Category: Mental Health

Marginalized Polya People

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Updated version of an article first published on Postmodern Woman.

What does polyamory look like when you’re poor or disabled? How do you maintain autonomy and independence when you require specific care or assistance? How do you have safe, kinky, enjoyable sex when you’re allergic to latex or have a condition that leaves your body racked in pain?

Other than being in the minority categories for my aromanticism, relationship anarchy, kinkiness, genderqueerness, pansexuality, noetisexuality, and being Black, there are other specific ways in which my polyamory does not fit into the norm. There are other considerations to make and reinterpretations of many actions and freedoms that many polya people take for granted.

The average polya person in the limelight (with the exception of Kevin Patterson’s Poly Role Models) is well-off, white or white-adjacent, and normally healthy. Solo polyamorists constantly talk about autonomy, lack of enmeshment, and independence and other polyamorists set up visits with ease. Yet there are huge and gaping holes in the polya and non-monogamous relationship conversation. Very few people know what life is like for those that fall through the cracks. There aren’t many stories of the poor, the marginalized, and the mentally or physically ill and how they navigate healthy, fulfilling multiple relationships. I’ve seen a lot of polya people say that they wouldn’t date someone with a mental disorder.

There are many people that I know who are polya and have less than perfect health. A friend of mine was recently diagnosed as autistic and has been experiencing close-mindedness and ignorance in the poly and kink communities. A blogger I follow has borderline personality disorder and writes deeply moving posts about his experiences in relationships from his unique perspective. I’ve been writing stories (and “living the life”) for nearly 20 years about the people you never hear about in the media, the situations that rarely get discussed elsewhere, and the ways that these unique people handle their circumstances.
Being poor or disabled can present their own obstacles for expressing one’s polyamorous leanings. There aren’t as many resources for people like me. But as the more visible polyamorous communities create new resources and expand the social narrative, so it is my hope that more people of color, people allergic to weird things, and those who aren’t the epitome of health can share and create resources to generate understanding, education, and community as well.
Nearly every relationship you have when you’re poor is like a long-distance relationship, or at least that’s been my experience. Unless you live in the same neighborhood regular travel and conferences and outings can become prohibitively expensive. Technology helps if you can afford it or have access to it.

You learn to treasure the moments you can be together all the more. You learn to be okay with being alone most of the time. You definitely learn to appreciate the little things. And you know with absolute certainty that you may not have all of your needs met. It takes a special kind of patience and maturity to deal with the cancelled dates, limits on time, and isolation that come so much more often when you’re poor and/or spoonie. I liken being poor to being in emergency mode more often than not.

Where the executive with a harried day has the opportunity and money to relax and unwind, the poor and disabled person has no access to the typical means with which to relieve their stress. When you don’t have the money or the means you have to get creative. When you’re not healthy you have to accept that there are times when you have to put down your superman cape and allow someone to help you and accept some entwinement, even if others label it enmeshment or dependency. Poor health and the higher possibility of an emergency can make the poor, Black, and unwell seem like high risk partners for other polya people.
Try to imagine the looks you’d get when you say you can’t use the condom your partner has brought because you’re allergic to latex. You either rush around in an effort to find the much less effective (and harder to find) non-latex condoms, call it off, or go through with it without a condom and hope that the STI test results are still accurate. I also have Premenstrual Dysphoric Disorder and endometriosis and polycystic ovarian syndrome (PCOS), which leave me subfertile — and less worried about accidental pregnancy — yet simultaneously leave me in pain more often than not.

There are times when, even if I want rougher sex, my partners have to be gentle. There’s nothing wrong with pain when you want it but the pain caused by those conditions is not the fun kind – and I’m not that kind of masochist. My PCOS and PMDD cause anxiety, which can lead to more stress, which can lead to a worsening of my conditions. These kinds of illnesses have no cure and anyone with a long-term illness knows that we have to find alternative and healthy ways to deal with them and lessen their impact on our lives. Unfortunately, the majority of people know nothing about it and when they can’t physically see what’s wrong with you it can breed resentment, disbelief, and dismissal.

It’s not all doom and gloom, though. You find out fairly quickly who is dependable and who is not, who is simply there for fun and who’d like to be around for a while, who is actively dedicated to anti-racism, who can healthily deal with stress and who cracks under the slightest pressure. You find support you never expected from the strangest places, you learn not to take anything for given or granted, and it makes effective communication all the more important.
Some people will see these things as obstacles or reasons not to be polya. They don’t exactly fit the “perfect polya” narrative (unless you realize that aros tend to have jealousy and compersion down pat!). But no matter who you are, life is usually only as difficult as you make it.

​Clarify Your Silence In the Name of Love by Michon Neal

Updated version. Previously appeared on Postmodern Woman.
Are you one of those people who hates awkward silences? Do you feel like you have to fill in the quiet with something, anything? Have you ever dated or talked with someone who went silent and assumed they were bored, angry, or shutting you out?

My longest term partner felt like that a lot. He still isn’t very comfortable with silence. And he couldn’t stand it whenever I would go quiet, or when I wouldn’t respond, or when I’d simply sit on my own without making conversation.
There has been a lot of talk going around about how silence is a form of violence. And this makes a lot of sense. After all, we all grow up with the messages that to be shunned (usually depicted by people literally turning their back on a character) is awful and that the silent treatment is a go-to move (especially for women). And we’ve all had that person drop out of our lives without even a parting word.

Silence has become the enemy.

But this is missing the ‘words’ for the trees.

