GenderMag and Cognitive Walkthroughs

GenderMag focuses on five facets of gender differences that have been extensively investigated in the literature pertaining to problem solving. It encapsulates them into a set of faceted personas to bring them to life, and embeds their use into a systematic process based on a gender specialization of the Cognitive Walkthrough (CW) [59, 63]. The five facets are:

Motivation: Research spanning over a decade has found that females tend (statistically) to be motivated to use technology for what they can accomplish with it, whereas males are often motivated by their enjoyment of technology per se [12, 13, 19, 31, 33, 37, 43, 57]. This difference can affect which software features users choose to use.

Information processing styles: To solve problems, people often need to process new information. Females are more likely (statistically) to process new information comprehensively-gathering fairly complete information before proceeding-but males are more likely to use selective styles-following the first promising information, then backtracking if needed [17, 22, 45, 46, 52]. Each style has advantages, but either is at a disadvantage when not supported by the software.

Computer self-efficacy: Self-efficacy is a person’s confidence about succeeding at a specific task, and influences their use of cognitive strategies, persistence, and strategies for coping with obstacles [3]. Empirical data have shown that females often have lower computer selfefficacy than males, and this can affect their behavior with technology [5, 6, 12, 13, 24, 32, 34, 43, 49, 50, 58].

Risk aversion: Research shows that females tend statistically to be more risk-averse than males [23], surveyed in [62], and meta-analyzed in [21]. These results span numerous decision-making domains, such as in ethical decisions, investment decisions, gambling decisions, health/safety decisions, career decisions, and others. Risk aversion with software usage can impact users’ decisions as to which feature sets to use.

Tinkering: Research across age groups and professions reports females being statistically less likely to playfully experiment (“tinker”) with software features new to them, compared to males. However, when females do tinker, they tend to be more likely to reflect during the process and thereby sometimes profit from it more than males do [6, 13, 18, 20, 33, 54].

Source: Finding Gender-Inclusiveness Software Issues with GenderMag: A Field Investigation

Cognitive Walkthroughs focus on just one attribute of usability, ease of learning.

Cognitive walkthroughs evaluate each step necessary to perform a task, attempting to uncover design errors that would interfere with learning by exploration. The method finds mismatches between users’ and designers’ conceptualization of a task.

The procedure uncovers explicit and implicit assumptions made by developers about users’ knowledge of the task and interface conventions. The evaluation procedure takes the form of a series of questions asked about each step in a task that are derived from a theory of learning by exploration.

Source: The Cognitive Walkthrough Method: A Practitioner’s Guide

Per the researchers, the five facets of the GenderMag method are backed by extensive empirical and theoretical work. Facets backed by at least 5 independent empirical studies were chosen, with some having 10 or 15. The majority of studies favor US populations and all are based on adults. Children are excluded from claims.

They realized that, really, it’s all about the facets. It’s not really about gender. It’s all about the facet values and being inclusive across the range of facet values.

I’m channeling Abby, and I do not like this software.

Source: Finding Gender-Inclusiveness Software Issues with GenderMag: A Field Investigation – YouTube

Presume Competence: A Hippocratic Oath for Education

“To not presume competence is to assume that some individuals cannot learn, develop, or participate in the world. Presuming competence is nothing less than a Hippocratic oath for educators.”

Never assume that the ability to speak equals intelligence. There are plenty of autistic people who have trouble speaking but who have glorious creative worlds inside them seeking avenues of expression. Never assume that an autistic person who can’t speak isn’t listening closely to every word you say, or isn’t feeling the emotional impact of your words. I’ve interviewed many autistic people who said they could hear and understand everything around them while people called them “idiots” or described them as “out of it” to their faces. Ultimately, presuming competence is the ability to imagine that the person in front of you is just as human as you are, even if they seem to be very impaired. If you understand that the autistic students in your class are just as complex and nuanced and intensely emotional and hopeful as you are, you’ll do everything in your power to help them lead happier and more engaged lives.

Source: A Q&A about autism with Steve Silberman, author of NeuroTribes

Presume competence. Begin any new learning adventure from a point of aspiration rather than deficit. Children know when you don’t believe in them and it affects their progress. Instead, assume they’re capable; they’ll usually surprise you. If you’re concerned, start small and build toward a goal.

Source: A parent’s advice to a teacher of autistic kids

Presume competence means – assume your child is aware and able to understand even though they may not show this to you in a way that you are able to recognize or understand.

To presume competence means to assume your child or the other person does and can understand when they are being spoken of and to.

Presume competence means talk to your child or the other person as you would a same age non-Autistic child or person.

Presumptions of competence means treating the other person with respect and as an equal without pity or infantilization.

It does not mean that we will carry expectations that if not met will cause us to admonish, scold or assume the person is being manipulative or just needs to “try harder”.

To presume competence does not mean we assume there is a “neurotypical” person “trapped” or “imprisoned” under an Autistic “shell”.

Presuming competence is not an act of kindness.

Presuming competence is not something we do because we are a “good” person.

We do not get to pat ourselves on the back because we have presumed competence. If we believe we deserve a pat on the back and/or acknowledgement, then we are not presuming competence, we are more likely being condescending.

Source: “Presume Competence” – What Does That Mean Exactly? | Emma’s Hope Book

What you will need is the awareness and patience to embrace people with autism as different, not less; the willingness to presume that people with autism are competent – even if evidence may be not be available at first; and the understanding that behavior is not random, but is instead motivated by necessity, frustration, sensory differences, or the need to communicate a request or thought.

People with autism may experience the world in ways that are unfamiliar to us, but they need us to remember that what we see on the outside may not be an accurate reflection of what exists within. The ability to communicate or regulate social interaction should not be confused with the ability to think or the capacity to love. Rather than labeling individuals as “low functioning” or “high functioning,” we should recognize that people with autism vary in their ability to demonstrate competence. Our responsibility is then to presume, find, and strengthen that competence.

Just because a child may not be able to speak doesn’t mean that he has nothing to say. Just because a person may be overwhelmed in social situations doesn’t mean that she doesn’t long for friendship. Just because someone has difficulty initiating movement doesn’t mean he doesn’t want to participate.

Researchers in applied psychology often use the term “child efficacy” to describe the belief that a child is capable of learning and improving. Likewise, the term “self-efficacy” is used to describe our own beliefs that we as parents or teachers are capable of helping a child to improve. It’s critical not only to recognize that a child can learn, understand, and improve, but that we have the ability to help.

The beliefs that parents and teachers have about their own abilities have an important effect on later outcomes for children with autism and other challenges. Greater parent efficacy results in more positive interactions with children, decreased coercive discipline, improved classroom behavior, reduced behavior problems, lower family stress, reduced parental vulnerability to stress and depression, and increased satisfaction with family life. These outcomes have been reported even after controlling for a wide variety of other factors.

Our beliefs that we are capable of helping are more than just happy feelings – they affect the amount of time we engage with people with autism, the quality of our teaching efforts, how frequently we offer them learning opportunities, and how patient we are in resolving difficulties. In a longitudinal study of children with disabilities and behavior problems, parental optimism/pessimism was the single best predictor of which children would have more severe problems years later.

Source: Presume Competence: A guide to successful, evidence-based principles for supporting and engaging individuals with autism

As a result of long-standing mythical and erroneous perceptions, when we encounter a person with a disability, positive presumptions and attitudes may be instantly replaced by negative stereotypes and prejudice (yes, we pre- judge), and the person with a disability is Presumed Incompetent. The guilt-by-association mentality may also kick in, so the person’s parents may also be Presumed Incompetent. (I was once told that my family was dysfunctional, our daughter was dysfunctional, and my husband and I were dysfunctional because of our son’s disability!)

Traditionally, we’ve Presumed Incompetence and forced a person with a disability to prove she’s competent before allowing her to be in a general ed classroom, participate in community activities, be employed in a real job, live in the home of her choice, etc. It’s easy to see that our actions put people with disabilities in a no-win situation: because we presume they’re incompetent, we don’t give them opportunities to demonstrate their competence, and this, in turn, is taken as “proof ” that they are, indeed, incompetent. The vicious cycle of the self-fullling prophecy is realized.

Source: Presume Competence

And here is a skeptical counterpoint. Don’t use “Presume Competence” or any other phrase as a substitute for thinking critically and responding to data. Don’t wrap discredited methods in “Presume Competence”. Growth Mindset has some good qualities, but the implementation is usually busywork for deficit model bikeshedders. Mind the implementation.

“Presume competence” appears to be the rallying cry for full inclusion advocates, but also is used to defend pseudoscientific and invalidated interventions like facilitated communication and rapid prompting method. The notion seems largely supported by professionals aligned with a postmodern epistemology and may have been a strategic tactic by proponents like Douglas Biklen. Is “presuming competence” different from “presuming capable” and, regardless of the position, should we refrain from skepticism of people like Carly Fleischmann, Ido Kedar, and Sue Rubin to implicitly endorse the notion, or suspend belief until compelling evidence to substantiate their communicative competence is presented?

Source: Is “presume competence” a propaganda phrase for fully inclusive education? – ResearchGate

Presuming competence is not idealism. Idealism ignores that there are challenges or barriers to overcome. The very definition is that the ideals are often “unrealistic.

Presuming competence is a philosophical difference. It’s a belief in socializing students for courage instead of compliance.

It is more than an ideology because when you start from the mindset that someone is capable and can grow, your actions start to reflect that. There are concrete, evidence-based ways that you can presume competence.

Presuming competence is more than believing that a child is competent of thoughts, ideas, and learning. It is also the practice of making sure people – ALL people – have the right to talk about what THEY want, even if it’s not the topic we planned.

Presuming competence isn’t about belief in students in the absence of evidence. It is a belief in their right to access the communication to demonstrate their abilities as humans. You’ll never gather evidence without providing opportunity. So when you’re marking down minuses on data sheets, ask yourself, “Is it possible that there isn’t an adequate way for them to show me that they know this?” When you do that, and acknowledge that there are a range of variables between a plus and a minus, you start to problem solve for your student(s) instead of testing them.

Presuming competence is giving students the opportunity to learn literacy, math, science, and history regardless of their disability.

It is providing the chance to build relationships. It’s exposing students with CCN to leisure activities and allowing them to decide if it’s something they enjoy.

Presuming competence gives children a chance to explore and make mistakes without penalty. It gives them time to learn with support rather than testing or criticism.  When you presume competence, you give the child a safe place to fail and the ability to learn from those small failures and try again. It’s how we grow. That growth and the confidence students gain from overcoming challenges gives them the courage to keep moving forward and develop skills to demonstrate their competence.

Source: Presuming Competence in Practice

Projects, Teams, and Psychological Safety

Collaborative, project-based teams make great things. Teams that offer psychological safety are more productive and creative. This is true for adults and children—especially children. “Every child deserves an education that guarantees the safety to learn in the comfort of one’s own skin.” What we have learned in industry through continuous iteration works also for students. Give them psychologically safe teams where they can collaborate on shared passions. Give them a home of opportunity.

Students and teachers are in the anxiety zone.

Screen Shot 2017-01-14 at 12.15.09 PM.png
Comfort Zone, Apathy Zone, Anxiety Zone

Source: Building a psychologically safe workplace: Amy Edmondson at TEDxHGSE – YouTube

In Silicon Valley, software engineers are encouraged to work together, in part because studies show that groups tend to innovate faster, see mistakes more quickly and find better solutions to problems. Studies also show that people working in teams tend to achieve better results and report higher job satisfaction. In a 2015 study, executives said that profitability increases when workers are persuaded to collaborate more. Within companies and conglomerates, as well as in government agencies and schools, teams are now the fundamental unit of organization. If a company wants to outstrip its competitors, it needs to influence not only how people work but also how they work together.

Google’s People Operations department has scrutinized everything from how frequently particular people eat together (the most productive employees tend to build larger networks by rotating dining companions) to which traits the best managers share (unsurprisingly, good communication and avoiding micromanaging is critical; more shocking, this was news to many Google managers).

Norms are the traditions, behavioral standards and unwritten rules that govern how we function when we gather: One team may come to a consensus that avoiding disagreement is more valuable than debate; another team might develop a culture that encourages vigorous arguments and spurns groupthink. Norms can be unspoken or openly acknowledged, but their influence is often profound. Team members may behave in certain ways as individuals — they may chafe against authority or prefer working independently — but when they gather, the group’s norms typically override individual proclivities and encourage deference to the team.

