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Sep 27, 2022·edited Sep 27, 2022

You can't have appropriate skepticism without gatekeeping, and you can't have gatekeeping without gatekeepers. In the case of health, it is natural to think the gatekeepers would be health experts. It would then follow that the health experts are likely to be doctors, people with a medical background, and people with a background in public health. In other words, the medical establishment.

Personally speaking, I have *negative* trust in the medical establishment of this country to gatekeep effectively; that is, I trust them less than I would a random, reasonable observer off the street. That is, I regard the medical establishment as actively detrimental to solving the issue of appropriate skepticism. There are lots of motives for this, and people on my side (the Right) often alight on the profit motive. That's part of it. But I think by far the greatest motive is simply that of not wanting to offer undue skepticism, of not wanting to question people, of trusting lived experience, of simply not rocking the boat. Basically, of being nice and compassionate. (Laudable things! In their place.)

Admittedly this manifests itself more in simple non-diagnosis and non-confrontation than it does fraudulent diagnosis. But in my view this is still a massive problem. Gatekeeping only works if it's proactive. We discourage drunk-driving before the crash, not after. But our medical establishment doesn't do this. It should be shouting from the rooftops that the glamourized self-diagnoses people give themselves are probably wrong and really damaging and you don't want them anyway. But they don't. The biggest indicator of this, for me, was so-called "long COVID", which they continue to treat with kid gloves long past the point that it should have been written off as a useful concept.

A common sense approach, rather than the expert-led approach that we live under, would surmise that people who have a hashtag "illness" with no ill effects but plenty of rewards within their subculture are probably just malingering attention-seekers, but the oversocialized can't and won't think that or say it, and are guided by their compassion to indulge it instead. So, here we are.

We can see exactly how society functions in this milieu by looking at long COVID and other examples that we needn't go into.

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author

Perhaps I'll sell "some gates need to be kept" merch

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Put a picket fence on a t-shirt and my wallet is open.

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I vote it includes an image of you as St. Peter.

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founding

> merch

Finally!!

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Sep 27, 2022·edited Sep 27, 2022

"That is, I regard the medical establishment as actively detrimental to solving the issue of appropriate skepticism. There are lots of motives for this, and people on my side (the Right) often alight on the profit motive."

Uh, have you not paid attention to decades of people not being believed by their physicians and doctor shopping for diagnoses and treatments?

Chronic Lyme disease patients asking for long term antibitoics prompted an actual study of long term antibiotics versus placebo for Chronic Lyme without any benefit shown. Of note is that these were patients who had been treated for Lyme disease, there is a huge difference between post Lyme treatment chronic Lyme and untreated Lyme.

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Of course I've paid attention to it. My belief is that now the pendulum has swung too far in the other direction.

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Do you think the concept of Long COVID is 100% bullshit, or that it exists but many people are claiming to have it when they don't?

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Depends on the definition of it. The working definition in the USA - "I had COVID and I still feel bad so I'm going to post about it online" - is 100% bullshit. It has no diagnostic value whatsoever. The laughable idea that it can affect almost any part of the body (or mind!) is voodoo. Inasmuch as it exists it's a mental pathology from people who love misery.

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I don't know if everyone who says they have Long COVID actually has "it" -- as the definition is pretty broad, i.e. health issues that continue or develop 4 weeks after infection.

That being said, it definitely seems like SOMEthing is going on. For example, a loss in smell or taste is a common symptom of acute COVID, and there have been a bunch of people who, infection, find that most food smells like rotting garbage and so they can only eat tofu. There is no amount of clout or sympathy in the world that would make me falsely claim that I can only eat tofu.

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Sep 27, 2022·edited Sep 27, 2022

Indeed - there is definitely something. My contention isn't that everyone - maybe not even that high a percentage - of people who struggle with their health post-COVID are malingering or delusional. (One of my mother's friends is in a bad way months adter the fact, and she is definitely *not* the type to glory in illness or fish for sympathy online or off.)

My contention, rather, is this: if someone is in a car wreck and busts their knee, and months later their knee hurts, they don't have "long car wreck." They have a narrowly-defined knee ailment whose original cause was probably the car wreck.

If someone has COVID and months later has a lung issue, they probably - but maybe not! - have a post-ARDS respiratory issue that may impact other organs in rare cases. In other words, they have a narrowly-definable condition whose original cause was COVID. You can draw the line from COVID to ARDS to what follows. But that intermediate step is utterly key.

Long COVIDeers, for the most part, don't have this. They have a medical dictionary's worth of random symptoms and a credulous audience of journalists (and, to their shame, medical professionals) who don't look for either a competing cause or even an intermediate one. It's instead "this depressive says they have these physical and mental symptoms of manifold kinds, and they had COVID so it's long COVID." I wish I was being hyperbolic here but that honestly was the media consensus on this fraud for the majority of the pandemic and an embarrassing number of supposed professional medics in the US continue to cling to it.

There will come a time, eventually, when we get bored and move on, and the same seismic causal shift that occurred when "deaths from COVID" and "deaths with COVID" were finally separated. In this case, as that, there will be *zero* reflection from those responsible that they did anything wrong. These people are sick, just not in the way they think, and a great first step in their rehabilitation would be to stop consuming social media, turn off the TV news, and abstain from Discord. That way they won't even know they're sick.

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founding

`These people are sick, just not in the way they think, and a great first step in their rehabilitation would be to stop consuming social media, turn off the TV news, and abstain from Discord. That way they won't even know they're sick.'

People suffering from long COVID don't need to be less online or stop consuming media. The whole problem of long COVID is that suffers *don't* have `have a narrowly-definable condition'. They've been to doctors who can't diagnose them despite taking blood tests, pulmonary tests, cardiac tests, and taking every medication prescribed them. Yet they continue to suffer: they can't speak without pain or they can't but help sleep or lie down for the majority of the day because of unending fatigue and pain.

What if they don't use social media, have never heard of Discord, don't follow the TV news, and have been to every doctor their (very good) insurance will allow? What do you suggest?

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Then how would they know about long COVID? Wouldn't they just feel sick?

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The distrust you indicate regarding the medical establishment isn't singular to "the Right". It might seem that way due to the politicization of Covid. But "the Left" have long had a distrust of the medical establishment and for many of the reasons the you indicate. Least of which is the profit motive. What is fascinating though is watching conservatives go from ardently defending the profit motives of the medical industry when profit motives were supposedly threatened by Affordable Care Act but now view the entire medical industry as questionable experts to be run out of town on a rail for being greedy ambulance chasers.

I have several family members who are in the medical industry. Doctors, by and large, are small c conservatives when it comes to dealing with patients. There is inherent skepticism that exists with patient interaction that has self-diagnosed ailment(s) attached to the visit. My brother-in-law sees this all the time in diagnosing PTSD claims at the VA center he works at.