    There are two types of relational silence — one that serves the connection, one that damages it. In the first, silence comes with the qualifier “I need some quiet time to reflect”, which is healthy and respectful to the connection. In the second, silence comes with no qualifier and others are left to wonder what is actually happening. In this case, silence is actually violence — a passive aggressive attempt to cause suffering, or, at the least, a negligent self-absorption that makes things worse. Given that so many of us grew up with the silent treatment, it is essential that we let others know what is happening when we go quiet. It is respectful and it keeps the love alive. Even something like “Time out!” can be enough to keep silence from turning into violence. (~an excerpt from ‘Love it Forward’)

For those of us who are introverted, who value our independence and individuality, who are autistic, who are empaths, who have been abused, who are creative (especially writers), who meditate or think a lot, or who are simply naturally quiet it is our default state.

For us, silence means many things:

  • It may mean we’ve been hurt.
  • It may mean we’ve been ignored.
  • It may mean we recharge with silence.
  • It may be that we’re just one of those who revel in it.

When people constantly talk over you, when you’ve been belittled or abused, when you think before you speak, when you recharge by focusing inward, when you need to focus it is by being silent if you are a person who is quiet.

Yet for those who don’t understand this sort of silence things can go terribly wrong. People have their feelings hurt. They don’t understand what went wrong. Like the quote above says: there are two kinds of silence. How are you to tell the difference? How can these types of people come to a healthy understanding?

Well, each one has a job to do.

The onus lies on the quiet person to speak up about their need for silence. Tell your partners what duration works best for you. Tell them if they’ve triggered you. If you’ve shut down then tell them why at the soonest possible moment or warn them that it’s coming. Tell them you need time to think about your reply. Tell them you enjoy having them near because being in the same space is a way to share yourself.

For the not-quiet person here are things to try: listen (quietly) while they speak. If you’re the type to interrupt or if you’re thinking about what to say next then work on that. You need to give them the space to open up in their own time. Instead of assuming they’ve shut down or shut you out, ask if they’re thinking or need time. If you find it hard to sit without talking then play some music.
Because for the empath, autistic, or the introvert it’s easy to be overwhelmed. Think about it as a smell. At first the scent is light and pleasant. But as the day wears on, the scent grows stronger and stronger, until you can barely concentrate on anything else. Even if you love the smell (say it’s your favorite perfume) you definitely feel uncomfortable when it’s caked on too much.

So the next time you find yourself panicking when your partner takes a breath that lasts three seconds (even if it seems like an eternity) or if you panic because only three seconds have passed before you’re being asked another question (they’re not trying to bombard you) please keep in mind that everyone is different. Remember that you must speak up so that they know your experience. Remember that you must listen so that you don’t miss anything. Remember that there are as many kinds of silence as there are people.

It is not something to fear. It is something to embrace. Because even if the silence is intentionally meant to hurt you, I can guarantee it still has nothing to do with you. And either way, you have to learn to deal with it. Let it go. Let it be.

Mental Illness and Dating for Polyamorous Folk Part 3

Jess Mahler

So far we’ve talked about how mental illness can interfere with dating, dating as a numbers game, and ways you can shift those numbers in your favor. Today we’re finally going to look at tips and tricks for keeping mental illness from fucking with you too much while you are meeting people/dating.

Pick Your Venue

Going out in public is a problem for many people with mental illness. Social anxiety for obvious reasons, but also depression, PTSD, schizophrenia and other mental illness can make it hard to get out. Going places comfortable and safe places will make meeting people, and especially meeting someone who would be interested in dating, a lot easier.

What this means will be very personal. For some people, it will mean the library and bookstores (join a local book club, attend author signings, etc). For others, it will be that one restaurant you’ve been going to for years and feel safe at. It might be a game store, a club or your friend’s house.

Alternatively, invite people to come to you. If going out is too spoony, start having get-togethers at your place. Volunteer to host a meetup, invite your friends over for game night, plan a summer bar-b-que. Whatever suits you. The important part: invite people to bring other people. For instance, if you invite friends and family to a bar-b-que, tell them to bring their friends and family. If you arrange a game night for your friends, invite their friends to join the game. Or you can call the local gaming store and tell them you’re doing a game night, will they add you to their list of local gaming groups?

Hosting a thing at your home can take a lot of spoons, so it isn’t for everyone. But it does give an alternative. If you can’t go to people, people can come to you.

And of course, we can’t forget the miracle which is the internet. If you are comfortable with long distance dating, dating online becomes pretty easy. Same rules as in-person dating: avoid the “usual” dating sites, find communities you feel comfortable in, get to know people, ask someone out.

Looking to date someone local restricts your options. But you can still find (for instance) a gamers’ Facebook group in your city, a coders’ subreddit in your state or an environmentalist forum in your county.

Get Your Support in Place

Mental illness is hard to deal with alone. This is true whether you are wading through flashbacks or trying to meet people. We tend to approach dating as something we need to do alone. But there are alternatives.

When you are going places where you hope to meet people, a friend can come with you both as emotional support and to help if your illness flares up suddenly. They can:

1) help you ease into the group
2) find a quiet spot if you need some time away from everyone but aren’t ready to leave
3) watch for signs that you are getting overwhelmed so you can slip out before you reach a breaking point

Double dates are a thing! Sure, it isn’t the “norm” for a first date to be a double date. But why be trapped by the “norm?” When you connect with a person who wants to date you, you can ask how they’d feel about a double date. (They are more likely to agree if they’ve met know the friend(s) who’d be part of the double date—another good reason to have a friend with you when you go out to meet people.)