As the researchers studied the groups, however, they noticed two behaviors that all the good teams generally shared. First, on the good teams, members spoke in roughly the same proportion, a phenomenon the researchers referred to as ‘‘equality in distribution of conversational turn-taking.’’ On some teams, everyone spoke during each task; on others, leadership shifted among teammates from assignment to assignment. But in each case, by the end of the day, everyone had spoken roughly the same amount. ‘‘As long as everyone got a chance to talk, the team did well,’’ Woolley said. ‘‘But if only one person or a small group spoke all the time, the collective intelligence declined.’’

Within psychology, researchers sometimes colloquially refer to traits like ‘‘conversational turn-taking’’ and ‘‘average social sensitivity’’ as aspects of what’s known as psychological safety — a group culture that the Harvard Business School professor Amy Edmondson defines as a ‘‘shared belief held by members of a team that the team is safe for interpersonal risk-taking.’’

Psychological safety is ‘‘a sense of confidence that the team will not embarrass, reject or punish someone for speaking up,’’ Edmondson wrote in a study published in 1999. ‘‘It describes a team climate characterized by interpersonal trust and mutual respect in which people are comfortable being themselves.’’

What Project Aristotle has taught people within Google is that no one wants to put on a ‘‘work face’’ when they get to the office. No one wants to leave part of their personality and inner life at home. But to be fully present at work, to feel ‘‘psychologically safe,’’ we must know that we can be free enough, sometimes, to share the things that scare us without fear of recriminations. We must be able to talk about what is messy or sad, to have hard conversations with colleagues who are driving us crazy. We can’t be focused just on efficiency. Rather, when we start the morning by collaborating with a team of engineers and then send emails to our marketing colleagues and then jump on a conference call, we want to know that those people really hear us. We want to know that work is more than just labor.

Google, in other words, in its race to build the perfect team, has perhaps unintentionally demonstrated the usefulness of imperfection and done what Silicon Valley does best: figure out how to create psychological safety faster, better and in more productive ways.

‘Don’t underestimate the power of giving people a common platform and operating language.’

Source: What Google Learned From Its Quest to Build the Perfect Team – The New York Times

Google researchers undertook a massive multi-year research project to understand the effectiveness of teams. They wanted to know why certain teams at Google performed highly and others did not. Was it the size of the team? The blend of personality types? Or even their physical environments? Over time it became clear that who was on the team didn’t matter so much as how the team operated. More specifically, the social norms that determined whether or not everyone got a voice, and whether or not the team members felt that if they made a mistake, they knew it could be openly discussed without fear of embarrassment. Incredibly, group traits like “conversational turn-taking” and “sensitivity to nonverbal cues” matters more than the intelligence or experience of the team members.

That’s encouraging news for those of us who don’t get to perform with John Coltrane and Cannonball Adderley.

There’s a term for this: psychological safety. The researcher Amy Edmondson demonstrated that teams can appear to be strong on the surface: people like and respect each other, and they get along well. Despite that, they may have an environment where everyone sits silently while the boss talks at them, or where people feel ashamed to be vulnerable and open up about their fears. They might all love hanging out together after work, but nobody can bring themselves to tell someone when they’ve got toilet paper stuck to their shoes. If we want a climate where people can accomplish groundbreaking things, we need to know our voice will be heard and where we’re not afraid to take risks.

The best jazz bands, like the best Google teams, provide the space to take risks. We already know jazz artists have hyperaware senses and can pick up on nonverbal clues. But everyone also gets a voice. In jazz, it’s assumed that unexpected contributions can come from anyone. Getting a “voice” also means every band member takes a turn soloing. Each player spends time as both leader and follower. Miles was always attune to the contributions of everyone. If he realized someone hadn’t had a solo in a while, he’d lean over to them and whisper in his gravelly voice that they should take the lead.

Followership in jazz is worthy of the highest respect—it’s known as comping. Comping is listening and responding without overshadowing. Followership needs to be active, not passive. It’s not about sitting back and letting someone else do all the work. You take an indispensable role in giving space, riffing, experimenting, and supporting. And yet leading and talking are more valued than following and listening in our work culture.

Source: Please Make Yourself Uncomfortable – What product managers can learn from jazz musicians – Ken Norton

“We call it ‘psychological safety,’  ” she said. Psychological safety is a “shared belief, held by members of a team, that the group is a safe place for taking risks.” It is “a sense of confidence that the team will not embarrass, reject, or punish someone for speaking up,” Edmondson wrote in a 1999 paper. “It describes a team climate characterized by interpersonal trust and mutual respect in which people are comfortable being themselves.”

Julia and her Google colleagues found Edmondson’s papers as they were researching norms. The idea of psychological safety, they felt, captured everything their data indicated was important to Google’s teams. The norms that Google’s surveys said were most effective— allowing others to fail without repercussions, respecting divergent opinions, feeling free to question others’ choices but also trusting that people aren’t trying to undermine you— were all aspects of feeling psychologically safe at work. “It was clear to us that this idea of psychological safety was pointing to which norms were most important,” said Julia. “But it wasn’t clear how to teach those inside Google. People here are really busy. We needed clear guidelines for creating psychological safety without losing the capacity for dissent and debate that’s critical to how Google functions.” In other words, how do you convince people to feel safe while also encouraging them to be willing to disagree?

“For a long time, that was the million-dollar question,” Edmondson told me. “We knew it was important for teammates to be open with each other. We knew it was important for people to feel like they can speak up if something’s wrong. But those are also the behaviors that can set people at odds. We didn’t know why some groups could clash and still have psychological safety while others would hit a period of conflict and everything would fall apart.”

Duhigg, Charles (2016-03-08). Smarter Faster Better: The Secrets of Being Productive in Life and Business (Kindle Locations 793-808). Random House Publishing Group. Kindle Edition.

“Comedy writers carry a lot of anger,” said Schiller. “We were vicious to each other. If you thought something was funny and no one else did, it could be brutal.”

So why, given all the tensions and infighting, did the Saturday Night Live creators become such an effective, productive team? The answer isn’t that they spent so much time together, or that the show’s norms put the needs of the group above individual egos.

Rather, the SNL team clicked because, surprisingly, they all felt safe enough around one another to keep pitching new jokes and ideas. The writers and actors worked amid norms that made everyone feel like they could take risks and be honest with one another, even as they were shooting down ideas, undermining one another, and competing for airtime.

“You know that saying, ‘There’s no I in TEAM’?” Michaels told me. “My goal was the opposite of that. All I wanted were a bunch of I’s. I wanted everyone to hear each other, but no one to disappear into the group.”

That’s how psychological safety emerged.

Duhigg, Charles (2016-03-08). Smarter Faster Better: The Secrets of Being Productive in Life and Business (Kindle Locations 889-898). Random House Publishing Group. Kindle Edition.

After looking at over a hundred groups for more than a year, Julia and the Project Aristotle team concluded it was something unexpected (group norms) were the key to better teams.

In particular, one factor stood out more than others: creating “psychologically safe environments.” Teams that encourage safe discussions and different viewpoints succeed more.

On the good teams, members spoke in roughly the same proportion, what researchers referred to as ”equality in distribution of conversational turn-taking.” On some teams, everyone spoke during each task; on others, leadership shifted among teammates from assignment to assignment.

The good teams had high social sensitivity, they had team members that could sense how others felt based on their tone of voice, their expressions and other nonverbal cues.

Young people are headed for a project-based world, and project based learning is the best preparation. Larmer said, “Do whatever you can to make the PBL environment more like a real-world workplace. If a team is not working well together, what would adults on the job do? If a co-worker gets sick, how might a team handle the situation? If deadlines are being missed and the project is falling behind schedule, how does a project manager adjust?”

“We constantly talk about collaboration and working in teams with students,” said Randy Hollenkamp. Teachers at the New Tech Network affiliate encourage students to create team norms and build contracts with each other prior to every project. “Teachers scaffold this with our students from day one,” said Hollenkamp, who added:

“We also talk with students about how trust is crucial in team work. It is as important to students doing the lion’s share of the work as it is to the students not doing the lion’s share. If someone in the group is doing more work, then there is a group trust issue that needs to be discussed. This idea is carried into our “culture of critique” as well. The norm here is to be “kind, specific, and helpful” when giving critique. In doing this our students build trust and seek and expect critique with each other and adults.”

In school, and in the workplace, successful projects start with a safe environment where diverse views are welcomed, differences are respected and quality contributions are expected.

Source: Building Better Teams for Project-Based Work

Performance terror. We’ve all known a classroom, meeting room or stage where we didn’t feel safe doing something we were quite capable of doing.

“As a college professor I encourage students to read their work aloud, but I never insist on it,” said Carey. “Sometimes those who are uncomfortable doing it will volunteer on their own because it’s their decision rather than mine.”

“I centered my instruction on the lives, histories and identities of my students. And I did all of this because I wanted my students to know that everyone around them was supporting them to be their best self,” said Simmons.

A supportive culture, sustained advisory relationships, and teaching strategies that create positive learning all promote psychological safety.

“Every child deserves an education that guarantees the safety to learn in the comfort of one’s own skin,” said Simmons.

Source: Psychological Safety: Key to Success at School and Work | Tom Vander Ark | Pulse | LinkedIn

If we want to create resilient, capable, problem-solving students, we need to allow them to make mistakes that encourage them to learn and grow. Students learn best when their affective filter is low. When mistake-making is perceived as bad, it is detrimental to learning.

The same holds for teachers.

We must allow teachers to model learning through trial and error.

When we create professional learning experiences that reward teacher risk-taking, we’re creating an environment of trust, which means encouraging teachers to continually re-new their practice through experimentation, failure and iteration.

Source: Model Mistakes and Creating Trust in the Classroom

Schools that fail have adults who talk relentlessly about how at risk their kids are. They have all the statistics at their fingertips. They focus on the perceived limitations… on vocabulary shortfalls, on lack of pre-school and parent involvement, on issues of attendance and language.

Schools that succeed have adults who talk about what their kids can do. They talk about the stories kids tell, the things kids make, the problems they solve, the way the collaborate, communicate, connect to the world. And when they’re really good you never hear the words “at risk,” or “title,” or “deficit,” when they plan.

A home of opportunity.

A school struggling with the ravages of American poverty has to first be a home — the kind of home the children may not have at home. A place that is relentlessly safe, that is both calming and exciting, that offers unconditional love, and that offers boundless opportunity.

That ‘home’ must be supportive and accepting, loving and encouraging, and it must provide the biggest possible window on to the world, on to the universe.

A home of opportunity.

What does opportunity look like? First, it looks like trust. It looks like freedom. And it looks like choice.

What does opportunity look like? It looks like understanding that relationships and social and emotional support mean more than traditional academics. It means that adults don’t fuel bullying through hierarchies — whether with honor rolls, ability grouping, or sports worship.

It looks like Universal Design for Learning, with kids learning to use the tools of a lifetime. It looks like a place where kids can hide when they need to and jump when they want to. It looks like a place where play is considered a high level learning path.

It looks like a place that respects kids’ needs and treats their lives as legitimately complex and difficult.

Source: You must see your school as a home of opportunity – Medium

Every child deserves an education that guarantees the safety to learn in the comfort of one’s own skin.

I centered my instruction on the lives, histories and identities of my students. And I did all of this because I wanted my students to know that everyone around them was supporting them to be their best self.

So while I could not control the instability of their homes, the uncertainty of their next meal, or the loud neighbors that kept them from sleep, I provided them with a loving classroom that made them feel proud of who they are, that made them know that they mattered.

There is a better way, one that doesn’t force kids of color into a double bind; a way for them to preserve their ties to their families, homes and communities; a way that teaches them to trust their instincts and to have faith in their own creative genius.

Source: Dena Simmons How students of color confront impostor syndrome – Ted Talk 2016   Ted com – YouTube

Psychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes.

Source: Building a psychologically safe workplace: Amy Edmondson at TEDxHGSE – YouTube

Self-advocate, silenced

I am autistic and take issue with those who silence autistic voices. We are abused into compliance and silence, stuffed into neurotypical boxes, and denied agency and self-advocacy. Those who silence self-advocate perspective in a disability support group for students—where connecting kids with an identitytribe, and voice are vitally important—will not receive silence in reply. They will hear my voice. They will hear it in the song of our systems as we move to the social model for minds and bodies.

Those who do not respect identity should not moderate a disability group. When you block the voices of self-advocates and their families, you fail inclusionNothing about us, without us.

 

Neurodiversity and Gender Non-conformity, Dysphoria and Fluidity

Gender nonconformity, dysphoria, and fluidity are oft discussed in neurodiversity communities. Neurodivergent people are more likely than the general population to be gender non-conforming. Many prominent autistic self-advocates identify as intersex, asexual, and genderqueer.

