I Aced the Test! Part 4: Know thy enemy

I promised we’d take a look at the consequences of long-term stress (and, by association, trauma) on the body, didn’t I? That’s today’s topic so buckle up, Class.

Before I jump in, I want to define a few terms so we’re all speaking the same language.

The amygdala is a little almond-shaped cluster that controls your emotions–namely, fear and the fight/flight/freeze response. Memory and decision-making are also controlled by the amygdala.

The autonomic nervous system controls all unconscious processes, like breathing, blood pressure, and heart rate. Think of it like a car with automatic transmission, or being on autopilot.

Adrenal glands produce adrenaline and cortisol when the body reacts to a stressor. The inner medulla is the part that produces the hormones epinephrine and norepinephrine, which help kick off the whole fight-or-flight response.

In a nutshell:

Stressors trigger the sympathetic nervous system and hormones come rushing in full-bore. The amygdala enters the chat, which sets off a chain reaction with the adrenal glands and other endocrine systems. Your blood pressure goes up, your heart rate increases, you sweat. Without you even noticing it, your body is preparing to take one of three paths: fight, flight, or freeze.

When in crisis, our bodies and minds work in tandem to respond to the situation. The good old autonomic nervous system kicks into gear, triggering an immune response (which is designed to protect the body and fight off “intruders,” so to speak)¹. This immune response releases histamines, which are also the cause of hay fever symptoms like itchy eyes and hives. It may sound counterintuitive, but all of these unpleasant symptoms are part of your body’s fight to keep you alive. The second the stress hit that tiny little amygdala, you were no longer in the driver’s seat. Ever since that moment, you’ve been on autopilot–think of your body as a kind of gundam suit designed to protect you by any means necessary. This response is as effortless and natural as breathing. 

When most people hear the word “adrenaline,” they often imagine a scene such as a mother lifting a car off her baby. Our entire autonomic nervous system is wired to keep us alive, and the body can do incredible things when under acute stress. 

However, you can’t sustain that level of intensity forever. Think of a rubber band. You can only stretch it so much before it begins to lose some of its elasticity, and the same principle applies to stress and the body. Our bodies are not built to sprint at 84,000 miles per hour 24 hours a day, 8 days a week, and that’s precisely what long-term stress demands of you. 

Miller, Chen, and Parker (2010) describe stress as something that “accumulates” in the body’s cells. What this means for you, dear Reader, is that your body is in a constant state of inflammation because those hormones are poppin’. Even if it’s more of a wallflower than the life of the party, that inflammation is still there. 

This leads us to our next point: vulnerability for chronic illness. When your body is constantly on high-alert, it reacts to stimuli that may not bother the average bear. Many trauma survivors have at least one, if not multiple, chronic health conditions. Autoimmune disorders such as lupus are more common in adult cis female trauma survivors². Additionally, the odds of an autoimmune disorder causing an individual’s first hospitalization were higher among adults who reported two or three different types of childhood adversity, such as physical, sexual, and/or verbal abuse; parental neglect; or having a parent or caregiver who struggles with substance abuse or mental illness³. 

There is a strong behavioral component to this complex issue as well. Early trauma leads to hypervigilance and mistrust, meaning there are cognitive and emotional factors layered on top of the biological aspect. (It’s like the world’s worst sandwich, basically.)

Let’s pause for a visual aid. I wonder how many of you are familiar with our good friend Ouroboros. 

Picture the biological factors as the head of the snake, and the cognitive/emotional factors as the tail. Or reverse it. Either way, they are simultaneously feeding and devouring each other. Much like our old pal Anxiety, stress feeds itself. 

So, that probably sounds terrifying, right? It doesn’t have to be. Here are some platitudes to explain why:

• Knowledge is power.
• Know thy enemy.
• If it bleeds, we can kill it.

If we know what our own vulnerability factors are, we can find ways to counter them. If you have a chronic illness, make sure you’re keeping in touch with your doctor and taking any medications you’re prescribed. Try to eat well, stay hydrated, get enough sleep. Take at least a minutes throughout the day to do something you enjoy and celebrate being alive. A client once very astutely described living (versus surviving) as “nurturing the being as well as the human.” We exist on many levels–physical, emotional, cognitive, spiritual. Please be kind to yourselves and send love into the darkness.

