Brain Injury Awareness Week: Survivors are already aware of difference, it’s time for everyone else to catch up

This week marks Brain Injury Awareness Week in the UK. In the neurorehabilitation service I work in we’ll be celebrating with a range of brain-related activities. We’ll be watching injury related films such as The Crash Reel, having a quiz and getting crafty with brain-themed cake decoration. We’ll be promoting the importance of looking after your brain – wearing a helmet, eating well and taking time to relax. Whilst it’s appropriate for us to throw these events, I can’t help but feel that are energy can be somewhat misplaced. Brain Injury Survivors aren’t the one’s who need their awareness raised. They live with disability and difference every day. Though some have difficulty fully understanding their injuries, they are experts in their own experience. The problem relates more to everyone else, the vast swathes of the population who have little understanding of brain injury and limit the social inclusion of survivors in their ignorance.

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Brain cake – delicious but perhaps not really raising awareness about the experience of brain injury

On the whole general knowledge about the brain isn’t high. It is after all, a highly complex organ that even expert neuroscientists don’t fully understand. Myths about the brain abound, ideas about “left and right brain thinkers” and the percentage of our brain we use haven’t been especially helpful. Understanding the brain requires looking at who we are as people, what makes us human, when makes up our identity, and how much control we truly have over our behaviour. This is what makes the brain fascinating, but it’s a difficult topic to confront. And then extrapolating from the delicate, blancmange like organ to understanding why it is that a survivor might suddenly get angry for no obviously observable reason, struggle to manage bills, become exhausted and overwhelmed, or any one of the many common consequences of brain injury.

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Halloween and representations of mental health

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‘Mental Patient’ costume. This is clearly inspired by Silence of the Lambs’ Hannibal Lecter. Does that make it ok? And who is to blame for the offense? The author of the book? The director of the film? Or the costume maker?

As Halloween looms closer, I’ve noticed a considerable number of stories appearing in my time-line about ‘scary mental illness’ being used in Halloween media. The best known examples being the campaign for Asda and Tesco to take down ‘mental patient’ costumes, and the current debate over Thorpe Park’s ‘Asylum‘.

Mental health service users  have been debating these issues online with strong opinions on both sides. On the anti-campaign are claims that these images of people with mental health problems as frightening are deeply stigmatising and build into the damaging discrimination that people experience. Mental health charity Mind encouraged followers to tweet pictures of themselves to who what a real ‘mental patient’ outfit would look like.

On the other side have been voices (including those of people who have experience of mental health problems) saying that these costumes and attractions are clearly based on horror movie imagery rather than real mental illness and that the campaign has drawn further attention to the attractions and made people with mental health problems appear obsessive and joyless.

I haven’t fully formed an opinion on either side. The costumes are indeed insensitive, though they wouldn’t be the only ones out there. Though I don’t necessarily support it, fancy dress is often very un-PC. Cultural appropriation is rife (think red indian and geisha costumes), as is sexism. When it comes to Halloween, I wonder how pagans/wiccans and people with facial disfigurements feel about the other ‘scary’ costumes out on sale? Everyone has the right to be offended and express their view, but if we take down these ‘patient’ costumes, we should probably do away with many of the others also.

The idea of someone with mental health problems as scary wasn’t invented by costume makers. We have a long history of characters in horror films who are portrayed as suffering for mental illness, often shown as the ‘motive’ for their behaviour. The ‘psycho-killer’ is a common stereotype. These films are very popular and the incredibly negative portrayal of mental illness has seemingly gone unchallenged. Often these ‘mental patient’ costumes seem to be based on characters like Silence of the Lambs‘ Hannibal Lecter.

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Mental illness and horror – a popular combination?

An abandoned asylum is often a horror movie setting (think House on Haunted Hill). Asylums have an awful history, and rightfully so. The patients who lived in these asylums were subjected to awful treatment, and there’s a reason why these places were shut down. Some horror films have used this history, portraying cruel doctors and the kinds of horrific ‘treatment’ that was given out. Unfortunately some have preferred to focus on the patients themselves, and characterised them as frightening characters. Mental health problems can cause someone to act in a way that others might find hard to understand and frightening, but these media characterisations of scary patients surely does nothing to encourage understanding.

