She thought that her mother’s pain pills along with a bottle of wine would do it. Soon after her last gulp of the merlot, she felt queasy and dizzy. The vomit that spilled from her mouth twenty minutes later was thin and sour. Frustrated and tired, she put herself to bed.

Disappointment filled her chest when she awoke. She spied the empty bottle of wine on her desk.

I can’t even kill myself correctly.

Trudging to the kitchen, she sank into a chair. Her mother looked at her, then at her watch, then back at her again.

“Which cereal do you want?” her mother asked, opening a cabinet. “Cheerios? Frosted Flakes?”

She rubbed her forehead and looked at the boxes.

Life,” she replied.


Tools I Regularly Use and Recommend.

Because I’m apparently not taking sufficient care of the Muse these days, I don’t have fresh stories to share right now. Thus, I instead present to you the tools I use to write and organize my ideas, in the event that you might find them useful for your work.

I was an ardent user of the now retired Writeboard. Though there are many who extol the virtues of Google Drive documents for rough drafts and editing, I found it lacking in comparison to Writeboard. I then stumbled upon Draft.

The feature I find most useful about Draft is the ability to review all previous drafts in their entirety. As I strive for brevity and clarity, sometimes I realize that what I had written in draft 2 is more useful than what I have in draft 7. It is easy to both review and compare what you previously wrote.

Draft also has a simple, uncluttered interface. The navigation is clear. The running list of documents (both in general and in any folders you have created) makes it psychologically easier to let go of (but not erase) those crappy first drafts, which often don’t seem as hopeless and terrible a few weeks or months later.

I use Field Notes to capture ideas and reminders. I’m fond of stationery and enjoy trying new notebooks. I’m that person who can spend hours at a stationery store, admiring all the different pens and pencils, looking with wonder at the staple-free staplers and brightly colored and curiously shaped sticky notes, and feeling the textures and weights of the pages in all the various notebooks. Many notebooks seem “too serious” for me: The sheets are crisp and formal, the cover fonts and designs are somber, and I worry that any scribbles from my mortal hand will ruin the pages.

An empty notebook is a useless notebook.

Field Notes are whimsical and hardy. As they travel through the world with me, the covers get dog-eared, pages crease, and the colors on the cover fade. Because they’re informal, though, these blemishes of time only add to their character and encourage me to fill the pages to completion.

I currently use bullet Space Pens to write in my Field Notes, though not because I am writing upside down, in oil, or in zero-gravity environments. Women’s pants often have small pockets and bullet Space Pens are small enough to remain inside the pockets. That’s it.

I otherwise am fond of Pilot G2 gel pens (ultra fine tip, usually black) and Marvy Uchida’s Le Pens (all the colors!). Le Pens have helped me get through many textbooks and journal articles.

Lastly, like this fellow, I am a believer of TeuxDeux. While I use Field Notes to capture the things I both need and want to do, TeuxDeux helps me schedule those things so that I actually do them. It is uncluttered, easy to use, flexible, and helps me stay focused on what I should do on a given day.

Though my penchant for paper makes me yearn for a paper-only organization system, the reality is that TeuxDeux is easier to manage. (As much as I would like to use the Bullet Journal system, I know I cannot sustain it.) I find TeuxDeux technical enough for efficiency and effectiveness, but not so technical that I spend a lot of time tinkering with it.

(May this be a sufficient offering to the Muse.)

Education Homelessness Policy Reflection

Commercial Sexual Exploitation.

I recently attended a presentation given by one of the founders of The Organization for Prostitution Survivors (OPS).

If you or your organization want to hear a compelling, educational, and thoughtful talk about commercial sexual exploitation, I encourage you to contact OPS.

The talk did not necessarily alter the way I go about my work as a psychiatrist, but it did challenge my assumptions about prostitution, highlight the different perspectives men and women have about sex (to be clear, the talk was not at all “anti-male”), and encourage me to reconsider the influences of our culture on commercial sexual exploitation.

I’ve included my notes and reactions from the presentation below. Any errors and lack of clarity are entirely mine.

The speaker (a man) began with a discussion about the social construction of gender. What does it mean to “act like a man”? The stereotype is that a “man” excels at sports, fights well, doesn’t show emotions (particularly sadness, fear, etc.), is dominant, and is skilled at and knows a lot about (heterosexual) sex.

Boys learn these stereotypes throughout their youth. Boys are eventually introduced to pornography, which may actually serve a means of male bonding (passing around a copy of Playboy, sharing links to online pornography, etc.). Pornography doesn’t teach boys how about sexual relationships, but instead offers flat, two-dimensional representations of women solely in the context of sex. Masturbation leads to orgasm, which is a potent reward for viewing women as sexual objects (instead of actual people).