The inverse of that is when you have people that have such a distrust of the medical establishment (not because they've had a bad prior experience but because they've been told to distrust the medical establishment) get diagnosed and not accepting the diagnosis. My sister-in-law is an ER doctor and this happened on quite a few patients admitted with breathing problems, insisting it was the flu or something and then going into complete denial when told it was Covid and they required intubation and a respirator.

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Talk about burying the lede. How did the small-c conservatism of invasion intubation work out for these people?

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Not noticing the irony that if you distrust the medical industry so much then why go to the ER where they will literally do everything they can to save your life?

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I've never been to the ER in my life.

You're not going to answer my question about the intubation?

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Intubation was/is a last resort for those patients. It's not something an ER doctor does casually but if you're trying to keep a patient from coding then you intubate.

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I asked how it worked out, not the rationale behind administering it, which I'm familiar with.

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Oh, my apologies. It worked out well for 99% of her patients. I believe she had one that coded because he was brought in to the ER too late.

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That's a massive outlier. Congratulations to her.

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I really like that you are addressing this issue. What I think is not 100% complete in your analysis is that "the glamour shot treatment" where we e.g encourage those who've suffered to share their story and pat them on the back is not fully negative - it's a tradeoff. I think you've done a good job describing the downsides, especially given most are not willing or able to do so. But I still think there is an upside. Let's say someone suffers from autism and really has a tough time all through high school, but still manages to graduate. Is it bad if that person were to speak at commencement about their experience and the audience applauds? I think there are pros and cons. Stories of perseverance can be inspiring, and I don't believe the reaction of most people would be to say, "hey, I wish I could get that applause too, maybe I'll lean into talking more about my bouts of mild depression" - but some might. I think the reaction of most would be to be happy for the individual who persevered, and count their blessings.

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This is question-begging. The person in your example actually has autism. The article is about those who don't have what they say they have, but glamourize it anyway.

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I read it as an article about those how glamorize their mental illness, and it's not clear how many of them actually have it - and that there's an unspoken question that some of these folks might not actually have the illness they describe.

And if we push back on glamorizing mental illness, there could be a trade off in disincentivizing those with diagnosed mental illnesses from sharing their story.

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There is a huge chasm between glamourizing mental illness and stigmatizing it. There is a huge chasm between encouraging internet self-diagnosis and malingering and discouraging seeking legitimate diagnosis and treatment. It is possible to deplore the current state of mental health discourse online without coming within a million miles of the latter extreme, of stigmatization, of denial of treatment.

"Some people who say they have autism don't actually have autism" does not, in any way, preclude your example from taking place. Your example is someone who does have autism achieving something to which her autism added another challenge. How does appropriate skepticism over an autism diagnosis do anything but *strengthen* her story, in this context?

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I think avoiding stigma is a good way to put it - and it seems that some of the current culture of celebration is born from an earlier, admirable, movement to de-stigmatize mental illness. My feeling is that this is not an easy balance to get 100% right without some tradeoff.

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There is a definite danger of slipping too far into the "no, you're not sick, just pull yourself together" mindset, absolutely. I don't think we're close to doing so, though.

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author

"Is it bad if that person were to speak at commencement about their experience and the audience applauds? "

No, of course not.

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Sep 27, 2022·edited Sep 27, 2022

Thanks for the reply, Freddie, I guess I don't understand the criteria by which we decide when we're glamorizing mental illness in a harmful way. Certainly those who don't actually have the illness forming a strong identity around it is counterproductive - but there will probably be hard to discern cases.

And I think that even celebrating people's struggles with diagnosed mental illnesses poses risks similar to those you describe, but has rewards too. It also depends on how it is done; it should be made clear that, look, you don't want to have this, it's really hard - and sometimes that's not how it is framed at all. It can be framed as a "super power" that had to be harnessed in a new way or something like that.

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Not to speak for Freddie but if the tenor of the speech is "I succeeded in high school despite this condition - a condition that created real, tangible difficulties for me" then it glamourizes not the condition but that the person has overcome it; that they have, in a sense, either "gotten better" or at least been able to power through it. The glamourization of disease, on the other hand, preaches the exact opposite: that the condition itself is beautiful, and the ur-source of the individual's identity, rather than something negative that the individual has to carry along with them unwanted.

(This, to be clear, is not to say that people with autism should be ashamed, nor even to say that they should wish themselves neurotypical, not necessarily. It is to say that, were autism something that conferred only benefits and not negatives, it wouldn't be a pathology at all and there would be nothing for the individual to overcome.)

If the individual isn't held back by the illness, it ain't an illness. If the individual overcomes the illness, it's glamourizing the person (and the person, in your example, deserves it!) and not the illness. Your example, then, is the exact opposite of what you think it is.

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Yes, I think that's a good way to put it, thanks.

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Thank you. In some online spaces there is definitely a "not like the other girls" vibe of fashionability for some kinds of mental illness, as with various food-aversions and weird allergy-adjacent claims (I'm not talking "need an epipen" allergies).

I see it as a broader sense of wanting to be different, yes, but also wanting to be seen as somehow too delicate, to cope with the world at full strength. And an implication that the hearty folks who can eat anything, and don't have anxiety, and aren't neurodiverse or whatever, are just unrefined oafs.

NORMAL is practically a pejorative.

And it's a tendency to pathologise normal human emotions. You get nervous before a test? That does not mean you "suffer from anxiety", that means you're a regular person.

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Spot-on. "Normie" is one of the dumbest words to ever catch on in the English language.

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I believe “mid” is what the kids are using now.

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I prefer "commoner"

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I love them all. Zen talks about “ordinary mind.” We could use more of that

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founding

How about "common," or "of peasant stock?"

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I remember wondering years ago whether people who claimed to be "environmentally ill" (is that still a thing?) were performing a kind of moral superiority. The fact that environmentally ill people were disproportionately women seemed a little suspicious.

Getting sick because of unspecified "toxins" all around us (which don't seem to bother anyone else) just seems like an updated version of refined Victorian femininity. Fainting when you heard a four-letter word was one era's virtue signaling; caring so much about the planet that you literally suffer along with it was a later one.

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I take your point about the fashionability of fragility, and I agree wholeheartedly (I've written a bit about it as a marker of status.)

But can you explain the intense hatred for all things "not like the other girls" that I see crop up everywhere, especially in feminist spaces on the internet? I would think "not like other girls" would be a cause for celebrating a woman's individualism and autonomy rather than a reason to break out the pitchforks. What am I missing? Or is it exactly as catty and conformity-enforcing as the reaction implies? (I'm a casual internet browser who's not active in any of these communities, thankfully, so I'm genuinely curious where this comes from....)

