When I was 15 a "friend" - whom I had tried to disclose OCD obsessions and resulting compulsive behaviors to - told me that my mental illness was "all in my head"

Like, no shit Carroll.

I've learned a lot since then - like that things being in your head doesn't make them not real.

The impact is real, even if the perception is different for one person than another.

And if all we have to understand the world with is our perceptions... idk. Not everything "real" can be seen or heard or touched.

And things that can be seen and heard and touched are *still* perceived differently from one person to the next.

Like, if you don't have a sensory processing disability... I can *promise* you that I experience seeing and hearing and touching very differently than you do.

And on that note - If we define what is "real" and what is "in your head" based only on neurotypical experiences... how do people like me fit into that model?

Idk, if it was *only* me maybe you could make an argument. But literally hundreds of thousands of people don't experience senses in the "typical" way... At what point are there enough of us that we stop being the "exception" and become part of the equation?

When we move this into things like discussion of OCD obsessions... many could be argued to be "all in your head"

Like, when I was little I had to cross the street if I saw an oak tree because I was afraid they would kill me.

On the one hand, that's very unlikely

On the other hand, like most OCD obsessions, the rule came from somewhere *real*

In my case, I had had a mild allergic reaction to an oak tree. My brain, prone to anxiety, latched onto that.

A *real* situation happened that caused a *real* anxiety response and *real* behavioral changes.

How, exactly, is that all in my head?

To an outsider, "If I walk by an oak tree I'll die" is a bit of a silly thing to even think. It's easy to say "oh that's all in your head"

And like... yeah, no shit. I have a mental illness. My head is exactly where that takes place.

But also, my experience is real.

I think this applies to mental illness with more stigma too.

Sure, hallucinations aren't "real" in the sense that other people cannot experience them. At the same time, if you see something scary, it's going to scare you... even if nobody else can see it. That's a real impact.

Are alters in plurality "real"? I mean I think so - in the same sense that any human is. You have an existence, experiences, and unique perception from other people too, don't you? You just don't usually have to share a body with those people.

But by the definition people usually use - of things you can see & hear & feel - alters must be very real because often if you know them well enough you can tell behavioral differences. Unlike hallucinations which other people can't see, alters existing is sometimes *observable*

I think of it similarly to identical twins - when I first meet them it is really really hard to tell them apart, but the more you get to know them the more you pick up on subtle behavioral differences, different language use, etc

Yet... alters are often also called "not real" and "all in your head"

It seems more and more that the standard definition of what is "real" and what is "in your head" is *not* based on sensory experiences at all. Not even if multiple people experience them.

It's based instead in a single, neurotypical understanding of the world with set rules and set sensory experiences that are accepted as real - everything else is dysfunction.

I'm not saying that having atypical experiences doesn't have an impact on mental health... because it does. ESPECIALLY in this society where having atypical experiences is so stigmatized.

But I've also been looking at research recently that indicated that folks w/ schizophrenia had *better* long term outcomes in "developing" countries than "developed" - despite the fact that the "developed" ones were supposed to have more information & resources on schizophrenia.

Difference mostly came down to community involvement. Was the person allowed to continue being involved in the community, but in accommodated ways when symptoms were present?

Or were they isolated & put under the care of professionals to "fix" the things "all in their head"

And it makes me think about autism...

Most autistic people are more concerned about sensory issues than learning to make eye contact. Yet therapy is focused primarily on behavioral intervention meant to normalize. The sensory experiences that cause stimming... "all in your head"

Seems to me that things would go better if we stopped trying to convince everyone that their experiences weren't real and instead accepted that everyone has a different lens to perceive the world through. Just because *you* don't experience something, doesn't make it not real.

Let's skip to the part where we actually help people process what they're *trying to tell you* that they experienced.

On a related note, I love this video -

Can y'all tell I want to be a therapist? Lmao