In one of Thorpe Park’s responses to the campaign they commented that the ‘Asylum’ attraction has been running for 8 years without complaint, and has been popularly attended. Why is it that uproar is only gathering now? Similarly, the ‘mental patient’ costumes are not new this year. It may be that mental health campaigners feel more empowered to take a stand and take on companies profiting from these negative stereotypes. While I hope this is the case, I think we need to consider why we’ve let negative portrayals of mental illness go so unchallenged for so long. We’re appalled by the straight-jacketed costumes but still flock to the films that inspired them. These costumes are in bad taste and I wouldn’t like to belittle the hurt they’ve caused to an already stigmatised group, but I think amidst the uproar surrounding them we need to think about where these ideas originate and whether taking down the costumes and attractions will really get to the heart of the stereotypes and stigma around mental health problems.

X-rated Mind-Control: Why do we think watching porn is risky?

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I’m currently working in a Learning Disability team (supporting adults who have low intellectual ability that causes significant functional and social impairment) and I came across the ‘Three Rs’ guide, which provides guidance on providing sex education, including several more controversial and problematic topics. One of these topics is pornography. The authors state that they do not recommend aiding a person with LD to access porn, as it gives unrealistic messages about sex and women. When I first read this I thought this view was quite narrow-minded. Adults without an LD can access porn without anyone else’s permission. There’s no one questioning how ‘realistic’ the porn they watch is, so shouldn’t adults with LD be able t to enjoy their sexuality in this way? Also is this a narrow-minded view of porn that carries with it assumptions of how porn influences behaviour?

I’m not an expert on the literature on how porn influences thought and behaviour (and if anyone knows any good papers I’d be interested in reading them), here I’m more interested in considering why it is we assume porn does influence us, even in the absence of evidence. Wikipedia has a bit of a summary on the mostly inconclusive and conflicting findings here

I’ve been considering the authors’ point of view. It’s made me wonder how much porn influences actual sexual behaviour, and also how much people think porn influences sexual behaviour (which may be quite different things!). Anti-porn campaigners feel strongly that porn distorts our views of bodies, women and sex/intimacy. Porn is said to be anti-women and exploitative and has been linked to increased pressure on women to engage in sex acts, and change their bodies to resemble those of porn-stars. I’m not sure what the actual evidence is that this happens. The allegations remind me of claims that violent films and computer games make people more violent, which has often been debated but very lacking in concrete evidence. What I do know is that porn as a topic tends to upset people and bring up strong emotions. Porn is frequently depicted as something unhealthy, deviant and a a threat to ‘normal’ relationships and sex. We don’t like to talk about it, but a very large proportion of adults (both male and female) enjoy porn as part of their sex life, without any obvious negative consequences.

Porn is essentially fantasy. In order to enjoy watching porn, and feeling turned on, there perhaps needs to be certain suspension of critical thinking. On some level you need to believe it’s real so you can enjoy it without thoughts like “Is she really enjoying that? Was that a fake orgasm? Would a plumber really be that easily seduced on the job?” Admittedly this might be easier with some porn that others! But it isn’t real, and part of the appeal is just that, it’s the sex you wish you were having, perhaps removed from inhibitions and other barriers, the women you wish you were having sex with, it’s the enactment of fantasies. Porn also provides gratification without any of the effortful interaction with another person. So people know it isn’t real yet they still enjoy it.

But how is it that you understand that porn isn’t real? I’d guess this is mostly a process of comparison, having enough experience of real-life men and women and sex to be able to identify which aspects of porn are less than realistic. And some people might be in a better position to engage in this kind of critique than others. If you have limited experience of sex (e.g. young people who may not yet be sexually active or people who are quite socially isolated) you might not have much of a basis to discriminate. Certain complex cognitive skills might also be necessary in order to discriminate between porn and reality and consider that what porn shows to be ‘true’ may not be so for others. If someone has cognitive abilities that are impaired or not fully developed (such as a child), this process might be a lot more difficult. Ideally good quality sex education would help someone to learn the discrepancies between porn and real-life sex, but this may not always be available in a timely and detailed manner. For some people, porn may be the only way they learn about sex. If this is the case, family and school have really let them down, and it makes sense that they might develop some more distorted views about sex and women.