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(I know i'm not the OP)

I remember growing up in high school that was a phrase that stemmed from boys...telling their girlfriends "you're not like other girls"..usually when the girl could 'hang with the boys' aka not get offended at their 'jokes', put up with their bad behavior, etc. So I think it kinda came into fashion as a catty way to be more popular than other girls. It tends to come with a superiority type vibe. As if women as a whole are some monolith that like "girly things" and are "basic" like liking live, laugh, love and the bachelor, etc. and other women want to prove that they are more complex and nuanced

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Interesting point about mental illness as a class/status marker.

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"Not like the other girls" is generally a term for women who behave as if other women are to be disdained and that male approval is a zero sum game where they have to throw other women under the bus. I'm not like the other girls - I'm cool, I don't get offended when you make rape jokes, I don't care if you cheat on me, I'm not some basic bitch who wants babies and will make you watch The Notebook, please like me and tell me I'm special. I hate the term "pick me girls" but it covers a similar territory.

It seems like "not like the other girls" has mutated over time into being about women who are just the kind of annoying person that wears a metaphorical "you laugh at me because I'm different, I laugh at you because you're all the same, ladies" t-shirt all the time.

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However, it does sometimes get used for gender policing, in a wraparound kind of way. For instance, I’ve seen people say it pejoratively on the internet, about women who don’t wear makeup and are straightforward and unapologetic about that fact — they’ll get an “oh, she’s Not Like Other Girls™️, huh?” (Implying that the reason one doesn’t wear makeup is to please men…which seems totally backwards…)

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Definition creep is definitely a thing. I've actually seen it on both sides of the makeup issue, aimed at women who unapologetically go barefaced or who wear "bold" makeup like red lips and winged eyeliner.

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It's the opposite of conformity-enforcing. It's throwing other women under the bus in an effort to kiss up to men. It's implying other women are fuddy-duddy numpties, but you're a 'cool girl', not like them. Most women grow out of it.

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I don't know its origin, but you'll find subreddits devoted to it.

It's not about being an individual but about seeking men's approval. (And shitting on other women in the process. The "other girls", who are basic or lame etc)

Gillian Flynn gave a pretty good description of it in GONE GIRL, where it's about being a "cool girl".

"Men always say that as the defining compliment, don’t they? She’s a cool girl. Being the Cool Girl means I am a hot, brilliant, funny woman who adores football, poker, dirty jokes, and burping, who plays video games, drinks cheap beer, loves threesomes and anal sex, and jams hot dogs and hamburgers into her mouth like she’s hosting the world’s biggest culinary gang bang while somehow maintaining a size 2, because Cool Girls are above all hot. Hot and understanding. Cool Girls never get angry; they only smile in a chagrined, loving manner and let their men do whatever they want. Go ahead, shit on me, I don’t mind, I’m the Cool Girl."

The cool girl and "not like the other girls" don't completely overlap (the latter more the "quirky" and fragile), but there's an underlying vibe that most women are terrible, and girls are trying to identify themselves away from it, by being "cooler" or "different" than the rest of those basic bitches.

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Exactly this. I actually copy and pasted Gillian Flynn's cool girl paragraph into my own reply above but then deleted because, as you say, it's not exactly the same as 'not like other girls'. But it definitely comes from the same toxic vibe.

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Sep 27, 2022·edited Sep 27, 2022

I'd prefer The Female I Can Live With.

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Contrast Cool Girl with Mean Mommy and we pretty much have a bro movie.

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Thanks to everyone who responded. This is a fascinating discussion! I hadn’t assumed the phrase would refer to something as banal as sexual competition for men, but of course it does! Haha. And here I was thinking women had progressed to where they might actually define themselves independently of men and male preferences.... Don't I feel silly.

Katrina said: “It's not about being an individual but about seeking men's approval. (And shitting on other women in the process…)”

But couldn’t the same be said about the critics using the term against them in a pejorative way? Aren’t they also seeking men’s approval when, for example, they dress and act as girly-girls, wear makeup, heels, and thongs, get waxed, etc. And aren’t they shitting on “other” women, too with criticisms like these? How is this different/better?

If we concede that the term refers, not to women who are transgressive of gender norms per se, but who transgress the norms of mating strategy and competition, then this becomes a conversation about envy, and what is deemed unfair or threatening behavior in the sexual marketplace. Women resent others who don’t play by established rules, whether they are “sluts,” “cool girls,” “not like other girls,” or whatever. But I still don’t see what makes these particular women lightning rods for such vitriol, other than that they generally seem to be tomboys who prefer the company of men to other women?

Also, the “cool girl” rant is fun, but it’s good to remember that the character speaking it in the book turns out to be an unhinged, jealous psychopath… just saying :-\

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It's not about being a tomboy, though. It's directly about dissing femininity, and women as a whole, as distasteful as a means of currying male favor. Maybe a few people aim it at tomboys who just happen to like being around dudes, but that's not the root of the term or the reason it exists.

Femmes who dunk on tomboys also suck! Women shouldn't be constantly dissing each other! But "not like the other girls" captures a very specific phenomenon (see also: "pick me" girls) and the vitriol isn't about the fact that these women aren't femme or aren't performing gender right.

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Well, if it's true that the term was invented to deal with this one very specific phenomenon of "luring" men by being (pretending to be?) laid-back, shouldn't a single term have sufficed? Why did we need so many, unless there is a pathological sentiment towards these women that does not exist in the reverse? Maybe they are mildly "dissing femininity" but they aren't inventing a dozen different categories of slang to organize and disseminate their disapproval of other women and how they live their lives. The name-calling is all one-way: Cool girl, pick me girl, internalized misogynist, not like other girls, etc. Who exactly is demeaning who here?

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The namecalling is absolutely not all one way, unless you think men are the only ones who call women sluts, bimbos, prissy, high-maintenance, divas, etc.

This one very specific phenomenon is common - that's why it has different names. "Not like the other girls" comes from women who say "I'm not like the other girls, I'm cool." It's a term that describes a specific attitude of misogyny that other women spout. It's a term for women saying things like "I don't get along with other girls because they're all so dramatic/catty/high-maintenance/shallow/etc" or "I don't think we need feminism because it's just a biological fact that men are better than women" or "I'm a woman and I wouldn't want a female president because lol I go soooo crazy on my period" or dismiss sexual harassment of other women because if it happened to them, they'd just laugh it off, haha. That's the original sin of pathological sentiment. The ire doesn't come from these women being attractive to men or casual or not femme, it comes from them identifying other women as a whole as a punching bag to performatively dunk on for male approval. And then there's been definition creep to encompass any woman who tries to make herself "special" by putting down other women.

