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Nice Lady Therapists

Real Social Skills

Content warning: this post is about physical and emotional harm done to people (especially children) with disabilities by (mostly) female therapists. Proceed with caution.

This is a hard post to write. It’s about abuse. It’s about a kind of abuse I haven’t seen described much. I think abuse is the right word, even though a lot of abusers probably genuinely think they’re doing the right thing.

Anyway, here goes:

Many, many people with disabilities I know have been harmed or even outright abused by Nice Lady Therapists. (Usual caveat: not all therapists are abusive, and this post is not opposition to childhood therapy. I’m saying that therapists need to stop hurting kids and other vulnerable people, not that therapy is evil. Pointing out that therapy is often important and that many therapists are good is not an answer to what I am describing.)

Nice Lady Therapists tell us that, whatever they do to us is by definition nice, and good for us. And that we like it, and that they love us, and that they are rescuing us, and that we are grateful.

They have a brightly-decorated therapy room full of toys, and assure every adult they come across that ~their kids~ love therapy. They use a lot of praise and enthusiastic affect, and maybe positive reinforcement with stickers and prizes. They might call the things they have kids do games. Some of them really do play games.

And every interaction with them is degrading in a way that’s hard to pinpoint, and hard to recover from. They do all kinds of things to kids with disabilities that typically developing kids would never be expected to tolerate. And they do it with a smile, and expect the kids they’re doing it to to smile back.

Sometimes it hurts physically, sometimes it hurts emotionally. Sometimes it’s a matter of being 12 years old and expected to trace a picture for toddlers for the zillionth time. And being told “This is fun! I used to do this all the time when I was a kid!”.

Sometimes it’s a matter of being forced to do a frightening or physically painful exercise, and being forbidden to express pain or fear. It hurts their feelings if a kid is upset. Don’t we know how much she cares? Don’t we know that she’d never do anything to hurt us? Don’t we want to learn and grow up to be independent?

Sometimes it’s a matter of being expected to accept intensely bad advice as though it’s insight. For instance, getting sent to therapy because you’re not making friends. And being told “We are all friends in this school! You have to give the other kids a chance.” And, if you try to explain otherwise, she patiently and lovingly explains to you why your thinking is distorted and you’ll have lots of friends if you just let yourself try.

Sometimes it’s – crossing a physical line. Touching in a way they have no good reason to be touching. Or touching over the objections of the kid in a way that is in no way justified by therapy goals. Sometimes sexually, sometimes not. Sometimes in ways that are against ethical standards of practice, sometimes not. But intimately, invasively. And if you say no, she patiently, lovingly, explains that you have nothing to be afraid of and that everything is ok. And that if you just trust her, you will have fun and get better. And when her profession has professional training about boundaries and appropriate touch, she thinks or even says “women don’t do that.”

Some male therapists do many of these things too, but there’s a gendered version of it that usually comes from women. And that can cause a problem for people with disabilities who are recovering from this. Most things about trauma and abuse of power are about misogyny in some way. They’re about men hurting women, and taking advantage of power dynamics that favor men to do so. Those descriptions are important because that pattern is common. But it is not the only abuse pattern, and it is not the only gendered abuse pattern.

Female therapists are subjected to misogyny and the power of men just as much as any other women. But they also have tremendous power over people with disabilities, many of whom are deeply dehumanized. The assumption that women have neither the power nor the ability to hurt anyone gets really dangerous really quickly for children with disabilities receiving therapy.

And it also means that people with disabilities often have a different relationship to gender than most nondisabled people. If you’ve been harmed by women over and over and assured that you liked it, it complicates things. If you’re a girl, it can make it hard to see a group of women as a Safe Space, especially if they think the thing making it safe is keeping the men out. If you’re a boy who has been repeatedly harmed by women who believed they were powerless, it can be hard to understand that the gender hierarchies that feminists and others talk about actually do exist. And it complicates things in any number of other ways.