Don’t be afraid to use speed dial. Telephones are beautiful things. When I’m having a panic attack, 90% of the time the first thing I do is call my mother is Israel. If you alone at any point in your journey have a friend or family member on speed dial. Just knowing you can excuse yourself for five minutes and call for support can be a big help.

Remember to be upfront about being polyamorous and to tell your date what they need to know about your mental illness.

Most important: try to relax and have fun.

This post is part of the Polyamory and Mental Illness blog series.

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Mental Illness and Dating for Polyamorous Folk, Part II

Jess Mahler

Last week we talked about the first rule of dating: dating is a numbers game.

The problems for people with mental illness (and many other people as well) are:

1) Mental illness can lower the number of people who are attracted to you

2) Mental illness can make it hard to meet people, making it harder to find people who are attracted to you (and who you are attracted to).

Stereotypical dating involves going out to where a lot of people looking for a date gather—bars, clubs, single’s MeetUp groups, dating sites, etc—and trying to make yourself attractive to people so they will go on a date with you.

For people with mental illness (and many other people) the problem is this makes the numbers work against you. A random group of people looking for a date means:

1) You will have little in common with most of them, meaning your chances of being attractive to them are low

2) The social situation will be designed around a “typical” person looking for a date: young, single, mainstream, etc. Chances are there will be nothing you can do to reduce the impact of your mental illness on your ability to attend/take part in these activities/events.

So what can you do?

Play by the Numbers

In order to date effectively, you need to do two things:

1) Increase the number of people you meet you might be attracted to you.

2) Find places and ways to meet people that work around or with your mental illness, rather than conflict with it.

Moving from 1 in 1000 to 1 in 100

Let’s say, on average, 1 in 1000 people will find you attractive. You can either run around meeting hundreds or thousands of people hoping to find the one who wants to date you (and who you want to date! Don’t forget that part!) or you can change the numbers.

So let’s look at how you do that.

Increase Your Attractiveness

Yes, a person who loves you should love you for who you are. Newsflash: someone you just met doesn’t love you. Yet. They need time to get to know you. In the meantime, you need to show them why you are worth the time and energy they spend getting to know you.

This means doing your best to take care of your appearance, developing hobbies and passions so you have something interesting to talk about, learning more about the ways people interact and your culture’s social customs.

Taking Care of Your Appearance

I want to focus on this one for a minute because it’s the most likely to get people up in arms against me and/or down on themselves.

Now, this is hugely important: taking care of your appearance does NOT mean trying to be conventionally attractive. It doesn’t mean trying to stay “in style” or spending hundreds of dollars on makeup to cover up your “deficiencies.”

My partner Michael describes my fashion sense as “granny style.” I have rosacea that makes me look like a red raccoon (especially in the summer). I wear hats everywhere, all the time. And some of my hats are…unusual. When’s the last time, outside of a historical docu-drama, you saw someone walking around in a snood?

But twice this month random people have complimented me on how I look. And not in a creepy way. In an “oh I love that outfit,” kind of way. I’ve been working on my wardrobe for over three years, slowly finding clothes I like at thrift stores and clothing drives, putting things I love but can’t afford on birthday wish lists for the folks who want to spend money on me. I’ve finally reached a point that as long as I keep up with the laundry, I can wear an outfit that I like and look good in every day of the week.

Taking care of your appearance is about finding ways to express who you are and what you love about yourself. And yeah, that’s one of the things that mental illness can make hard. It’s hard to love yourself when you are struggling with mental illness, and it’s hard to find the spoons to care about your appearance when you can barely drag yourself out of bed. At the same time, and speaking from experience, being able to look in the mirror and like what you see can be a big help in fighting mental illness. So if you have the spoons, showering, caring for your hair, slapping some moisturizer on your face, and putting on clothes that make you look and feel awesome can be a major win.

And if you can’t?

That’s okay! Yeah, these days I can generally reach into the draw and find clothes that look good on me. Before I built my wardrobe I lived in 10-year-old t-shirts, “nice” shirts with holes in them, and whatever pants I could find that fit. You do what you have too. There are still days I go out without brushing my hair. (Pro-tip: the right hat can hide a LOT of bed head.) This isn’t about putting more pressure on yourself or shaming you. This is about giving you ideas on things you can do to change your numbers in the dating game. If taking care of your appearance isn’t an option right now, focus on other things.

Now, it is completely true that with this advice I’m going against a lot of other good advice. No, we shouldn’t judge a book by its cover. Yes, we should take all people as they are. There are people doing good work to push for acceptance of others regardless of how they look or talk. But they are fighting an uphill battle against human nature. We form a general impression of people within seconds of meeting them. We have a solid impression within the first few sentences of a conversation. If you don’t make that impression a good one, either with your appearance, your conversation, or your general attitude and presentation, you will be fighting an uphill battle against an initial bad impression.

By working on growing and changing, you can increase the total number of people who will find you attractive.

Selective Filtering

Okay, that’s how you can change your numbers by making changes in yourself. Since I consider growth a good thing, I don’t have any problem changing myself, as long as the changes are ones I like. (And yes, I do like walking out the door thinking “Damn I look good today!” just as much as I like how much I’ve learned about social justice and intersectionality the last few years.) If you don’t want to change yourself this is another approach that can help.

Or you can combine two approaches and get even better numbers.

So, selective filtering.

When you are looking for people to date, try to filter out as many people as possible that you will not be attracted to and who will not be attracted to you. Go where people who will be attracted to are likely to gather.

