The Expanding Staircase

Square spiral staircase
Photo by Elena Kuchko on Unsplash

The following is a work of fiction, based on my experiences working with clients but not a reproduction of an actual session with a specific person.

My office, any given day:

— It just feels like I’m not making any progress. I mean, I know I’m making progress, but…it just doesn’t feel like it.

— Yeah. It’s hard to keep going when you can’t tell where you are.

— Yes, it’s like, I keep doing the things that are supposed to help—getting in to see you, getting in to see the psychiatrist, getting the referral for the assessment, starting the medication—but each step takes such a long time, and then that psychiatrist turned out to be unable to do the assessment, and then when I finally got the referral and scheduled it, it turned out they don’t even do those assessments either…

— Does it feel like those steps—for instance, getting in to see the psychiatrist or starting the medication—are getting you to where you want to go?

— Not really, because the psychiatrist couldn’t do the assessment, and the medication isn’t really helping so now I have to try another one.

— Right. It’s frustrating when the steps you take don’t seem to “count.”

— Exactly. Like, if the medication isn’t helping, did that step really take me anywhere?

— What does your gut tell you?

— No. Well, I don’t know. Obviously I had to try the medication that was offered first. The doctor wouldn’t have known it wouldn’t work until I tried it.

— But nevertheless, it doesn’t really feel like a productive step.

— No, it doesn’t.

— So, what if…we know that this process can take a really long time. That’s really frustrating and disempowering, but the delays are part of the process—

— But a lot of those delays are because I keep procrastinating. Like, I don’t even know why I haven’t called the next place yet. I got the referral from the doctor and it’s in my phone somewhere but I don’t even remember what it’s called right now. And if I hadn’t missed that one appointment, I would’ve seen the psychiatrist much sooner, started the medication sooner…

— That’s what I mean, though. That is part of the process. You’re struggling with executive function. So of course it’s going to take a bit longer to do some of these things than it might for some other people. And that’s not even taking into account the other part, which is the delays inherent in the system—waiting for the doctor to have availability, waiting for insurance to approve the medication, and so on.

— So…

— So, imagine you could somehow know all of the steps that this would take. And imagine that the steps are a literal staircase that you’re looking up at, and each flight of stairs is a stage of this process. At the top of the stairs is your goal—having an accurate diagnosis, having effective treatment, managing the symptoms, succeeding in school. It’s a really tall staircase—obviously, we’re not making this too fantastical of a thought experiment—but you’re already part of the way up. For instance, the first flight of stairs was realizing you needed to go to counseling. The second flight was getting in to see me. The third was telling me about your symptoms, and me figuring out that you probably have ADHD. The fourth was getting in to the psychiatrist, who could prescribe some medication that might help but couldn’t do a formal ADHD assessment. The fifth was trying the medication. The sixth was getting the referral for testing—you get the point.

— Right, so I can tell that I’ve gotten off the ground at least.

— Exactly. And you’re looking up to the top of the staircase and it still seems quite far away, but you’re also a ways off the ground now. How would that feel?

— I mean, that wouldn’t feel nearly as bad as I feel now, but that’s because I would at least know where the top was. Like I could see how far away it was.

— And instead, it’s more like the staircase keeps expanding.

— Yeah! It’s like I keep climbing the stairs but the top keeps getting further away.

— That’s where your frustration is coming from. Unfortunately, in the real world, you can’t actually know how many discrete steps some overwhelming task is going to take, especially when it involves factors you can’t control, like what doctors can prescribe, what insurance will pay for, which clinic provides which assessments…and you know which steps you have taken so far.

— But what does it matter how many steps I’ve taken if the staircase just keeps growing?

— Because in reality, it’s not actually growing. It’s more like that thing where you’re walking towards a distant landmark, like a skyscraper in a city, and you feel like you’ve walked so far but it still seems just as far away. It’s not, though—that’s just a trick of our vision and also of our frustration with how long the journey is taking. In reality, there is an actual physical distance being crossed, and that gap is closing inch by inch whether or not it appears that way in the moment. This is even harder, because while you can Google how far away the Empire State Building is from Battery Park and get some sense of how long that walk will be, there isn’t a knowable answer here. Not right now. When you reach the end, you will know exactly what steps it took, and how long you spent climbing the staircase. There is a real number. You just can’t know it yet. …How well does that fit with your experience?

— I agree with that. I do believe that there will be an end, at least, even though I often feel like there won’t be. Do I have to just accept feeling that way?

— I think you do have to accept feeling that way, but you don’t have to just accept feeling that way. You feel that way for now. Just as you’d feel frustrated on long walk that’s taking even longer than you thought, towards a landmark that doesn’t seem to be getting any closer, you will feel frustrated here, in this situation. But in the example of the long walk, you would know, rationally, that you’re making progress. You wouldn’t just quit walking, unless of course you need to—that’s a separate thing. You would tell yourself, “This is a really frustratingly long walk and I had hoped it wouldn’t take this long, but I’m going to get there.”

— That definitely sounds more reassuring than what I’ve been telling myself, which is that I’ll never get there.

— And that’s not the only tool at your disposal, either. Imagine the staircase again. We talked about what it’s like to look up. What’s it like to look down?

— Well…I definitely keep getting further up from the ground. As long as all those things you listed were actually steps, and not just like…detours.

— Do you think they were steps? Even if they didn’t propel you all the way to the top?

— Definitely.

— Does your distance from the ground ever shrink?

— I sure feel like it does…

— Do you, though? What brings you back towards the ground?

— I mean, no. I’m only feeling that way because of the thing where the stop of the staircase seems farther away.

— Exactly. And, not to bring math into this—

— Please no math.

— Okay, no math, just words: there’s a difference between absolute and relative. As you revise your estimate of the height of the staircase—unfortunately, you keep learning that there are more steps than you expected—your relative progress changes. Maybe before you hoped you were at 50%, but now you realize it’s more like 30. Hence your frustration. But your absolute progress never changes. If you’ve climbed six flights of stairs, you’re always gonna have climbed six flights of stairs, no matter how the top of the staircase is looking at this particular moment. Feeling shitty about how hard this is doesn’t just suddenly knock you back down a few flights.

— But how do I actually, like, feel that?

— When you find yourself looking up, try looking down instead.


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The Expanding Staircase
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“But You’re a Therapist!”

It can be weird being open and vulnerable with others as a person who also happens to be a therapist. People are sometimes very surprised to hear that their therapist friends also, believe it or not, struggle to understand their partners, get petty or irritated, feel abandoned, lash out at people, avoid flossing or exercising or initiating difficult conversations, or feel judgmental. For example.

I’ve been hearing the refrain “But you’re a therapist!” since—actually—before I even technically became a therapist. (Back then it was, “But you’re going to be a therapist!” Yes, and? You’re apparently going to be a millionaire or a bestselling author one day, and yet.) I even see therapists themselves throwing this at other therapists in some of the Facebook groups I’m in. That, combined with actually becoming a therapist and hearing a lot about how other people think, has given me a lot of opportunities to reflect on what causes people to say this.

People seem to be of two minds about therapists. Either we are fully self-actualized human beings who float through the world with the gravity-defying force of our own impeccable coping skills and preternatural ability to sense others’ thoughts and intentions; or we’re all “crazy” and “broken” and got into this field either to wallow in our misery along with our clients, exploit those clients, or use them to somehow fix our own unusually severe mental issues.

Obviously, I highly dislike both of these stereotypes (though the latter is of course more offensive and ableist). The reality is that most people will experience some sort of significant mental distress at some point in their lives, therapists included, and experiencing it early in one’s life can be a motivating factor when it comes to choosing a career path.

But I think there’s more going on here than just stereotypes about particular professions, and I think it reflects a common misunderstanding of how therapy works. That misunderstanding is:

  1. Go to therapy
  2. Talk about yourself
  3. Have a Sudden Realization™ or receive a powerful Insight™ from your therapist
  4. ???
  5. Profit/recover from your mental illness.