But if you have been hurt by Nice Lady Therapists, you are not alone. If it has affected your relationship to gender, you are not alone. If it has left scars that others say you shouldn’t have because she was nice and meant well, you are not alone.

You don’t have to think someone is nice because she says she is. It’s ok to think that someone is hurting you even if that upsets them. You don’t have to think someone is safe or loving just because they are a woman or a therapist or smiling. Women can be abusive too. In human services, it is common. You are not alone, and it was wrong to treat you that way. The harm done to you was not because of your disability, and it’s not something that you could have fixed by being more cooperative or working harder or having a better attitude.  It’s not your fault, and it’s not because of anything wrong with you. And it’s not your fault if it still hurts.

Honesty

Real Social Skills

When you’re teaching vulnerable kids social skills, it’s important to tell the truth.

They need skills for living in the world as it is, not as you would like it to be.

For instance: If you teach them to walk away from bullies, you have to tell them that sometimes bullies will follow them.

If you teach them to tell an adult, you have to teach them that sometimes the adult won’t care, or will take the bully’s side, or will tell them to stop tattling.

If you teach them to say “That hurts my feelings!”, you have to teach them that some bullies will laugh at them.

If you don’t teach kids that, when those things happen, they will think it is their fault. Or they will think that you don’t care. Either way, they’re not likely to be able to come to you for further support.

It’s much better to admit that your answers are imperfect. It’s much better to admit when you don’t know how to help. It’s much better if you can listen.

Sometimes the best thing you can say is “I’m sorry that people are being so mean to you. Do you want to talk about it?" 

“As a last resort”

Real Social Skills

Content warning: This is a graphic post about brutality towards people with disabilities. ABA and justifications for abuse are discussed. Proceed with caution.

People do a lot of brutal things to people with disabilities, including children.

Some examples: pinning them to the floor, punishing them with electric shocks, medicating them into immobility, putting them in 10-40 hours a week of repetitive behavioral therapy, taking away everything they care about and making them earn it by complying with therapy, taking away their food, and confining them in small places.

These things are now somewhat politically unpopular. We identify, as a culture, as having got past that point. We think of this kind of brutality as something that happened in the past, even though it is still common.

What this means in practice is that whenever people do brutal things to someone with a disability, it will be called the last resort. People doing the brutal things will claim that they minimize them, that there are protections in place, and that they only do them when necessary.

For example, this is an excerpt from the (as of this post) current ethical standards for BCBAs (certified ABA experts):

“4.05 Reinforcement/Punishment.

The behavior analyst recommends reinforcement rather than punishment whenever possible. If punishment procedures are necessary, the behavior analyst always includes reinforcement procedures for alternative behavior in the program.

4.06 Avoiding Harmful Reinforcers. RBT

The behavior analyst minimizes the use of items as potential reinforcers that maybe harmful to the long-term health of the client or participant (e.g., cigarettes, sugar or fat-laden food), or that may require undesirably marked deprivation procedures as motivating operations.”

In other words, the current standards of ethics for ABA practices explicitly allow punishment, harmful reinforcers, and “undesirably marked deprivation procedures”. But, they claim to “minimize” it, and only do it when they consider it necessary in some way.

This is an empty claim. Everyone who has ever used harmful reinforcers and brutal punishments has claimed that they are only used when they are necessary. Even the people who deprived children of food and made them live and study on electrified floors (graphic link, proceed with caution.) Even the electric shocks and food deprivation used by the Judge Rotenburg Center do not violate the BCBA ethical guidelines, because they claim that they are necessary and only used in extreme cases (even though they shock people for things like standing up from chairs without permission.) 

Whenever any of this is done to someone, it will be justified as “a last resort”. Even if it’s an explicit part of their plan. Even if it’s done regularly with no attempt to transition to another approach. Even if nothing else has ever been tried. Someone who is treated brutally will be assumed to have deserved it.