I think you don't really understand what the phenomenon being discussed is, despite people clarifying it, possibly because you either haven't encountered it yourself or because you haven't recognized it, which is why you're secondguessing whether the phenomenon even exists and calling it just "how they live their lives." It's a specific behavior but it isn't an uncommon one. It has a lot of names because a lot of people encounter it.

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I have encountered plenty of women who dislike most women (especially in groups), prefer the company of men, and reject hyper-femininity. What I don't understand is the equation of this with a sexual strategy. You attribute a malignant motive behind these preferences, when I'm just saying lots of people genuinely feel this way and it's not a plot to steal your guy. If a nefarious motive is built in to the definition of the term, that's one thing (weird, but whatever), but from my perspective, it seems like projection.

As for those words you mention, they're mostly just ordinary adjectives that could apply to almost anyone or thing. Some even proudly self-identify as sluts and divas. But they weren't phrases specifically coined to label a class of competitors.

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I’m wondering if there are citations for that? Based on my own experiences, I had thought that the etymology went something like:

1. “You’re not like other girls!” (Used as a pejorative by other teenagers, in the same way that girls would be called lesbians as an insult if they didn’t perform femininity “enough”)

2. “OK, yeah, guess I’m not.”

3. #2 becomes like a badge of pride (if not being like other girls is wrong, I don’t want to be right, because that’s the way I am)

I dunno, it just seems very odd to me — my own experience with this in high school was one of being looked down upon by those who were more plugged into Girl Culture, so the claim that we were the ones looking down on them seems like an alternate world or something.

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This was my experience as well, so that was where my assumption came from.

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I've always thought it was horribly toxic that women are being dissed because their strategy for finding a mate was "find something we have in common" instead of "look pretty."

I suppose "slut-shaming" is also sort of an example of this.

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The reactions to your post are almost all female ... and quite catty :-) I wonder why they care so much? I find it very hard to imagine I would lift an eye brow if a man claimed 'not to be like other man'? Good for him! Aren't we all? Who cares? The public world out there is big and there is space enough for all variations. If being a cool girl (or not like the other girls) gives you the upper hand with the opposite sex, what is not to like? Sounds like a nice tool in the tool chest of sexual warfare? Why do the people that responded seem to imply women should have solidarity with other women? Just like why so many women oppose pornography, what is it to them that some other women sheds her clothes for money? Why do they want to control the behavior of other women?

For me, Madeline Albright's "there is a special place in hell for women that do not help other women" is the reason I despise the modern incarnation of feminism. Albright made it no longer about equality but about creating a coalition against males and I never signed up for that. And please do not give me the poppycock that such a coalition exists on the male side. It doesn't. Males tend to quickly organize in fluid hierarchies based on competence and competent females that could compete have always been able to find a place in these hierarchies.

If another woman says that she is, and acts like, a "cool girl" she might gain a competitive edge. Why do women seem to see this as treason of the coalition while similar behavior in a male, when successful, would raise compliments from his competitors: 'Well played!'.

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"Males tend to quickly organize in fluid hierarchies based on competence and competent females that could compete have always been able to find a place in these hierarchies."

Exactly. This, for me is kind of the missing ingredient here. Women who naturally find a place in this hierarchy are demonized by other women, and it's assumed that they are being disingenuous or inauthentic--that it's all a cynical ploy and they're just there to "suck up to" the men. It's inconceivable to some women that members of their sex might actually ENJOY and prefer this space to the mean girl's faux-feminist lunch table. That's when the claws and accusations come out... "Real" women simultaneously crave the validation of men and despise them as toxic trash! Why would anyone want to spend actual time among them? Gross. :-\ And they wonder why so many women are rejecting modern feminism, the absurd excesses of me too, etc.

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Freddie routinely writes about white men who self-flagellate and simper and call themselves "one of the good ones" in order to obtain "a crumb of pussy." He wrote a whole listicle dunking on white men who performatively bitch about their whole gender to get social justice points and appeal to leftist women. No one jumped in to say that no, these men are just sincerely living their lives, no man would ever debase himself like that for female attention. We are literally just talking about the female version of this.

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Lisa,

> We are literally just talking about the female version of this.

Getting the 'crumb of pussy' is a major motivator for men but not for most women. The far (far!) majority of women can get the male equivalent on Tinder in 5 mins, this venue does not exist for the super majority of males.

In my experience the 'cool girls' are not looking to get into my pants but they tend to like the banter, rough-housing, and task focus that is more common in male collaborations. And I can understand often organizations become a hell hole when the number of females increase beyond a ~30% threshold.

But it is interesting that my first honest reaction to these men is 'good for them' ! (Assuming they succeed, otherwise they're of of course losers) Instead, you use negative words like 'debase' that seem to imply you condone the self proclaimed 'cool girls'?

Even if the 'cool girls' would get into our pants that way, what is it to you that you should judge them negatively instead of congratulating them on a job well done? I would really be interested to understand why you seem to care?

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I think you're falling a bit in the trap of viewing the differences as good/bad. I think the masculine & feminine social interaction works out differently in the public sphere and the private sphere. Men have evolved to survive in a hostile environment; surrounded by (sexual) competition. Women evolved in a place where genetic interests were more shared so equity and harmony was crucial.

If you look at the masculine qualities: strength, size, stoicism, focus, risk taking, technology focused, energy, good soldiers, massive number of tiny gametes, and yes even a few extra IQ points, then it is clear they're built for the rugged outdoors where its not that important that they make it before procreation; history shows that 2/3 of our ancestors are female. Feminine qualities like caring, focus on people, fairness, tiny number of gametes, preventing harm, strong conformance to the environment, and yes, even neuroticism & anxiety have been optimized to safely bring the next generation into our societies.

I think that many of the feminine traits work excellent in the private sphere and I would hate to not have that around. However, I also have come to believe that these feminine traits become toxic when you try to apply them blindly to the larger public sphere.

The topic under discussion, the 'cool girls', is imho a clear symptom of how equity, crucial in the private space, is scaled far beyond its useful range in the public space. I am often flabbergasted when some women seem to think that you need to like each other to effectively work together. There are some brilliant a-holes out there that I really enjoyed working for.

It is just that we're in a unique time in history where women did not only dominate the private sphere but also came to dominate the public sphere. I do not think we've yet worked out how to share this public sphere for the benefit of our progeny though. If only males could develop some immunity against their omnipresent kryptonite we might be able to mainsplain it to them ...

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I don't view the differences as good vs bad, but specific to different environments and roles, as you lay out. If traditionally "feminine" environments and roles don't appeal to a woman (as they don't appeal to me) then the prospect of finding a position within a merit-based male hierarchy (what is often mislabeled "the patriarchy" but can really just be any field where men excel) is appealing. Excelling here requires the ability to employ masculine "tools" or qualities, rather than substituting feminine attitudes and preferences. (And vice versa--If a man with more feminine qualities wanted to join a women's field, have at it.) As I said above, I identify with and prefer these more than squishier feminine traits, which certainly have their value in society and in many arenas, but not in every facet of social, political, or professional life.