Actually, it’s more like:

  1. Go to therapy
  2. Fill out a lot of paperwork (sorry)
  3. Talk about yourself
  4. Hopefully, maybe (please) do some homework stuff outside of the session (I call them experiments!)
  5. Learn things about yourself and your mental illness, both through information and perspectives provided by your therapist and your own experience
  6. Apply that knowledge to change some of your patterns of thinking and/or behavior
  7. Have a really bad week/month and forget all of that knowledge for a while
  8. Relearn the knowledge and resume applying it
  9. Increase your tolerance of painful thoughts and feelings and your confidence that you can climb out of future mental health setbacks
  10. End therapy and continue being an awesome person.

The first model doesn’t work chiefly because 1) there’s no magical realization or insight; shit is way too complicated for that and more importantly 2) knowledge alone doesn’t automatically change people’s thoughts, behaviors, or circumstances.

(Why does anyone still think that therapy is about Receiving Insights from on high? I blame Freud.)

But if it did, then it would generally be true that therapists wouldn’t have the same problems other people do.

But since it doesn’t, it stands to reason that our knowledge about mental health and creating positive change doesn’t automatically cure our personal problems. Kind of how even the best brain surgeon in the world doesn’t operate on their own brain.

The inconvenient thing about therapy is that it is, at its core, an interpersonal process. That’s why the strongest predictor of effectiveness in therapy is the strength of the working relationship between the therapist and the client.

Although there are a lot of fascinating processes that go on in therapy (I hope someone has written a blog post about them), I would argue that the core process—the one that’s absolutely necessary for any kind of change to occur—is the one in which the therapist shows the client that they have worth, that they deserve respect, that their experiences are real, that their feelings are valid, and that their attempts to cope with their situation make sense, even if they aren’t working well for them anymore .

And that is really hard to do for yourself. I would say it’s a bit like giving yourself a hug. Can you go through the motions? Sure. Is it even anything like a hug from another person? Nope.

And this is why all good therapists have their own therapist at least some of the time. And also why we have the exact same super cool fun problems as the rest of you.


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“But You’re a Therapist!”

A Support Role Taxonomy

Close-up of a life preserver.
Photo by Jametlene Reskp on Unsplash

A universal human dilemma: you need social support, but the type of support you need isn’t the type you’re getting.

You just want to vent, but your partner jumps in with advice. A sick person gets tons of gifts, but all they really want is someone to come over and spend time with them while they’re stuck in bed. Everyone wants to come hold the newborn baby, but nobody’s offering to do the parent’s laundry or make some meals for them.

This is complicated by the fact that most people find it difficult to articulate exactly what they need in terms of support, especially when they’re already in a rough spot. Even if they do know, and could verbalize it, many people feel like they shouldn’t look a gift horse in the mouth. So, sure, you don’t need all those nauseating frozen meals while you’re dealing with chemo, but at least they were nice enough to think of you, right?

It can help to learn how to identify what it is that you do need and how to communicate that to people. On the flip side, it can also help to learn which types of support you’re best suited to providing and look for opportunities to do those things—as well as to be careful not to push those types of support onto people who don’t need or want them.

This article is a taxonomy of different types of support that people might need. There are probably many more, although just about anything I can think of fits into one or more of these types. Some are subtypes of each other–advocacy is a type of assistance; perspective could be considered a type of information.

There are three major types of social support. Emotional support involves directly creating space for the person’s feelings and helping them to express or process them. It includes validation, affirmation, comfort, and perspective.

Intellectual support requires using your knowledge and critical thinking to help the person find ways to move forward. You can offer it through information, advice, feedback, or motivation.

Practical support helps people set up their lives and environments in ways that promote coping and healing, and is an ideal way to help if you struggle with emotional labor, listening, or other interpersonal skills. You can provide practical support by giving resources or assistance, supplying distractions, or simply being physically present.

Here are the twelve support roles, broken down in detail. They’re in order (roughly) from least involved and complex, to most.


1. Presence

Presence is the gift of intentional togetherness—the simplest way of “being there.” When you’re present with someone, you are physically[1] there with them. Even if you’re both doing your own separate activities, the person you’re supporting knows that you will shift your focus to them if they need it.

You may need presence if: You just don’t want to be alone.

Ways to be present with someone: Sit with or near the person. Don’t check your phone or start doing other things until they do, and stop if they stop. If they aren’t speaking, resist the urge to fill the silence with talking.

2. Distraction

When the person who needs support isn’t ready yet to actively resolve their problem, or there isn’t a realistic way to resolve it right now, you can help them distract themselves so that they can have a few hours of relief from what’s troubling them. Your main role here is to be the one who suggests the distractions and obtains or sets them up.

You may need distraction if: Focusing on the problem at hand is doing more harm than good; you can’t keep yourself from ruminating and feeling even worse; there’s no practical or effective way to resolve the issue right now, and you just need to get through the next hour(s).

Ways to provide distraction: Take the person out to do something they enjoy. Come over and watch TV or movies together. Talk to them about your own life or tell funny stories. Play games together. Let them play with your pet.

3. Comfort

When two people have an attachment bond, they can comfort each other—a social process that actually reduces the body’s physiological stress response. [2] (Remember oxytocin from all that fear-mongering about casual sex? This [among other things] is what it’s really for.) Comfort can involve touch or words, but the words are just there to make those bodily changes happen. People don’t have to be sexual/romantic partners to be able to comfort each other this way—these types of bonds are common between family members (even adults) and close friends, as long as those relationships are healthy and consensual.

You may need comfort if: You feel unsafe or scared, and there’s someone you trust to reassure you.

Ways to comfort someone: Hug, cuddle, or hold hands with the person (with their consent). Reassure them verbally that everything will be okay, that you’re here, that they’re safe. Keep repeating any words or phrases they find soothing. It’s okay to be repetitive—this isn’t about conveying information to them, it’s about facilitating a physiological response. Give them your full attention, or it won’t work.

4. Validation

Validation is often the first and most important significant process that occurs in therapy. [3] It’s important in other types of relationships as well. When going through difficult times, almost everyone struggles on some level with feeling like their thoughts or feelings don’t make sense or aren’t reasonable or proportional to the situation. For whatever reason, humans can’t really start to heal until we start to understand that it’s completely okay to feel and think as we do. If you’re finding that your attempts to support others fall flat, it may be because they needed validation first, and you skipped over this step. [4]

You may need validation if: You’re struggling with feeling like your experience isn’t real, visible, recognized by others, or “that bad”; you have people actually telling you that it’s not “that bad”; you feel ashamed of your own thoughts or feelings; you worry that you’re being “overdramatic” or irrational.

Ways to provide validation: Listen. Verbally acknowledge what you’re heard. (“I hear you.” “I’m still listening.”) Remind the person that it’s okay to feel the way they do. Reiterate that what they’re saying makes sense to you; if it doesn’t, ask open-ended questions until it does.

5. Affirmation

Closely related to validation, affirmation is the process of helping someone feel that you like them and think well of them. Just as people typically need to feel that their internal experiences are valid, they also tend to cope and heal better when they are reassured that the people close to them still respect them and want relationship with them. It may seem irrational, but I think it has to do with how fundamental our need for social connection is.

You may need affirmation if: You feel diminished or beaten down by your experience; you worry that people think less of you because of it; you’re receiving lots of negative feedback or criticism.

Ways to affirm someone: Tell the person why you admire or respect them. Compliment them. Give them genuine positive feedback about how they’re coping with the situation.

6. Resources

Sometimes, throwing money and/or stuff at the problem really does help. The prevalence of crowdfunding campaigns online is a testament to this. If you can afford it, supporting someone with resources can make a huge difference.

You may resources if: You’re faced with a financial crisis you can’t handle alone; there are tangible things you don’t have and can’t find or afford that would help; dealing with your situation has left you without money to spend on small pleasures or self-care that would help you cope and heal.

Ways to provide resources: Donate/contribute money. Ask what they need and buy it for them.

7. Assistance

If you don’t necessarily feel up to supporting someone emotionally, don’t forget the importance of practical assistance. It’s common to offer this when someone is going through a serious physical illness or has recently had a baby or lost a loved one, but people need it in all kinds of situations. Mental illness or stress can make it difficult to do basic “adulting” tasks, and helping someone with basics like food and laundry can free up time and energy for them to resolve whatever they’re going through.