People call things last resorts to justify doing them. They choose to do brutal things to a vulnerable person, but they think of it as inevitable because it is “the last resort”. Calling something “the last resort” means “it’s that person’s fault I’m doing this; I could not possibly do otherwise.”

Treating someone in your care brutally and then blaming them for your choices is inexcusable. 

To those treated brutally and told it was a last resort: I’m sorry that happened to you. I’m even more sorry if it’s still happening. It’s not your fault. It’s not because of anything you did, and it’s not because there’s anything wrong with your mind. You were abused because others chose to abuse you.

The point is to build

Real Social Skills
A reader asked:
Your last post mentioned “coming to terms with how awful the world is.” When recognize that injustice is everywhere, and that you personally benefit from it, is it ok to find joy in the world even though it’s awful? Things like (in the US) visiting a national park and having a fun hike, when the land was taken a long time ago from Native Americans; or watching a good movie that’s problematic; or enjoying sledding after a snowstorm that was responsible for a few deaths?
 For me it is impossible to keep injustice in mind all the time. So whenever I have fun, or feel happy, I feel guilty later because that fun indirectly came out of injustice, and instead of fighting that injustice I was enjoying it. How can you keep in mind that the world is a horrible place without neglecting your right (is it a right even?) to joy?
realsocialskills said:
The world contains much, much more than pain and injustice. It’s important to acknowledge and fight evil. It’s also important not to become so consumed by the fight that you can only see the horrible things.
The point is to build and to love. (And, sometimes, to fight battles that need fighting.)
Sometimes, people try to seek out some sort of purity by cutting out everything tainted by injustice. That doesn’t work, because everything is tainted in some way. If you go down that road seeking purity, you get stuck cutting out more and more things and not being able to find anything pure enough to like without shame. That doesn’t help. Everything is connected to something destructive. Sometimes particular kinds of destructiveness are dealbreaking, but it can’t be everything that has any connection to something bad. You can’t become pure that way, but you can do a lot of harm to yourself and others trying.
Liking things is good. Misery isn’t a moral accomplishment. If you want to make the world a better place, treat people right and build something good. The point is not to be miserable at the horrors of the world. The point is to build.
This is not about attaining moral purity through abstinence and misery. It’s about doing the work of making things better and building worthwhile things, and loving others more than our culture hates them. Your purity will not help anyone. Your work can.
To use some of the examples you gave:
Regarding the snow: it didn’t snow so that you could sled. Enjoying the sledding will not hurt anyone. Just don’t brag about sledding to people who are really upset about the snow. People who have been harmed by the snow might not want to hear how much you’re enjoying the snow, but that doesn’t mean that enjoying it is wicked, it just means it’s important to be considerate.
Watching a good movie that’s problematic: All movies have horrible aspects to one degree or another. It’s ok to ignore them and like something; *that’s the only way anyone ever gets to like anything in the media*.
But it’s also important to be willing to acknowledge that the problems are there and not be obnoxious about other people not wanting to hear about the thing you like. Everyone’s patterns of what’s deal-breaking are different. If the ableism in a movie is dealbreaking for someone, respect that, and don’t talk to them about how great you think it is. If someone got badly injured in the snow, don’t talk to them about how wonderful the snow is. Being considerate of other people’s boundaries, and their right to decide what is and is not personally dealbreaking, goes a long way.
You are allowed to be happy. It’s good to be happy. There’s a lot that’s wrong with the world, really really wrong, even. But…
The point is not to be constantly miserable about it. The point is not to wallow in shame. The point is to build.
Some building is activism and advocacy and fighting injustice. Some of it is just… building. All of it involves identifying situations in which you have the power to act, and finding things you can do that make good things more possible.
You can like things; you can love; it is good to like things and enjoy life. Refusing to ever like anything impure will not make the world better; your work can.