The broadest definition of neurodiversity is a social model umbrella that includes LGBTQIA and genderqueer.

Spectrums and rainbows, double rainbows.

Autistics and LGBTQIA share some dark history—and some bad actors. Chapter 7 of NeuroTribes, Fighting the Monster, shares the legacy of Ole Ivar Lovaas, the twisted father of Applied Behavior Analysis (ABA) and conversion therapy. He applied his abusive, torturous techniques to autistic kids and “sissy boys” to make them “indistinguishable from their peers”. He had little regard for their humanity—they were engineering projects.

“The fascinating part to me was to observe persons with eyes and ears, teeth and toenails, walking around yet presenting few of the behaviors that one would call social or human,” he wrote. “Now, I had the chance to build language and other social and intellectual behaviors where none had existed, a good test of how much help a learning-based approach could offer.”

He explained to Psychology Today, “You see, you start pretty much from scratch when you work with an autistic child. You have a person in the physical sense— they have hair, a nose, and a mouth— but they are not people in the psychological sense. One way to look at the job of helping autistic kids is to see it as a matter of constructing a person. You have the raw materials, but you have to build the person.”

Source: Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 285). Penguin Publishing Group. Kindle Edition.

ABA and its conversion therapy kin are with us still, all too alive and well.

#ActuallyAutistic reject ABA. I don’t know a single autistic person who supports it.

Protecting LGTBTQIA kids protects also neurodivergent kids—and vice versa. The fight is for inclusion and acceptance—for all operating systems, for all of our different ways of being human. Supporting our kids means supporting all of their possibilities and expressions.

Children on the autism spectrum are more than seven times more likely to show signs of gender variance, according to a study led by New York University.

The study, published last month in Transgender Health, recruited the parents of 492 autistic children ages six to 18. When the researchers asked these parents whether their children often “wish to be the opposite sex,” a little over five percent of participants said yes, compared to less than one percent of the general population.

Bolstering these findings is the fact that a previous study from the Children’s National Medical Center in 2014 found almost the exact same results. The NYU study found that 5.1 percent of children on the autism spectrum showed signs of gender variance. The 2014 study put that number down at 5.4 percent.

Both studies show that counselors working with autistic children should ask about their gender identity. Being both autistic and gender non-conforming, some children face a double-challenge in responding to society’s biases.

Study: Autistic kids more likely to be gender non-conforming | PhillyVoice

Ollie’s parents wondered if his gender nonconformity — behavior that doesn’t match masculine and feminine norms — might have something to do with his autism. Ollie had been diagnosed with sensory processing disorder at age 2: An extreme sensitivity to sounds, light, the texture of some foods or the feel of a particular fabric can send children like Ollie into a meltdown. He also had difficulty falling asleep and staying asleep. It would take his parents four more years to find a doctor who recognized the classic symptoms of Asperger syndrome — above-average intelligence combined with social and communication deficits, and restricted interests. (Ollie was diagnosed with Asperger syndrome before the diagnosis was absorbed into the broader category of autism spectrum disorder in 2013.)

Ollie’s parents are not alone in pondering this puzzle. A handful of studies over the past five years — and a series of case reports going back to 1996 — show a linkage between autism and gender variance. People who feel significant distress because their gender identity differs from their birth sex — a condition known as gender dysphoria —have higher-than-expected rates of autism. Likewise, people with autism appear to have higher rates of gender dysphoria than the general population.

Between 8 and 10 percent of children and adolescents seen at gender clinics around the world meet the diagnostic criteria for autism, according to studies carried out over the past five years, while roughly 20 percent have autism traits such as impaired social and communication skills or intense focus and attention to detail. Some seek treatment for their gender dysphoria already knowing or suspecting they have autism, but the majority of people in these studies had never sought nor received an autism diagnosis. What’s more, roughly the same numbers of birth males and females appear to be affected — which is surprising, given that in the general population, autism skews male.

Over the past decade, people with gender dysphoria have developed new ways of expressing their sense of self. Whereas many once identified as transsexual or transgender, some now call themselves ‘genderqueer’ or ‘non-binary.’ Rates of autism and autism traits appear to be higher in those identifying as genderqueer. Like Ollie, these people generally say they don’t feel fully masculine or feminine, and explicitly reject the notion of two mutually exclusive genders. The word ‘trans’ is often used to encompass all of these identities and the phrase ‘affirmed gender’ to convey a person’s sense of self.

Inspired by the Dutch study, Strang and his colleagues approached prevalence from another angle. Instead of measuring the incidence of autism among gender-dysphoric children and adolescents, they assessed gender variance — defined as a child “wishing to be the other sex” — in children with autism. “We found rates that were 7.5 times higher than expected,” Strang says.

Still, she cautions that sometimes, what looks like autism may actually be untreated gender dysphoria. “So much of the experience of being trans can look like the spectrum experience,” she says. People who don’t want to socialize in their birth genders may seem to have poor social skills, for example; they may also feel so uncomfortable with their bodies that they neglect their appearance. “That can sometimes be greatly alleviated if you give that person appropriate gender support,” she says.

Others agree with these insights. A 2015 study by researchers from Boston Children’s Hospital reported that 23.1 percent of young people presenting with gender dysphoria at a gender clinic there had possible, likely or very likely Asperger syndrome, as measured by the Asperger Syndrome Diagnostic Scale, even though few had an existing diagnosis. Based on these findings, the researchers recommend routine autism screening at gender clinics.

Source: Living between genders | Spectrum

Gender norms should not be imposed on people with autism to make the rest of the world more comfortable. Why teach girls with autism how to apply makeup, dress in a feminine manner and shop? Therapists, educators and parents only consider these to be important goals because our society imposes strict gender norms.

As a member of the LGBTQ community who is also autistic, I encounter inequality based on my gender identity, my sexual orientation and my disability. Societal barriers in housing, employment, transportation, healthcare and education systematically exclude queer, gender-queer, transgender and disabled people; outdated and negative attitudes about gender, sexuality and autism affect our social relationships.

Queer environments don’t often account for our sensory processing issues or social differences, whereas autism services don’t often recognize that we may identify beyond the gender binary or have queer relationships. Shifting the focus from the tired narratives of delayed diagnosis and sex differences can help the autism community take responsibility for improving our day-to-day quality of life, whatever our age at diagnosis or gender identity.

Source: Focus on autism must broaden to include non-binary genders | Spectrum

Nearly a quarter of young persons diagnosed with gender dysphoria, or who are transgender, screened positive for Asperger syndrome, a form of autism, according to a new paper in the academic journal LGBT Health.

The study was a small retrospective review of intake files of 39 children at Boston Children’s Hospital. Lead author Dr. Daniel E. Shumer explains, “We found that 23 percent of kids fell into the ‘possible, likely or very likely category’ when using the evaluation tool to screen for Asperger’s.”

“Having autism is a burden; a lot of things in the world change when you have autism,” says Strang. “But adding transgenderism, or maybe some of them aren’t transgender but they are just exploring gender, that is complicated in itself.”

“Knowing how to navigate in a world that is not really friendly with people who are trans can be tricky when you are missing social cues.”

Shumer says it is important that parents and medical providers be aware of the increased possibility for co-occurrence of autism and gender variance. If treating patients for one condition, they should screen for the other and be prepared to treat it.

“There also may be implications for how to provide informed consent for things like hormonal interventions,” he adds.

Source: PrideSource – Transgender Youth More Likely to Have Autism

Lovaas’s crusade to “normalize” deviance was not limited to autistic children. In the 1970s, he lent his expertise to a series of experiments called the Feminine Boy Project, the brainchild of UCLA psychologist Richard Green. After interviewing one hundred men and women who applied for gender reassignment surgery, Green became interested in tracing the roots of sexual identity back to childhood. He teamed up with Lovaas to see if operant conditioning could be employed as an early intervention in cases of gender confusion to prevent the need for reassignment surgery in the future.

The project’s most celebrated success story was Kirk Andrew Murphy, enrolled at UCLA by his parents at age five. Bright and precocious, Kirk would ask for his favorite snacks by their brand names at the supermarket. But after seeing Green interviewed on TV about “sissy-boy syndrome”— his term for early-onset gender dysphoria— Kirk’s parents became concerned that he was exhibiting behavior that was inappropriate for a little boy. One day, his father caught him posing in the kitchen in a long T-shirt and saying, “Isn’t my dress pretty?” Children with this syndrome, Green claimed, often grew up to become transsexual or homosexual. Lovaas assigned a young graduate student named George Rekers to become Kirk’s behavioral therapist.

In a case report that would go on to become a classic in undergraduate psychology courses, Rekers and Lovaas wrote that Kirk (called “Kraig”) possessed “a remarkable ability to mimic all the subtle feminine behaviors of an adult woman.” They framed his “offer to ‘help mommy’ by carrying her purse” as an example of the boy’s devious manipulation of his mother to “satisfy his feminine interests.” Their descriptions of the little boy’s behavior, compared with the transcripts of Green’s intake interviews with Kirk’s parents, were decidedly more extreme, as if the boy were clearly a world-class drag queen in the making at age five. They claimed that he had an elaborate “history of cross-dressing” that included plundering his grandmother’s makeup kit for cosmetics and “swishing around the home and clinic, fully dressed as a woman with a long dress, wig, nail polish, high screechy voice, [and] slovenly seductive eyes.” (In family photographs, Kirk more resembles a Mouseketeer.)

Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 320). Penguin Publishing Group. Kindle Edition.

In a case report that would go on to become a classic in undergraduate psychology courses, Rekers and Lovaas wrote that Kirk (called “Kraig”) possessed “a remarkable ability to mimic all the subtle feminine behaviors of an adult woman.” They framed his “offer to ‘help mommy’ by carrying her purse” as an example of the boy’s devious manipulation of his mother to “satisfy his feminine interests.” Their descriptions of the little boy’s behavior, compared with the transcripts of Green’s intake interviews with Kirk’s parents, were decidedly more extreme, as if the boy were clearly a world-class drag queen in the making at age five. They claimed that he had an elaborate “history of cross-dressing” that included plundering his grandmother’s makeup kit for cosmetics and “swishing around the home and clinic, fully dressed as a woman with a long dress, wig, nail polish, high screechy voice, [and] slovenly seductive eyes.” (In family photographs, Kirk more resembles a Mouseketeer.)

Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 320). Penguin Publishing Group. Kindle Edition.

In a case report that would go on to become a classic in undergraduate psychology courses, Rekers and Lovaas wrote that Kirk (called “Kraig”) possessed “a remarkable ability to mimic all the subtle feminine behaviors of an adult woman.” They framed his “offer to ‘help mommy’ by carrying her purse” as an example of the boy’s devious manipulation of his mother to “satisfy his feminine interests.” Their descriptions of the little boy’s behavior, compared with the transcripts of Green’s intake interviews with Kirk’s parents, were decidedly more extreme, as if the boy were clearly a world-class drag queen in the making at age five. They claimed that he had an elaborate “history of cross-dressing” that included plundering his grandmother’s makeup kit for cosmetics and “swishing around the home and clinic, fully dressed as a woman with a long dress, wig, nail polish, high screechy voice, [and] slovenly seductive eyes.” (In family photographs, Kirk more resembles a Mouseketeer.

Source: Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (pp. 319-320). Penguin Publishing Group. Kindle Edition.

To nip the little boy’s inappropriate behavior in the bud, they devised a program of total immersion based on Lovaas’s work on autism. This time, instead of hand-flapping, gaze aversion, and echolalia, the behaviors targeted for extinction included the “limp wrist,” the submissively yielding “hand clasp,” the notorious “swishy gait,” the girlish “hyperextension” of the limbs in moments of exuberance, and prissy declarations like “goodness gracious” and “oh, dear me.”

At home, Kirk’s “masculine” behaviors were rewarded with blue chips that could be redeemed for candy and other treats, while his “feminine” behaviors were punished with red chips that were subtracted from the total. In interviews conducted by blogger Jim Burroway, who undertook a thorough investigation of the case in 2011, Kirk’s brother, Mark, recalled their father punishing the boy— with Rekers’s approval— by converting each red chip into a “swat.” Mark broke down sobbing as he confessed to hiding red chips from his brother’s pile so that Kirk wouldn’t have to endure the abuse.

Source: Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (pp. 320-321). Penguin Publishing Group. Kindle Edition.

Studies:

Resist

We face an emerging hyper-capitalist, far right, white supremacist kleptocracy that will dismantle and starve public systems. What’s more, this kleptocracy is much too closely tied to the established hyper-capitalist, far right, white supremacist kleptocracy in Russia. We must be wary. We must resist. Champion diversity and inclusion, and resist intensely ideological authoritarian parties.