For instance, if you, like me, are a geek and a nerd, but not a big sports fan, going to a tailgate party will not be a good way to meet people. Sure, if football is big in your town dozens of potential dates might turn up. But how much good does that do you when they are huge football fans wanting to talk football and you don’t know the end zone from the goal posts? (I actually do like sports, and can talk the talk, but not something I’ll spend hours of my life on. On the other hand, hitting the local gaming store and joining the gaming group may only introduce you to a half-dozen people, but they will be people you have something in common with. And people you have something in common with are more likely to find you attractive.

You, as a person, have an automatic membership in a bunch of communities. If you are reading this blog you are probably polyamorous, so you can claim membership in the poly community. Fandom communities are (theoretically) always open to fans. The crafting community is always open to crafters. People who are mentally ill have our own community, mostly made up of people who are mentally ill and a few people who have someone they love who are mentally ill and are trying to learn and be supportive.

If you haven’t claimed membership in your communities, doing so is a great way to meet people who are more likely to be attracted to you. If you can find community overlaps (for instance many poly people are geeks, and many geeks are neuroatypical) even better!

This works online too. Michael and C met because there were both part of the Twitch gaming community.

The important thing about joining these communities is you can’t jump in and immediately start looking for a date. While they are better places to find a date than typical dating scenes, not everyone in them will be looking for a date. You need to take the time to get to know people, find out who is interested in new relationships, who do you enjoy talking with, maybe do a little flirting, and asking only the people who are A) open to having a new relationship, B) you are attracted to, C) you think might be attracted to you. If they say no, DON’T make a big deal out of it. Go back to enjoying the community, participating in discussions and activities, etc. Sooner or later you will find someone else to ask.

Okay, this has turned into a longer post than I planned on, so we’ll stop here. Next week will finally look at ways mental illness directly interferes with dating and what you can do about it. For now, remember: dating is a numbers game, and you can shift the numbers in your favor.

This post is part of the Polyamory and Mental Illness blog series.

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Mental Illness and Dating for Polyamorous Folk

Jess Mahler

Hadn’t meant this to be a two parter, but overdid it last week and paying for it. Other posts this week may be very short or delayed depending on long my recovery takes.

I like spending time on Quora. It’s an interesting site with a lot of good information, and I’ve wrangled myself a spot on the Polyamory Top 10 Writers list.

One question that comes up a lot on question in Dating and Relationship topics on Quora is how to find someone to date. People with mental illness and/or who are neuroatypical seem to struggle with this question a lot. My regular readers know this is a topic I usually wouldn’t touch with a thirty-nine and a half foot pole. But it is relevant to polyamory and mental illness, and I’m here to try to help folks. So here we go.

Before we get into details specific to mental illness and polyamory, I want to review the first rule of dating.

Dating is a numbers game.

It really is that simple. There is some percentage of people in this world who will find you attractive when they meet you. There is another percentage of people in this world who will find you attractive when they get to know you. The way you find one of these people is you meet a whole bunch of people, get to know the ones who interest you, and sooner or later one of the people you meet will be one of those people who find you attractive.

The rest of dating is just ways to shift the odds in your favor.

Okay, now the challenge for poly folks with mental illness is 1) being poly lowers your numbers of possible dates, 2) mental illness often lowers your numbers of possible dates, and 3) many mental illnesses make it hard for you to get out and meet people.

The ultimate secret to dating success is just go out and meet a lot of people. Unfortunately, that “secret” is well nigh useless when your depression keeps you frozen to your couch or anxiety makes you afraid to answer the door, never mind go out in public.

Next week we’ll look at how you manage to find poly partners anyway.

 

This post is part of the Polyamory and Mental Illness blog series.

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Polyam Advice for the Mentally Ill: Use Direct Communication

Jess Mahler

Standard Poly Advice: Use Direct Communication

“Direct communication” is the term used by Franklin Veaux and Eve Rickert in their book More Than Two. But the same idea, unnamed, is extremely common in the poly community. “Did you state your needs?” “You need to clearly state your boundaries.” “You can’t expect them to guess you are upset, you need to tell them.”

Let me be clear: direct communication is powerful. It is an awesome tool that can and should be used as often as possible. Because it is the only method of communication that you can be reasonably sure people will hear what you mean to say. Note, NOT 100% sure, because I can say “I need more intimacy” but because you and I and have different ideas of what intimacy means we can still have a misunderstanding. But direct communication is a lot LESS likely to have these kinds of problems than indirect and passive communication or reading tone and body language.

The problem is, not everyone is able to use direct communication. And even those of us who can use direct communication may only be able to use it part of the time. For instance:

1) A victim of emotional abuse and/or gaslighting may not be able to recognize their needs or know how to express a boundary.

2) Someone in the middle of an anxiety or panic attack may not be able to think clearly enough to tell people what they need, or even what is going on.

3) There’s over 6000 languages in this world. I can muddle through the basics with a Spanish speaker, but we’re going to need to talk around a lot of things.

4) Many people who were raised as boys have been conditioned to not recognize their own emotions and need for emotional connection.

There’s lots more reasons direct communication may not always work (or even be an option). And mental illness, which can cause situations from disorganized speech to not being able to speak at all, makes up a lot of those reasons.

Poly Advice for the Mentally Ill: Be Patient, Learn Eachother’s Cues, Use Inquiring Communication

Patience is the most important part here because misunderstandings, missed signals and general miscommunication are going to happen. Needs will not get met, boundaries will be broken. Not because anyone is doing so intentionally, but because when you can’t say shit clearly, these things happen.

So, be patient. Try not to throw around blame when an inability to communicate leads to problems. Don’t be afraid to take time working through things.