Marginalized people are not revolution objects

Real Social Skills

So, here’s a thing I’ve seen happen:

  • People get really into social justice theory
  • and then they read a lot from people who all agree with each other
  • and then they assume that everyone in that group agrees
  • and then, when they encounter someone in that group who doesn’t think that thing, they don’t know how to deal with them
  • or they’re rude and condescending

For instance:

  • Someone who reads a lot of disability theory is excited about the idea of acceptance
  • And, in particular, the reasons that mobility equipment is liberating and wonderful
  • And they encounter someone who is enduring considerable pain rather than use a wheelchair
  • And then they talk at them about how they just need to accept themself already, without listening to where they’re actually coming from
  • That is not respectful. It can sometimes be ok to express an opinion or offer advice (emphasis on offer; people can say no to hearing your advice), but it’s not ok to try and run someone else’s life, or to take control of their self image, or related stuff
  • Respecting someone has to start with respecting them as people who think for themselves, not trying to make them do what you think self-respecting people do

keep in mind that:

  • No matter how much you’ve read, you’ve never been the person you’re talking to
  • That goes double if you’re not a member of their group, but it applies even if you are
  • Having read a lot of social justice theory, or even being part of that group and having found that it described your experience, does *not* mean that you know better than someone else how they should be living their life
  • Don’t try to take people over, and don’t talk down to them
  • The last thing marginalized people need is yet another person trying to run over them for their own good. They get that enough already

People are complicated, and you are never the expert on someone else’s life. Reading social justice theory, and even being really insightful about what’s wrong with our culture, does not make you an expert on someone else’s life. Their life is for them to live and make decisions about. Marginalized people are not revolution objects.

About anger and social violence

Real Social Skills

Those of us who experience routine social violence can’t afford to become enraged about it every single time. We also can’t afford to fight it every single time.

If you don’t experience social violence, this can be hard to understand. It can be easy to think we’re under-reacting and that we ought to be flying into a rage and reporting it. You might want to get furious on our behalf.

As furious as you think you’d be if that happened to you. The thing is, when it happens to you multiple times every day, you can’t always afford to make a big deal of it. If we did that, we wouldn’t be able to do anything else. It’s important to fight sometimes, but not always. There are other things to be getting on with.

So telling someone “wow, you should report that!” is not necessarily a helpful response.

Similarly, it also isn’t helpful to try to calm someone down or come up with lots of ways to interpret what happened as just an innocent misunderstanding. 

Misunderstandings aren’t so benign when they happen to you several times a day and prevent you from doing what you need to do. Particularly when people become hostile when you tell them that they’re creating a problem, no matter how polite you are about it. Sometimes things really are that bad, and sometimes you’re not in a position to fix them.

Sometimes we don’t need help adjusting our perspective, or help filing a complaint. Sometimes what we need is to know that you are willing to listen to something that happened to us, and that you will believe us and understand.

Sometimes, you can’t make it better in that moment. Sometimes, we can’t make it better, and all we can do is survive it. We can’t fight every battle. And sometimes, the battles we don’t fight can take as heavy a toll on us as the battles we do fight. It is not easy to let things go when they are unjust and in which we’d really like to fix things. But, the only thing to do is see it as unjust *and* go on without fighting a battle then and there.

Just as no one should ever have to fight these battles alone, no one should have to be alone when they decide to sit out a particular battle. We need support every time this kind of thing happens, not only in instances in which we’re directly fighting.

If you want to be a good ally, don’t pressure people to fight every battle. Instead, stand with them consistently, when they chose to fight, and when they regard discretion as the better part of valor. Presume that they are capable of making those calls, listen respectfully, and offer support that is appropriate to the situation and consistent with the choice they are making about it.

Sometimes, in a situation, all you can do is listen, understand, and be someone who understands that they are being treated unjustly and that it isn’t their fault. It hurts not to be able to do more, but it’s important not to let that pain get in the way of offering the support, respect, and listening that can help some in that situation.

You can’t always fix things, either by fighting or by explaining things away. Sometimes there is no ready solution. But, you *can* always be a respectful ally.

Listening to people who have disability accents

Real Social Skills

People with certain disabilities often have heavy disability accents. Their speech can sound very different from the way most nondisabled people speak.