I think the hyper-sensitive, safety/harm-obsessed moment we're living in, in which our culture and institutions have almost universally assimilated feminized attitudes, values, and even conflict resolution strategies (e.g. engaging in reputation assassination and social ostracism rather than direct confrontation, etc.), is quite toxic and unsustainable. Women who thrived in public spaces and leadership roles traditionally did so because they possessed more "no-nonsense" masculine qualities. They succeeded, not because they were trying to land a sex partner, but because there is real-world value in being focused, stoic, and thick-skinned--qualities we seem to be forgetting.

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Reading this, I am reminded of old novels where girls and women in the books were "invalids.," or "delicate." Maybe this is something that has always been around--people, mostly women but not always, who formed an identity around illness, and whose illnesses required special treatment.

Growing up, there were people in the extended family who seemed to derive a lot of meaning from various surgeries, injuries, etc., but they were mostly my grandparent's generation. I remember my mom and her sister discussing one of these people, and my aunt remarked "she enjoys ill health," and then they both laughed.

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Women of the leisured classes, it must be noted.

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> The Americans with Disabilities Act standard is one of the most elegant and useful in law - that we should extend every reasonable accommodation, but not every conceivable accommodation, to those with disabilities.

My late disabled uncle advocated for the ADA and I agree, it is an elegant standard. I'm a big proponent of Universal Design practices: it would be great if all new builds included wider door frames and flat thresholds, for instance, and adopting that standard hurts nobody while helping a great deal. Requiring all homes to have elevators, for example, would be ridiculous. Part of disability is the coping. Same with mental illness. The ADA demands dignity and respect for people's physical realities; it does not demand praise, or pity, or veneration of the disabled.

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I’m no expert by any definition, but no I do not believe so—although I believe accommodation for learning disability may be part of it? From my understanding, the ADA is about access, not treatment or therapeutic practices.

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I think it does, to a point. I recently applied to some federal jobs and they ask about disability, including mental illness, but they clarify it's illness that would impact your job performance like major depression or schizophrenia.

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It absolutely can, if a judge or agency policy manual says it does.

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It's only elegant and useful insofar as people retain a functional and good-faith sense of what a "reasonable" accommodation is. Recent developments in discourse regarding sex, gender, and race show convincingly that, whatever you think of the objective claims, the use, function, and definition of words is also highly subject to social pressure.

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I agree completely.

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I take it, you have never seen this meme: https://i.redd.it/kqg9y426nkn71.jpg

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Hey we agreed on “accommodations” so we’ll fight about “reasonable” for a couple centuries and once we get that nailed down we can move on to other ambiguous words like “the” and “under.”

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Sep 27, 2022·edited Sep 27, 2022

Another way this learned helplessness manifests is the "affirm everything" / "that is SO valid" therapy- speak culture that is getting stronger and stronger in certain yuppie spaces. What's so sad about it to me is that, under the guise of allowing for greater emotional support and connection, it actually does the opposite and creates layers of vapid bullshit between people and destroys any ability to form ACTUAL connections which are not in fact rooted in running your brain like a computer constantly scanning for the politically correct thing to say and indulging each other non stop on a hippie fest of "feelings" all over the place. There IS a crisis of ennui in society and young people in a society that had any kind of community left could nurture and support each other on the road to building a life and finding some meaning but people are taught to make themselves marketable forever. It's like some of these people are living their lives as if it's one long bullshit college admissions essay.

Of course, the solution is to advocate for the complete and total destruction of the physical infrastructure that enables the internet to exist as I've long been advocating.

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I don't understand the reference sadly

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Sep 27, 2022·edited Sep 27, 2022

I guess since the cause of the problems is very literally one specific thing then getting rid of that one specific thing would solve the problem

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I'm not in the military under the command of Joe Biden who is the one that I am advocating for that. There is a natural evolution to platform economies! If you destroy one it is true that it will be replaced but it will be replaced by le 10 new ones and then, overany years, one.will get a critical mass, become the platform, and the others will shut down. That wi give you plenty of time to identify and destroy it before it starts controlling us again

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I don't understand why you think I am saying that I am going to do that. Are you trying to bait me? I am saying they should be destroyed, you're the one who keeps inventing some language around "blowing stuff up". Oh I forgot to add- bruh.

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Could we just destroy social media and keep the rest of the internet? I really like reading Freddie's essays and watching Halo gameplay videos on Youtube.

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This is the year where it has become undeniable: the internet is a net negative for humanity. Maybe it won't always be, but it currently is.

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Have been saying this for a few years now. Nice to hear someone else agree.

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There are at least 3 of us, our numbers are growing

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Four. ☝️🙂

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IMHO the Internet is a net positive.

It's social media apps that are the net negative.

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tentative agree that w/out social media the internet is a net positive but social media and the platform economy is way worse than the rest of the internet is good such that amputating the limb to stop the infection is worth it

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Of course, during the 30 years war the Printing Press also looked like a net negative for humanity. It remains to be seen whether/how we will adapt to digital information flows

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Yes, I've seen this comparison made a lot. It isn't persuasive to me in part because I won't live to see if humanity is able to adapt to this insane level of information glut, and in part because I sincerely doubt it's possible, at least in the short term. And humanity may well destroy itself (through AI, not reproducing, nuclear annihilation, pick your poison) before we get a chance to adapt in any event. I'm a pessimist, in case you're wondering. 😆

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Why this year and not last year or next year?

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I was patient for many years. I never jump to conclusions quickly. I first intuited that the internet might be a net negative almost a decade ago, but I didn't become certain until this year.

The social media apps keep getting worse, and every single form of news media keeps getting more and more deranged by the internet. Tiktok is the most toxic app by far, and to such an extent that it makes me shudder to think of what will replace it.

There's also a personal aspect: the internet greatly enhanced my childhood in the 90s, so from my perspective it started off as a great good. But by this point it has ruined the lives of hundreds of millions (soon to be billions) of children and teenagers, and that pretty much outweighs any of the positive gains it has ever brought our species.

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I think we could but many people on this site will claim contrary to evidence that there always be a new social media that will fill the void so I tried to phrase my comment on the physical infrastructure of the internet to preempt those objections

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w/out the internet he could produce a zine which could be distributed via the postal service

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I've often suspected that a lot of the language policing grew out of the fact that these sensitivity meter maids never found a way to genuinely connect with the people around them. They want a map to human interaction as much for themselves as anyone else. This hyper-sensitivity creates the appearance of compassion and connection online and in conversations, when it's simply another manifestation of this era's real crisis: self-absorption. Ornate manners don't facilitate kindness, but they do a bang-up job of hiding malice and confusion, which is why I sense they're so popular right now.