Indivisible: A Practical Guide For Resisting the Trump Agenda

The authors of this guide are former congressional staffers who witnessed the rise of the Tea Party. We saw these activists take on a popular president with a mandate for change and a supermajority in Congress. We saw them organize locally and convince their own MoCs to reject President Obama’s agenda. Their ideas were wrong, cruel, and tinged with racism — and they won.

We believe that protecting our values, our neighbors, and ourselves will require mounting a similar resistance to the Trump agenda — but a resistance built on the values of inclusion, tolerance, and fairness. Trump is not popular. He does not have a mandate. He does not have large congressional majorities. If a small minority in the Tea Party can stop President Obama, then we the majority can stop a petty tyrant named Trump.

To this end, the following chapters offer a step-by-step guide for individuals, groups, and organizations looking to replicate the Tea Party’s success in getting Congress to listen to a small, vocal, dedicated group of constituents. The guide is intended to be equally useful for stiffening Democratic spines and weakening pro-Trump Republican resolve.

We believe that the next four years depend on Americans across the country standing indivisible against the Trump agenda. We believe that buying into false promises or accepting partial concessions will only further empower Trump to victimize us and our neighbors. We hope that this guide will provide those who share that belief useful tools to make Congress listen

Indivisible: A Practical Guide For Resisting the Trump Agenda

The Indivisible Guide provides a one page summary of four top-level takeaways, which I’ll excerpt here.

How grassroots advocacy worked to stop President Obama

We examine lessons from the Tea Party’s rise and recommend two key strategic components:

  1. A local strategy targeting individual Members of Congress (MoCs).
  2. A defensive approach purely focused on stopping Trump from implementing an agenda built on racism, authoritarianism, and corruption.

How your MoC thinks — reelection, reelection, reelection — and how to use that to save democracy.

MoCs want their constituents to think well of them and they want good, local press. They hate surprises, wasted time, and most of all, bad press that makes them look weak, unlikable, and vulnerable. You will use these interests to make them listen and act.

Identify or organize your local group.

Is there an existing local group or network you can join? Or do you need to start your own? We suggest steps to help mobilize your fellow constituents locally and start organizing for action.

Four local advocacy tactics that actually work.

Most of you have three MoCs — two Senators and one Representative. Whether you like it or not, they are your voices in Washington. Your job is to make sure they are, in fact, speaking for you. We’ve identified four key opportunity areas that just a handful of local constituents can use to great effect. Always record encounters on video, prepare questions ahead of time, coordinate with your group, and report back to local media:

  1. Town halls. MoCs regularly hold public in-district events to show that they are listening to constituents. Make them listen to you, and report out when they don’t.
  2. Non-town hall events. MoCs love cutting ribbons and kissing babies back home. Don’t let them get photo-ops without questions about racism, authoritarianism, and corruption.
  3. District office sit-ins/meetings. Every MoC has one or several district offices. Go there. Demand a meeting with the MoC. Report to the world if they refuse to listen.
  4. Coordinated calls. Calls are a light lift but can have an impact. Organize your local group to barrage your MoCs at an opportune moment about and on a specific issue.

Our family has used some of these approaches in the fight for transgender, neurodiversity, and disability inclusion in our school district.

I am autistic and uncomfortable talking. I do not like interacting with ableist, exclusionary systems that rely on synchronous meatspace conversation. But, sometimes we must show up to talk to representatives and their staff, face to face. Show up at town halls and other events and let them know your PoV exists. We need to be in the room with power. You must personally present your words, or at least work together with someone who will be in the room for you.

Congressman Steve Israel recommends showing up at an event your representative is at and asking them “Why did you vote a certain way?” and “What’s your position on a certain issue?”

The Indivisible Guide stresses two key strategic elements that made the Tea Party successful.

  1. They were locally focused. The Tea Party started as an organic movement built on small local groups of dedicated conservatives. Yes, they received some support/coordination from above, but fundamentally all the hubbub was caused by a relatively small number of conservatives working together.
  2. They were almost purely defensive. The Tea Party focused on saying NO to Members of Congress (MoCs) on their home turf. While the Tea Party activists were united by a core set of shared beliefs, they actively avoided developing their own policy agenda. Instead, they had an extraordinary clarity of purpose, united in opposition to President Obama. They didn’t accept concessions and treated weak Republicans as traitors.

Defend your neighbors. Defend your schools. Defend our institutions and ethics.

Call the Halls

I believe phone calls have a significant impact because of their immediate call to action. It requires an office to formulate a response right away and in our district office, we began tallying calls immediately when we received a large number on a specific topic. I also liked hearing the voices of constituents because they felt more personal than an email or letter. However, I also agree with the CMF’s assessment that large amounts of calls can be disruptive in a bad way and they should be used responsibly, so you don’t damage your message:

  1. Only call the representatives who represent you.
  2. Identify yourself as a constituent.
  3. Call the D.C. office as well as the state offices.
  4. Call once about an issue.
  5. Tell your story on the phone to the staffer.
  6. Ask for specific action.
  7. Be brief and respectful

Source: Call the Halls: Contacting Your Representative the Smart Way

Even if you don’t speak directly to the lawmaker, staff members often pass the message along in one form or another.

Emily Ellsworth, whose jobs have included answering phones in the district offices of two Republican representatives from Utah — Jason Chaffetz, from 2009 to 2012; and Chris Stewart from 2013 to 2014 — said the way your points reach a lawmaker depends on how many calls the office is getting at the time and how you present your story.

In some cases, it’s a simple process. When a caller offered an opinion, staff members would write the comments down in a spreadsheet, compile them each month and present reports to top officials, she said. If the lawmaker had already put out a statement on the issue, the staff member would read it to the caller, she said.

But a large volume of calls on an issue could bring an office to a halt, sometimes spurring the legislator to put out a statement on his or her position, Ms. Ellsworth said. She recommended the tactic in a series of tweets shared thousands of times.

“It brings a legislative issue right to the top of the mind of a member,” she said. “It makes it impossible to ignore for the whole staff. You don’t get a whole lot else done.”

Source: Here’s Why You Should Call, Not Email, Your Legislators – The New York Times

People need to have a relationship with their elected officials.

#CallTheHalls

Resistance Manual

Action begins with information.

There are more of us who believe in equity and justice than those who support Donald Trump’s ideology of fear and hate.

Together, we can harness the collective power of the people to resist the impact of a Trump presidency and to continue to make progress in our communities.

Get educated. Get organized. Take action.

Source: Resistance Manual

20 steps for resisting fascism

  1. Do not obey in advance.
  2. Defend an institution.
  3. Recall professional ethics.
  4. When listening to politicians, distinguish certain words.
  5. Be calm when the unthinkable arrives.
  6. Be kind to our language.
  7. Stand out. Someone has to.
  8. Believe in truth.
  9. Investigate.
  10. Practice corporeal politics.
  11. Make eye contact and small talk.
  12. Take responsibility for the face of the world.
  13. Hinder the one-party state.
  14. Give regularly to good causes, if you can.
  15. Establish a private life.
  16. Learn from others in other countries.
  17. Watch out for the paramilitaries.
  18. Be reflective if you must be armed.
  19. Be as courageous as you can.
  20. Be a patriot.

Source: 20 Lessons from the 20th Century on How to Survive in Trump’s America – In These Times

Sarah Kendzior and The View From Flyover Country

Sarah Kendzior is an anthropologist, journalist, and expert on Central Asia and authoritarianism. Follow her on Twitter for insight into authoritarianism and kleptocracy and how to #Resist.

Her book The View From Flyover Country offers insight into the structural problems that got us here.

I’m calling it for Trump. I think he’s going all the way. I think people who dismiss this have no idea how poor off people are now and how badly they want a savior and scapegoats. This country has nothing left but pain and exploitation of pain for entertainment. Enter Trump. Deal is sealed.

Here is that pain.

This is the view from flyover country, where the rich are less rich and the poor are more poor and everyone has fewer things to lose.

At play, notes Byrne, was more than a rise in the cost of living. It was a shift in the perceived value of creativity, backed by an assumption that it must derive from and be tied to wealth. “A culture of arrogance, hubris and winner-take-all was established,” he recalls. “It wasn’t cool to be poor or struggling. The bully was celebrated and cheered.”

New York – and San Francisco, London, Paris and other cities where cost of living has skyrocketed – are no longer places where you go to be someone. They are places you live when you are born having arrived. They are, as journalist Simon Kuper puts it, “the vast gated communities where the one percent reproduces itself”.

This is the New York artist today: A literal servant to corporate elites, hired to impart “creativity” to children whose bank accounts outstrip their own.

Creativity – as an expression of originality, experimentation, innovation – is not a viable product. It has been priced out into irrelevance – both by the professionalization of the industries that claim it, and the soaring cost of entry to those professions.

The creative class plays by the rules of the rich, because those are the only rules left.

Today, creative industries are structured to minimize the diversity of their participants – economically, racially and ideologically. Credentialism, not creativity, is the passport to entry.

“What the artist was pretending he didn’t know is that money is the passport to success,” she writes. “We may be free beings, but we are constrained by an economic system rigged against us. What ladders we have, are being yanked away. Some of us will succeed. The possibility of success is used to call the majority of people failures.”

Failure, in an economy of extreme inequalities, is a source of fear. To fail in an expensive city is not to fall but to plummet. In expensive cities, the career ladder comes with a drop-off to hell, where the fiscal punishment for risk gone wrong is more than the average person can endure. As a result, innovation is stifled, conformity encouraged. The creative class becomes the leisure class – or they work to serve their needs, or they abandon their fields entirely.

But creative people should not fear failure. Creative people should fear the prescribed path to success – its narrowness, its specificity, its reliance on wealth and elite approval. When success is a stranglehold, true freedom is failure. The freedom to fail is the freedom to innovate, to experiment, to challenge.

To “succeed” is to embody the definition of contemporary success: sanctioned, sanitized, solvent.

“People”, in Grosse and Thomas’s formulation, are not those who actually live in north Philadelphia and bear the brunt of its burdens. “People” are those who can afford to view poverty through the lens of aesthetics as they pass it by. Urban decay becomes a set piece to be remodeled or romanticized. This is hipster economics.

These dismissals, which focus on gentrification as culture, ignore that Lee’s was a critique of the racist allocation of resources. Black communities whose complaints about poor schools and city services go unheeded find these complaints are readily addressed when wealthier, whiter people move in. Meanwhile, long-time locals are treated as contagions on the landscape, targeted by police for annoying the new arrivals. Gentrifiers focus on aesthetics, not people. Because people, to them, are aesthetics.

Proponents of gentrification will vouch for its benevolence by noting it “cleaned up the neighborhood”. This is often code for a literal white-washing. The problems that existed in the neighborhood – poverty, lack of opportunity, struggling populations denied city services – did not go away. They were simply priced out to a new location.

In cities, gentrifiers have the political clout – and accompanying racial privilege – to reallocate resources and repair infrastructure. The neighborhood is “cleaned up” through the removal of its residents. Gentrifiers can then bask in “urban life” – the storied history, the selective nostalgia, the carefully sprinkled grit – while avoiding responsibility to those they displaced. Hipsters want rubble with guarantee of renewal. They want to move into a memory they have already made.

Rich cities such as New York and San Francisco have become what journalist Simon Kuper calls gated citadels: “Vast gated communities where the one percent reproduces itself.”

Struggling US cities of the rust belt and heartland lack the investment of coastal contemporaries, but have in turn been spared the rapid displacement of hipster economics. Buffered by their eternal uncoolness, these slow-changing cities have a chance to make better choices – choices that value the lives of people over the aesthetics of place.

“I’ve heard several young hipsters tell me they’re socially-liberal and economic-conservative, a popular trend in American politics,” he writes. “Well, I hate to break it to you buddy, but it’s economics and the role of the state that defines politics. If you’re an economic conservative, despite how ironic and sarcastic you may be or how tight your jeans are, you, my friend, are a conservative …”

But while these were memories for some, for others they were merely rumors. A functional local economy was a story our parents told us.

Our rundown towns had little anyone wanted: empty lots, boarded windows, vacant stores. Decades passed, and no one rebuilt them. Now the malls follow, and no one will rebuild them either. My generation watches the malls fall like our parents watched the downtowns die. To our children, the mall will be a nostalgic abstraction, a 404 in concrete.

Materialism may remain rampant, but now its spaces are secret. Retail work has been replaced with jobs in online shopping warehouses where “pickers” labor unseen in brutal conditions.

Malls were once castigated for turning consumers into zombies. Now, the zombie is the ideal online retail employee, unthinking and robotic. Advice by algorithm, delivery by drone: This is what a dehumanized landscape looks like.