One final note:

Take care of yourselves, Readers. Go take a safe, socially distant rainbow walk. Get some vitamin D–it’s good for you! Read a book. Plant a tree. Take a hot shower with a frozen orange. Meditate. And for the love of god, wear a mask and stop touching your face.

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1 Quas, J. A., Bauer, A., & Boyce, W. T. (2004). Physiological reactivity, social support, and memory in early childhood. Child Development, 75(3), 797-814.

2. Roberts AL, Malspeis S, Kubzansky LD, et al. Association of trauma and post-traumatic stress disorder with incident systemic lupus erythematosus in a longitudinal cohort of women. Arthritis Rheumatol. 2017 Nov;69(11):2162–2169.

3. Miller, G. E., Chen, E, & Parker, K.J. (2011). Physiological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a mdoel of behavioral and biological mechanisms. Psychological Bulletin,137(6), 959-997.

I Aced the Test! Part 3: The COWs are out to pasture

Disclaimer: Growing up in the Midwest, I never encountered any actual stories/incidents of cow-tipping. But my god, I wish I had.

In 1959, Carl Rogers coined the acronym “COWs,” or Conditions of Worth. According to the man himself:

“The self-structure is characterized by a condition of worth when a self-experience or set of related self-experiences is either avoided or sought solely because the individual discriminates it as being less or more worthy of self-regard. … A condition of worth arises when the positive regard of a significant other is conditional, when the individual feels that in some respects he is prized and in others not. Gradually this same attitude is assimilated into his own self-regard complex, and he values an experience positively or negatively solely because of these conditions of worth which he has taken over from others, not because the experience enhances or fails to enhance his organism.” *

TL;DR: We crave unconditional positive regard from our caregivers pretty much from the get-go (example: “I will love you no matter what”). Unfortunately, a lot of times, you end up with a child receiving the message (whether overtly or through subtext) “I love you if/when you ___” and/or “You’re bad/undeserving of love/etc. if you [insert thing that caregiver/person of influence has determined is bad].”

That’s radically different than the message of “I love you, you’re safe, I’ll take care of you” that we instinctively need. Again, the pleasure principle applies: We’re hardwired to gravitate toward what feels good and avoid what feels bad. 

Ironically, it’s the uncomfortable things that stick in our minds. Think about a time you received a critique at work or got into a fight with a loved one. When you think about that day, what do you remember most–the critique/fight or everything else you did within that 24-hour span?

That negative little voice in your head–whose is it? A parent? A friend? A romantic partner? …

Yourself?

This is where core beliefs come into play, but that is an entirely different discussion for another day. In the meantime, take a look at this worksheet for more info on core beliefs and how to identify yours.

This is one of the reasons why those pesky ACEs are so persistent, even years later. We may be designed to move toward the comfortable, toward stasis, and yet we’re awesome at making ourselves miserable.

The next post in this series will focus on the biology of chronic stress and how ACEs can be a risk factor for certain illnesses. In the meantime, readers, take a moment to reflect on the following questions about your own inner monologue/critic. 

 

* Rogers C (1959) ‘A Theory of Therapy, Personality, and Interpersonal Relationships, As Developed in the Client-Centered Framework’, in Koch S (ed) (1959)

I aced the quiz! Part Two: That face.

Okay, so now that we know what ACEs are, let’s get a little more personal.

To begin, I’d like to share with you two pictures from my childhood.

1993, age four

1994, age five – kindergarten photo

Are these the same child?

Yes.

In the photo on the left, I am dolled up and mugging for the camera. I’m not sure who took me to get my photo taken that day (probably at Sears). If it was my biological mother, she was having an exceptionally good day. The reality is that one of my aunts probably arranged the whole thing. But I look happy, round-cheeked, grinning at the camera with a twinkle in my eyes.

In the photo on the right, taken roughly a year and change after the first, I am posing for my kindergarten photo. I was grumpy partly because of that damn cowlick, but also because my home life had basically gone to hell in a handbasket in the space of a year. My mother was drinking again, heavily. She would often leave me alone in the house at night to go out to bars. One of my earliest memories is waking up alone and wandering through the darkened house. I walked outside and paced the sidewalks for what felt like hours, watching as the lights in the houses lining the street flickered off, one by one by one.

Readers, that is the loneliest I have ever felt in my life.