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I think that's exactly right

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This is a great insight. Plus a way to mark hierarchies ("look at me being more conscious of this week's language rules than you")

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I'm stealing 'sensitivity meter maids."

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Yes, but this issue is not limited to online culture; it has permeated actual therapy and treatment. In the name of not stigmatizing or pushing the patient away from treatment, there is a culture of validation that quickly becomes out-and-out non-judgmentalism.

It's fine (and even necessary) in some cases but disastrous in others. It allows Cluster B personality folks (borderline, narcissist) to manipulate the therapeutic process, receiving validation and praise while making little/no actual progress, and with no thought or care for their victims

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This is very true. It's like every therapist thinks every patients main problem is "self esteem". I've run into this issue finding a therapist quite a bit myself. I don't need to be validated to kingdom come. It also is clear many therapists are THEMSELVES getting mental health advice from tiktok which is terrifying. IMO it has a great deal to do with scope creep. Years ago it was mostly psychiatrists who practiced psychotherapy. Now that's very rare and nonexistent if you want insurance to cover it. Instead you have well meaning LCSWs or LMFT or ARB of whatever BS degree is next. Not to mention the push towards making everything online. IMO part of it is patients fault for a bunch of worried well people thinking a therapist is like a hairdresser and something they need all the time overwhelming the demand. But a big part is the culture of therapy. You never see this kind of thing anymore sadly, https://www.youtube.com/watch?v=bzVeLjj6Ao8

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Also I should add "all men need to go to therapy" type of vapid bullshit

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A lot of us want to do more traditional talk based therapy, but there's a big push in the industry for CBT and other cookie-cutter approaches because they make outcomes easier to measure. And I think one of the ways well-meaning therapists try to resist that is this tiktok crap. I think the whole thing is a bit more complicated than what you describe, but I'm joining you in saying it's difficult to find a good therapist.

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I’ve been a therapist for like 25 years and the reality is is that psychiatrists are not that knowledgeable about psychotherapy. I think it’s weird that you call MSW‘s a BS degree. I am an MSW and I have a PhD and I’ve been practicing like many social workers have been practicing for years and in fact social workers have been doing therapy since the early 1900s. I think that there are a lot of things around scope creep and a lot of issues around overly validating people that’s problematic. But if you think the problem is that marriage and family therapist and social workers are not qualified the way the psychiatrists are, I don’t know what to tell you because I think that’s very off-base and total bullshit.

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Sep 27, 2022·edited Sep 27, 2022

Why are there so many different degrees for what should in theory be the same practice and why did psychiatrists regularly practice psychotherapy through the 1990s?

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Sep 27, 2022·edited Sep 27, 2022

There is a lot you’re asking about the history of psychiatry. Part of it is that before the 50s, psychiatric medication didn’t work very well so the psychiatrist weren’t really doing a lot beyond talk therapy that was effective. When you look at something like schizophrenia, it made sense that people develop communication theory just because the alternative medical interventions before the development of Thorazine’s were so damaging , that it was more efficacious for a psychiatrist to look at talk therapy.

Once they moved into an era where there are multiple medications that have a high degree of efficacy, things really changed and their focus really change to a more medical one. Now I have worked with psychiatrists who have done mental health care but the reality is is that their job is so complex on the medical side, that it’s hard to imagine them also doing psychotherapy and a lot of them concur with that.

As far as the other degrees, there are histories with these degrees that have a lot to do with the history of psychotherapy. For example like marriage and family therapist grew out of theorists like Ackerman who emphasized the family as the central unit of study rather than the individual. There is always been a tension between psychoanalysts whi look primarily at the individual and those who look at the relationships and systems which is part of the reason things are different. People have complex needs.

In social work it came out of a couple of different movements and originally was developed on some level as a response to war trauma in World War I and to the issues of changes in immigration. As the field adapted, the emphasis change to large extent because of being encompass within the medical model and that’s always been kind of a battle among social workers. However, for years people have been trained in like psychotherapy psychoanalysis and other types of philosophical models but in social work for example, there’s always a bigger emphasis on the social environment then there might be in psychology which looks at internal processes.

There’s a lot of reasons why these different philosophical strains and fields have developed and having other people other than psychiatrist is not the primary problem. I think there’s a lot of diffusion in terms of what psychotherapy is being asked to do and there’s a problem with people using their problems as their social identity and making it performative.

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I wish I could find a therapist like this. I don't need to feel better about myself -- I feel good enough. What I need is a push sometimes.

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It's just the mainstreaming of Tumblr-culture; that sort of validity-speak was de rigeur over there in the 20-teens.

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While setting many tumblr users into the wild may have made the internet and society in general worse, it's made tumblr much better. I, for one, am glad that particular horse is no longer in my preferred internet barn.

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One large factor with this sort of thing is people confuse identifying their own suffering with identifying the cause of their suffering.

Suffering is subjective, and the best person to determine if you are suffering is you. However, that doesn't mean that the cause of your suffering, or how best to treat it, is subjective, or that the sufferer necessarily has any particular insight into these questions.

Along these same lines, a lot of people confuse questioning someone's diagnosis with questioning their subjective experience. If someone tells you that your pain/fatigue/brain fog/etc. aren't caused by chronic Lyme because chronic Lyme isn't a thing, they aren't denying that you have these symptoms, only that you have misidentified the cause of them. And just like one of the major problems with imprisoning an innocent man for a crime he didn't commit is that it leaves the real perpetrator on the street to commit more crimes, settling on the wrong diagnosis for your real symptoms makes it harder, not easier, to address those symptoms.

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This is far and away the best way to address the issue. Trust the experience, vet the explanation.

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A corollary to this is I tend to think that people to quick to assume that they are being dismissed when an MD suggests that their symptoms may be psychosomatic. People hear this as "made up," but that isn't what psychosomatic means. Someone who is suffering from psychosomatic symptoms is actually suffering from those symptoms and can't just choose not to suffer them. It is just that the problem is with their mind, not their body (or at least not the part of their body that isn't their mind).

That being said, I do think that some MDs are quick to blame psychosomatic symptoms when they can't find an obvious physical issue in the same way that tech support at Dell is quick to blame your problem on a software issue - it makes it someone else's problem.

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My brother-in-law runs into this quite often dealing with PTSD patients at the VA. Being able to discern between legitimate claims and those looking to game for benefits is something he didn't think he'd have to deal with. But he's also acutely aware that he has to walk a fine line between healthy skepticism and dismissal.

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Yeah, the problem of self-diagnosis comes up a lot with ADHD. I get that not every doctor is good and is willing to take you seriously, and may prevent you from getting help you need. But displaying ADHD symptoms is not necessarily actually ADHD, but could be some other medical issue that you're then ignoring. And an important part of medical diagnosis is ruling those other potential causes out!