Our connections and commerce are dependent on our screens. Pay attention, pay attention, to the men behind the screens.

Do not rejoice at the fall of the mall. The setting may have been artificial, but the people in it were real.

The reality is that, in the “jobless recovery”, nearly every sector of the economy has been decimated. Companies have turned permanent jobs into contingency labor, and entry-level positions into unpaid internships. Changing your major will not change a broken economy.

It is not skills or majors that are being devalued. It is people.

To which the 30-something, having spent their adult life in an economy of stagnant wages and eroding opportunities, takes the 20-something aside, and explains that this is a maxim they, too, were told, but from which they never benefitted. They tell the 20-something what they already know: It is hard to plan for what is already gone. We live in the tunnel at the end of the light.

If you are 35 or younger – and quite often, older – the advice of the old economy does not apply to you. You live in the post-employment economy, where corporations have decided not to pay people. Profits are still high. The money is still there. But not for you. You will work without a pay rise, benefits, or job security. Survival is now a laudable aspiration.

When survival is touted as an aspiration, sacrifice becomes a virtue. But a hero is not a person who suffers. A suffering person is a person who suffers. If you suffer in the proper way – silently, or with proclaimed fealty to institutions – then you are a hard worker “paying your dues”. If you suffer in a way that shows your pain, that breaks your silence, then you are a complainer – and you are said to deserve your fate. But no worker deserves to suffer. To compound the suffering of material deprivation with rationalizations for its warrant is not only cruel to the individual, but gives exploiters moral license to prey.

In the post-employment economy, jobs are privileges, and the privileged have jobs.

Most human rights, policy and development organizations pay interns nothing, but will not hire someone for a job if they lack the kind of experience an internship provides. Privilege is recast as perseverance. The end result hurts individuals struggling in the labor market but also restructures the market itself.

Unpaid internships lock out millions of talented young people based on class alone. They send the message that work is not labor to be compensated with a living wage, but an act of charity to the powerful, who reward the unpaid worker with “exposure” and “experience”. The promotion of unpaid labor has already eroded opportunity – and quality – in fields like journalism and politics. A false meritocracy breeds mediocrity.

Post-recession America runs on a contingency economy based on prestige and privation. The great commonality is that few are paid enough to live instead of simply survive.

Mistaking wealth for virtue is a cruelty of our time. By treating poverty as inevitable for parts of the population, and giving impoverished workers no means to rise out of it, America deprives not only them but society as a whole. Talented and hard-working people are denied the ability to contribute, and society is denied the benefits of their gifts. Poverty is not a character flaw. Poverty is not emblematic of intelligence. Poverty is lost potential, unheard contributions, silenced voices.

In reality, profits are soaring and poorly compensated labor tends to lead to more poorly compensated labor. Zero opportunity employers are refusing to pay people because they can get away with it. The social contract does not apply to contract workers – and in 2013, that is increasingly what Americans are.

In America, there is little chance at a reversal of fortune for those less fortunate. Poverty is a sentence for the crime of existing. Poverty is a denial of rights sold as a character flaw.

American ideology has long tilted between individualism and Calvinism. What happened to you was either supposed to be in your control – the “pull yourself up by your bootstraps” approach – or divinely arbitrated. You either jumped, or you were meant to fall. Claims you were pushed, or you were born so far down you could not climb up, were dismissed as excuses of the lazy. This is the way many saw their world before it collapsed.

Unemployment is not only the loss of a job. It is the loss of dignity. It is the loss of the present and, over time, the ability to imagine a future. It is hopelessness and shame, an open struggle everyone witnesses but pretends not to see. It is a social and political crisis we tell a man to solve, and blame him when he cannot. When you are unemployed, your past is dismissed as unworthy. Your future is denied. Self-immolation is making yourself, in the moment, matter.

They cut and blame us when we bleed.

In authoritarian states ruled by tyrants, in democracies allegedly ruled by law, we find the same result: hard-working people let down by the systems which are supposed to support them. When the most you can ask from your society is that it will spare you, you have no society of which to speak.

While the start and end dates of the millennial generation are up for debate – and the idea of inherent generational traits is dubious – people of this age group share an important quality. They have no adult experience in a functional economy.

A generation that can barely stand on its feet is in charge of another generation’s welfare.

Millennials are chastised for leaning on elders, but the new rules of the economy demand it. Unpaid internships are often prerequisites to full-time jobs, and the ability to take them is based on money, not merit. Young adults who live off wealthy parents are the lucky few. They can envision a future because they can envision its purchase. Almost everyone else is locked out of the game.

Dependence may be the primary trait of the millennial generation, but it is a structural dependence, caused not by “laziness” or “narcissism” but by a lack of options or social mobility. For millennials much more than for the generations which immediately preceded them, the future is determined by the past. The son is indebted to the debt of the father.

It is one thing to discover, as an adult, that the rules have been rewritten, that the job market will not recover, that you will scramble to survive. It is another to raise a child knowing that no matter how hard they work, how talented they are, how big they dream, they will not have opportunities – because in the new economy, opportunities are bought, not earned. You know this, but you cannot tell this to a child. The millennial parent is always Santa, always a little bit of a liar.

Americans should not fear riots. They should fear a society that ranks the death of children. They should fear a society that shrugs, carries on, and lets them go.

Source: The View From Flyover Country

Matthew Stoller’s work complements Kendzior’s narrative of a post-employment economy.

#Resist

These folks—from a variety of political and professional backgrounds—have been out front on Trump + Putin + Russia + kleptocracy + supremacy.

I have included tweets from these sources in the comments on this post. Scroll down.

Flocking

Collective action increases individual survival. Birds, fish, insects and herbivores have been doing it for a long time. It’s called flocking behaviour. In the presence of danger they run as one, turn as one. It makes it much harder for, say, a predator to single out an individual.

More than ten years of research (see, for example, Consensus Decision-Making in Crowds) shows that humans flock, too. It takes only 5% of a crowd to begin to move for the other 95% to follow; we do it subconsciously. Flocking is emergent behaviour: it happens when certain criteria are met without the participants making any conscious decisions. Imagine how powerful that strategy could be if we acted consciously.

Fairness and diversity cannot happen until allies speak out. So, to those with power, platform, and access: You probably don’t like the idea of going from predator to potential prey. Oh, well. But you must not duck for cover, you must not hide. You must speak out. Speak out in concert. Talk to your friends and colleagues. Figure it out. Pick a day; do something.

Source: How to defeat an autocrat: flocking behaviour | Nicola Griffith

Power Mapping

In order to effect social change, an advocate needs to be aware of the political and social power structures in play. A power map is a useful visual tool for figuring out who you need to influence, how to influence them, and who can do the influencing in order to reach a specific goal. This guide will help you create your own power map for your area.

Source: A Guide to Power Mapping | Move to Amend

Hat tip: Safety Pin Box

Youth Activist’s Toolkit

Organizing is the process of building power as a group and using this power to create positive change in our lives. Throughout history, organizers have played a key role in addressing injustice in our country. From the Civil Rights movement, to the feminist, LGBT and immigrant rights movements, organizers have come together, created strategies and built collective power to win lasting change.

Organizing has everything to do with power and shifting relationships of power. Power is the ability to control our circumstances and make things happen outside of ourselves. Everyone has power inside themselves—power to make decisions, to act, to think, to create. However, not everyone has equal power to make things happen outside of our own lives due to inequality of resources and authority. Nevertheless, we can build our own power and the power of our community through organizing. Collective power is the power that a group has by working together with a shared interest in achieving a goal.

Sometimes we think that if our cause is right, we will be able to win easily without building power. We might think that if decision makers just understood the problem then they would act. Unfortunately, in most cases, even if we are right, and those in power know about the issue, they still don’t act. This is because they are being pressured by others not to act, such as donors who want school funds to be allocated to sports programs instead of a student health center. Most campaigns will require you to be more than right. You will find that you must build power in order to put pressure on those who can make decisions. Organizing is about figuring out what resources you really need in order to win change. This could mean you need the votes of members of your student council; chatter on social media; the allegiance of a person with power; or it could mean building crowd support to disrupt business as usual with direct action (such as a protest). You must identify what you need and then figure out how you can make it happen.

This guide will serve as a tool you can use to think through how to make change in your community. It will walk you through the steps of developing a campaign strategy that includes setting goals and establishing demands, analyzing key players, building power, and using power to achieve your goals.

Source: Youth Activist’s Toolkit

Hat tip: Safety Pin Box

Direct Action

These movements include the civil rights movement, the student movement, the anti-Vietnam War movement, the women’s movement, the gay rights movement, and the environmental movement. Each, to varying degrees, changed government policy and, perhaps more importantly, changed how almost every American lives today.

Supporters of these movements questioned traditional practices about how people were treated. Why did black and white children attend separate schools? Why were women prevented from holding certain jobs? Why could a person be drafted at 18 but not able to vote until 21? This questioning inspired people to begin organizing movements to fight against injustice and for equal rights for all people.

In addition, they did not use traditional methods of political activity. Instead of voting for a political candidate and then hoping that the elected official would make good policies, these protesters believed in a more direct democracy. They took direct action—public marches, picketing, sit-ins, rallies, petition drives, and teach-ins—to win converts to their causes and change public policies at the local, state, and federal levels. They contributed their time, energy, and passion with the hope of making a better, more just society for all.

Source: Protests in the 1960s

You may well ask: “Why direct action? Why sit ins, marches and so forth? Isn’t negotiation a better path?” You are quite right in calling for negotiation. Indeed, this is the very purpose of direct action. Nonviolent direct action seeks to create such a crisis and foster such a tension that a community which has constantly refused to negotiate is forced to confront the issue. It seeks so to dramatize the issue that it can no longer be ignored. My citing the creation of tension as part of the work of the nonviolent resister may sound rather shocking. But I must confess that I am not afraid of the word “tension.” I have earnestly opposed violent tension, but there is a type of constructive, nonviolent tension which is necessary for growth. Just as Socrates felt that it was necessary to create a tension in the mind so that individuals could rise from the bondage of myths and half truths to the unfettered realm of creative analysis and objective appraisal, so must we see the need for nonviolent gadflies to create the kind of tension in society that will help men rise from the dark depths of prejudice and racism to the majestic heights of understanding and brotherhood. The purpose of our direct action program is to create a situation so crisis packed that it will inevitably open the door to negotiation. I therefore concur with you in your call for negotiation. Too long has our beloved Southland been bogged down in a tragic effort to live in monologue rather than dialogue.

Source: Letter from a Birmingham Jail

Action and Measurable Allyship

Harm reduction, addiction, tough love, 12 steps, neurodiversity, and the troubled-teen industry

If addiction is like misguided love, then compassion is a far better approach than punishment.

Source: Can You Get Over an Addiction? – The New York Times

Maia Szalavitz poses addiction as a neuro-developmental learning disorder—one often developed while trying to cope with trauma, poverty, or an over reactive nervous system, particularly during adolescence.

Many neurodivergent have hyper-reactive nervous systems. Anxiety and sensory overwhelm flood the senses. A substance that eases anxiety and sensory overwhelm offers relief and escape.

I’m autistic. Much of autism is anxiety and sensory overwhelm. A widely available—and destructive—tool for coping is alcohol. Compulsive damping of my reactive neurology with alcohol compromised my health.

There are less harmful ways to medicate. Cannabis is a neuroprotectant and powerful harm reducer that is friendly to neurodivergence.

Cannabis is the least harmful way for we humans to cope with the burdens of sentience, senescence, and mortality. Cannabis is popular in STEAM cultures, at least the ones I’ve inhabited. It is part of the process of living, creating, and coping. I think the neurodivergent have long used it to regulate and cope in a world that does not accommodate. If your neurodivergence is accompanied by tics, seizures, paresthesia, fasciculations, panic, anxiety, or self-harming stimming, as but a few examples, then cannabis is a tool and ally. There are as many human operating systems as there are humans. The endocannabinoid system is a useful interface to our operating systems for which we have a natural, easy-to-grow key. All humans and their mammalian kin share this interface and this plant. We plucky prometheans figured out how to decarboxylate with fire.

Source: On cannabis and neurodiversity

The drug war’s perverse notions of addiction, addicts, and coping limit our vocabulary, stifle our empathy, and harm us all–especially those with neurodivergent operating systems and those enduring poverty and structural racism and ableism.

Through compassion, the social model, and respect for neurodiversity and structural disadvantages, we can improve our views of addiction.

Follow Maia Salavitz on Twitter and read her book.