People with disabilities that affect communication are often pushed into separate programs, particularly in adulthood. Even when they are in the same classes in the same schools, there isn’t much of an expectation that any peers listen to them. This was even more true a generation ago. As a result, most people without disabilities are lousy at understanding people with disability accents, and don’t understand that this is a glaring hole in their social skills.

Many unskilled people tend to maybe ask people with disability accents to repeat themselves once, and then they get frustrated and start ignoring them. Sometimes they pretend to understand, and smile and nod rather than actually listening. Sometimes they hang up on them. Sometimes they pass them off to another person, who also doesn’t bother to actually listen. Sometimes they hang up. If they are medical workers, sometimes they write on a chart that someone is impossible to understand or has no communication (particularly if that person also has an intellectual disability.)

Do not be this person. If you can’t understand someone with a disability accent, the problem is your skills, not their voice. (If you have a receptive language disability that prevents you from learning to understand accents, then it’s no one’s fault and you need an interpreter to communicate. Neither their voice nor your brain is wrong. In that situation, the skill you need to develop is finding an interpreter.)

If you listen, and make it clear that you are listening, you will learn to understand, and you will be able to communicate successfully with more people.

An important phrase for this is “I’m having trouble understanding what you’re saying, but I care what you are saying.”

Make sure it’s true, and keep listening. The more you listen, the easier it will be to understand. Understanding . And practice. You get better with practice.

Too many people are ignored because others can’t be bothered to understand their accents. You can make this better by listening (and by insisting that people you supervise listen.)

Autism language politics and history

Real Social Skills

Some people emphatically prefer to be called people with autism. Others get very offended. Some people emphatically prefer to be called autistic people. Others get very offended. There are reasons for all of that.

They have to do with the history of the intellectual and developmental disability community, the autism parent community, and the specific autistic self advocacy community.

For intellectual and developmental disability:

  • Most self advocates have a very strong preference for person-first language
  • Person-first language in this concept means “I am a PERSON, and I am not going to allow you to treat me as a disability case study, nor am I going to tolerate your diagnostic overshadowing.”

Autism is a developmental disability. There is a highly visible and destructive community of parents who consider themselves to be afflicted with their child’s autism. There is an autistic self advocacy community that developed in part specifically due to the need to counteract the harm being done by autism parents. The language someone prefers will often depend on which of these facts seems most important at a given time.

Regarding developmental disability.

  • Folks who are primarily involved in the IDD self advocacy community usually prefer to be called people with autism
  • This is for the same reasons people with any sort of developmental disability usually prefer person first language
  • In that context, “person with autism” means “I am a PERSON, and you are not going to treat me like an autistic specimen.”

Regarding the destructive autism parent community:

  • This parent community pushes the agenda of parents who believe that their child’s autism is a horrible tragedy that befell their parents and family
  • They call themselves the autism community, but they consistently refuse to include or listen to autistic self advocates (especially adult self advocates). They only care about neurotypical parent perspectives (and only from parents who think autism is horrifying)
  • They promote things like intense behavioral therapy for young children, institutionalization, group homes, sheltered workshops and genetic research aimed at developing prenatal testing. They do not listen to autistic self advocates who object to these things.
  • They don’t care about the priorities of autistic self advocates. They do not do any work on issues such as self-directed adult services, enforcing the Olmstead mandate to provide services in the community rather than institutions, or research into skills for listening to people whose communication is atypical
  • These parents have an emphatic preference for person first language. They say “people with autism.”
  • What they mean by this is “Autism is NOT a part of who my child is, it’s an evil brain slug attached to their head, and I want to remove it at all costs.”