The speaker then asked the audience for adjectives attributed to “good girls” and “bad girls”. The assumptions about “bad girls” are often the same for prostituted women[1. The speaker used the phrase “prostituted woman” instead of “prostitute” for the same reason that I use “man with a diagnosis of schizophrenia” instead of “schizophrenic”. Let’s please remember that we are talking about actual people here.] (they have multiple sex partners; they drink alcohol and use drugs; etc.). The words we use to denigrate women are synonyms for prostituted women: whore, slut, etc.

As a consequence, prostituted women become a legitimate target group for male violence. We somehow come to believe that it is okay for men to hurt prostituted women. They are, after all, “bad girls”.

The speaker discussed Gary Ridgway (the “Green River Killer”), who sought out prostituted women and murdered them. Nearly half of the women he killed were under the age of 18. The speaker asked why the media consistently describes these women as “prostitutes” and omits that nearly half of them were, in fact, “children”? What if we described Gary Ridgway as the “most prolific killer of children” in American history?

The speaker then described how a former pimp would find and select women (girls). His strategy was essentially this: If he spoke to a woman and she responded with any direct eye contact (even if she was flattered), he would walk away and end the “grooming” process right there.

Why? Because he knew that those women who made no eye contact with him already had life experiences that would make the pimp’s job easier. “Someone else has already beaten her down so I don’t need to do as much to make her work.”

The speaker then noted that researchers often wonder about the mental health of prostituted women… but why hasn’t anyone examined the mental health of buyers and pimps (mostly men)? Prostituted women often develop PTSD, which is unsurprising given the chronic trauma they endure while working. What is wrong with us as a society that we haven’t shown the same interest in what is “wrong” with the johns?

A discussion followed about the words we use to describe men viewing women. In the US, we often say that men “ogle” or “leer at” women. Those words have a “hubba hubba hubba!” quality to them; men who want an interactive, romantic relationship don’t “ogle” or “leer at” women. When was the last time you heard of a man “beholding” a woman?

One of the most striking points the speaker made was when he asked, “To the men in the audience: What do you do to protect yourself from rape?”

Silence ensued. Some men in the audience were perplexed.

“To the women in the audience: What do you do to protect yourself from rape?”

Many women answered immediately: “Travel in pairs.” “Keep my drinks with me at all times when I’m out.” etc.

Both men and women in the audience were stunned at the disparity of responses.

The speaker then discussed the issue of consent: Consent for sex should be an “enthusiastic yes!”, not something that requires negotiation. In prostitution, the exchange of money for sex is coercion. Economic coercion is never true consent.

The speaker also commented that buyers aren’t paying to learn the reality of the prostituted woman. If the girl is 16 years old and the buying man asks her age, of course she is going to say that she is 18. If he asks her if she has a pimp, of course she will deny it.

The speaker then challenged the audience to speak up even when someone tells a sexist joke against women. Doing so helps to construct a world of equality where women aren’t reduced to sexual objects. He commented that a sexist joke is on a continuum that also includes a man forcing his wife to have with him (“why did I get married if I couldn’t have sex with her whenever I wanted?”), paying a prostituted woman for sex, rape, and murdering women.

The speaker shared that prostitution “is like domestic violence on crack”. The cycle of abuse applies to both. He reported that prostituted women leave and return to their pimps between seven and ten times before leaving for good. It is often difficult for the women to leave because they often identify with their pimps due to something like Stockholm syndrome, though “trauma-bonding” is probably more precise. Prostituted women also frequently develop drug and alcohol problems as a means of coping with the ongoing trauma associated with the work. (Imagine getting into the cars of buyers multiple times a night without knowing if you will get hurt; imagine a pimp beating you because you did not bring back sufficient earnings; etc.)

The speaker also discussed the “bad date list”, which has historically been a paper list that prostituted women have passed around with names and identifying information of buyers who don’t pay, hurt the women, etc. He said that they hope to develop a “bad date” app because of the ubiquity of smart phones.

The speaker closed by discussing different models of managing prostitution in societies. He said that he is strongly opposed to legalized prostitution. He cited some data where states and countries with legalized prostitution often results in more sex trafficking and prostitution. He gave the example of Germany: The demand for prostitution has gone up since it has become legal, so Eastern European women are often lured and trafficked into Germany to work as prostitutes.

He expressed hope in the “Swedish model“: Sweden has taken the approach that women working in prostitution are victims and, thus, the selling of sex is not considered a crime. However, buyers, pimps, and traffickers are prosecuted to the fullest extent of the law. Some data suggests that, as a consequence, there is less visible prostitution and fewer women working in prostitution.