Addiction as a learning disorder

More people than ever before see themselves as addicted to, or recovering from, addiction, whether it be alcohol or drugs, prescription meds, sex, gambling, porn, or the internet. But despite the unprecedented attention, our understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as brain disease, and in equally outdated treatment.

Challenging both the idea of the addict’s “broken brain” and the notion of a simple” addictive personality,” Unbroken Brain offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention and policy. Like autistic traits, addictive behaviors fall on a spectrum — and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture and chemicals come together to create both illness and recovery- and why there is no “addictive personality” or single treatment that works for all.

Source: Unbroken Brain – Maia Szalavitz

Addiction is indeed a brain problem, but it’s not a degenerative pathology like Alzheimer’s disease or cancer, nor is it evidence of a criminal mind. Instead, it’s a learning disorder, a difference in the wiring of the brain that affects the way we process information about motivation, reward and punishment. And, as with many learning disorders, addictive behavior is shaped by genetic and environmental influences over the course of development.

The studies show that addiction alters the interactions between midbrain regions like the ventral tegmentum and the nucleus accumbens, which are involved with motivation and pleasure, and parts of the prefrontal cortex that mediate decisions and help set priorities. Acting in concert, these networks determine what we value in order to ensure that we attain critical biological goals: namely, survival and reproduction.

In essence, addiction occurs when these brain systems are focused on the wrong objects: a drug or self-destructive behavior like excessive gambling instead of a new sexual partner or a baby. Once that happens, it can cause serious trouble.

If, like me, you grew up with a hyper-reactive nervous system that constantly made you feel overwhelmed, alienated and unlovable, finding a substance that eases social stress becomes a blessed escape.

The learning perspective also explains why the compulsion for alcohol or drugs can be so strong and why people with addiction continue even when the damage far outweighs the pleasure they receive and why they can appear to be acting irrationally: If you believe that something is essential to your survival, your priorities won’t make sense to others.

Recognizing addiction as a learning disorder can also help end the argument over whether addiction should be treated as a progressive illness, as experts contend, or as a moral problem, a belief that is reflected in our continuing criminalization of certain drugs. You’ve just learned a maladaptive way of coping.

Moreover, if addiction resides in the parts of the brain involved in love, then recovery is more like getting over a breakup than it is like facing a lifelong illness. Healing a broken heart is difficult and often involves relapses into obsessive behavior, but it’s not brain damage.

If addiction is like misguided love, then compassion is a far better approach than punishment.

This makes sense because the circuitry that normally connects us to one another socially has been channeled instead into drug seeking. To return our brains to normal then, we need more love, not more pain.

People with addictions are already driven to push through negative experiences by their brain circuitry; more punishment won’t change this.

But it’s equally possible that I kicked then because I had become biologically capable of doing so. During adolescence, the engine that drives desire and motivation grows stronger. But unfortunately, only in the mid-to-late 20s are we able to exert more control. This is why adolescence is the highest risk period for developing addiction — and simple maturation may be what helped me get better.

At the time, nearly all treatment was based on 12-step groups like Alcoholics Anonymous, which help only a minority of addicted people. Even today, most treatment available in rehab facilities involves instruction in the prayer, surrender to a higher power, confession and restitution prescribed by the steps.

We treat no other medical condition with such moralizing — people with other learning disorders aren’t pushed to apologize for their past behavior, nor are those affected by schizophrenia or depression.

Once we understand that addiction is neither a sin nor a progressive disease, just different brain wiring, we can stop persisting in policies that don’t work, and start teaching recovery.

Indeed, if the compulsive drive that sustains addiction is directed into healthier channels, this type of wiring can be a benefit, not just a disability. After all, persisting despite rejection didn’t only lead to addiction for me — it has also been indispensable to my survival as a writer. The ability to persevere is an asset: People with addiction just need to learn how to redirect it.

Source: Can You Get Over an Addiction? – The New York Times

I want people to understand that addiction is a learning disorder. If you don’t learn that a drug helps you cope or make you feel good, you wouldn’t know what to crave. People fall in love with a substance or an activity, like gambling. Falling in love doesn’t harm your brain, but it does produce a unique type of learning that causes craving, alters choices and is really hard to forget.

It’s compulsive behavior that persists despite negative consequences. Once you realize that that’s the definition of addiction, you realize that what’s going on is a failure to respond to punishment. If punishment worked to stop addiction, addiction wouldn’t exist. People use despite their families getting mad at them, despite losing their jobs and being homeless. And yet we think the threat of jail is going to be different? Addiction persists despite negative consequences. That doesn’t mean that people don’t recover through coercive means, but that doesn’t mean it’s the best way to get there.

My problem with addiction memoirs has always been that this is a deeply political problem and none of them have any political consciousness. They typically tell the story of sin and redemption, an individual story that can stand in for everyone else’s story. That’s just not true.

People who become addicted are wired differently, and it affects the manner in which they learn. We see people with addiction as valueless—literally, pieces of junk. But the interesting thing with different types of brain wiring is, they don’t bring only disadvantages. They can also bring advantages. Sometimes there are blessings hidden inside of curses. The compulsive drive that set me up for addiction probably also makes me a good journalist.

Having the ability to persist despite negative consequences is a plus in many ways. You could never parent or be in a relationship without that ability. Diaper-changing is not fun. There’s a lot of stuff in life where you just have to stick it out. When those same systems that give us motivation get misdirected toward a drug, that’s problematic. It doesn’t mean you’re broken, it just means you fell in love with the wrong thing.

If addiction was genuinely a disease that got worse and worse, it should be harder to recover the older you get. But the data say differently: by their early thirties, half of people who have addiction, excepting tobacco, no longer meet diagnostic criteria. They learn to cut down on their own—and only 10 percent ever get treatment.

Language is power, and it’s important not to dehumanize people who have addiction. The term “addict” is stigmatizing and demonizing. The stereotype of the “addict” is also a stereotype we have for people of color. We have to move away from that language in order to move away from that racism.

Also, when we use the word “abuse,” it connotes really awful behavior, like domestic abuse, child abuse, sexual abuse. Nobody’s abusing a poor little drug. They might be misusing it, but they’re not abusing it.

And the very point of making something a crime is to stigmatize it. You want it to be stigmatized so people don’t do it. Yet you can’t say on one hand that you want to destigmatize addiction while you criminalize certain drugs. And the other thing that undermines the argument about addiction being a disease is that the only disease in America where 80 percent of the treatment is meeting, confession, and surrendering to a higher power.

We should decriminalize all drug possession, legalize marijuana, use the money we save to fund evidence-based treatment. We need to get rid of the cap on suboxone prescribers, (the law allows doctors to prescribe to only 100 patients) and use it as harm reduction as well as a path to recovery. We’d have fifty percent fewer deaths if we relied on medication-assisted therapy. People have to be alive to recover.

Source: Why Addiction Is a Learning Disorder – The Daily Beast

Addiction, in your view, is a neuro-developmental learning disorder. What does that mean?

It means that for one, addiction can’t occur without learning. When I say that, what I mean is literally if you don’t learn that the drug comforts you, makes you feel euphoric or allows you to cope in some way, you cannot be addicted to it—because you cannot crave it, because you don’t know what to pursue despite negative consequences. And that’s important, because people have often thought addiction is just this physiological process that hijacks your brain. That’s really not quite accurate. It involves learning, it involves interacting with the environment, interpreting the environment, and it involves making choices.

The other reason that I think it’s important to see addiction as a developmental disorder is that 90 percent of all addiction occurs between the teens and 20s. That is similar to other developmental conditions such as schizophrenia and depression, which tend to start at that age. That suggests there is a particular period of vulnerability that the brain has and also probably has to do with your life history, as well. When you hit your teens or 20s you’re learning the coping skills you need to handle the adult relationships that are necessary for survival and reproduction. If you are using drugs to escape during this time not only is your brain developmentally vulnerable to not being able to control the use of the drug, but you’re also missing out on developmental experiences that allow you to create other methods of coping.

Unfortunately, in the addictions field, we’ve developed this idea that one size fits all, and whatever works for me is going to work for you, and we can extrapolate from my experience to be the experience of all people with addiction. That’s why I like the saying from the autism community, which is: if you met one person with autism you’ve met one person with autism. We should be saying that about addictions. I find it really annoying when people say “all addicts do X or Y.” Well, maybe you do X or Y, but don’t speak for me.

Imagine I’m trying to argue that the medical condition I have is a disease. But, everybody who has that medical condition can be locked up for having that medical condition, and, if they’re not locked up, they are sent to treatment that involves prayer and restitution.

So, am I going to believe that’s a disease? If I go to cancer treatment and I get told I’m going to be locked up if my tumor grows or I’m going to have to pray to a higher power and surrender in order to get better, I’m going to definitely think that I’m not in mainstream medicine. I’m definitely going to be thinking that this is not a medical condition, that it’s some kind of sin. The 12-step people don’t see any contradiction in saying addiction is a disease and the treatment is prayer, meeting, and confession. But, from the outside that sounds completely absurd. It does not bolster the disease argument at all.

When I talk about addiction being a learning disorder, I’m not saying that it isn’t a problem of the brain, obviously. I’m saying the kind of problem it is is more like ADHD than it is Alzheimer’s. And I think that fits the data. If addiction is actually progressive, it should be harder to recover as you get older and that is not actually true. It also gives a much more hopeful message. Because when people hear “chronic progressive brain disease” they think dementia. When they hear hijacked brain they think: oh my god, these are zombies who are dangerous and we better lock them up for the protection of the rest of us. They think of people who have no responsibility for their actions so therefore we can treat them like children.

If addiction is a learning disorder, fighting a ‘war on drugs’ is useless.

In terms of marijuana: it should be legalized. It is the least harmful, not completely unharmful, but the least harmful psychoactive substance that is regularly used. It makes absolutely no sense to give that profit to the mafia.

Where you end is a comment on neurodiversity, the idea that people with different wiring do not only have impediments, but also assets that ought to be celebrated and respected. Can you explain how this relates more to your work?

It’s quite obvious for some people on the autism spectrum that they’re quite good at things like programming but quite horrible at socializing. I think the neurodiveristy movement is really cool in valuing everybody and letting people see that what may look scary or different or totally weird on the outside may, from the inside, make total sense. It expands the world for everybody.

It’s not just that people who have disabling conditions benefit from the world being friendlier towards us, but we also benefit from being able to function and offer things that we are uniquely equipped to do. I think with addictions in particular, you can’t succeed as a writer if you can’t persist despite negative consequences.

Source: Addiction is a learning disorder: Why the war on drugs is useless, AA undermines treatment, and addiction studies can learn a lot from autism

Many of us grew up with antidrug programs like D.A.R.E. or the Nancy Reagan-inspired antidrug campaign “Just Say No.” But research shows those programs and others like them that depend on education and scare tactics were largely ineffective and did little to curb drug use by children at highest risk.

The traits that put kids at the highest risk for addiction aren’t all what you might expect. In my case, I seemed an unlikely candidate for addiction. I excelled academically, behaved well in class and participated in numerous extracurricular activities.

Inside, though, I was suffering from loneliness, anxiety and sensory overload. The same traits that made me “gifted” in academics left me clueless with people.

That’s why, when my health teacher said that peer pressure could push you to take drugs, what I heard instead was: “Drugs will make you cool.” As someone who felt like an outcast, this made psychoactive substances catnip.

They focus on four risky traits: sensation-seeking, impulsiveness, anxiety sensitivity and hopelessness.

Importantly, most at-risk kids can be spotted early. For example, in preschool I was given a diagnosis of attention deficit/hyperactivity disorder (A.D.H.D.), which increases illegal drug addiction risk by a factor of three. My difficulty regulating emotions and oversensitivity attracted bullies. Then, isolation led to despair.

A child who begins using drugs out of a sense of hopelessness — like me, for instance — has a quite different goal than one who seeks thrills.

Three of the four personality traits identified by Preventure are linked to mental health issues, a critical risk factor for addiction. Impulsiveness, for instance, is common among people with A.D.H.D., while hopelessness is often a precursor to depression. Anxiety sensitivity, which means being overly aware and frightened of physical signs of anxiety, is linked to panic disorder.

Source: The 4 Traits That Put Kids at Risk for Addiction – The New York Times

Addiction vs. Dependence, Interventions, Rehab

Much of the advice given by treatment groups and programs ignores what the data says in a similar way that anti-vaccination or climate skeptic websites ignore science. The addictions field is neither adequately regulated nor effectively overseen. There are no federal standards for counseling practices or rehab programs. In many states, becoming an addiction counselor doesn’t require a high school degree or any standardized training. “There’s nothing professional about it, and it’s not evidence-based,” said Dr. Mark Willenbring, the former director of treatment research at the National Institute on Alcohol Abuse and Alcoholism, who now runs a clinic that treats addictions.