Learn about eachother’s cues. Body language is a thing and an important thing. Body language isn’t universal, though there are some things that are extreme similar from person to person. If you understand your own body language tell your partner “When I do this, it means I’m feeling this way.” If you notice something about your partner’s body language, ask them. “What does it mean when you start picking at your fingers?”

Finally, sometimes instead of direct communication you need inquiring communication.

Inquiring communication is about asking questions and inviting answers. It can be very helpful when you can’t find words for what you are feeling, are having a mental health crisis, or otherwise can’t put things into words.

You can let your partner know you need to tell them something, “I’m upset right now and I don’t know why. Help me figure it out?”

And they can ask questions to help identify what is going on.

“When di dyou notice you were upset?”

“Is it related to John coming over today?”

“Do you need something you aren’t getting?”

Alternatively, your partner may notice something in your body language or behavior and ask, “Hey, you’re really tense, are you okay?”

If your mental health is interfering with your ability to speak entirely, your partner can even use yes/no questions to help you tell them what is going on and what you need.

“Are you having a panic attack?”

You shake your head.

“Okay, maybe it’s sensory overload. Do you think leaving will help?”

You nod, and your partner helps extract you from where you are and get to a safe place.

For more on the problems with direct communication and why asking questions can be important, check out Ms Syren’s Communication Doesn’t Happen in a Vacuum

This post is part of the Polyamory and Mental Illness blog series.

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Polyamory and Psychotic Disorders, Part 3

Jess Mahler4 Comments

Continuing our review of the psychotic disorders and the way symptoms of psychotic disorders impact polyamory.

Disorganized thinking (speech): communication is the key to any healthy relationship. And when someone can’t speak their thoughts it’s hard to communicate about relationship needs, problems, or just get clear consent.

Some people find ways around this. For instance, the part of the brain that controls speech is very different from the part of the brain that controls writing. So some people whose thoughts are disorganized when they speak can be very clear when they write. (I don’t know how sign language would fit in here, would be very interested in anyone who has information on it.)

Another option is to be patient. Spend enough time with someone that you learn to understand their disorganized speech. For this, polyamory can actually be kind of helpful. Prior or current poly partners can help new poly partners learn to understand.

Grossly disorganized or abnormal motor behavior won’t have much direct impact on relationships. You will need to get used to judgmental shitwads staring and making comments when you are out with your partner. Also, I can see this symptom sometimes making sex more complicated until you are both learn to make your bodies work together. Someone with abnormal motor behavior may not be able to control a vehicle (car, bicycle or other). If that is the case, they may be reliant on their partners to pick them up for dates and such.

Negative symptoms (lack of emotional expression, lack of speech, inability to motivate or direct oneself in completing tasks, not being able to feel pleasure from normally pleasurable experiences, and lack of motivation to socialize/interact with other people). Some of this is the executive dysfunction we discussed last week. A lot of it isn’t. And this stuff can really mess with a relationship. When you can’t express your emotions, or speak, or motivate yourself to call your partner, it doesn’t do good things for a relationship. Not being about to feel pleasure can make it had to even want a relationship.

This post is part of the Polyamory and Mental Illness blog series.

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The Impact of Executive Dysfunction on Relationships

Jess Mahler4 Comments

(The last part of Schizophrenia and PTSD is giving me trouble, so you’re getting next Sunday’s post a week early. Enjoy.)

Executive dysfunction is associated with major depressive disorder, bipolar disorder, generalized anxiety disorder, ADHD, ADD, schizophrenia, autism, and Parkinson’s disease. It is probably found in numerous other contexts as well, but that’s a long enough list to be going on with.

But before we get into executive dysfunction, we need to talk about executive function.

Definitions for executive function sound either vague or jargony. WebMD says “Executive function is a set of mental skills that help you get things done.” Well, that doesn’t tell us very much. Wikipedia goes for full on jargon “Executive functions (also known as cognitive control and supervisory attentional system) are a set of cognitive processes — including attentional control, inhibitory control, working memory, and cognitive flexibility, as well as reasoning, problem solving, and planning — that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals.”

Breaking down the jargon, executive functions are “a set of cognitive processes” aka “things the brain does.” These processes “are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals” aka “being able to decide what to do and follow through on that decision so you can meet your goals.” And we are right back at WebMD’s definition: shit the brain does so we can get things done. Okay… it sounds vague, but being able to get shit done is pretty important. Still without knowing what these “processes” or “mental skills” are, these definitions don’t help much. So let’s take a look at the rest of the jargon.

What Are the Executive Functions?

Attentional control

Aka, being able to control your attention span. This includes both being able to pay attention to things when you need to and being able to break your attention away from things when appropriate.

Inhibitory control

You ever drop a 5 pound can of beans on your toes and bite your lip to keep from yelling “Oh my fucking god that hurts!” in the middle of the grocery store? That’s inhibitory control. Inhibitory control stops us from doing the things that we know we shouldn’t do.

Working memory

just what it says. Being able to remember things.

Cognitive flexibility

Aka being able to mentally cope with and adapt to change. One test for cognitive flexibility in children is giving them a stack of cards and telling them to sort by color. Half way through the stack tell them to switch to sorting by number. Cognitive flexibility lets us deal with changing plans, realign our actions to meet new goals, or just shift from casual shoot-the-shit mode to more formal interactions when your boss walks into the break room.

Reasoning

What is says, the ability to think, reason and understand shit. It is kind of scary to go from being able to think through and debate Focault to not being able to string two thoughts together well enough to figure out that 2+2=4, but that’s what many people with executive dysfunction live with. At least, those of us who are well to have times when are executive functions work and times when they don’t.

Problem solving.