More on ‘rape-porn’ and links to risk under cut…

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Vaginas are revolting

And they refuse to do it quietly.

I was recently involved in a research study about women’s perceptions of their labia. Seven-plus pages of questions about my opinion of my labia majora. Do I think they’re too big? Too small? Too droopy? Too hairy? Do they bother me? Do I avoid swimming or sex to prevent others from noticing them? Would I like to pay to get someone to nip and tuck them to a more acceptable standard? The questionnaire was definitely something of an eye-opener and did leave me feeling somewhat depressed. Although I was often ticking at the ‘never’ or ‘rarely’ end of the scale, there were some questions where I did have to admit that sometimes I do have less-than-positive opinions about my body. Also I was fully aware that there would be some women out there who would be ticking ‘very much’ and ‘always’ to many of the given statements. There are many people out there who truly hate their labia, or other parts and aspects of their genitalia. That makes me really sad.

I’ve been umming and erring over what language to use in this piece. It’s about female genitalia, vaginas, vulvas and everything that comes attached to them. Often the word ‘vagina’ is used in a non-anatomically-correct (oh, this makes me seethe!) to mean the entire internal and external genitalia. I like ‘cunt’, though I know a lot of people find it offensive. It’s a short strong word that I think holds a similar impact to words used for male anatomy. Plus it’s an old English word, it has the history. Don’t like ‘pussy’, it’s become a little too America-porno and I’m not a fan of cutesy euphemisms, as if there’s something rude or shameful about calling it what it is. I do find myself using phrases like ‘lady-garden’ (mostly because I find this one quite funny, as is the equivalent ‘gentleman-forest’!) and girl-parts, which probably contradicts my previous statement, but it works for me. And you’d probably use different words in different contexts; though anatomical terms are the most accurate, you might not want to throw them into an intimate moment. The Vagina Monologues does a great piece all about this. But we’re talking about the same thing, whatever we call it.

I’m not a historian, but I don’t think this level of dissatisfaction with genitalia was always around. Female body-dissatisfaction is obviously not something new, though it seems to be ever-growing. Operations to ‘trim’ labia into a ‘neat’ shape have not always existed. Whereas much plastic surgery focuses on parts of the body that are immediately obvious to others – bigger breasts, straighter noses, slimmer buttocks. If you wanted to appear more attractive to others, perhaps this makes sense. But your labia aren’t (usually) on show, they’re actually hidden most of the time. Yet woman may feel this pervasive need to change this part of their body that may only be seen by themselves, their gynae and their partner.

I imagine plastic surgeons would say they are responding to a demand, they may well be right. Though I wonder what effect it has even knowing that such an operation exists. A standard is set for the ‘correct’ and ‘appealing’ labia, and the question is posed ‘Is yours attractive? Is it normal? Would you like to change it?’ Health and beauty companies thrive off the fears and insecurities of the masses. Once the customer has been made aware of their need, a product can be sold to them to ‘fill’ this need. Wrinkles, a natural part of aging, are demonised, and a magical cure is sold. Women didn’t use to buy razors. Now the sight of a woman with hairy arm-pits is often treated with disgust. Yet there is no particular hygiene benefit to shaving arm-pits (after all, the majority of men don’t), yet now for women it is considered the norm. As is shaving leg-hair. A new market is created. Special razors for women are marketed, in pretty baby-pinks and blues. A generation of girls are born into a culture where this is completely normal and grooming of body-hair is just something you do.

Looking at older pornography can be quite enlightening (all in the name of research!). I think if you showed a bunch of teenage boys Playboy images from the 70s, with their full-bushes, tan-lines and natural breast, they’d probably laugh and show signs of disgust. Yet this was the height of sexiness not too long ago. For many people, porn is the first time they get to have a really good look at the genitalia of another person. A heterosexual woman may not have many opportunities to have a close to look at another’s parts, being only able to see her own and these images in the media. Even if you do have sex with women, I don’t imagine everyone really gets an opportunity to have a really long, well-lit, inspection of another person’s genitals (doing so may unnerve your partner, so please approach this with caution!). Porn is now very easily accessible. So for many women (and men), they’ve only ever seen their own goods, and the neat and tidy presentations on screen.