You may need assistance if: An illness or disability is making it difficult or impossible for you to do something that needs done on your own; managing your current situation is taking up so much time you can’t do other necessary things like cooking, housecleaning, etc.; you lack transportation; you’re concerned about caring for your children or pets while you deal with things.

Ways to assist someone: Ask the person (or someone closer to them) what you can do for or with them. Offer rides, household help, childcare, petsitting, or other types of practical help. Identify what your skills are when it comes to helping people: Are you handy around the house? Great with kids? Skilled at making nutritious frozen meals? Let the person know that you are available to do this thing for them, preferably in writing so they have an easier time remembering to reach out to you if they decide they need it.

7. Information

Information is an often-overlooked form of support, perhaps because it doesn’t seem like a social process. But it is—even if you get it from a book or from the internet, you’re still receiving it from someone, hopefully someone you trust. Some people are very resourceful and tend to quickly learn what they need to know. They may not even realize that information is a specific type of support someone else might need. Others struggle with resourcefulness, and may not realize that they’re missing information, or that someone trustworthy may be able to provide it. Some people have been resourceful their whole lives and flounder when a crisis they’ve never faced before makes them suddenly incapable of finding the knowledge they need.

You may need information if: You don’t understand the facts of what’s going on; you’re feeling stuck because you don’t know enough to feel confident that you’re making a good decision; you feel like there’s nothing that can be done in your situation; you have a serious medical condition that your doctor didn’t adequately explain; you’re facing a situation that involves legal issues, financial decisions, or other specialized knowledge that you don’t have.

Ways to provide information: Suggest books, articles, or other educational materials. Recommend a doctor, lawyer, accountant, therapist, or other professional that you trust. If you specialize in this issue, donate some of your time to provide some education around the issue (within the boundaries of your professional ethics, of course.)

8. Advice

Advice is without a doubt the most-given and least-wanted form of support, which is something we have to acknowledge before we can even talk about helpful advice. While it’s almost always a good idea to get consent before offering support, advice is one of the most important types of support to never give if it’s not asked for. Unsolicited advice isn’t just useless much of the time; it also tends to directly interfere with other vital support processes, such as validation and affirmation. Nevertheless, people do often want advice—they just tend to want it from specific people, and only when those people have the context they need to give advice that’s actually useful.

You may need advice if: you want to know how other people would handle the situation if they were in your shoes; you want to hear from someone else who’s been through this.

Ways to give advice: Ask first! Consider how you’d handle the situation, but take the person’s own needs and values into account. Ask what they’ve already tried or considered, and why it didn’t or wouldn’t work. Make sure you have all the information you need to give helpful advice.

9. Motivation

There are many things that can mess with our executive function—ongoing conditions like ADHD or autism, situational factors like sleep deprivation, long-term emotional states like grief or stress, or simply having way too much to do. Internal motivation is one of the main executive functions, and often one of the first to go. Thankfully, motivating each other is something we can easily learn how to do.

You may need motivation if: You have the capability to do what you need to do, but can’t seem to get started; anxiety, perfectionism, or depression are getting in the way or resolving your issue; you need someone to hold you accountable.

Ways to motivate someone: Check in with the person about the things they’ve said they’d do. Offer encouragement and positive reinforcement. Ask helpful questions (“What would be the next step?” “What’s keeping you from doing that?”).

10. Feedback

Sometimes people need a more involved version of advice or motivation—that’s feedback. Note that sometimes people want constructive criticism specifically, and other times they may only want “negative” feedback if you see something actively wrong with what they’re thinking or doing. It’s the difference between “Do you think I handled this wrong?” and “How could I handle this better?”

You may need feedback if: You’re not sure if you handled a tricky situation appropriately; you’re not sure if you’re interpreting something correctly; you want constructive criticism.

Ways to provide feedback: Point out the person’s strengths or what they’re doing well. Offer suggestions for improvement, or alternate interpretations of a situation. Ask useful questions (“What’s your goal here?” “What other options are you considering?”)

11. Advocacy

Advocacy is a very special type of assistance that involves using privilege, social skills, or knowledge that someone else doesn’t have in order to communicate on their behalf. This usually comes up when someone needs something from some sort of institution or authority figure, but it can also apply to mediating an interpersonal issue or backing someone up when they set a boundary.

You may need advocacy if: You need something from a person or institution and don’t feel empowered to try to ask for it; you feel that it might help to have someone (perhaps someone with more privilege or with skills you don’t have) in your corner.

Ways to advocate for someone: Accompany the person to appointments and help them express themselves effectively. Make sure they are being understood. Resolve an interpersonal issue on their behalf, or serve as a mediator. Obtain their consent to speak to their doctor, therapist, or insurance company to appeal a decision or provide collateral information.

12. Perspective

One of the rarest and most precious gifts you can offer to someone who is suffering is perspective. Like advice, this one is offered much more often than it’s actually available to give, and that’s because many people don’t have as much perspective, or as useful of one, as they think. Perspective isn’t “it could be worse” or “I’ve suffered worse.” Perspective never minimizes the problem; if anything, it shines a clarifying light on it. It can come from a religious or spiritual approach, but doesn’t have to. It can also be thought of as wisdom.

You may need perspective if: You feel lost or hopeless. You have no idea how anyone could get through this. You need someone’s wisdom.

Ways to provide perspective: Make sure you actually have perspective to offer on this issue. (Have you been through something similar? Are you knowledgeable in the person’s faith tradition?) Share an empowering, comforting, or personally meaningful way of looking at the issue. If appropriate, provide a religious, spiritual, or secular interpretation. Use perspective-finding tools that the person values, such as a tarot reading. Recommend a work of art, a book, or an essay that offers wisdom. Perspective is not the same as advice, and does not necessarily include any guidance on what the person should do. It’s more about providing a new lens for them to look through if they want to.


It’s a good idea to explicitly make sure you know what the person wants before providing any type of support. This is especially important with comfort, resources, assistance, information, advice, feedback, and advocacy, as these things are the most likely to cross boundaries when they’re unsolicited. But any type of support can come across as invalidating, tactless, or even violating if it’s not wanted. Nonconsensual touch that’s meant to be “comforting” can be actively harmful.

I’ll break down some of the more complex support roles in later articles. For now, I hope this taxonomy helps you give and receive support to others.


[1] Sometimes presence can be virtual, as when people hang out together via video call or have an ongoing text chat that they know they can use at any time. But it’s much harder to demonstrate presence without a face-to-face (or side-by-side) connection.

[2] https://www.sciencedirect.com/science/article/pii/S0306453013002369

[3] https://www.miriammogilevsky.me/blog/2018/8/21/what-is-therapy

[4] https://the-orbit.net/brutereason/2015/06/29/dont-tell-people-how-not-to-feel/


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A Support Role Taxonomy

Back Through the Fire

Smoke after a forest fire.
Photo by Joanne Francis on Unsplash

[Content note: cancer, illness, suicide]

In November, I had my last cancer-related surgery. My temporary tissue expanders were replaced with permanent breast implants, and I was instructed to give my body six weeks to recover, after which I could return to my usual activities.

After five weeks and 6 days, I gave in and started exercising. It was almost the New Year. It was deep winter, a time of planning and setting things in motion. I was finally done with treatment, and I was ready to live again.

So for the next six weeks, I lived. I worked out almost daily. I started my private practice. I made plans. I designed a backyard garden. I took classes, learned new things. I took on new roles at work. I returned to freelance writing.

For six weeks, I lived. I was determined to get back everything I’d lost to cancer, and then some. I enjoyed my time with family, unburdened at last by the demands of treatment or recovery. Having emerged unburnt from the fire, I felt that nothing could stand in my way.

For six weeks I lived like a person reborn. This lasted until February 13.

That day my mom told me she had cancer too. That day, my newfound momentum sent me clear off what I now realized was a cliff, and like the coyote in the cartoon, I looked down and found myself unmoored, unsafe, and spiraling down.