Consequently, families are often given guidance that bears no resemblance to what the research evidence shows — and patients are commonly subjected to treatment that is known to do harm. People who are treated as experts firmly proclaim that they know what they are doing, but often turn out to base their care entirely on their own personal and clinical experience, not data.

In the past, researchers believed addiction just meant that someone needed a substance to function without suffering withdrawal. But now medical experts such as the National Institute on Drug Abuse define addiction as compulsive drug use that continues regardless of negative consequences.

That’s different from just depending on a daily dose. The latter is called physiological dependence; it affects almost anyone who takes opioids daily long term. “Physiological dependence is the normal response to regular dosages of many medications, whether opioids or others. It also happens with beta blockers for high blood pressure,” said Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse. Although many chronic pain patients are physically dependent on opioids, few develop the life-threatening compulsive pattern of drug use that signifies addiction.

When opioid addiction occurs, it is rarely someone’s only mental health problem.

Addressing these underlying issues is usually essential to successful treatment – but unfortunately, many treatment programs are just not equipped to do so, despite claiming otherwise.

“Interventions are almost always destructive, and sometimes, they destroy families.”

“The pure tough love approach does not seem particularly effective and is sometimes quite cruel and potentially counterproductive,” Compton said.

Jail is not treatment. Prisons and jails tend to be neither safe nor drug-free — and interaction with the criminal system, even with drug courts, often restricts access to the best treatment while sometimes punishing relapse more severely than the original offense.

Consequently, do not try to use legal consequences as a way to help people you love, and if possible, bail them out if they get arrested for drug crimes. This doesn’t mean you shouldn’t hold them accountable, but do so in ways that are less likely to lead to lifelong problems. Meaningful employment is an important factor in recovery — and few things are more harmful to the chances of getting a good job than having a criminal record.

Because opioid addiction rarely exists by itself, experts recommend starting any search for treatment with a complete psychiatric evaluation by an independent psychiatrist who is not affiliated with a particular treatment program.

For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question

In the U.K., researchers looked at data from more than 150,000 people treated for opioid addiction from 2005 to 2009 and found that those on buprenorphine or methadone had half the death rate compared with those who engaged in any type of abstinence-oriented treatment.

“Rehab kills people”

Shame and punishment do not work: These tend to drive relapse, rather than recovery.

Families and loved ones can improve the odds for people with addiction by helping motivate them to get treatment; seeking evidence-based care; keeping naloxone on hand; and treating addicted people with the empathy, support and respect they’d offer if they faced any other life-threatening medical problem.

Source: What Science Says To Do If Your Loved One Has An Opioid Addiction | FiveThirtyEight

In other words, if pain medications are making your life genuinely better and improving your ability to love and work, what you are experiencing if you have withdrawal symptoms is dependence, not addiction.

“Even patients themselves confuse addiction and dependence and feel guilty about it and feel like something is wrong with them,” says Richard Saitz, professor and chair of community health sciences at Boston University. “They are often treated as if something is wrong with them, when there’s nothing wrong at all. All of that ends up leading to actions or policies or guidelines that are really misguided and address the wrong thing.”

Early definitions of addiction often did indeed see it as being identical to dependence, in part because physical withdrawal symptoms can be objectively measured and researchers were trying to minimize subjectivity.

“It is clear that any harm that might occur because of the pejorative connotation of addiction would be completely outweighed by the tremendous harm that is now being done to patients who have needed medication withheld because their doctors believe they are addicted simply because they are dependent.”

An accurate conception of addiction also has implications for the fate of children exposed to drugs in the womb. During the crack era, stigma against “addicted” babies did real harm: Teachers, parents and medical professionals viewed so-called “crack babies” as doomed to be either helpless invalids or psychotic criminals. Of course, babies can’t get addicted, since a helpless infant cannot pursue drugs despite consequences and doesn’t even know if what he craves is drugs or a diaper change. But at least one study found that the derogatory labeling produced more punitive responses from adults and lowered their expectations of the children—in itself a harmful outcome.

In fact, much of the damage initially attributed to crack exposure in babies turned out to be associated with stress and poverty—and could be ameliorated by a loving, stable home.

Addiction is not dependence, and dependence is not necessarily a problem.

Until America understands that, needless suffering will continue.

Source: You Can Rely on Drugs Without Being an Addict – VICE

12 Steps, The Troubled Teen Industry, and Tough Love

The myth is that 12-step programs and their associated treatment industry thrive simply because Americans love them. In fact, both are substantially built on and maintained by force.

Coercion into the 12 Steps comes from five main sources: criminal courts, family courts and family services, health care systems, families and employers.

So even by dated and conservative estimates, hundreds of thousands of Americans per year are forced into AA and 12-step-oriented treatment. Yet a steady stream of legal decisions confirms that such court-ordered treatment is illegal.

Every Federal Circuit Court (federal appeals court) and state supreme court that has ruled on such coercion has declared that the 12 Steps are religious in nature, and that it violates a parolee’s or probationer’s First Amendment rights for a court to require AA attendance when the 12-step philosophy violates the individual’s belief system.

Perhaps you didn’t believe that in a major American city in 2016, a court—nay, a drug court—could force people into AA against their belief system, with no sense that this was illegal, inappropriate, or ignorant of other options?

In fact, it remains standard practice.

We must realize that the American 12-step-treatment monolith, thought to be so facilitative and appealing to millions of people—and I have often lamented its cultural dominance—couldn’t operate to anything like its current extent without constant threats of denial or withdrawal of legal freedom, of custody of children, of licensure or employment, of medical care, of family support.

In the meantime, drinking problems, drug addiction and drug deaths in America continue to grow unabated, with our only response being more of the same.

Source: American Gulag: The Five Ways Hundreds of Thousands of People Are Coerced Into Rehab and AA | TheInfluence

Island View — which housed more than 100 children at a time, aged 13-17, and charged parents at least $10,000 a month — caused lasting damage to its students, a dozen of them told HuffPost. Former residents said the staff tormented and abused them — pitting teens against each other, physically restraining them, secluding them, medicating them with high doses of powerful antipsychotics and forcing them to sit without speaking for hours or days at a time.

But there’s little evidence that “tough love” techniques such as isolation and humiliation actually work. And the basic setup of residential treatment facilities lends itself to abuse, critics of the industry argue.

“If you have an institution where you have vulnerable people, abuses of power will almost always occur unless you have really strong safeguards against them —especially if you have vulnerable people who can’t contact the outside world,” said Maia Szalavitz, a journalist who wrote a book, Help at Any Cost, about the troubled-teen industry. “That in itself is a recipe for abuse.”

Despite this record of abuse — which journalists have been writing about for decades — parents upset by their children’s treatment at facilities like Island View often have just one option: lawsuits. “It’s one of the most horrendous things,” said Thomas Burton, a Utah attorney who has helped parents sue the centers. “The state isn’t going to prosecute these RTCs, and local law enforcement agencies aren’t going to impair the enormous amounts of money being brought into local communities. I mean enormous amounts of money — they’re cash cows. So where else can [parents] turn?”

Even solitary confinement — which President Barack Obama has banned for juveniles in federal prison — is permitted at many private treatment centers.

Island View and similar facilities demand one thing from students: absolute compliance.

Compliant children were rewarded with special privileges, like trips outside the facility. Noncompliant children were punished with physical restraint and isolation. They were all expected to participate in group “therapy” sessions that required them to complain about and attack each other. Many of them were medicated with high-dose antipsychotics.

Demands for compliance began the moment students arrived at Island View. Staff strip-searched new students.

“Long-term treatment facilities are like … a jail without having done anything illegal,” said 25-year-old Michelle Lemcke, who attended Island View in 2006.

Pysically restraining students and pitting them against each other weren’t the only ways Island View staff had to enforce compliance.

Island View’s resident handbook forbids “any form of sexual acting out … including note writing.” So when Graeber passed a note to a boy in her class one day — and locked eyes with him — she was immediately sent to the Yellow Zone.

Students in the Yellow Zone had to sit silently in a white plastic lawn chair at a desk in a hallway for hours — or days.

Graeber and others said they were often given the maximum sentence: 72 hours of isolation and silence.

“These kids were being used as damn lab rats,” he said. “Poor kids are falling asleep in class, getting in trouble, and they’re always so thirsty — mouths super dry. … All they did was pass pills. But if a kid was sick or throwing up from the medication, they wouldn’t do much else but give you a Sprite and watch you.”

Then she was placed in a Yellow Zone variation called “Individual Focus” — which included sleeping in a brightly lit hallway — for more than two weeks. As an additional punishment, Graeber said she was not allowed to speak for 58 days.

Parents sometimes forget that “troubled teen is not a diagnosis,” said Szalavitz, the journalist who wrote the book on the industry. “If your kid has behavior issues, generally the first thing to do is get a psychiatric evaluation — somebody who is independent, not an educational consultant, no affiliation with any industry — and figure out what the heck is going on.”

Moreover, the rote compliance these places demand is not a useful coping strategy for life outside an institution, Burnim said. “You can teach them to be compliant in an institution because they get the reward of … getting out,” he explained, “but once they get out, it’s the same old problem, and they haven’t learned how to better manage their condition.”

But the gold standard for treating most disturbed children is giving parents the support and services they need to keep their kids with them. There is a “virtual national consensus among people in the mental health field that children with mental health difficulties and behavioral problems should be treated at home,” Burnim said.

Source: The Troubled-Teen Industry Has Been A Disaster For Decades. And It’s Still Not Fixed

However, I’ll also deeply regret that people in the program persuaded me to give “tough love” a try.

The tougher I became, the worse Wyatt and I fought and more sneaky he became. He lied, stole, bullied and badgered me. And I was consistently guided to hold my boundaries, to kick him out of my home before I let him call the shots.

There’s a reward/shame element to the 12­-step philosophy. You get a chip when you do well. You start from square one when you “relapse.” After his anti­-extended care outburst, Wyatt was promptly bumped down a level and his phone privileges were taken away. In retrospect, this seems like nothing but pure punishment.

I have two very close friends whose sons died of heroin overdoses. When we talk, it’s often about our pain and anger over the rehab racket. And it was one of them who first told me about a different type of approach, known as “harm reduction,” that opened a bright new door for Wyatt and me.

“Harm Reduction means taking control—of your use of drugs or alcohol, of the damage that use does to you, of the harm your use causes others, and how you live your life,” write Patt Denning, Jeannie Little and Adina Glickman in Over the Influence.

According to this philosophy, abstinence is not required to be the goal—moderation, a reduction, or simply safer use are also seen as valuable positive outcomes. Importantly, individuals are encouraged to set their own goals, rather than having them imposed by others.

Substance use disorders don’t have to be viewed as lifelong diseases. And within this framework, many therapies, such as Cognitive Behavior Therapy (CBT) or Dialectical Behavior Therapy, process groups and individual counseling can be utilized. It does not hold that someone experiencing drug-­related problems must hit “rock bottom”—quite the contrary.

After a couple of sessions with a harm reduction counselor, Wyatt agreed to go to a SMART Recovery rehab in California. SMART Recovery support groups are abstinence-­based, but they recognize that not everyone walks in the door with an abstinence goal, and everyone is welcome. They don’t require the use of terms such as “addict” or “alcoholic”—in fact, these are discouraged. The overarching philosophy is one of empowerment and the use of scientifically proven tools.

When Wyatt returned home he continued to see his therapist. One day he described his cravings to me, and how marijuana helped them. I was still in abstinence­-only mode, but then a light switched on: If he found that using cannabis could help his PTSD and keep him off other, potentially much more harmful stuff, so be it.

I was very reluctant at first. But I considered a dear friend of mine who has acute lymphoid leukemia, and who treats her pain and nausea with cannabis. I decided I had nothing to lose.

It works. For Wyatt, it alleviates the anxiety and panic he experiences and assuages most (if not all) of his cravings for dex.

Last week, Wyatt commented that it had been a full year that he had not been in a hospital, in jail, on probation or in a rehab—the first full year since 2009.

I am certain that had I continued on the “tough love” path, he’d be dead or in jail. I am also certain that in addition to the trauma of my parents’ deaths, there was considerable additional trauma as a result of the application of certain Al-Anon principles.

I no longer attend Al-Anon. I wish I could comfortably and honestly share in meetings about the benefits of marijuana, but I can’t. My friend whose son died has told me she’d have been more than willing to let her son smoke some marijuana to keep him alive. She feels she has learned too late about harm reduction.