If we ignore the backstory and focus only on the images (lighting and photo quality aside), what remains is this: The girl on the right has lost all the baby fat from her cheeks. Her eyes are huge, dark, and sunken. She is trying to smile but her teeth are gritted. She does not look at the camera, but rather past it, as if trying to see something in the distance. You know, that old chestnut–the Thousand Yard Stare.  Still a cute kid, but not the type of child you’d look at and go, “Oh, yeah, she’s doing well.”

Chronic stress changes the body in a myriad of different ways. I’ll touch on the biology of chronic stress (behavioral medicine is a fascination of mine) in the next post, but for now, let’s focus on face.

They say the eyes are the windows to the soul. If we peeked through your windows, what might we find? I’m looking forward to hearing from you, readers!

I aced the quiz! Part One: Know thy enemy.

Disclaimer: The information contained in this post is not intended to diagnose or treat any condition. I am a licensed therapist, but I am not your therapist. 

I ACEd the quiz! Tongue firmly in cheek, of course. There is no quiz, but today I would like to touch on trauma and its physical effects–hence the reference to ACES, or the Adverse Childhood Experiences Scale.

As any even casual reader of the blog knows, trauma is kind of My Jam. I love working with clients who are struggling with the same core issues I struggled with the first 20+ years of my life. I knew that was going to be bailiwick from the time I started therapy myself, at 18, but I didn’t really do much with it until I entered grad school and suddenly had to write a thousand different papers (that were not centered around arguing whether the box of money in Faulkner’s The Sound and the Fury is actually a box of shit. Look it up. It’ll change your life).

When I got my very first assignment, my brain went “PING!” and told me trauma was the area to hit. It’s a touchy area, for sure. Go too fast, and you risk re-traumatizing your client and damaging rapport. Go too slowly, and your client will stagnate. It’s like a dance.

The ACES study began in an obesity clinic in 1985, believe it or not. Physicians were interested in figuring out why people kept dropping out of their weight loss program; long story short, they developed the Adverse Childhood Experiences Scale and administered it to their patients. The results were unprecedented: they uncovered a link between childhood trauma and struggles with controlling their weight later in life. 

I’d love to wax poetic about the biology of chronic stress and implications for adulthood, but that needs its own post.

On to the significance of ACEs. The instrument itself is simple–ten self-report items, scored either “0” or “1.” I’ve re-typed it here for the sake of your eyes, but you can see the original and lots of great info on acestoohigh.com.

To avoid inadvertently triggering readers, I’m going to put the actual scale underneath this spoiler tag, as the questions do involve all forms of child abuse.

On Vulnerability

There are so many words in the English language relating to innocence and vulnerability, and most of them can bring me way down if I’m not careful. They provoke some ancient anxiety that I’ve come to realize, with the help of my excellent therapist, are linked to what she calls my “wounded younger self.” (I was incredibly skeptical of inner child work at first, but it is incredibly effective and incredibly healing.)

“Little” is an adjective that, when paired with certain words that also remind me of innocence, usually messes me up emotionally. That’s the word that got under my skin tonight.

I’ve been feeling kind of “off” the last few days. I recently blocked my mother completely on my phone–including the second number I thought she’d deleted until she used it to contact me after I blocked the first number–and was treated to some really unsettling dreams on Monday and Tuesday night.

Monday’s main feature involved me skipping my grandmother’s birthday party because my mother was going to be there and I knew she’d be drunk. Tuesday’s late-night horror show involved a healthy helping of guilt because I was hiding from her (in a Target, of all places) while she wailed and lamented that she “couldn’t believe [I] didn’t want to talk to her.”

Naturally, this put me in a pretty weird headspace today. Wednesdays are my big clinical days and I do group as well as individual client work. As such, I generally store my feelings away to deal with later and do a pretty good job of not thinking about them at all during the day because I’m 100% focused on my clients. (Side note: I adore them, and I’m bummed that I’m leaving my practicum site in a few weeks!)

On the drive home from class this evening, though, those neglected feelings reared their ugly collective heads and roared.

The anxiety and guilt were so powerful that I considered just going to bed early and sleeping it off.

Instead, I took a shower.

I focused hard on those thoughts and attempted to get a good, cathartic cry in. Nothing happened.