It was nothing like my own diagnosis, first of all. I never thought that “I’m thankful for the way I was diagnosed with cancer” would be a set of words my brain would assemble in that order. But I am. I got the call one day. I saw an oncologist the following day. Within a week, I had a clear diagnosis, a treatment plan, a second opinion confirming those things, and a team of medical professionals I trusted.

This was about as different from that as it could get. For starters, the initial “diagnosis”–the one my mom called me about on February 13–wasn’t even that. It was unfounded speculation from a rude, shaming primary care doctor. I let myself believe for a bit that it wasn’t true. But for the next six weeks, as my mom was bounced around between doctors, hospitals, and scan machines like a dented ping pong ball, the picture continually came into focus, then blurred again.

One day it was early-stage lymphoma. Another it was metastatic ovarian cancer. Some days, other diagnoses were thrown out like beanbags on a cornhole board–lung, stomach, liver, breast, uterine. Doctors would walk out of her exam room completely confident and optimistic, only to return subdued and humbled, their hypotheses disproven, without any others waiting in the wings to be tested.

Picture yourself surviving the worst thing you can imagine, and before your scars–literal ones, in my case–have even fully healed, that same thing happens to the person you love most. That was me.

My mom had always been the person I called when I was so desperately upset I couldn’t do anything else. Now I had lost even that. My parents, through no fault of their own, relied on me in completely unsustainable ways during that time. I found myself supporting both of them, trying to curb my spiraling panic whenever they talked about metastasis and preparing for the worst, comforting all three of my siblings (especially the two teenage ones), fielding calls from extended family and close family friends, driving an hour to question doctors at the hospital while sick with the flu, researching–always, always researching–calling and begging my oncologist to take on her case or make a referral, talking my mom down from panic attacks over the phone, using my own therapy appointments to try to figure out how to live if my mom dies.

I could’ve handled this for a week. Maybe two. The mind goes into crisis mode and you somehow push on.

But it lasted for six. By the third week, I was coming apart. I started to become paranoid almost to the point of delusion, refusing to believe anything any doctor said because so many of them had been wrong. When my mom finally had a vague diagnosis and some semblance of a treatment plan, my mind rebelled against it, refused to accept it, and I ranted like an unhinged person over the phone about how this was wrong, and they hadn’t done this or that test or ruled out this or that possibility, and they needed to find a “real” doctor and get another opinion.

To their credit, they did get more opinions. The opinions all converged on the fact that the particular way my mom’s cancer had played out was so statistically improbable that it had only been recorded 20 times in medical history.

By way of comparison, there have been 23.2 million cases of cancer recorded historically in the United States alone.

This broke my brain.

I walked through the world like a fading ghost. Everything was a reminder of the thing I couldn’t forget anyway. The lemon tree my parents gave me as an engagement gift right before my surgery had unceremoniously dropped its leaves over the winter–they do that–and I couldn’t shake the fear that I was killing the last tangible symbol of her love I would ever get. All of my clients suddenly turned out to have dead or dying mothers that they needed to talk about.

My work suffered–everybody noticed. My parents were often calling and texting me during the workday and I would grasp at whatever few minutes I had between appointments to talk to them, sob inconsolably on the floor of my office, or both. I no longer wanted to be alive whatsoever, but even stronger than that feeling was the belief that I absolutely could not die, accidentally or on purpose, without dooming my family for good. By then I was living only for other people–my family, my partners, my clients–and I was starting to fail every single one of them, noticeably and repeatedly. The more I failed, the more I hated myself, my life, and the world.

It was, in short, a complete fucking living nightmare.

You have to understand—I was never one of those people who wonder Why me? when they get sick. Totally reasonable reaction—just not mine. In some ways this is because I incorporate and adapt to new knowledge quickly, and I was immediately focused on survival.

But the other half of it has to do with the way in which having cancer stripped me bare. I discovered that all of that emotional baggage and maladaptation I thought I’d handled years ago were actually still there, dormant. As all of my learned coping skills and cognitive strategies were eroded away like layers of sediment, I found that there was no bedrock of self-love underneath, no protective sense of my own worth as a person.

And so I didn’t feel the need to wonder what I did to “deserve” getting cancer. I didn’t think I deserved it, but I also didn’t think I’d done anything to deserve a happy, healthy life, either. Honestly, getting cancer kind of made sense. On my worst days I really do hate myself enough to make renegade killer cells an apt (if heavy-handed) metaphor.

My mom’s illness was completely different. As the weeks leading up to the eventual beginning of her treatment wore on and on, I hated the world more and more, and wanted to live in it less and less. I wished an asteroid would hit and destroy it. I wanted nothing to do with a world in which something like that could happen to someone like her. I wanted nothing to do with a life without her in it.

As a patient, I had a dark source of comfort—this too shall pass. You either survive cancer or you die.

I survived. My illness taught me that I can overcome anything. My mom’s taught me that no matter what I overcome, the suffering it brings will never end.

And yet. With something approaching an actual working diagnosis, my mom started her treatment in late March. The treatment seemed to be effective. The tumors shrank. I found myself sometimes thinking about something other than her. Spring came, as it always does, and the seeds went into the ground, and my wondrous garden sprang up once again as if from nothing.

And, just like last year, the new life in my backyard brought life back into me, too.

I don’t know what will happen with her treatment, or the rest of her life. There are reasons for hope and there are reasons for despair. Which one will win out in my mind in any given moment is a coin flip. I still haven’t figured out why or how to live without her if she dies. When she dies, as that’s obviously going to happen eventually. That’s another one of those things I didn’t expect to be thinking about this much at my age.

I haven’t written about this for months, except for scribbled ranting in my journal, because I had nothing to say. I could find no meaning or narrative in it. With my own cancer I learned things, experienced things. I had things to say about fear and bodies and friendship and family and work and joy. It was awful but it was also in many ways profound.

This was nothing. I learned nothing, saw nothing. “What am I supposed to write about?” I remember asking my therapist. “There’s no ‘there’ there. I just don’t want my mom to die. I’m just miserable and terrified and grieving already about that. That’s literally it.”

“You should think about why this happened to you,” my mom’s first doctor said, after ordering CT scans. I have also thought about why this happened to me, to us, as has she. We got nothing.

When I lost the thread of my own story last year, even that became part of the story itself. It was a gap, but the gap spoke volumes. When my mom got sick, I wasn’t weaving the web anymore. I was a fly trapped in it.

So I made do with what I have, and made myself a little cocoon from the fibers.

Then, midway through her treatment, everything changed again. She finally got her genetic test results back. She has BRCA-1, the same genetic condition I have. Then I understood.

She was always going to get cancer. It has always been a near-certainty, since long before I was even born, since before she watched her own father survive cancer.

My dad called and told me, and asked me to be the one to tell her. I froze. Couldn’t do it. On the one hand, it was “good” news, of a sort–it was a medical explanation, and it increases her chances of survival because it makes certain additional treatments possible. On the other hand, I shuddered to think of anyone, let alone someone I love so much, going through the hell I went through. What do I say to someone about to go through what was my worst trauma?

I told my dad this. He said, “It won’t be anything like that. We have your experience to guide us.”

And that’s when everything clicked for me at last.

My mom, like me, was always going to end up in this situation. Statistically, it was much more likely that she would go through it first, and I would go second. But that’s not how it happened, thank god, because this way it was my body and sanity on the line, not hers. Because this way I was the one to be mistreated and traumatized like that, I was the one who learned what I learned, I was the one who had to figure out how to demand humane treatment and pain control, I was the one who realized that panic attacks interact uniquely with this particular kind of post-op pain, I was the one who lived to write about it, I was the one who made it my mission to learn how to talk so doctors will listen and to start to teach that to others.

Now none of that will happen to her, so help me god, because I will be for her what nobody was able to be for me.

And with that came the realization that if I had a choice—if I could’ve somehow chosen to be put through this first so that she may survive it with fewer psychological scars—I would’ve chosen this, because I would do absolutely anything to save her life and her happiness, even face down death myself.