Labia show as much variation as human faces, they vary in their colouring, amount of hair, relative sizes and lengths, symmetry…they’re wonderfully diverse. Yet if you’ve only ever seen one particular type and your own, a negative comparison is easily made. (I think this is probably true for men to some extend too, and insecurities around penis size relating to the well-hung men who are sought out for porn. Although culturally men do tend to see other men naked more often – think showering and urinals, than women see other women). Hungry Beast created this fantastic mini-documentary about labia in the media, particularly relating to censorship and photo-editing. As someone who has worked in nude photography I can relate to this. A photograph that displays more labia is often considered more explicit than one that does not. Yet for a model with larger labia, the same pose may show off more than that of another model. Is this in itself inherently offensive? The result is fewer and fewer images that show the true variation of labia, leading those who don’t fit this model to believe that there’s something strange and ugly about themselves.

I once over-heard a conversation given by someone I know about a ‘scary vagina’. A ‘scary vagina’ apparently has hair on the outer labia, and the inner labia and larger than the outer. This isn’t a ‘scary vagina’, it’s a totally normal one! And it’s this kind of attitude that perpetuates shame and body-loathing.

The recent back-lash over the latest Fem-Fresh campaign has pulled this campaign for cunts of the world into the more mainstream attention. The team behind the adverts for vag-wipes probably thought they were empowering women, with their adverts of a jubilant woman saying ‘Woohoo for my froo-froo!’ and ‘Whatever you call it, love it’. It isn’t all bad, we should be able to have information about women’s body parts out there. Recently a women’s group were reprimanded for leaving ‘sexually explicit’ material around where children could see them. The material in question was a poster advertising support services and awareness of female genital mutilation and featured an image of a young woman of Africa-heritage. I have looked at the material several times and all I can come up with is that the school did not wish for children to see the word or references to ‘genital’. What message does this send, to sufferers of these atrocities, but also to young people in general? That we can’t talk about what’s between our legs?

Anyway, back to Fem-Fresh. It seems we can only talk about vaginas under cutsey euphemisms. And this is the razor story all over again. Create insecurity and need: your vagina smells bad. Sell product to fix need: here is a wipe to make your vagina smell lovely. Provided you wash regularly and don’t have an infection, your vagina smells completely normal. It isn’t supposed to smell like a flower. Vaginas are moist, it’s how they clean themselves. They have their own, natural smell. I don’t think it would be a big leap to say that many people like this smell, it’s erotic. I’m reminded of Pamela Des Barres 70s groupie memoir when she talks about using chocolate and strawberry douches (now out of favour mainly due to being particularly unhealthy and actually promoting infection). Vaginas aren’t supposed to taste like ice-cream.

It goes without saying that it is absolutely a woman’s choice to do exactly what she wishes with her own genitalia. And if that means that she wishes to have her labia surgically cut and trimmed, all the hair waxed off and for her vulva to be lightly fragranced, so be it. It’s her choice. But it should be because that’s what she wants, rather than out of a fear that her vagina is shameful and disgusting as it is and needs to reach a certain standard before it can be unleashed on others. Unless you work in the sex industry, your genitalia are probably only seen by yourself and the people you choose to have sex with. It’s something personal and private, not on show to the world in the same way that other parts of the body are. There are women around the world who are having their genitals savagely mutilated and disfigured, having their right to a natural body and sex-life taken from them, yet we’re inflicting our own private battle on our lady-parts. Owners of vaginas: Your genitals aren’t an identikit flesh-light, they’re a diverse and wonderful piece of human anatomy. You weren’t born believing there was something wrong with your body, yet somehow the idea became more and more acceptable to the point where it’s completely accepted. An entire industry thrives on making you hate what you have and buy a piece of altered perfection. It doesn’t have to be that way.

And for everyone else who loves vaginas: Show them some appreciation! Each is different and they’re not strange or scary. Go and tell your favourite vagina how much you like her, just as she is.

It’s not really in the flavour of this article, but as some of you may be at work, images below the cut.

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