Again, what it says. Being able to look at a problem and figure out how to solving it.

Planning

Yup, what it says. Being able to plan the steps to do something, reach a goal, or put together a damn schedule.

 

Read over that list and think about how hard daily life would be if you couldn’t do those things.

Several times Michael has needed to know how to do something and I’ve researched it for him. He couldn’t figure out how to get on google, search for what he wanted, and apply what he found to the problem. The more out of his comfort zone the “something” is, the more likely he is to need help. This is executive DYSfunction. When the executive functions, don’t.

I’ve dealt with my share of executive dysfunction as well. In my case it’s worst with decision making. On a bad day ask me what I want for dinner, and I’ll freak out. I can’t hold all the options in my head so I can compare them and decide “Pizza sounds good.” This became a major problem during my last child birth. I hit a point where I couldn’t think clearly enough to make decisions. I told the nurses “I can’t make decisions right now, any decisions that need to be made, go through Michael. He knows what is best for me.”

Well, when the baby was crowning they ignored me (which was somewhat understandable as I was completely out of my head—but damn they had better options than manhandling me), ignored Michael, and ignored my birth plan. And I couldn’t process what was going on well enough to realize that they were trying to help me, never mind communicate why they were making things worse. I’m still dealing with the trauma from that.

Executive Dysfunction and Polyamory

Executive dysfunction impacts relationships in a lot of ways. For instance, on a night when I can’t make decisions—I can’t decide to have sex. (Pro-tip: if someone is not capable of deciding to have sex, you don’t have sex.) Or maybe I’m horny and both my partners are there, and I can’t decide who I want sex with. (Pro-tip: if someone is not capable of deciding who they want sex with, you don’t have sex.) If I was thinking clearly, maybe we would have sex. But I wasn’t, so we didn’t.

Michael and C have been talking about him taking a trip down to see her in September for nearly 6 months. I (foolishly, because I know Michael better than this) assumed they’d handle the planning and tell me what they decided. C doesn’t know Michael well enough to help him through the planning process. He hasn’t traveled by plane, never mind traveled alone, since he got sick. This is very far out of his comfort zone. C kept asking him open ended questions without any information, like “how long to you want to visit?” She was approaching it from “once I know how long he wants to visit, I’ll be able to set up accomodations for him and find flights and such.” But he couldn’t process his options well enough to pick how long he wanted to stay. So nothing got planned. I ended up in a three way phone call with both of them helping Michael with his end of the planning and (hopefully) showing C what kind of help he needs for next time. Most importantly: break things down into small, easy steps and yes/no question.

Communication

Executive dysfunction can make it difficult to put words to your thoughts and feelings, can make it hard to follow a conversation, and if multiple conversations are happening at once (like at a restaurant, con, or munch), it can be very difficult to follow the conversation you are trying to take part in.

Meeting people’s needs

Difficulty with problem solving can make it hard to figure out how to meet people’s needs. Often needs don’t mesh perfectly or are in conflict. You need alone time to regain your mental balance but your partner needs attention and reassurance that they are loved. Or one partner needs help making dinner while another partner needs someone to listen to their concerns. Or even just addressing concerns. “I don’t feel like you care about me,” can be hard to address when your brain won’t process “ways to show I care.”

Dealing with conflicts

Multiple relationships often require navigating conflicts. Difficulty focusing, problem solving, and other aspects of executive dysfunction can all cause problems here.

Issues of consent and consideration

You ever meet someone who doesn’t seem to have a mental filter on their mouth? Whatever they think they say, and often end up putting their foot in their mouth as a result. Well, some people with executive dysfuction have a broken mental filter on their actions. They curse when it is inappropriate, they scratch themselves in public. And yes, they may touch you when you haven’t given permission. This is something Michael and I struggled with a lot, and sometimes still do struggle with. My PTSD means there are times when I can’t deal with being touched, much less having my boobs grabbed. And there are times when he will come up from behind, reach around, grab my boobs, and when I freak out he ends up curled in a ball, trembling, “i’mm sorry, I’m sorry, I’m sorry, I’m sorry.” He knows he shouldn’t have grabbed. He knows I have reason to be angry, but somewhere in his brain between “idea” and “action” the red flag that was supposed to say “No, don’t do that.” didn’t pop up.

Personal opinion, but I believe problems with inhibitory control are closely related to difficulty with cognitive flexibility. Michael doesn’t go around grabbing random women’s boobs. He knows that grabbing a random woman’s boobs is never appropriate. But we have been in a relationship for 7 years. He has often been allowed to grab, play with, tease, bite, and otherwise touch my boobs. This means when his brain needs to take a couple extra steps. Instead of “Want to touch,” “DON’T” his brain needs to think “Want to touch.” “touching might be okay.” “Assess situation” “public? Private? Sexy times? Not sexy times? Has she said she is having a bad day?” etc, etc. And somewhere in that process, his executive dysfunction kicks in and before his brain can work through all the steps to “It’s not clear if it’s okay to touch or not, I need to ask,” his hands are on me.

Possible solution: set the rule that he needs to ask before every time he touches me. That avoids the issue of needing to process different situations. Problem with this solution: If we are having sex, I don’t want to need to give approval to every single touch. I want to be able to say “yes, please play with my breasts,” and relax and enjoy myself. So I live with the random grabbiness at other times.
Maybe you’d make a different decision.

Okay, I’m already past 1500 words, and I’ve barely touched on all the ways executive dysfunction can impact a relationship. But at least this gives you a start on understanding what executive dysfunction is and how it can cause problems. Every situation with executive dysfunction is different, and executive dysfunction varies in how bad it is.