Everyone hopes on some level to find some sort of ultimate meaning in the horrors they go through; my answer to that basically got handed to me. I went through it so she wouldn’t have to, so that I could one day walk right back through the fire I’d escaped, and lead her out with me.

Things became somehow easier after that. While there isn’t any sort of cosmic meaning or significance to all this, I don’t really need there to be. In the unanswerable question of her tragedy, I found an unquestionable answer I didn’t know I was looking for.

After that I did something I didn’t expect to do. It won’t seem like a big deal to anyone but me, but I know what it means.

What I did was I bought trees. Berry trees. Black currant, gooseberry, cornelian-cherry dogwood, lingonberry, hawthorn, fig, mulberry, and, of course, rosa rugosa, which produces those rosehips my mom so prizes.

For the first time I was willing to plant things that wouldn’t give fruit for at least a year if not more, and to trust that on the day they repay all of my digging, watering, fertilizing, pruning, and protecting for the first time, I will still be around, and I will still care. That one beautiful fall day, maybe one of the last, my mom will visit me, and she will steal rosehips from my bushes, telling me that I wouldn’t use them anyway, and her laughter will be strong enough to send the birds from the feeders and bushes, flocking up, up into the dying light.

So that’s where I was, last weekend, digging holes in the yard as the rising summer sun woke up and thawed me.

On the patio behind me, where I’d set it out after the last frost, my parents’ lemon tree was waking too, sending bursts of new smooth green leaves from its buds like offerings to the sun god it worships.

I finished my work, picked fresh herbs from the garden for my mom, threw my stuff in the car, and drove west to Dayton, where my family was waiting for me.


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Back Through the Fire

Speaking Gently to My Body

I’ve always criticized what I’ve sometimes called the chocolate-and-bubble-baths model of self-care, where a series of supposedly “pampering” actions is supposed to somehow replenish you and make you ready to face the world again.

But I think I’ve found the usefulness of these types of activities, and the answer, as usual, lies in mindfulness and intentionality rather than escapism and consumerism.

I used to have a lot of body image issues, and then I found feminism and did a lot of personal work and (I thought) resolved them. Then cancer hit and a lot of that work completely undid itself. Suddenly I was standing in front of the mirror saying shit to myself that I hadn’t said for a decade. That was weird.

But by 2019 my body and I had arrived at a sort of uneasy truce, held together by 1) it not having cancer and 2) me practicing intuitive eating and engaging in regular movement that feels good to me.

And then I got a severe flu, went to urgent care, was not diagnosed with the severe bacterial infection I also coincidentally had, and ended up hospitalized for two days on a near-constant drip of IV antibiotics.

If getting hospitalized for two days due to medical mismanagement isn’t perhaps the most on-brand thing that can happen to me at this point, I don’t know what is. I mean, it’s not like I’m writing a book about that or anything.

That said, the other really on-brand thing that happened was that I rallied and got discharged from the hospital just in time to get a good night’s sleep, keep my travel plans, and hop on a plane to Austin, where I’m now typing this in a backyard wearing nothing but leggings and a tank top. (I deserve this.)

But before all that, I was home from the hospital in a shitty mood with barely enough energy to stand up without something to support me. I also needed a shower. I’ve now done it several times and if you haven’t experienced this, I can absolutely assure you, the post-hospital shower is the best shower you will ever take in your life. It beats post-camping showers. It beats “the landlord finally fixed the sputtering showerhead” showers.

In the shower, I shampooed my hair, used two different kinds of conditioner, and used both body wash and scrub to exfoliate my severely-neglected skin. When I got tired, I sat down on the floor of the shower and let it wash the conditioner out of my hair.

When I felt ready to be done, I grabbed a towel from the towel warmer (I should mention, this was at my parents’ house, by no means do I personally own a towel warmer) and slid the shower door shut again so I could dry off in the remaining warmth.

I noticed that I felt compelled to dry myself more gently than I usually do. Of course this was probably in part because of my recent infection, but that had only affected a small part of my body. I realized I wanted to pamper myself—not in the mindless sense of showering the body in fancy products or putting it through a particular set of actions (no shame if you enjoy mani-pedis, but to me they are painful and awful and I have no idea how that came to abstractly represent self-care for anybody who does not enjoy pain), but by treating it with the sort of gentleness I would treat a loved one returned from the hospital.

After I finished drying off, I found myself saying, “Now, my dear, you are good as new.” I continued: “Thank you for everything you’ve done for me. You fought hard and you won.”

Then I started tearing up.

Then I left the shower and started asking myself why I never thought to speak to my body this way after (let alone during) cancer.

I mean, if what I said was true in this situation—and it certainly felt true—how the fuck isn’t it even more true for the process of going into remission from cancer, regrowing my hair, losing the bloat and swollenness of chemo and steroids, and healing my surgical scars?

The truth is, as miserable as it was to suffer through both a viral and a bacterial infection at the same time—and it was literally worse than chemo, by the way—I didn’t hold it against my body that it happened. It wasn’t something my body “put me through.” It was something we got put through together. I felt awful when I was sick and I felt awful for my poor body. My fever spiked to 105 at times. Almost my entire face turned red and swollen. My lymph nodes ballooned. My head hurt so much I could barely find a way to set it down on the pillow so I could sleep. After my dad made me drink TheraFlu one night, my body violently rejected it into the toilet. (Kids: do not have TheraFlu be the only thing you consume all day, unless you’d like to use it to expel an accidentally-injested poison.) It was just an awful six-day slog of fucking misery.

And I didn’t blame my body for it at all.

I could’ve—immune system failure and whatnot. But I didn’t.

Cancer and surgical trauma felt entirely different. Cancer seemed personal and internal two times over—once because it involved my flawed genes, once because it involved my own rogue cells. After surgery, my muscles seemed to attack me and nobody listened to me.

This time, nobody denied that I was sick and hurting. I felt able to complain, to lie in bed and moan, to seek emotional and medical help. (Half-assed as the latter was at times.) With surgery, my medical care was absolutely top-notch, but that and practical assistance were pretty much the only forms of support I had.

As it turns out, it’s much easier to not to blame your body when your non-physical needs are being heard. It’s easier to care for and even move toward loving your body when you feel fully cared for and loved by others.


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Speaking Gently to My Body

My Zine, “The Girl Survives Cancer in This One,” is Now Available!

Banner for "The Girl Survives Cancer in This One." Visit bit.ly/GirlSurvives

As you may know, I’ve been writing a book of essays about my experience as a breast cancer survivor. Last month, I decided to publish a zine that collects some of the essays I’ve written so far, to put my writing out there and build some interest in my book.

It ended up being a very fun project (my first zine!) and although I didn’t end up with the old-school photo-copied look I originally planned on, it’s very pretty and the writing is very much the focus.

A photo of the inside of my zine.

It’s now available on Etsy in digital format for $4, and as a paperback for $8. You can even get the paperback signed! Who knows, maybe it’ll be worth something one day.

If you want to get updates on my book as it progresses, you should subscribe to my newsletter here.

I hope many of y’all buy it and read it, and don’t forget to leave a review on Etsy!

A photo of the cover of my zine.

My Zine, “The Girl Survives Cancer in This One,” is Now Available!

Building Blocks of Mental Distress: A Dimensional Assessment of Mental Illness

This is a cross-post from my professional blog, where the most updated version of this will be.

The field of mental healthcare has its roots in medicine. The earliest mental health professionals were doctors—psychiatrists. Like medicine, psychiatry and clinical psychology are based on the process of assessing patients’ symptoms, performing some sort of test if needed, assigning a diagnosis, and creating a treatment plan based on that diagnosis.

This is a very sensible approach for most medical issues. If I appear at my primary care doctor’s office complaining of persistent headaches, she shouldn’t just treat the headache by prescribing a painkiller. She should refer me to someone who can figure out what’s causing the headache, and then treat that condition, whether it’s extreme stress, a head injury, a bacterial infection, a brain tumor, or some other problem.

Even though we’ve been treating mental health issues this way for at least a century, it’s not the best way to treat them. And many psychiatrists, therapists, and researchers are starting to realize that.