I can no longer tolerate the sobs of a parent who has tossed their child on the street in the name of “tough love” and “hitting rock bottom.”

I now know that there’s a better way.

Source: How I Learned That “Tough Love” Was Failing My Son—And Found Something So Much Better | TheInfluence

Fully buying into the program requires desperation, in other words, and to “help” addicts get to that desperate point is to help them recover: “From this perspective,” writes Szalavitz, “the more punitively addicts are treated, the more likely they will be to recover; the lower they are made to fall, the more likely they will be to wake up and quit.”

Szalavitz explains that this is a totally pseudoscientific concept — the founders of A.A. embraced it as dogma but were not in a position to test it scientifically. And even they realized, on some level, that “hitting bottom” was it was a bunk idea, simply because some A.A. members would recover before thoroughly screwing up their lives. A.A. had to introduce the conceptual trick of “high bottoms” — some people hit “bottom” at a relatively high point, in other words — to account for this.

“Misinterpreted ideas taken from 12-step-based rehabs are integrated with the criminal justice system and are part of the belief system that quietly upholds current policies. They are deeply embedded … in nearly every public and private system that addresses addiction.” Specifically, 12-step programs “are now a required curriculum in at least 80% of American addiction treatment programs.” And since many people get referred to these addiction programs via court orders, countless vulnerable people are shuttled into programs that embrace a totally false, harmful view of what addiction is. In many cases, drug-court advocates argue against treatment and in favor of harsh punishment, simply because it fits into the 12-step, “bottoming out” framework — a bare prison cell certainly feels more like “hitting bottom” than a treatment program.

Forcing patients to hit bottom had results that were, in retrospect, predictable: It gave rise to “attack therapy” in programs like Synanon, launched in 1958, where “the idea was to demolish the ego, using intimate secrets people revealed to find their weak spots and try to obliterate the ‘character defects’ believed to be found in all people with addiction.”

But what is clear is that these ideas all fly in the face of what the literature shouts at us about treating addiction: that it’s best done by providing addicts with empathy, support, and healthy social networks — not by snatching these vital lifelines from them.

But throughout her book, Szalavitz argues, and argues compellingly, that when it comes to “hitting bottom” and so many of the other pseudoscientific approaches to fighting addiction, the actual goal — or part of it, at least — has always been to marginalize the addict, to set them apart and humiliate them. There’s a deep impulse to draw a clear, bold line between us, the healthy people, and them, the addicts. What clearer way to emphasize that divide than to cast them down into a rock-bottom pit, away from the rest ofus?

Source: The Tragic Myth of Addicts ‘Hitting Rock Bottom’ — Science of Us

I think that 12-step programs are fabulous self help. I think they can be absolutely wonderful as support groups. My issue with 12-step programs is that 80 percent of addiction treatment in this country consists primarily of indoctrinating people into 12-step programs, and no other medical care in the United States is like that. The data shows that cognitive behavioral therapy and motivational enhancement therapy are equally effective, and they have none of the issues around surrendering to a higher power, or prayer or confession.

I think that one of the problems with the primary 12-step approach that we’ve seen in addiction treatment is that because the 12 steps involve moral issues, it makes people think that addiction is a sin and not a disease. The only treatment in medicine that involves prayer, restitution and confession is for addiction. That fact makes people think that addiction is a sin, rather than a medical problem. I think that if we want to destigmatize addiction, we need to get the 12 steps out of professional treatment and put them where they belong — as self-help.

Source: ‘Unbroken Brain’ Explains Why ‘Tough’ Treatment Doesn’t Help Drug Addicts

Cannabis and Harm Reduction

Using data on all prescriptions filled by Medicare Part D enrollees from 2010 to 2013, we found that the use of prescription drugs for which marijuana could serve as a clinical alternative fell significantly, once a medical marijuana law was implemented. National overall reductions in Medicare program and enrollee spending when states implemented medical marijuana laws were estimated to be $165.2 million per year in 2013. The availability of medical marijuana has a significant effect on prescribing patterns and spending in Medicare Part D.

Source: Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D

The researchers found that in states with medical marijuana laws on the books, the number of prescriptions dropped for drugs to treat anxiety, depression, nausea, pain, psychosis, seizures, sleep disorders and spasticity. Those are all conditions for which marijuana is sometimes recommended.

If the trend bears out, it could have other public health ramifications. In states that legalized medical uses of marijuana, painkiller prescriptions dropped — on average, the study found, by about 1,800 daily doses filled each year per doctor. That tracks with other research on the subject.

Marijuana is unlike other drugs, such as opioids, overdoses of which can be fatal, said Deepak D’Souza, a professor of psychiatry at Yale School of Medicine, who has researched marijuana. “That doesn’t happen with marijuana,” he added.

Source: After Medical Marijuana Legalized, Medicare Prescriptions Drop For Many Drugs : Shots – Health News : NPR

A 2002 review of seven separate studies involving 7,934 drivers reported, “Crash culpability studies have failed to demonstrate that drivers with cannabinoids in the blood are significantly more likely than drug-free drivers to be culpable in road crashes.” This result is likely because subject under the influence of marijuana are aware of their impairment and compensate for it accordingly, such as by slowing down and by focusing their attention when they know a response will be required. This reaction is just the opposite of that exhibited by drivers under the influence of alcohol, who tend to drive in a more risky manner proportional to their intoxication.

Today, a large body of research exists exploring the impact of marijuana on psychomotor skills and actual driving performance. This research consists of driving simulator studies, on-road performance studies, crash culpability studies, and summary reviews of the existing evidence. To date, the result of this research is fairly consistent: Marijuana has a measurable yet relatively mild effect on psychomotor skills, yet it does not appear to play a significant role in vehicle crashes, particularly when compared to alcohol. Below is a summary of some of the existing data.

The results to date of crash culpability studies have failed to demonstrate that drivers with cannabinoids in the blood are significantly more likely than drug-free drivers to be culpable in road crashes.

“Cannabis leads to a more cautious style of driving, but it has a negative impact on decision time and trajectory. However, this in itself does not mean that drivers under the influence of cannabis represent a traffic safety risk. … Cannabis alone, particularly in low doses, has little effect on the skills involved in automobile driving.”

1. There is no evidence that consumption of cannabis alone increases the risk of culpability for traffic crash fatalities or injuries for which hospitalization occurs, and may reduce those risks.

In contrast to the compensatory behavior exhibited by subjects under marijuana treatment, subjects who have received alcohol tend to drive in a more risky manner. Both substances impair performance; however, the more cautious behavior of subjects who have received marijuana decreases the impact of the drug on performance, whereas the opposite holds true for alcohol.”

Evidence from the present and previous studies strongly suggests that alcohol encourages risky driving whereas THC encourages greater caution, at least in experiments. Another way THC seems to differ qualitatively from many other drugs is that the formers users seem better able to compensate for its adverse effects while driving under the influence.”

Source: Marijuana and Driving: A Review of the Scientific Evidence – NORML.org – Working to Reform Marijuana Laws

The reduced rate of opioid-related fatalities translated into about 1,700 fewer deaths in 2010 alone. The researchers suggest several possible explanations for this effect. “Patients with chronic noncancer pain who would have otherwise initiated opioid analgesics may choose medical cannabis instead,” Bachhuber et al. write. “In addition, patients already receiving opioid analgesics who start medical cannabis treatment may experience improved analgesia and decrease their opioid dose, thus potentially decreasing their dose-dependent risk of overdose. Finally, if medical cannabis laws lead to decreases in polypharmacy—particularly with benzodiazepines—in people taking opioid analgesics, overdose risk would be decreased.”

That last possibility could be more significant than you might think, since opioid-related deaths typically involve mixtures with other drugs, with benzodiazepines playing a substantial and increasing role. Bradford and Bradford found that medical marijuana laws were associated with decreases in prescriptions for drugs used to treat anxiety and sleep disorders. Benzodiazepines are commonly used for both purposes.

“We find fairly strong evidence…that states providing legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medications,” Powell et al. write. “We provide complementary evidence that dispensary provisions also reduced deaths due to opioid overdoses….Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.” Like Bachhuber et al., they found that the longer medical marijuana was legally available, the bigger the apparent benefit.

Source: Medical Marijuana Replaces More Dangerous Drugs – Reason.com

Cannabis is the least harmful way for we humans to cope with the burdens of sentience, senescence, and mortality. Cannabis is popular in STEAM cultures, at least the ones I’ve inhabited. It is part of the process of living, creating, and coping. I think the neurodivergent have long used it to regulate and cope in a world that does not accommodate. If your neurodivergence is accompanied by tics, seizures, paresthesia, fasciculations, panic, anxiety, or self-harming stimming, as but a few examples, then cannabis is a tool and ally. There are as many human operating systems as there are humans. The endocannabinoid system is a useful interface to our operating systems for which we have a natural, easy-to-grow key. All humans and their mammalian kin share this interface and this plant. We plucky prometheans figured out how to decarboxylate with fire.

Because, the drug war. The drug war preys on and abuses the different and the powerless. It puts neurodivergent kids in pipelines to prisons and foster systems where the incentives are to drug minds into compliance so that bodies can be more conveniently warehoused and souls more conveniently iced. The great many of us using cannabis to medicate and regulate are under constant threat of violence, humiliation, and confinement  in inhumane jails and prisons. The drug war’s perverse notions of addiction, addicts, and coping limit our vocabulary, stifle our empathy, and harm us all. The drug war, zero tolerance, and compliance culture are enemies of neurodiversity. Cannabis is a friend and a lever for change.

Source: On cannabis and neurodiversity

“The Silk Road website was in many respects the most responsible such marketplace in history, and consciously and deliberately included recognized harm reduction measures, including access to physician counseling,” he wrote. “Transactions on the Silk Road website were significantly safer than traditional illegal drug purchases and included quality control and accountability features” that kept purchasers “substantially safer” than regular drug purchases.

Many reformers, myself included, have long been highlighting the forward-thinking benefits of Silk Road and the ways it began to slowly revolutionize drug sales around the world. For instance, it provided a platform that could allow indigenous growers and cultivators around the world to sell directly to the consumer, potentially reducing cartel participation and violence… None of the transactions on Silk Road, for instance, resulted in women drug buyers being sexually assaulted or forced to trade sex for drugs, as is common in street-level drug transactions. Nor did any Silk Road transactions result in anyone having a gun pulled on them at the moment of purchase.

In his declaration, Caudevilla testifies that the site “espoused a harm reduction ethos which was reflected in the individual buyer-seller transactions on the site and in the community created on the site’s forums.” That community “enabled some site participants to reduce, if not entirely eliminate, their drug use.”

Caudevilla participated on the Silk Road forums for seven months and states that he “never came across even a single report of a Silk Road-related drug overdose.” Ulbricht’s lawyers point to the lack of such a “report” as a telling fact, although one wonders which section a user who had overdosed was expected to post in.

Source: Ulbricht’s lawyer: Silk Road was “the most responsible” drug market in history | Ars Technica

Supervised Injection

The more we degrade and ostracize people who inject drugs, the harder it is for them either to quit using their painkiller or to use it in a less risky way. When marginalized drug users walk through the doors of a supervised injection facility, the medical staff often become the only people in their lives who believe in them.

SIF staff may administer naloxone to stop clients from dying, but it is the human connections they forge that may give their clients the will to live.

Source: Supervised Injection Facilities Save Money and Lives: My Research Shows They’d Work for San Francisco | TheInfluence

 

The problems presented by injection drug use are legion, but creative solutions exist. One is the provision of safe drug-use rooms. Cities as far-flung as Vancouver, British Columbia, and Paris and Berlin have opened safe, well-lit rooms where addicts can get clean needles and other equipment without fear of incarceration. In New York State, Ithaca and Manhattan are considering similar initiatives. Such facilities can also connect addicts to needed services like preventive testing, acute care and treatment for addiction.

Safe drug-use rooms are typically designed to help keep addicts out of the hospital, but they could work for addicts within hospitals. A safe place to inject for addicted patients in the hospital could reduce conflict with staff, protect patients and providers from dirty needles and other drug hazards, and enable patients to receive respectful, high-quality care when back in their hospital beds. Safe drug-use rooms could also offer treatment for addiction, a step often neglected in hospitals.

The creation of these rooms for hospitalized addicts won’t be easy. There will be legal liability concerns, and hospitals must safeguard against the risk of overdose or unseemly behavior. It will be worthwhile to tackle these issues if it enables the provision of compassionate care for at-risk patients whose treatment would otherwise be endangered by conflict with providers.

Source: Let Opioid Users Inject in Hospitals – The New York Times

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