Monday Miscellany: Cutlery, Competing Access, Dementia Care

1. You know the Spoons Theory story for disability? Ozy has the Forks Model. Also, Ozy has a new blog! Both of these things make me happy.

The spoons model is an excellent model. However, in thinking about my own mental illness, I have discovered that it is, in fact, the exact opposite of how my mental illness works. Therefore, I have decided to coin the forks model.
(Look, I was not the one who decided that all our emotional energy metaphors needed to be utensil-based.)
Forks work somewhat like spoons, in that you have to pay varying amounts for tasks. However, unlike spoons, forks don’t replenish gradually over time. Instead, you get forks when you finish particular tasks. For instance, socializing might cost you ten forks and give you twelve, showering might cost you three and give you ten, and eating might cost you one and give you twenty. (Eating is important.)
There is a second problem, which is that you don’t always get the forks. For instance, I’ve found I get socializing forks if the people seem to like me and want to hang out with me, working forks if I feel like I’ve accomplished something, and eating forks if I actually manage to eat the food. If I hang out with people who are only sort of vaguely tolerating my presence, or I discover that my two hours’ work is wasted, or I get halfway through cooking but don’t finish making it, I don’t get the reward but I still have to pay the forks. That is probably fine for our startup founder PhD triathlete, since the only consequence for her is that she now has a sleeping place that isn’t covered with cutlery. But if you have low forks to begin with– particularly if you’d spent your last handful of forks on trying to do the thing– it can be disastrous.

2. I literally knocked over my cup of coffee in enthusiasm when I read that scientists have intentionally opened the blood-brain barrier.

3. Over on tumblr I wrote two different things about getting talk therapy. First, about basic advice for your first therapist. Second, about telling a therapist that you don’t want to try a common therapy.

4. Ionnadis is known for writing about psychology methodology, echoes my concerns about ‘evidence-based’ interventions. His whole manifesto, How To Make More Published Research True, is worth reading.

Currently, major decisions about how research is done may too often be based on convention and inertia rather than being highly imaginative or evidence-based. For example, there is evidence that grant reviewers typically have only modest CVs and most of the top influential scientists don’t review grant applications and don’t get funded by government funds, even in the United States, which arguably has the strongest scientific impact at the moment than any other country (e.g., in cumulative citations). Non-meritocratic practices, including nepotism, sexism, and unwarranted conservatism, are probably widespread. Allegiance and confirmation biases are powerful in scientific processes. For healthcare and clinical practice, while evidence-based medicine has grown stronger over time, some argue that it is currently in crisis and “evidence-based” terminology has been usurped to promote expert-based beliefs and industry agendas.

5. Neuroscientists and brain training.

6. You didn’t even ask for it, but I offer you some advice on unsolicited advice.

Instead of unsolicited advice in response to a statement where someone is simply speaking to something that’s going on in her life, try just saying: ‘I hear you.’ If you have experience in that area, ‘I’ve been there.’ If you don’t, ‘I’m listening.’ ‘So sorry you’re struggling with this.’ ‘Thinking of you.’ Just stop there. You don’t need to say anything else. The original comment was simply a statement, an expression of frustration or anger or grief or fear or pain, and sometimes, people just need to know that people are paying attention, that people are thinking of them.

If you just can’t help yourself, don’t jump into advice. ‘I had the same problem with Sofia when she was Nico’s age! If you want any suggestions, happy to help.’ ‘Ugh, sorry to hear your new meds aren’t working. If you need me to pick anything up at the store, let me know.’ The first is an offer of advice, if it’s wanted. The second is a constructive offer of help, framed in a way that allows someone to take it or leave it. Both center the speaker, not the responder, and both extend a clear, concrete offer, but not one that must be taken.

7. Dementia care is just so broken. Both here in the U.S. and in the U.K.

At some point the GP wrote to my dad. The letter asked him to ring or make an appointment to discuss his “Alzheimer’s problems”. By then he could no longer read. He couldn’t write, and only spoke simple words that he was sure of. When my mother phoned to make an appointment, she was told the GP couldn’t discuss my dad because of patient confidentiality. It got worse. After all the phone calls, the carers who came and went, the desperate attempts to find proper help, my mother says, “I gave up asking. I thought I could cope.” This is how dementia is mostly cared for these days.

8. Safe spaces and competing access needs.

Safe spaces are great. Safe spaces are a really important thing. But sometimes I see people talk about them like the point is to expand them outwards and make the entire world a safe space, which sounds great…

and which really won’t work. And the way it fails will hurt a lot of people.

because say there’s a religious community. It’s fair of them to want a safe space where atheists won’t come in and say ‘these beliefs make no sense’ and ‘have you looked at double-blind prayer tests?’

And say there’s a person who was raised in an extremely coercive faith community, and now they’ve decided it’s not true, and they’re in the process of angrily rejecting hateful and damaging things that they internalized as religious teachings. (I know several people like this).

These people both need safe spaces. One needs a safe space to practice their traditions without people interrupting to say ‘none of this is true’, and the other one needs a space to say ‘none of this is true!’ and ‘I can’t believe I agreed with this nonsense!’ and ‘wow look at these double-blind prayer tests!’ What’s disruptive for one person is healing and important and necessary to another.

If we pick one norm and stick to it (like ‘people rejecting the oppressive environment they grew up in is a good thing, and that process can make them emotionally vulnerable and in need of a community, we should welcome that in our safe space!’ or ‘criticizing other faith communities makes you a jerk, no doing that in our safe space!’) then we’re inevitably hurting one of them.

9. Good morning.

Things I read this week:

The Maze Runner, James Daschel
YA dystopia fiction of a common, Hunger Games-esque genre. Would have been boring, except that I actually couldn’t predict what was going to happen.

All the Presidents Men, Bob Woodward, Carl Berstein
Watergate, from the mouths of the journalists who broke the story. I learned a lot, but should have read the Wikipedia entry first; it’s not an intro-level book. (This is from my sudden quest to learn more history, as I haven’t taken history classes since high school, and never took modern history.)

Alice I Have Been, Melanie Benjamin
Dramatized life of the woman who was Alice in Wonderland. I liked it, but ah, if child sexual abuse is a trigger, this might not be your cup of tea.

Shadow of the Hegemon, Orson Scott Card
Somehow, I never read this part of the Ender’s Game universe series. This might even be my favorite of them: politics and allegiances and intelligence gathering and double-crosses.

Looking for Alaska, John Green
This book by John Green is exactly the sort of book John Green would write.


2 thoughts on “Monday Miscellany: Cutlery, Competing Access, Dementia Care

    1. I have an hour commute each way every day! And a weekend! (Also, those were all pretty short–it was a combo of things that made for that many)

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