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Also the way people dismiss that lifestyle can make ADHD symptoms worse. Even if you have ADHD your symptoms are gonna be worse if you're not taking care of yourself! but so many people think that even mentioning that is ableist. I got trapped in the online ADHD culture for a year or two after I was diagnosed with it until I realized that it's almost entirely bullshit. Not having the energy of a type A neurotic overachiever does not mean someone has "ADHD" and in that community I see a big tendency to vastly overestimate what "normal" people can do.

"I took an adderall and worked for 9 hours interruption free, cleaned my entire apartment, did my taxes, and cooked 3 weeks of food. Is this what life is just LIKE for neurotypical people all the time". No, it's not.

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It's hard to be too critical of people who self-diagnose when the definitions of various psychological conditions keep getting more and more expansive and vague. When I was a kid, ADD (as it was known at the time), was a diagnosis given to kids (almost always boys) who was bouncing off of the walls in class, disrupting everybody, and physically active way beyond the usual boy rambunctiousness. A kid in my class would get up on his desk and walk across the desktops and end up standing on the radiator...that kid was probably ADD. Here is the latest definition of the inattention component of ADD--we haven't even gotten to the "active" part of the disorder:

Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

Often has trouble holding attention on tasks or play activities.

Often does not seem to listen when spoken to directly.

Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).

Often has trouble organizing tasks and activities.

Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

Is often easily distracted

Is often forgetful in daily activities.

I look at that list and think that a lot of it is normal kid behavior. Part of maturing is learning how to pay attention to things that you don't care about, or things that are difficult, or things that are complex...e.g. remembering to gather all your materials and put them in your backpack). And what does "often" even mean? If a kid forgets to hand in her homework two days a week, is that often enough for a diagnosis? What about the kid who never has to learn to remember, because his mom always packs his backpack for him?

Maybe we shouldn't be so quick to blame people for self-labeling, when the criteria are so expansive and vague that a lot of people exhibit these behaviors. Maybe the real issue is expecting a twelve year old to have organizational skills that would challenge some adults.

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As far as I know, self-diagnosis of ADHD is not really a thing amongst children, it's more of an adults on the internet thing.

Moreover, diagnosis is based not just in a list of context less symptoms, but relative to what is considered developmentally appropriate for that age group, and also causes significant challenges in their life. A six year old having the attention span of a typical six year old isn't an issue, but a six year old having the attention span of a two year old is, perhaps, cause for concern.

But also, part of diagnosis is looking at your symptoms, figuring out what else could be causing them, and ruling them out. And often, people who self-Dx don't go through that process, they just glom on to the first thing that could describe their experiences.

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We need to start using the appropriate language:

You may be experiencing psychic discomfort but it's because you're bored, lonely, dissatisfied, and/or too-online.

The best means of ameliorating the unpleasant symptoms is addressing the situational issues, not medicalization or accommodation.

A major problem is no one wants to tell anyone to face the truth. Who wants to tell someone who is emotionally and socially invested in this type of performance to cut it out? You will only bring grief on yourself by telling people things they don't want to hear.

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Of course we could solve the problem tomorrow if we destroyed the transatlantic cables on which the entire infrastructure of the internet depends.

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A solution that creates a thousand other problems is not a solution.

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Sep 27, 2022Liked by Freddie deBoer

There’s a real Twilight Zone quality to the current situation where everyone (?) is basically aware that social media is making us sick. It’s in the New York Times, it’s in the congressional testimony, it’s in the leaked documents from the tech companies. People know it! And they’re just kinda scrolling right past it. Are we just going to do this forever?

I remember my brain feeling a lot better, like ten years ago, in the six months between getting rid of Facebook and getting Twitter. It definitely was not as good of a feeling after getting rid of Twitter earlier this year, because social media sickness has eaten so much of the actual world. That, and you somehow still manage to be aware of many of the worst tweets...

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I think the OP was referring to himself in the *second* person.

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Yes, thank you.

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That last part is a huge issue. You can quit Twitter, but articles in other outlets quote tweets all the time. Tweets are shared on other social media apps. You can't truly escape it; you can only hope to reduce it.

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They quote, but also, the amount of time and way journalists spend time on the computer is pretty clearly shaping what stories even get written in the first place.

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They have given up. There are just so many losers who are aware social media is shit, yet still keep using it. They compound their error by admitting total defeat and then claiming that this is just the way things are: everyone has to use social media and there's no escaping it. This just isn't true. There is no "digital public square." Unless you have a shitty boss or a shitty job there's no imperative to use these drug-apps.

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I agree. The only "drug app" I use is Instagram, and my feed is curated to give me nothing but dance choreography and pictures of cute frogs. I don't have a Twitter, Tumblr or Facebook and I still manage to stay engaged with friends and current events. The idea that you need these particular social media sites to be a part of society is just patently false.

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Hah! That really is true. I quit Twitter at a similar time, and it's mindblowing how much you still end up learning about all the most famous tweets, you're just not on there and coming to the inevitable conclusions in real time.

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Or more generally, our phones. Something I started doing recently is sleeping with my phone in another room. It's great. I sleep much better and don't spend any more time scrolling in bed in the morning, though it does take a little bit a discipline to put it away at bedtime.

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Smartphones are another net negative for humanity for sure.

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Two years on from quitting a quite ‘successful’ Twitter account I congratulate you, Nick. You will continue to be aware of it, but your health will improve if your experience is anything like mine.

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I quit Twitter this year, and it definitely freed up a lot of space in my mind for emotions other than vague outrage.

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[eyes glazed over a bit] wow, haven’t gotten so many sweet, sweet likes in a while...hmmm...

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IMO, Substacks are a mild form of social media, too. The others? I thank my lucky stars I was offline when they became "necessary." Easy to give up after brief excursion.

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Lol there's always a new thing in every generation. Social media is making us so mentally ill is another version of what Freddie's talking about.

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Luckily there's an entire substack pointing out, in brilliantly-written detail and over many posts, why your argument is overly simplistic and wrong

https://theconvivialsociety.substack.com/p/we-are-not-living-in-a-simulation

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lol there are substacks pointing out the world is flat as well

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WaPo is somehow more pathetic than the NYT, which is a real fucking accomplishment. They should do an article on the many ways Taylor Lorenz is messed up - there's probably at least one diagnosis to be made there.

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Yup yup yup. I waited and waited for my bipolar frenemy to acknowledge on Twitter that their problem wasn't autism or depression or ADHD.