There is also an autistic self advocacy community. It developed in significant part to counteract the harm done by the autism parent community:

  • A lot of the agenda of the autistic self advocacy community is the same as the IDD community and pursued in cooperation with the IDD community
  • But there is also a lot of work that’s specifically about countering the harm that has been done by the autism parent community
  • Much of the worst harm done by the parent community comes from the cultural consensus that autism is like an evil brain slug, and that any amount of brutality is a good thing if it might mean that the slug shrinks or dies
  • For this reason, participants in the autistic self advocacy community generally have a very strong objection to person first language
  • They call themselves autistic or Autistic.
  • In this context, “autistic person” means “Autism is part of who I am. I’m ok. Stop trying to get me to hate myself. You do not need to remove autism to make me into a full person. We are already people. Stop physically and emotionally mutilating people in the name of treatment.”

Neither set of self advocates are wrong. Both positions are legitimate and important to be aware of. In order to know what someone means by their language choices, you have to consider the context.

An addition from Mel Baggs:

And there’s also an autistic self-advocacy community that is separate from the DD community and also separate from what most people call “the autistic self-advocacy community”.  That self-advocacy community is heavily affiliated with a parent community that also prefers person-first language.  In many cases, people in that community prefer “person with autism” both because of the history of their community, but also because for them being called “autistic” has always meant “you are nothing but your autism and you are nothing but a walking collection of symptoms”.  Which is a much more common experience for people in that community, because they tend to be people who were considered low-functioning for their entire lives.  AutCom — as originally constituted, not as recently-blended — is a good example of such a community, so are any communities that are largely made up of FC users.

You are not alone

Real Social Skills

If you are being hurt by a person, they’re likely trying to convince you that no one else could possibly understand your relationship.

If you’re being hurt by your family, they’re likely trying to convince you that no one else could possibly understand your family.

If you are being hurt by a community, they’re likely trying to convince you that no one from outside the community can possibly understand.

It’s not true. You are not alone. There are others outside your relationship, family, and community, who can relate to what you’re going through and who can help.

Some aspects of your relationship, family, or community are unique. Some of them are probably unusual, positive, and hard for outsiders to understand. But that is not the barrier that those who are hurting you want you to think it is. It is not insurmountable.

People do not have to understand absolutely everything in order to relate to your experiences in important ways.

You can make connections with others, and a lot of things you have experienced will be very, very similar. Some aspects of abuse are universal. Others are very common. (One very common aspect of abuse is that there is often something about the relationship that is positive, unusual, and secret or hard to describe.). 

The people who you can relate to may be very different from you in a lot of ways. They may be a different age, ethnicity, religion, race, gender, or culture than you. Maybe they are disabled and you aren’t. Maybe their disability is different, or more severe, than yours. Maybe the particular horrors they faced took a different shape. That matters, but it’s not the only thing that matters.

It is ok to relate to the experiences of people who are very different from you. It is not appropriation. (It is not ok to pretend that your experiences are identical; but it’s completely possible to relate without doing that.) Don’t let anyone tell you to only listen to people who are just like you. We all need each other.

People may be trying to isolate you, but you are not alone. Other people can and do understand and care about the ways in which you are getting hurt.

Short version of the problem with Nonviolent Communication (NVC)

Real Social Skills

This is the short version of this post and this post:

  • In a conflict, sometimes one person is right and the other person is wrong
  • In such cases, it is important to judge the situation and figure out who is in the right
  • Emotional abuse exists
  • Working to meet an abuser’s emotional needs will not stop them from abusing others
  • Genuinely felt emotions can come from an abuser’s abusive values and mentality. Expressing those feelings can be a form of abuse in itself.
  • It is possible to say horrible things about and to other people under the guise of talking about your own feelings and needs
  • It’s important to be able to judge abuse as abuse. Calling it “behavior that does not meet my needs” is not always sufficient.
  • People need emotional boundaries. Your feelings are not always anyone’s business, and you are not always obligated to care about or listen to the feelings of others.

All of these things are vitally important to understand. People who don’t understand these things abuse their power over others. People who don’t understand these things are incredibly vulnerable to being abused by others.

NVC culture denies all of these things. That does tremendous harm to vulnerable people.