That’s why we’re finally starting to see approaches to assessment and treatment of mental illness that move away from the much-argued-about diagnoses in the DSM, and sometimes away from the concept of mental illness altogether. Psychologists such as David Barlow, Rochelle Frank, and Joan Davidson have been working on so-called transdiagnostic approaches[1]; the newest edition of the DSM includes a chapter about a proposed new way to diagnose personality disorders that’s based on specific personality traits rather than broad, stigmatized labels[2].

I’m looking forward to the day when the field as a whole has shifted to these types of approaches entirely. For now, I needed a tool I can use with clients to help them (and myself) understand what they’re dealing with and access helpful resources and support. So I created my own informal dimensional assessment.

This assessment is a list of 33 (and counting, I’m sure) ways in which our brains can get in our way. You could think of them as symptoms, but I prefer to think of them as painful patterns, or building blocks of mental distress. Everyone has at least some of these; many people have a lot of them and don’t necessarily suffer greatly for it. It’s all a matter of degree.

Most of these terms are actual mental illness symptoms that appear in the DSM or in other clinical psychology texts. Some of them I coined from existing words because they aren’t really being talked about very much yet. Each of them shows up commonly with at least one established diagnosis, and most relate to quite a few of them.

In creating this list, it was important to me to try to get at the ways in which people who aren’t therapists or scientists might actually think of these experiences. So each building block has a statement with it. The way I plan to use this clinically is to show clients a list of the statements and ask them to rate each one on how much they agree or disagree with it. That would give both of us a sense of what their psychological landscape looks like, regardless of which DSM diagnoses it might resemble.

The initial feedback I’ve gotten is that folks find this really helpful for communicating with their therapists and psychiatrists about what they’re dealing with. I think that’s a great way to use this tool. Therapists know specific interventions that target many of these things; coming to a session and saying that you’d like to address your amotivation, emotional disregulation, and tendency to ruminate is bound to be more helpful than just saying that you want to be less depressed.

  • Agitation: “I often feel so on edge that I need to be moving constantly, as if I want to crawl out of my skin.”
  • Amotivation: “I struggle with getting myself to actually do things, even when I want or need to.”
  • Anhedonia: “I don’t get any joy out of things I used to like.”
  • Attention disregulation: “I can’t seem to choose when to stop or start paying attention to something.”
  • Avoidance: “I find myself trying to avoid things that bring up painful thoughts or feelings.”
  • Cognitive inflexibility: “When things don’t go the way I wanted or planned, it’s very difficult for me to adjust my expectations or make a new plan.”
  • Compulsiveness: “Sometimes I feel like I need to do an action or ritual in order to feel okay, and I feel awful if I try to force myself not to.”
  • Depersonalization: “Sometimes I feel like I’m not really in my body, or I don’t know who I am.”
  • Disordered eating: “I have a hard time controlling what or how much I eat; or, I need to control it so carefully that it’s hurting me.”
  • Dissociation: “Sometimes I experience a memory so strongly that I’m not sure who, where, or when I am.”
  • Distress intolerance: “I don’t feel like I can handle strong emotions. I need to make them go away.”
  • Dysmorphia: “I seem to see my body differently than other people do.”
  • Emotional disregulation: “When I have strong emotions, it’s very difficult for me to manage them and calm myself down.”
  • Emotional lability: “My mood can change quickly between extremes.”
  • General anxiety: “I often think about things that could go wrong in the future.”
  • Guilt: “I feel guilty even when I didn’t do anything wrong.”
  • Helplessness: “I don’t really believe that there’s much I can do to help myself feel better or improve my life.”
  • Hopelessness: “I feel like things won’t turn out okay.”
  • Hyperactivity: “Having to sit still and not move makes me extremely uncomfortable.”
  • Hypervigilance: “I’m always on the lookout for possible danger, and often I sense danger where there isn’t any.”
  • Identity disturbance: “I don’t have a strong sense of who I am; it depends mostly on the opinions of the people around me at the time.”
  • Impulsivity: “Sometimes I say or do things without thinking about them first, and afterward I can’t always tell you why I did them. When I have an urge to do something, it’s very difficult to keep myself from doing it.”
  • Inattention: “I can’t make myself focus on things I need to do.”
  • Irritability: “Little things annoy me so much I want to yell or snap at people.”
  • Mania: “I have periods of time during which I feel extremely energetic, irritable, or ‘high,’ and during these periods I tend to sleep little, talk too fast, accomplish a lot of things, or do things I later regret.”
  • Obsessiveness: “I have intrusive thoughts that bother me and I can’t make them stop.”
  • Panic: “Sometimes, my breathing speeds up and my heart starts rushing, and I feel like I’m going to die.”
  • Psychosis: “I perceive or believe things that feel very true to me, but aren’t true according to everyone else.”
  • Rejection sensitivity: “I feel like I can’t deal with it if someone dislikes me, or says no to me. I’m constantly on the lookout for potential rejection, and I probably sometimes see it when it isn’t really there.”
  • Rumination: “When I start thinking about something negative, I tend to keep thinking about it over and over and feeling even worse.”
  • Social anxiety: “When I’m around people, I worry about how I’m coming across or what I should say or do.”
  • Splitting: “I tend to see people either as extremely good or extremely bad, and I can switch quickly from one to the other.”
  • Suicidality: “I have thoughts that I want to die, or that I wish I could just not exist.”

Although I’ll probably never be able to turn this into an Official Research-Verified Published Thing or anything like that, I do hope to keep refining it and making it useful to my clients—and to any other therapists who want to give it a try.


[1] https://www.newharbinger.com/blog/transdiagnostic-psychology-why-we-need-transdiagnostic-road-map

[2] https://www.psychologytoday.com/us/blog/fulfillment-any-age/201303/whats-new-and-old-in-the-dsm-5-personality-disorders


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Building Blocks of Mental Distress: A Dimensional Assessment of Mental Illness

Stuff I Read That You Might Like, Vol. 1

An e-reader with a cup of coffee, a notebook, a pen, and a pair of reading glasses.
Photo by Aliis Sinisalu on Unsplash

For a long time I’ve used Tumblr primarily to share quotes from my favorite articles that I read online (and sometimes books, too). Since I’m no longer using Tumblr due to their atrocious, sex-negative decision about adult content, I haven’t been able to find a better way to do this. Most so-called Tumblr “replacements” are pretty barebones and/or nonfunctional.

So, clunky as it is, I’ll be doing it here! Every so often I’ll post some quotes and links to stuff you might like.

Starting off with a very topical one:

Tumblr made sex a community experience.

—Vex Ashley, “Porn on Tumblr — a eulogy / love letter

Now that the full scope of this administration*’s political vandalism and base criminality is largely being copped to in broad daylight in various federal courthouses, a good chunk of the elite political press is moving into the Hoocoodanode? stage of political journalism. This is best exemplified byThursday’s New York Times podcast, the headline of which—“The Rise of Right-Wing Extremism, and How We Missed It”—got dragged like Hector’s corpse all over the electric Twitter machine until someone at the Times sharpened up and changed the last half of it to “…and How Law Enforcement Ignored It,” which is a little better, but not much.

To take the simplest argument first, “we,” of course, did no such thing, unless “we” is a very limited—and very white—plural pronoun. The violence on the right certainly made itself obvious in Oklahoma City, and at the Atlanta Olympics, and at various gay bars and women’s health clinics, and in Barrett Slepian’s kitchen, and in the hills of North Carolina, where Eric Rudolph stayed on the lam for five years and in which he had stashed 250 pounds of explosives for future escapades.

—Charles P. Piece, “‘We’ Did Not Miss the Rise of Right-Wing Extremism. You Did.

Inspired by online recipe sites, he’d sit down to dinner and then let me know what rating I earned. “If I give you five out of five, you’ll quit,” he joked. And I laughed because when I was in my 20s, I believed that you were supposed to laugh when someone hurt your feelings. I thought you were constantly supposed to be trying harder.

—Lyz Lenz, “Now That I’m Divorced, I’m Never Cooking for a Man Again

“As you become more acclimated to the cold, your body becomes more effective at delivering warm blood to the extremities, your core temperature goes up, and all that contributes to being more resistant to the cold,” Leonard told me.

