Stroke, sexuality, sexism…back on track!

Harmless fun? If my meal's going to be unnecessarily gendered I hope it comes with pink icing and glitter

Harmless fun? If my meal’s going to be unnecessarily gendered I hope it comes with pink icing and glitter

After a long hiatus I’ve finally got time to get back to this blog. I can see that my last entry was Halloween 2013 – which was about 6 months before my thesis hand-in (so you can imagine how the time following this was spent). I’ve now completed my studies, qualified and am working as a clinical psychologist in a brain injury service. Getting up to speed on my new job (not to mention actually having to go to work 5 days a week, without a study day in sight!) has left me pretty shattered but I’m slowly adjusting to my new routine. A quick update on my recent movements:

  • I recently submitted my thesis (which was about sexual issues post-stroke and how rehab professionals work with these) for publication and I also presented it as part of a talk on sexuality and acquired brain injury that I did at the last SHADA (Sexual Health and Disability Alliance) meeting. I think I’ve now exhausted the potential to spread this piece of research (until it’s finally published), I’m ready to move onto studying something a little different now and also getting back to writing.
  • Following the submission I finally got round to writing something for my university blog, “Discursive of Tunbridge Wells”, something I’ve been meaning to do for ages. Salomons runs their own blog as part of their public engagement drive, it covers a whole range of issues related to applied psychology – debates within mental health, professional roles, lived experiences. It has some great content from a really wide range of contributors and I’m quite proud that my old department is putting something like this out there – I think it’s the only clinical psychology course to do so. My piece is about supporting people with cognitive impairments (e.g. brain injury, LD) to vote and how mental capacity relates to this (or doesn’t). It’s something I’d come across in my work recently and I definitely feel it needs more awareness! I’m hoping to do more writing relating to health and disability issues in forums such as this.
  • A couple of days ago I received a request from a journalist. I was initially quite excited as I thought maybe they’d picked up my voting piece (it is topical after all…). But alas no, they were running a piece on something on twitter I’d responded to the other day. The “story” relates to a picture of a cafe menu in Bristol that has “for him” and “for her” breakfasts. The masculine meal is a greasy Full English whilst ladies get a lighter option with salad leaves and blueberries. Whilst I don’t think a gendered breakfast is the biggest threat to feminism, this kind of lazy stereotyping annoys me, especially the underlying idea that women should have the diet-friendly dish. The story was originally published in the Bristol Post, but was then picked up by several other media sources (including the Daily Mail) which pretty much recycled the entire article and quotes “Outrage at Sexist Menu!!”. The article has of course attracted many entertaining commenters who see us as miserable feminazis with nothing better to do than get offended. I’m amused that this has generated far far more interest than any of my research or any of the many articles I’ve written over the years!  I feel sorry for the cafe who admittedly acted thoughtlessly but didn’t really deserve the level of attention this piece of non-news has achieved.
No need to actually go on the Daily Mail website, here's the bit that mentions me as if I have some kind of special knowledge on these matters.

No need to actually go on the Daily Mail website, here’s the bit that mentions me as if I have some kind of special knowledge on these matters.

So I’m hoping to do much more writing, presenting and generally getting out into the world in the coming year. If anyone needs a comment or piece written on any of my usual topics (brain injury and rehabilitation, neuropsychology, sex and disability, ableism and “invisible disabilities”, sexual and gender minority issues and related things) do let me know! Or I can comment on minor acts of unintentional sexism, I’m versatile.

Unmentionables: Talking about sex in the healthcare setting

'The Sessions', in which a disabled man sees a sex worker, draws attention to the desire for individuals with disabilities to enjoy a sex-life

‘The Sessions’, in which a disabled man sees a sex worker, draws attention to the desire for individuals with disabilities to enjoy a sex-life just as much as the able-bodied.

Doctors, psychologists and other healthcare professionals, both in mental and physical health, are used to talking about difficult subjects. Bowel movements, terminal diagnoses, suicide and self-harm, tricky topics are a standard part of the job. Yet somehow when it comes to sex, many struggle to find the words or avoid the topic all together.

Sex, whether defined by sexual acts, more generally as intimacy or in many other ways, is an important human need. It contributes highly to individuals’ quality of life. On Maslow’s famous Hierarchy of Needs it comes only after physiological and safety needs in terms of importance. I think I can go as far as to say that changes or difficulties relating to sex are common to the majority both physical and mental health problems, whether they relate directly to the symptoms (e.g. impact of pain and limb weakness on sex positions, hypersexuality in mania) or are secondary to medication used to treat the problem or further consequences (such as impact of taking on a sick/carer role, self-consciousness relating to skin conditions). Anti-depressants are very widely prescribed, yet often information on the (common) sexual side-effects is left to be read in the small print. I’m reminded of a quote from Ben Goldacre on SSRIs,

“ I’m trying to phrase this as neutrally as possible, I really enjoy the sensation of orgasm. It’s important to me, and everything I experience in the world tells me that this sensation is important to other people too. Wars have been fought, essentially, for the sensation of orgasm.”

Stroke for example, is a condition where sexual dysfunction has been well documented. Yet in research speaking to rehab staff, they rarely brought the topic up with clients and on the occasion when it was brought up, staff often felt embarrassed and uninformed (McLaughlin & Cregan, 2005). Reasons given for staff not approaching the topic also included fear of upsetting clients and there has been other research suggesting that (often unconscious) stereotypes relating to sex, relationships, illness and disability, play a role in this silence. Although sex problems have been particularly highlighted in stroke, there is evidence that these staff attitudes and difficulties exist in a variety of settings and in relation to many other conditions. Whilst working in a clinic for Chronic Fatigue, I approached staff about the possibility of including sex and relationships as a topic to include in a psycho-education group, and was met with quite a dismissive response. It was too sensitive, and time was needed for other important areas. However, a friend with the condition informed me that on a service-user forum, the sections relating to questions and advice about sex were by far the most used. Service-users often have to go and seek out their own information because professionals fail to provide it.

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Quest To See Inside My Head – Getting my brain scanned

I would really like to have my brain scanned. As someone with a big interest in psychology and neuroscience, I think seeing what’s inside my skull would pull everything together, put it into context, make it real.

It’s not that I don’t believe it’s in there, but sometimes it feels somewhat distant, the colour-coded textbook diagrams, the plastic models, you wonder ‘Is that really going on, inside MY body?’ I think a small part of me holds the irrational belief that inside me is just space, or machine cogs. All those instricate processes that I learned about in biology lessons, that can’t all be really going on. I get a strange enjoyment from seeing the outline of bones, blood vessels, tendons, and feeling like I’m getting a glimpse of the workings of this human machine. It does feel strange that it’s all happening, it’s such a part of me, yet I’m often so oblivious to it.

I took an open unit in anatomy at university and for one of our first dissection classes we formed groups and were given a cat’s head, instructed to remove the brain. So we did. And then it sat there, this little mound of grey putty, so fragile, on the sterile table surface. I’d never seen a real brain before, and all the diagrams and photos, it didn’t really prepare me for how flimsy and squishy it seemed, so easily damaged. And how all the different lobes, the cranial nerves, which I’d learnt to identify and label so particularly, they all looked the same, all rolled together into this bundle of grey mush. It seemed no wonder that a quick jolt to the head can do so much damage, when the skulls’s so hard and the brain’s so delicate. It seemed amazing that people don’t damage their brains more than they do already.

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