I turned the focus to that wounded younger self I mentioned and took the opportunity to literally hug myself while I waited for the conditioner to work its magic on my decidedly unruly hair. I decided to speak aloud because I’m home alone most days during the week and hey, I knew the cat wouldn’t judge me. (Audibly, anyway.)

I told my younger self that it’s okay. I told her I love her and that I’m sorry she felt like no one could keep her safe. I told her that I’m going to do it. This changed into me speaking to whatever hypothetical future child I’ll end up having. I promised that child to take the best care of it I can and to make sure it never feels afraid or lonely.

And I cried. Instead of stifling it or trying to be tough, I gave myself over to it completely–ugly, wracking sobs. After a while, those sobs turned into relieved laughter that I’m sure sounded like I’d finally gone completely ’round the bend.

I think there’s something to be said for having a good cry.

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On Monday, I spoke to my clients in group about the concept of “ghosts”–they had all shared some intense and profound stories about their deepest wounds, their secret shames, their most painful memories. I told them that while they can haunt you, they can’t physically hurt you. You can start to let go of them.

I led them in one of my new favorite exercises, which is “HA!” breathing. Basically, you take a deep breath and push that breath out while making a “HA!” sound. I opened the group with the exercise and invited them to imagine themselves yelling at someone or letting frustration out. I demonstrated (because I am not afraid to look silly anymore), and they loved it. After the big, intense sharing session, I led them in the exercise again, this time instructing them to imagine the “HA!” on the exhale as them blowing out part of their ghosts.

I’m glad it was a hit, and I encourage you all to try it, readers. Howling into the void or, as I called it, “therapeutic yelling,” is incredibly cathartic.

 

It’s okay not to go home again.

For Thanksgiving, we flew back to my hometown in the Midwest to visit my remaining family–my mother, the aunt who was my legal guardian when I was a child, and another aunt who lives about an hour away from said hometown but visits regularly.

As I told my therapist this afternoon, “I don’t want to say it sucked, but…it sucked.”

I don’t want to get into any of the messy details, but I realized a few things during our brief Thanksgiving trip.

The first is that my grandmother is dead, like, for real-real. My “mom” is dead. Full stop. It’s not that I was pretending otherwise, but being in her house without seeing her there drove the point home in an unexpectedly painful way, and I had to hold it together while I was there because I knew if I lost it, so would everyone else, and then it’d be this whole terrible thing that I was just not equipped to handle.

The second is that it’s not normal to spend the week up to your flight being anxious and trying to brainstorm ways to defuse any potential arguments. It’s not normal to be five minutes from landing in your hometown and freaking out because you have no idea how many fights there will be this time or how bad they’ll get.

The third is that it’s simply not healthy for me to go “home” again. My therapist agreed with this assessment–there really is nothing there for me anymore. I’m 28 and am building my own life, my own family. If anyone wants to visit me, they know where I am. There are several large airports nearby. I never turn my phone off, though I have become more selective about when I answer calls–if I’m emotionally exhausted and have nothing left to give that day, I let the call go to voicemail.

It’s not like I’m unreachable. I just don’t want to make the effort anymore. I’m tired of throwing myself out into the wilds of my family-of-origin and hoping I come back in one piece. I’m tired of having to tell them, “Hey, I flew all the way here, can we all just get along?” I’m tired of having to put a dog into the fight. I’m tired of there even being a fight.

I went back “home,” and all I got was the flu and three days of crippling anxiety and depression.

Readers, it’s okay to set boundaries. If, like me, you’ve finally hit your breaking point, please try not to feel guilty about it. You need to take care of you first. You can’t pour from an empty cup, and life is too short to spend it with people who make you miserable.

News Day Tuesday: Local Mental Health Resources

Good afternoon, readers! This time, let’s talk local resources for mental health care.

I saw a wonderful counselor through the Johns Hopkins Student Assistance Program (which I’m eligible for because my significant other is currently a student). I’ll share more of the personal details in a post later this week, but the counselor I met with gave me some information about local resources I had no idea existed, and I’d like to pass those on to you. I feel they’ll be particularly useful to anyone in the Baltimore area, but I’m sure there are similar programs throughout the country.

First is Sheppard Pratt. Being new to the area, I was unfamiliar with this hospital, but they have a program specifically designed to help people dealing with all sorts of trauma.

