in front of him. And Mr. Bent is a man who pays very close attention to details.
So, what is the in-universe explanation for this? I'd like to propose that Moist is very skilled at seeming to laugh, without actually laughing. He smiles, he's friendly, and he makes other people laugh, which is another thing Bent dislikes about him. He gives the impression of being someone who laughs a lot. (He certainly left that impression on me; I was very surprised by the lack of examples in the first two books.)
Even staying strictly within the bounds of canon, it's easy to imagine why this might have become part of Moist's camouflage in his previous life. He wasn't looking to get attached to anyone, and he didn't want anyone getting inside his head. Engaging with people genuinely enough to laugh at their jokes would run counter to both of those things, but some of his personas still needed to come off as friendly and sociable.
Still working within the canon, it makes sense to assume he's similarly distanced himself from emotion in general. He sits in a cell for several weeks without truly believing he's going to die. He's bewildered when Mr. Pump points out that his schemes have hurt innocent people. He has no idea what to do with his feelings for Adora. Etc.
Interpreting Moist as having cataplexy adds an extra element of danger. Moist thrives on danger, but there's a difference between the thrill of a con and the threat of sudden, uncontrollable displays of vulnerability. And so it becomes even easier to see him stifling his own emotional capacity.*
We meet Moist at a moment of great upheaval. He is forcibly removed from his cocoon of false identities, and pushed out into the world as himself. And we are shown and told throughout Going Postal that he does not know how to be himself. (See also.)
He is repeatedly stymied by his own emotions. He gets tongue-tied and confused around Adora, he snaps at Mr. Pump, he lashes out at Mr. Groat, he gets lost in school flashbacks when he meets Miss Maccalariat. This thread continues in Making Money, where the sudden reappearance of Cribbins immediately rattles him into making an uncharacteristic mistake.
I called him Cribbins! Just then! I called him Cribbins! Did he tell me his name? Did he notice? He must have noticed!
Later in the same book, Moist misses a crucial opportunity to run damage control on the bank's public image... because he's excited to see Adora.
The Moist of GP and MM is not used to feeling things so deeply. It throws him off his game. I'm not at all suggesting cataplexy is the only (or even primary) reason for that, but I do think there's room for it on both sides of the cause and effect equation.
With or without the cataplexy, I find Moist's relative emotional openness in Raising Steam... really nice. (It's a work in progress. He's still getting a handle on anger.)
Cataplexy just adds another dimension. A physical manifestation of emotional vulnerability, which would have been especially untenable for a teenager on the run. Just one more facet of the real, human, fallible Moist von Lipwig who spent years buried beneath Albert Spangler and all the rest.
Another piece of himself that Moist is growing to understand and accept, as he learns to more comfortably be himself.
The Moist of Going Postal runs into a burning building to save lives without fully understanding why he wants to, and justifies it on the fly as an essential part of the role he's trying to play.
The Moist of Raising Steam��mindlessly throws himself under a train to save two children, and then blows up at Harry King about the lack of safety regulations. Freshly traumatized by the murder of several railway workers and his own violent, vengeful response to it, he still offers, in the face of Harry's own grief, to be the one to inform their families. On a long and dangerous journey with plenty of moving parts to think about, he worries about Dick Simnel and the other engineers, and pushes them to take better care of themselves.
He also meets a bunch of kids who nearly derailed a train as part of a childish scheme. His admonishment is startlingly vivid.
"Can you imagine a railway accident? The screaming of the rails and the people inside and the explosion that scythes the countryside around when the boiler bursts? And you, little girl, and your little friends, would have done all that. Killed a trainload of people."
[...]
"I'll square this with the engine driver, but if I was you I'd get my pencil and turn any clever ideas you have like this into a book or two. Those penny dreadfuls are all the rage in the railway bookshops."
Maybe what he is also saying, between the lines, is:
I left home at 14 and began a life of smoke and mirrors. I was empty inside, and I thought everyone else was, too. It was all fun and games, and then a man made of clay told me I was killing people. Nip it in the bud, child. Write books.
------------
*There are studies suggesting that in addition to deliberately employed "tricks," people with cataplexy may experience physiological reactions in the brain meant to inhibit laughter. (Source 1, Source 2.)
Most of the information here is way over my head, but that second link also says "one region of the brain called the zona incerta (meaning 'zone of uncertainty') was only activated during laughter in people with narcolepsy, not in controls. Research on the zona incerta in animals suggests that it also helps to control fear-associated behavior."
The linked article about that (https://www.nature.com/articles/s41467-018-03581-6) is also over my head, but I would certainly describe Moist von Lipwig as having unusual fear responses.**
**Narcolepsy is a fun roller-coaster ride of constant scientific discoveries about exactly which parts of your brain are paying too much attention, not paying enough attention, or trying to eat each other.
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