The one useful tip I can give you: come up with a “safe word” for when executive dysfunction is a problem. I tend to say “my brain is broken” and “that breaks my brain” for “my executive dysfunction is bad right now and I can’t to what you are asking me” and “this specific thing is usually a problem because of executive dysfunction, even on a good day I might not be able to do it,” respectively. This way, people who care about me know that either this thing needs to be dealt with later or I will need help with whatever they are asking of me.

 

Disclaimer

This post is part of the Polyamory and Mental Illness blog series.

Help Support Polyamory on Purpose.

Polyamory and Psychotic Disorders, Part 2

Jess Mahler

We’re going to do something a bit different this time. We’re going to look at the main symptoms of psychotic disorders and see how they each impact polyamorous relationships. This is pretty involved, so Polyamory and Psychotic Disorders is going to end up as a 3 parter. Today we’ll be focusing on delusions and hallucinations.

Delusions

Delusions are fixed beliefs that cannot be changed by evidence that contradicts them. That’s the official definition, I’m going to add the qualifier I learned from my abnormal psych teacher. In order to qualify as a delusion, a belief must be abnormal within your culture. Sorry, atheists, your theist friends don’t qualify as delusional because they believe in an invisible sky man. Nor do people of the opposite political party qualify as delusional because they believe that obviously idiotic thing you can prove is wrong without even trying. You may be right—their belief may be categorically wrong. But if their culture supports their belief, it isn’t a delusion. The cultural matrix itself functions as “evidence” supporting the belief.

A stereotypical delusion is the belief that the someone, usually the government, is spying on the person. One real delusion I’ve run into—someone who believed that one day ninjas would sneak through his window and drag him back to live with his parents. These two together illustrate something I’ve noticed about delusions—they tend to have a basis in reality. While it is extremely unlikely that the FBI is monitoring your partner to keep them from revealing the secrets of the mole people, the FBI does spy on people. The person who feared ninjas coming through the window had run away from an abusive home as a teenager and been forcibly returned to it. The delusion is false, but built on something real.

Most delusions won’t directly impact your relationship. Having a partner who lives in fear of ninja’s coming through the window (or fearing ninjas yourself) isn’t going to have much impact on dates, meeting people, or communication. It may make your partner tired and grumpy in the morning from sitting up looking for ninjas. Other delusions, like a delusional belief that your poly partner is plotting against you, will have a large impact on a relationship. Someone with this delusion will have a hard time letting their partner out of their sight and will want to monitor everything they are doing. Not a recipe for a healthy monogamous relationship, never mind polyamory. (Side note: NEVER plan a surprise party for someone who believes people are plotting against them. It will not end well.)

Delusions are easier to deal with when they are recognized. An old shrink told me that all mental problems are easier to deal with when you know they are there. Anyone else remember the old G.I. Joe cartoon that always ended with an “educational” skit and Sargeant Slaughter saying “And knowing is half the battle!” ? Think about jealousy. A person who knows their jealousy is irrational will try to deal with the feeling without making demands of their partners. They may or may not know what will help, but they know they need to work on their own feelings and it is not their partner’s fault. Someone who is irrationally jealous but doesn’t realize they are irrational will blame their partner and try to fix the relationship by demanding their partner make changes.

Someone who believes their partner is plotting against them but knows they are delusional will need reassurance. They may ask invasive questions about your schedule and conversations with other people. But they know the problem is in their head. They will not be interrogating you to prove that you are after them, but will be seeking reassurance to quiet their delusion.

Someone who believes their partner is plotting against them and doesn’t realize it is a delusion… honestly, I don’t think you can HAVE a healthy relationship in that circumstance, no matter how willing you are to be supportive and try to work with them.

Hallucinations

A hallucination is seeing, hearing, or otherwise sensing something that isn’t there. From people I have spoken with who have delusions, they can be obviously false or impossible to distinguish from reality. Delusions can range from seeing Barney dancing on the lawn in a Richard Nixon mask to hearing your poly partner call your name to having the entire world turn into goo.

Someone who suffers from hallucinations and knows they have hallucinations will put a lot of their mental energy into telling what is real and what isn’t. They may be a bit fanatic about always being right—if they are wrong about where they left their coat they may also be wrong about what is and isn’t a hallucination. If they are wrong about things, like thinking they left their coat on the chair when they actually fell asleep wearing it, this can feed into delusions in scary ways. If they left the coat on the chair, and they woke up wearing, someone must have put the coat on them, right?

Hallucinations can have some interesting impacts on a relationship. For instance, if someone is constantly hearing a voice whispering in their ear, it can be hard to get their attention. They will have trouble following a discussion when Barney pops up and begins dancing in the middle of the room. Waving to get someone’s attention doesn’t work very well when their view of you is blocked by a hallucination of someone else. These all have huge implications for communication.

When hallucinations mimic reality that adds another layer. If you see your partner come home from a date and go straight to bed completely ignore you, you are likely to be hurt and angry. But what if your partner is still on the date? Their coming home was a hallucination. A half hour later they walk in and you are an emotional mess about how they ignored you—when it wasn’t even them! The hurt doesn’t magically disappear, you saw them ignore you, you lived through it. To your partner, you are upset over something that never happened.

As with delusions, someone who knows they have hallucinations and works to try to recognize them will do better in a relationship than someone who believes all their hallucinations are real.

Disclaimer

This post is part of the Polyamory and Mental Illness blog series.

Help Support Polyamory on Purpose.