The Trauma Disorders program at Sheppard Pratt specializes in dissociative disorders and CPTSD, which is exciting because I had no idea these types of programs existed anywhere. They certainly weren’t a thing in the Midwest, where I’m from. It’s an inpatient program, which isn’t a good fit for me for a number of reasons, but I plan to reach out to see if they know of any good outpatient therapists who are well-versed in these issues.

It’s comforting to know that there are facilities that offer support specifically tailored to complex post-traumatic stress disorder, which can present challenges to many therapists. I found one therapist during my time in Madison who seemed to know quite a bit about PTSD, including my dissociative symptoms, but she went on maternity leave shortly after I began seeing her. My subsequent searches for therapists was largely unsuccessful, which is not a negative reflection on any particular counselor–as I said, it can be a tricky affliction to effectively treat. I’ve been told that because of the depth of my dissociative symptoms, I’m not a great candidate for EMDR, which eliminates one of the most widely-used techniques for treating PTSD.

The second resource I learned about last Friday is the Baltimore County Crisis Response, which offers not only crisis intervention (as the name suggests), but also a 24-hour hotline and–this is the most exciting part–one-time psychologist and psychiatrist consults, which are particularly useful for people who are in a transitional period and looking for providers in the area but need refills of medication or therapy. That’s right, readers; there’s actually a place you can go for those all-important refills you can’t get anywhere else, which means no more rationing of medication to make it through.

The counselor at JHSAP was also kind enough to email me a long list of references for therapists in the area. Admittedly, I’ve been procrastinating a bit and haven’t gotten around to checking them out, but it’s on the list for this week.

Are you aware of resources and programs in your area, readers? Are they easy to locate, or do they require a bit of digging?

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Five stigmatizing/problematic phrases and why you should stop using them.

I’m generally a pretty tolerant and patient person when it comes to talking about mental illness— I want to be polite and educate people and I think it’s counterproductive to get pissed off about every single thing (also, I don’t have the energy for that). That being said, there are a couple of phrases I hear on a regular basis that make my blood boil. They’re often used out of ignorance, not actual malice, which is why I believe it’s so important to call people out and use the mistake as a teachable moment.

1. “I’m so OCD about that!”

What people usually mean: “I have some quirks and like to have some things a certain way.”

Why it’s hurtful: Obsessive-compulsive disorder is a mental illness, and by misusing this phrase, you’re essentially invalidating the everyday struggles of those living with the disorder.

One of the main characteristics of the disorder is obsessive, invasive thoughts, ideas, or behaviors that often interrupt other thoughts or activities. In order to alleviate these thoughts, the person typically has to partake in a certain behavior or set of behaviors (sometimes called rituals)—this is the compulsive part of the disorder.

For example, I’m sure you’ve all heard of the fear of being contaminated/hand-washing obsession/compulsion. What people don’t realize is that many people living with OCD find the disorder distracting, disruptive, and embarrassing. By saying things like “I’m so OCD!” you’re minimizing their very real concerns and struggles and turning it into a cutesy one-liner. Don’t do that.

2. “I don’t want to go to that party; I’m so antisocial.”

What people usually mean: “Well, ‘social’ means you like being around people, right? So ‘antisocial’ must mean the opposite!”

Why it’s hurtful: This one actually does piss me off because the people who say this are completely misusing the word. It doesn’t even mean what you think it means so in addition to trivializing a very real and serious disorder, you’re also making yourself look like an uneducated ass-hat.

In reality, “antisocial” refers to a specific personality disorder, the hallmark of which is a persistent disregard for the rights and feelings of others. There’s a whole list of diagnostic criteria at the linked page, but the most common example/trope used to describe this disorder is the person who hurts people and feels no remorse for what they’ve done.

People with antisocial PD are not bad people. It’s problematic and can cause a lot of emotional damage, but again, the thing to remember with any mental illness is that the person suffering from it did not cause it.

3. “I’m so bipolar!”

What people usually mean: “I had, like, one mood swing today and it took me off-guard so I’m going to misappropriate a mental illness because of my very general and poor understanding of what it actually is.”

Why it’s hurtful: Like most of the examples on this list, “I’m so bipolar!” is problematic because it minimizes another really serious disorder by presenting it as one-dimensional, and that one dimension everyone knows about is the mood swings. If you ask a person on the street what they think bipolar is, nine times out of ten they’ll say “mood swings.”