That means the only cure for hating winter, unfortunately, is just more winter.

—Olga Kazan, “Why So Many People Hate Winter” (ugh.)

Mattis saw it up close. He bore it as long as he could, in hopes of mitigating the damage. But when Trump broke America’s promise to the Syrian Kurds, he stained Mattis’s honor, too. That, apparently, Mattis could not accept. He leaves and takes his honor with him. And now the question for Congress is: The Klaxon is sounding. The system is failing. What will you do?

—David Frum, “No More Excuses

It’s called Star Wars. Not Star Trek, not Star Peace, not Star Friends, not even Star Tales. This gargantuan fictional universe is labeled with a title that guarantees the ability to travel space… and near-constant warfare.

We can debate the relative okay-ness of this focus from a moral standpoint, sure. But in reality, I think that Star Wars is accidentally teaching us the greatest lesson of all: It’s depicting what a universe looks like when you dedicate all of your research and technological advancements to war and destruction, and unwittingly showing us what an incredibly dark place that universe is. Because the Star Wars universe is a fun fictional playground for sure, a great place to build weird and wonderful stories… but it’s not a good place. Not by a longshot.

—Emily Asher-Perrin, “Star Wars is Really a Cautionary Tale About Devoting All Technological Advancements to Death

It’s no longer socially acceptable to believe that women are somehow less than especially not during a time when feminism is wielding so much cultural power. But arguing that women are just naturally better at caretaking or domestic work has become a clever way to shirk living up to progressive values while claiming you are simply complimenting women on their stellar ironing skills.

One way to combat this line of thinking is to highlight how fully capable men are in the private sphere. It is true that American culture relishes in portraying men as dolts when it comes to parenting and cleaning, and it’s an unfair stereotype.

But for women to make real progress in and out of their homes, men must give something up: the backwards dream of holding onto their feminist bona fides while seeking out female partners willing to limit their own aspirations to the home.

—Jessica Valenti, “The ‘Woke’ Men Who Still Want Housewives

So yes, forced birthers and [Status Quo Warriors], if you’re going to play it like that, I am OK with the idea of a world into which you, personally, were never born. I am equally as OK with the idea of a world where I don’t exist, either. Neither you nor I personally matters that much in a universe so vast and a sea of human experiences so rich. You and I both are accidents in our existence, possibly unhappy ones.

I would’ve rather your mother not have been forced to carry a pregnancy she didn’t want to term. I would’ve rather your father had approached your mother respectfully in an appropriate setting, or not at all. I dare to love your mother as a fellow human being more than you do and to dream of a better world for people like her. It’s rank misogyny and not very humanist at all to think otherwise.

—Heina Dadabhoy, “Why I Don’t Care If You Wouldn’t Have Existed

It is maddening to watch adult men respond to revelations of endemic sexual harassment in the workplace by instituting a series of ludicrous personal codes, rather than by learning the relatively straightforward lesson on offer: Don’t sexually assault or harass anyone.

At best, these “rules” are reflective of employers’ woefully incomplete approach to sexual harassment. Employers have long done the absolute minimum to comply with the law, relying on trite videos focused on what you can and cannot say or do in the workplace (“don’t give back rubs” or “don’t offer promotions in exchange for sex”) and sexual harassment policies designed primarily to protect them from lawsuits. The sweeping scale of the Me Too movement makes it clear that no mere set of rules is sufficient to prevent workplace harassment, especially when those rules fail to speak to all of the various power imbalances that make the critical distinctions between genuinely consensual workplace romances and harassment.

—Tahir Duckett, “Avoiding Women At Work Is A Childish, Cowardly Response To #MeToo

When you are terribly afraid of being held responsible for the emotional well-being of others, it feels very mature and responsible to decide that you should “work on yourself.” It becomes both a way of retroactively absolving yourself (wow, can you believe all of the ways my issues manifested before I decided to work on them) and a rather elegant little trick to exonerate ongoing bad behavior (dang, those pesky issues again! I guess I must keep working on them). This is especially true for those too-clever-by-half motherfuckers who think that nobly warning someone in advance they “are working on their issues” mitigates any way in which they might disappoint or harm. And even with the best of intentions, it obviates the fact that relationships themselves are a process of being made ready, not something you come to static and fully formed.

[…] We need each other desperately, in ways none of us can be ready for.

—Brandy Jensen, “Ask A Fuck-Up: I’m still in therapy. Should I be dating?


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Stuff I Read That You Might Like, Vol. 1

Do Not Let Tumblr Frame Their Adult Content Ban as “Positive”

Tumblr is banning all “adult” content. Besides being a terrible business move, this is also one of the most disingenuous decisions I’ve ever seen from an internet company. And I’ve seen a lot.

Yes, the change is happening because the Tumblr app was temporarily removed from the iOS App Store due to child pornography. (The collaborative database Tumblr shares with other companies that’s supposed to filter out probable child porn apparently let some posts through that shouldn’t have been.) Rather than justifying the new policy, though, that just adds insult to injury. In my (very heavily-regulated) field, we have a term for this: CYA.

The disingenuity of Tumblr’s statement starts very early on, when they describe their position on posting child porn: “Let’s first be unequivocal about something that should not be confused with today’s policy change: posting anything that is harmful to minors, including child pornography, is abhorrent and has no place in our community.”

That’s nice, but if you don’t want this policy change to be “confused” with banning child pornography, you might try not instituting it in response to getting criticized for allowing child pornography.

They continue:

We spent considerable time weighing the pros and cons of expression in the community that includes adult content. In doing so, it became clear that without this content we have the opportunity to create a place where more people feel comfortable expressing themselves.

Which people? Who feels “uncomfortable” posting on a site that also allows adult content, and who will be made to feel uncomfortable—or even unsafe—now that this change is happening?

There are no shortage of sites on the internet that feature adult content. We will leave it to them and focus our efforts on creating the most welcoming environment possible for our community.

Are there? I mean, yes, there’s YouPorn and Fetlife and whatnot. These are very different types of websites than Tumblr. While I’m sure sex-friendly alternatives to Tumblr exist, I honestly can’t name any off the top of my head. Given how entrenched I am in internet culture, that suggests that there may well be a “shortage.”

Another thing, filtering this type of content versus say, a political protest with nudity or the statue of David, is not simple at scale. We’re relying on automated tools to identify adult content and humans to help train and keep our systems in check. We know there will be mistakes, but we’ve done our best to create and enforce a policy that acknowledges the breadth of expression we see in the community.

This is perhaps the most honest part of this entire statement, as it at least admits that there’s going to be collateral damage. Except realistically, it won’t be statues of David or even “political protests with nudity.” It will be queer, trans, and non-white individuals sharing their experiences and identities—the exact sorts of people who use Tumblr to “speak freely about topics like art, sex positivity, your relationships, your sexuality, and your personal journey,” as the statement admits.

What this means in practice is that, like Facebook and Instagram, Tumblr’s “automated tools” (along with the biased humans supposed to keep them “in check”) are going to ban photos of breastfeeding mothers, topless photos of trans men, references to menstrual blood, and the like. Many Tumblr users are already testing this, with hilarious but also depressing results.

And on the topic of topless photos. In their definition of “adult content,” the Tumblr team writes: “Adult content primarily includes photos, videos, or GIFs that show real-life human genitals or female-presenting nipples, and any content—including photos, videos, GIFs and illustrations—that depicts sex acts.”

What the fuck are “female-presenting nipples” and why are they less appropriate than “male-presenting nipples”? (What happens with nipples that are evidently nonbinary?)

The definition continues:

Examples of exceptions that are still permitted are exposed female-presenting nipples in connection with breastfeeding, birth or after-birth moments, and health-related situations, such as post-mastectomy or gender confirmation surgery.

Why are “female-presenting nipples” acceptable when it comes to birth or breastfeeding, but not when it comes to just existing on their own, without cancer or surgery?

Once my mastectomy scars heal, they’ll be barely visible, and once I buy fake adhesive nipples, my breasts are going to look extremely realistic (not to mention totally bangin’, but that’s a separate conversation). Say I want to post a photo to reassure other survivors that they are able to get these fantastic results too. Why wouldn’t my photo get flagged and removed?