They still haven't done that but they've stopped claiming to have those other conditions, so that's a plus

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Just want to say I’ve been thinking about this a lot, as I’ve been feeling incredibly anxious (like heart racing, gut churning, brought-to-tears moments) and distracted/mentally frantic in recent months. How much of this is a product of external factors, of the way many of us live now, of me being just kind of a moody and sensitive person, and how much of this could be a deep brain-misfiring breed of anxiety that medication could address so that I can simply cope better? How much of this could be ADHD? (Which my father does have and apparently that makes me more likely to have it.) I find myself very much not wanting to define myself with these terms because they make me feel stuck; the more I describe myself as anxious the more anxious I feel.

It feels strange that so many people I know are suddenly talking about being neurodivergent, though I don’t discount the “realness” of it. I wonder if many (not all) of us are actually just really emotionally sensitive and in jobs that aren’t the best fit for how we think, or need better practical and interpersonal skills re: modern relationships and communication, need to set up our lives differently. I hate the “just exercise and meditate” brand of “advice” in this regard so that’s not what I mean. But I do wonder whether the fact that life just feels so fucking difficult for many of us isn’t a medical issue, it’s an emotional and personality-driven one. But then, what to do? I still have to work a job and deal with modern life. I get why a diagnosis can be comforting—like, “Here’s your problem, now you get medicine.”

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I'm a big fan of treating mental illness with modern medicine. Give ADHD people their medicine, if it helps them. But let's locate swings in diagnoses in a sociocultural context when we consider where they come from. And by all means, if you think you have a clinical disorder, see a doctor.

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My own personal experience with ADHD medicine as an adult is that it's really not that helpful as a daily medicine - at least if you're in the kind of job where you're jumping around into lots of different tasks. Instead of getting distracted I just get hyperfocused on one thing, which often isn't the highest-priority task to do, so it doesn't actually help much with productivity.

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I'm an architect so multi-tasking on a project is part of the job. And one that I enjoy in that I get lost in the weeds working out little and big problems on projects. I once tried half a dose of adderall in grad school to "help focus" on a thesis model and found myself unable to actually think, but instead being intensely focused on one task for 3 hours...only to discover I had been cutting the same model piece over and over and incorrectly. Needless to say, it made me realize I'm capable of managing my mind better through various means than medication. And I count myself lucky for it.

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I relate to this a lot and my belief is that it is personality factors interacting with the environment. I'm in my 40s, and as I told a friend recently that I grew up in a world that I could marginally process and tolerate, but I now live in a world that I find utterly overwhelming, alien, and hostile. I am and always have been a person prone to experiencing negative emotions, easily overstimulated by sensory stimuli, especially visual, and apt to blame myself and my own shortcomings for everything and ruminate endlessly. These are personality issues that are going to make life more challenging in any era, but which make the present day downright unbearable on many occasions and in many contexts. Do I need medication because my personality traits are undesirable and especially ill suited for life in the 21st century? I could do that, many people do. But I suspect it would be unlikely to help much.

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"How much of this is a product of external factors, of the way many of us live now, of me being just kind of a moody and sensitive person, and how much of this could be a deep brain-misfiring breed of anxiety that medication could address so that I can simply cope better? How much of this could be ADHD?"

Often, I think we don't get to know how much is which. If a doctor thinks it's a good idea to try you on anti-X medicine to see how you do, you might find it helps even if you doubt you "really have" X.

That might have happened to me. I was a sickly teen with low blood pressure and vascular headaches. I was also getting surprisingly forgetful and inattentive. A psychiatrist tried me on ADHD meds, and I felt "clearer" and calmer, less agitated. Later, I found out that my low blood pressure and headaches were symptoms of a connective-tissue oddity that doctors routinely skip testing for, assuming it's too rare (though the test is low-tech and cheap). By coincidence, ADHD meds are vasoconstrictors, even the non-stimulant Atomoxetine, which now shows good results for orthostatic hypotension:

https://www.ahajournals.org/doi/10.1161/hypertensionaha.114.04225

Did I ever "really have ADHD"? Did the drug work on me only by dampening headaches and hypotension? How much did why the prescription worked matter?

I think it would have mattered if the ADHD diagnosis were the reason to avoid testing my connective tissue, but that test is commonly overlooked even when ADHD isn't suspected. Drugs can be just a band-aid, but if a band-aid's all that's realistically available...

If a doctor wants to prescribe you something, go in with your eyes open. There may be drugs you *really* don't want to try. (For example, benzos scare me.) Even if a drug gives some benefit, you may find it's not worth the cost.

Still, you've got the job you've got, in this modern world, not another. Most people seem OK with caffeine for coping. Getting sucked into temporary coping strategies whose long-term costs aren't worth it, er, sucks. But prescribing physicians, if they do decide to prescribe, are supposed to help ensure that's not what their prescriptions are doing.

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Great piece, thanks.

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Sep 27, 2022·edited Sep 27, 2022

It's been fascinating and horrifying to watch something that was once practically a Tumblr in-joke spiral out into something with real-world relevance. You can basically draw a direct line from those years where Tumblr users were super into tulpas to the extent it looked like people were trying to induce schizophrenia in themselves, and whether it was sincere or ironic or both was rather unclear, to people pretending to have DID on Tiktok.

As Monia Ali put it: "Much of what we did online was like roleplay, I didn’t think of it like that, and I still don’t like thinking of it as such, but it’s the only way I can think of how to describe it. It’s not that we were putting on an act, but rather that we observed self-imposed rules. This was fine as long as all everyone was on the same page, that the lines in the sand would be respected."

That's what happens with a lot of online communities, whether Tumblr or 4chan. A lot of what goes on is performative -- not quite roleplaying, not quite real. But eventually it gets discovered by people who don't really get its a semi-ironic set of cultural mores and memes, and that's when you start running into problems as those ideas begin to get picked up by people closer to the mainstream. It astounds me to see people just plainly and obviously pretending to have mental disorders and I don't really know where it leads or how to stop it beyond just hoping that people on social media find some new fad.

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Sep 27, 2022Liked by Freddie deBoer

"Young people understand the allure of being seen; they don’t yet understand the horror of being frozen in other people’s gazes." I really think that's true.

I'm 38 and I really think that up through my mid-thirties, I assumed that new identities would always be available off the shelf. I can't put my finger on why and how that changes - I'm tempted to call it age but I often wonder if it's really life milestone things like getting married - but it definitely changed. And I legitimately do think that part of it is "pure age," in a sense.

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This is very, very good. It also studiously avoids the 4000%-increase-elephant-in-the-room implicated by the very, very good points being made here.

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I think this excellent piece ties in with another small but burgeoning subset—the ‘Long COVID’ crew. **NOTE: No doubt this can be a thing, and exists**However, it simply can’t apply to everyone whose vision has gotten a little worse—welcome to aging!—or who has more headaches now, etc. There are a *lot* of claims floating around out there.

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