That’s why this phrase is so damaging—it completely ignores all the other symptoms of this very complicated illness. I’m assuming most of you have been following this blog for a while, so I’m sure you’re familiar with what goes on in the brain of someone who’s bipolar. (I prefer the term “manic depressive” because while it’s technically outdated, it’s more descriptive than “bipolar,” implying a range of emotions rather than two strict “poles.”)

If you’re new or need a refresher, check out NIMH’s website for an awesome and relatively simple description.

4. “He’s so schizo/psycho!”

What people usually mean: “He is behaving erratically or in a way that does not make sense to me.”

Why it’s damaging: This is two-fold.

First of all, schizophrenia is a particularly severe mental illness; there is no cure, and treatment options are kind of dismal at the moment. When you call someone “schizo” when you’re referring to nonsensical or erratic behavior, you are (once again) minimizing the actual severity of the illness and all of its nuances.

This is bad for one simple reason: it perpetuates misinformation and makes it seem like having a mental illness makes someone “bad,” which perpetuates the stigma.

The same goes for the term “psycho.” I’ve actually cut people out of my life for repeatedly using the term after I’ve explained why it’s so harmful and offensive. “Psycho” usually refers to “psychosis,” which is a break from reality. It can happen for a variety of reasons—trauma, substance abuse, or mental illnesses like schizophrenia (the one most people associate with psychosis) or bipolar type I (psychosis/hallucinations/delusions are not at all uncommon during severe manic or depressive episodes).

You say “He/She is psycho/schizo,” and what happens? People laugh. When you misuse those words (and really, you shouldn’t be using them at all because they’re offensive abbreviations that are always used in a derogatory manner), you’re telling people that it’s okay to laugh at people with mental illnesses because they’re “different.” They’re “crazy.” I’d like to think that the people who fall into this category are simply misinformed, but the reality is that there are a lot of terrible people out there who are unwilling to learn or change their behavior.

5. “She’s crazy!”

What people usually mean: This can mean one of two things. It’s sometimes used as a positive descriptor, in which case it means something like “She’s wild and uninhibited, which makes her fun.” I really don’t have a problem with it being used in that context because “crazy” is one of those words that can be used in a variety of ways, and this one happens to be complimentary. If you want to use that term to refer to yourself as a coping mechanism/making light of the situation, that’s totally fine. It’s when other people begin to use it that it becomes an issue (if you haven’t given them permission to do so). But in general, I still believe that people who aren’t mentally ill have no right to use that word to describe someone.

When it becomes problematic: When it’s used to hurt people or make a generalization about someone’s mental health. I’ve had “You’re crazy” thrown at me hundreds of times in the last twenty-some years, and it has almost exclusively been used to mean “You’re unhinged, you’re different, you’re not like us, there’s something wrong with you.”

That’s what stigma is—perpetuating the idea that the mentally ill are somehow “different” or “wrong,” not like the general public and certainly not worthy of being treated like people who are mentally healthy.

I’m sure you’re having the knee-jerk “Jesus H. Christ” reaction when you read it broken down like that—or at least, I hope you are. I hope you realize that it’s definitely not okay to discriminate against another human being for any reason, and I hope you’re doing your part to call people out and be more mindful of your own phrasing.

What to do when you’re called out: This is pretty simple. There are three steps to dealing with being called out for saying something problematic:

1. Listen to what the person is saying and make every effort to understand why they’re upset.
2. Apologize sincerely. Say something like, “I’m sorry for saying x. I didn’t realize it was hurtful, but now that I know, I am going to do my best not to say it anymore.”
3. And then move on. Don’t get butthurt or dwell on it (“Those mean social justice people! They’re too uptight, they made me feel bad, bawwww.”) Just take it as a learning experience and try to use what you’ve learned to educate other people.

That’s really the only way we can fight this thing, the gigantic stigma-beast that makes life unpleasant, if not downright hellish, for most of us. At some point, we’re going to need people on the outside, allies who aren’t mentally ill (and remember, “ally” is a verb, not a noun) to help spread the word and back up what we’re saying.

The sad reality is that a lot of people are dismissive of our experiences with mental illness because we’re mentally ill, and therefore we’re apparently not credible sources about our own oppression. (Lollll.) And common sense tells us that the more people are fighting this battle, the more people we’re going to reach and the more minds we’re going to change.