The difference is pretty obvious. It’s not really about the gender of the nipples’ owners or whether or not they’re laying in a hospital bed. It’s simply this: tits are okay as long as they’re not there to titillate.

To that end, nipples that aren’t “female-presenting” are fine, because the assumption is that they’re not pornographic to anyone—nobody gets off on them. (That’s obviously false.)

What is all this for? What is Tumblr trying to change about the way their platform is used?

One word that keeps coming up in their communications about the change is “positive.” “A better, more positive Tumblr.” “We won’t always get this right, especially in the beginning, but we are determined to make your experience a positive one.”

The word “positive” is doing some interesting work in this statement and I want to unpack that a bit. In what way is a community without (consensual, legal) adult content a more “positive” (or more “welcoming”) community? What is “negative” about the presence of consensual, legal adult content? What is negative about “female-presenting” nipples as opposed to other kinds? Why is a breast uncovered for feeding a baby more “positive” than a breast that’s just hanging out?

The staff writes in their update to the community guidelines that “we do not judge anyone for their desire to post, engage with, or view this stuff,” yet they also say that a space without “this stuff” is “more positive.” What is that if not judgment?

There’s only one neutral word to accurately describe the new Tumblr, and that’s “more child-friendly.” The only reason for removing adult content is to make it (more) possible for children to exist safely in a space. But Tumblr already had a Safe Mode for that reason—a feature that is now being discontinued because it is no longer needed.

“More child-friendly” is not “more positive.” It’s just more child-friendly. And unfortunately, even that can be a loaded term. Many websites, most notably YouTube, have been criticized for removing LGBTQ content in the name of the children, even when the same content would be deemed appropriate if it featured straight, cisgender people.

(As an example, just think about how many people screech “BUT THE CHILDREN” if a same-sex couple cuddles or shares a quick kiss in front of kids. Yet these kids see similar forms of affection between their straight parents all the time. [I mean, judging by how shitty some of these people are at relationships, maybe not.])

Competing access needs are a thing. Yes, a space where people can freely post pornographic content will not be as open to minors, even if there is a Safe Mode. However, children as a group do not seem to be suffering right now for lack of websites to use. But queer and trans people, and sex workers (many of whom rely on Tumblr to make a living), absolutely are. And these are the types of people who have made Tumblr what it is. For example, many people I know used to enthusiastically follow Cliff Pervocracy’s Tumblr, an invaluable resource on consent and sex-positivity. As Cliff pointed out on Twitter, his Tumblr account was already banned even before this change was made.

I get freaking out because you’ve messed up something as serious as banning child pornography from your website. I really do. And I’d be more understanding of this change if the Tumblr team were at least upfront about that.

Instead, they literally come right out and state that a Tumblr without consensual adult content is a “more positive” Tumblr. They conflate consensual adult content with child pornography, which is as offensive as conflating consensual BDSM with violence and consensual sex work with trafficking.

And speaking of conflating sex work with trafficking: this is bigger than Tumblr and it’s bigger than getting kicked out of the iOS App Store. It’s a direct consequence of SESTA/FOSTA, and will probably get worse.

Our society’s irrational and extreme fear of sex is killing people and ruining lives.

But back to Tumblr: unless they reverse this change (unlikely), I’ll be ending my presence there. Whether or not you have a Tumblr account and do the same, here’s my charge to you—do not let anyone get away with framing these types of changes as “positive” or “friendlier” or even “safer.” At best, these changes make spaces more accessible to minors. At worst, they further stigmatize marginalized people and cut them off from community and financial support.

If that’s what we’re doing, let’s at least be honest about it.

Do Not Let Tumblr Frame Their Adult Content Ban as “Positive”

How Big is Your Hard Drive?

Close-up of a hard drive.
This is relevant, I swear.

This is a cross-post from my professional blog.

Some friends and I were talking recently about the concept of “emotionally unavailable” people. Most of us have had a friend—perhaps ourselves—who has tried to date someone who seemed into them, but just wasn’t quite present. Sometimes this type of partner is upfront about their ability to commit and/or be there. Sometimes, they aren’t, and their behavior seems confusing and contradictory. These pseudo-relationships can drag on for years until we are finally able to move on, understanding that however much the person enjoys our presence, they are not interested in making things more committed or structured than they currently are.

If I knew what to do in these situations I’d probably be retiring a millionaire, but I do have an analogy that might be helpful. I thought of it on the spot to give my friend some advice. (If you’ve ever been my client, you know how much I love a good geeky analogy.)

Computers come with different hard drive capacities. If yours doesn’t have enough space for you, you can maybe buy and install a new one—but for the moment, you’re stuck with the one your computer came with. Maybe you can’t afford a new one right now.

Different hard drives also have different things stored on them, and these things take up different amounts of space. I know people whose hard drives pretty much just contain the system files, maybe a few extra apps. These people use their computers mainly to get online. Maybe computers aren’t very important to them and they don’t use them much at all.

Some people have a lot to store—photos, music, videos, complex projects they’re working on. These folks are buying hard drives in capacities I didn’t even know existed. (This year, the world’s largest solid state drive hit 100 terabytes. What are they storing on that hard drive???)

Don’t think of the hard drive as your brain. Those analogies are really reductive, and usually insulting to us humans. The hard drive is a symbol, and it represents something I call your capacity as a person. That encompasses a lot of things—time, energy, physical and mental ability, willpower (which isn’t really a thing, but that’s another article; it’s useful here as a concept), tolerance for uncertainty or negative emotion, and much more. For instance, not everyone has the capacity to be a therapist. Being a therapist requires having a lot of space to hold other people’s pain. Not everyone has enough space for that. Unfortunately, some therapists end up without enough space to hold their loved ones’ pain, or even their own.

Say I have a 1 TB hard drive that’s full of music and photos. Maybe there’s 300 GB left over. Then a friend asks, “Could I put some of my videos on your hard drive? I need somewhere to store them for a while.” I say sure, but then they come over with their external drive and I see that they have an entire terabyte of videos. That’s not going to fit on my hard drive. I could probably store some of their videos, and that might still be helpful for them. But maybe they really needed to store the entire drive’s worth. I don’t have the capacity.

This kind of thing happens in friendships and relationships all the time. You might have a good amount of your own shit to deal with, but that doesn’t mean you can’t listen to your friends vent about their own problems from time to time, or give them advice about a work situation, or treat them to a nice dinner while they’re going through a breakup.

You might not be able to be a friend’s primary source of support as they navigate a serious illness, however. First of all, the time factor would be prohibitive—you may not be able to drive them to all of their medical appointments, be at their house enough to care for them when they can’t care for themselves, and so on. The stress of being a full-time caregiver would be way too much. Holding their anguish as they face the possibility of death or disability is also, well, a lot. Your friend needs more people on their team.

Some people are carrying a lot of trauma, hardship, or personal responsibilities with them already. No matter how large their hard drives happen to be, there may not be space there for you.

Not only that, but some people have pretty small hard drives to begin with. I’ve known many people who just don’t seem to have a lot of space for others in their lives. They don’t tolerate much emotional turbulence when it comes to other people. They may be interested in sex, casual friendship, or even romance, but they don’t have the capacity to build interdependent, long-lasting relationships with others—at least not until they do some work on themselves, and get some bigger hard drives. Some people want to do that work; others are perfectly content as they are.

Here’s where this analogy really breaks down—buying a new hard drive is a million times easier than increasing your capacity for holding other people. And while you can buy a larger hard drive for your friend whose computer you’re always wanting to store your videos on for some reason (this is weird), you cannot increase others’ capacity for them. They have to choose to do it for themselves, and they may not want to. Or it may take them a long time, or they may not be able to do it at all.

If you are hoping for a deeper relationship with someone whose hard drive seems to be too small—or who has way too much data on it already—you have to ask yourself whether or not it’s likely that this person is going to have more space for you anytime soon, and whether or not they want that space to be yours.


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How Big is Your Hard Drive?