Polyamory, Schizophrenia, and other psychotic disorders (Part 1)

Jess Mahler2 Comments

This post and others discussing specific mental disorders will reference the Diagnostic and Statistical Manuel of Psychiatry and Psychology, Edition Five (DSM-V). Apologies to my international readers, I’m just not familiar enough with the ICD to use it as a reference.

Please note: everyone’s experience of mental illness is different. This is general information meant to give you an idea of what to expect. Nothing in this blog is intended to diagnose or treat. Please see a psych professional if you or someone you love may be suffering from a mental illness.

The Psychotic Disorders

  1. Delusional disorder
  2. Brief psychotic disorder
  3. Schizophreniform disorder
  4. Schizophrenia
  5. Schizoaffective disorder
  6. Other

Delusional disorder, as the name says, involves delusions specifically. Brief psychotic disorder is for what seems to be an episode of schizophrenia that lasts less than a month. Schizophreniform is if it lasts less than 6 months. Schizoaffective disorder is when the primary diagnosis is mood related (primarily depression or bipolar) but there are psychotic symptoms. And of course schizophrenia a long term disorder manifesting multiple symptoms of psychosis.

Symptoms of Schizophrenia and Psychotic disorders

There are five features that define psychotic disorders in DSM-5. Delusions are fixed beliefs that cannot be changed by evidence that contradicts them. Hallucinations are sensing something (usually seeing and/or hearing, but sometimes tactile or taste/smell) that isn’t there. Disorganized thinking (speech) means not being able to follow a conversational topic, lack of coherence in speech, or loose associations. Grossly disorganized or abnormal motor behavior (including catatonia) is when the body doesn’t move right and/or doesn’t move at all, when there is no physical illness to explain the problem. Finally what are called negative symptoms–lack of emotional expression, lack of speech, inability to motivate or direct oneself in completing tasks, not being able to feel pleasure from normally pleasurable experiences, and lack of motivation to socialize/interact with other people.

Interestingly, the way symptoms manifest can change depending on the culture a person is living in. In the US today, hallucinations from psychotic disorders are often terrifying experiences. Voices telling you to kill someone else or kill yourself, threats, personal attacks, and other really nasty things are common. However, 100 years ago most hallucinations where benign. The voice of your dead relative, or a saint, or an angel were common. And in other parts of the world, hallucinations often continue to be benign, usually harmless but sometimes actually supportive.

Society has a long history of demonizing people with schizophrenia and psychotic disorders. We need to remember that, like all mental illness, schizophrenia and other psychotic disorders grow out of healthy (or at least normal) mental processes. Most people have had that time walking home at night when they would swear someone was following them–but if you turned around you were alone, many of us got home and locked the door “just to be safe” (delusion). Almost everyone, at one time or another, has heard their name called when no one was calling them (hallucination). Everyone I’ve ever met has had days where their thoughts are disorganized and they can’t follow a conversation. For most of us, these things pass in a few moments or a few hours and laugh at ourselves and go on with our lives. We all have days when we just don’t want to deal with other people or have trouble motivating ourselves to get shit done (I know I’m not the other person who procrastinated my entire way through Freshman year.)

People with psychotic disorders can be scary. Not gonna lie about that. But the world they are living in is far more frightening for them than they are for you. So if you do meet or know someone who has a psychotic disorder, please start with compassion.

Treatment

Medication

Medication is the primary treatment for psychotic disorders. Antipsychotic medications are divided “conventional” and “atypical.” Conventional antipsychotics are older medications with a higher rate of severe side effects. Atypical antipsychotics are newer medications with significantly reduce side effects. Unfortunately, conventional antipsycotics are much cheaper. When dealing with a medication which will likely be lifelong, price can be a significant concern.

Therapy

So far, no therapy has been found that helps the symptoms of psychotic disorders. However, therapy has been very effective in helping people manage their symptoms. It is especially important for people with schizophrenia to recognize when stress in their life might trigger an acute phase. Preventing the occurrence of an acute phase by managing stress and recognizing early warning signs can be key to successfully managing schizophrenia.

Social skills training and vocational rehabilitation can be important treatments as well, especially for people with long term psychotic disorders.

Other treatments

I don’t know enough about alternative treatments (either alternative therapies such as art and music therapy or alternative medicine such as meditation, herbs, and massage) for psychotic disorders. If you or a loved one wants to explore alternative treatments, start by talking with your psychiatrist and psychologist.

Schizophrenia and Bipolar Disorder

I don’t know what the relationship is between schizophrenia and bipolar disorder. Officially, there isn’t one. But there has to be some reason they are so consistently misdiagnosed as each other. Again, culture seems to play a role–an American diagnosed as schizophenic who moved to Britain will usually be diagnosed by a British doctor as bipolar. The opposite often happens when a British person comes to America. With in America, it is very common for someone to go years thinking they have schizophrenia, make little or no progress in treatment, then have a new doctor diagnosis them with bipolar and the treatments for bipolar start working. Again, the opposite (someone diagnosed bipolar gets a new diagnosis of schizophrenia and stars seeing improvement) happens just as frequently.

If you look at the diagnostic criteria for schizophrenia and bipolar this makes no sense. There is nothing in bipolar about hallucinations or delusions or general motor problems. And nothing in schizophrenia’s criteria about mood swings. I don’t get it. But it’s something to be aware of.

 

Okay, usually I’d start talking about the impact of psychotic disorders on polyamory here, but that’s gonna be a very long discussion, so we’ll save it for next week.

Thanks to Richard Sprott for providing the diagnostic criteria for schizophrenia.

This post is part of the Polyamory and Mental Illness blog series.

Help Support Polyamory on Purpose.