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Double-binds [Jul. 11th, 2009|09:45 am]
[Current Mood |awake]

The first time I clearly recognized a double-bind, I was a skinny (too skinny, my family physician said) teenager.  Over the long haul, the cause was impacted, infected wisdom teeth that gave me a near-constant low-grade fever, aching joints, and also destroyed my appetite (most things tasted bad) but that wasn't discovered for another few years.  Right then, my doctor was urging me to eat more and suggested having a malted milk with an egg in it when I came home from school every day, recommended two peanut-butter sandwiches instead of one, and so on.   Then I went to the dentist, who did not detect the subterranean dental infection but instead told me not to eat peanut butter, sweets, or drink things like malted milk. 

I said he should talk to my doctor, because I was supposed to eat peanut butter and drink malted milk...at least I recognized the double-bind--no matter what I did, it was going to be wrong.   That made me think about the other double-binds in a girl's life back then (and probably now, as well.)   

We girls were supposed to dress and act "feminine" and want boys and men to think of us a pretty and dainty and so on...but if we attracted male attention that went beyond what was considered desirable, it was our fault for "showing ourselves off."   Girls who didn't show themselves off were scolded, lectured, coached in how to be attractive and warned about the consequences of not caring, not trying....but also scolded if we guessed wrong about the results of our attempts.  And where I grew up, with a mix of cultures who did not at all agree on what the right limits were for girls (which meant, what limits their boys were supposed to respect, boys having, all agreed, no self-control beyond that point)  it was impossible to satisfy everyone.  A dress that one group considered the right level of feminine would be, to another, too revealing or too dowdy.  You couldn't win.

Another double-bind, familiar to mothers of sick children, is the one about when to see the doctor.   Many illnesses--both serious and trivial--start the same way.   The runny nose, the sore throat, the little cough, the bit of fever, the child who just doesn't feel good.   It might be a cold.  It might be something else.   If you take the child in early, you're told to go home and wait it out....if the fever doesn't go away after x-many hours or days, then come back.   If you don't take the child in early, and it turns out to be serious, some medical person (and if you're unlucky, CPS) will demand to know why you didn't bring the child in sooner.  (Because the last three times, when I did, you told me to go home and see if it got worse or lasted too long...)    On the one hand, you can be the silly, over-anxious mother over-using medical resources that the nurse or doctor can feel superior to, and on the other hand you can be the stupid, neglectful mother who should have brought your child in two days ago (when he had the runny nose, the slight fever, the sore throat just like all the previous ones...)  You can't win.   It is next to impossible to pick the exact right moment to bring in a four-year-old with sniffles, sore throat, and a fever, unless you have a doctor in the house.  

I was reminded of this recently when looking at the hurricane season and flu season recommendations for preparedness and remembering the scorn heaped on some who, in emergencies, are found not to be as prepared as their critics think they should have been.   Take for instance the matter of medicines.   People are urged to have extra medicines on hand, in case they can't refill them when they usually would, or are being evacuated and won't be near the pharmacy that has their records.   You find this recommendation on all the sites that talk about emergency preparedness. 

But many people are not allowed (by law, by their doctor, by an insurance company)  to stockpile even two weeks' worth of medication.   This is not even talking about narcotics...this is true of many if not most prescription drugs--for heart conditions, hypertension, diabetes, for any chronic condition.   They must finish up the bottle of pills they have, before they're allowed to have another...they must be completely out before they can get more...which means that they cannot be prepared, medically, for any interruption in service even though such interruptions are predictable in emergency situations.   And now, with so many people in financial distress through job loss, bankruptcy, etc.,  they cannot afford to buy an emergency backup supply on their own, even if a pharmacist would sell it to them.  

So they are subject to disapproval and denial of services for even wanting to follow preparedness recommendations, and then sneered at for not having followed them when they cannot comply.  They can't win.
The people who give out the preparedness advice can feel smug and justified in dumping on those who don't do what they're told...the people who deny drug refills that would give the user a cushion between refills can feel smug about preventing drug abuse or waste or whatever reason they have...and neither one wants to look at the whole situation.   Two smug people are unlikely to get together and realize they have no justification for feeling smugly superior to those whose lives they make harder.  (Smug is a comfortable feeling.)

Several times now we've been involved in helping out families displaced by big hurricanes.   It makes clear how close to the bone coastal families (we've dealt with ones from Louisiana and Texas) often live, and how little they may escape with.   I've heard about the inability to refill prescriptions, the difficulty of getting them filled outside the home county (especially for those on Medicaid, whose benefits are set state by state.)   How impossible it is for so many people to comply with the advice, and how conflicting advice is commoner than you might think.  

We love to make rules for other people.    It appears to be a common human trait, from the restrictions on women's dress set by various religions, to the restrictions on hair style for both genders (also often set by religions), to the rules set at all levels from homeowners' associations to Congress, from schools to insurance companies.   Even the people who claim to be against laws and rules have rules of their own, which they happily impose on others if they get a chance.   And since many such groups make rules, the rules do not agree, and many people--including some of us--are caught in these double-binds where it is impossible to follow all the rules. 

At least we can learn to recognize the double-binds and reveal them to the rule-makers...and have some compassion on those who are caught in them.


[User Picture]From: mirtlemist
2009-07-11 03:58 pm (UTC)
So true! Another double bind are all the rules about self-defense. I used to live with my sister and bil back in the day, briefly. He was a marine in the MPs. He used to give me lectures on just how much was legally allowed or I would be the one carted off to jail: I had to warn repeatedly that I had a loaded weapon and would use it; perp had to enter the premises by force; I was to retreat to a locked room and wait for perp to beat down the door; I couldn't shoot until perp was at least five feet from me with the declared intention of doing bodily harm; etc. I was 17 at the time and terrified I'd forget some technicality.
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[User Picture]From: e_moon60
2009-07-11 04:23 pm (UTC)
Oh, yeah. Not just the variable and inconsistently applied rules on the use of lethal force but all the other double-binds women are put into in case of attack.

Police routinely criticize women who resist too forcefully (like the little old lady who bashed the intruders over the head with a pot, or the one who held a robber at gunpoint) because "you might be hurt" but they also tell women to resist abduction...

They're very uncomfortable with women who don't act what they consider "normally" (i.e., as pure victims, sheep in need of a sheepdog protector) but also contemptuous of women who do.

And then there are their rigid internal rules on how family members should act after a tragedy...which allows them to suspect foul play if anyone in the family doesn't follow their particular script. I have enough experience in emergency medical situations to know that yes, family violence is a major cause of trauma...but I also have no faith whatever that the police (or anyone else) can tell from any particular grief reaction whether it's genuine or not. Some people are hysterical, some are stoic, everyone does it his/her own way, progressing through grief at his/her own pace. Every time I see some TV program (news or fake-news) where a policeman is declaring that so-and-so wasn't upset enough, or was too upset, I think "You idiot. Wait til it happens to you."

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[User Picture]From: msminlr
2009-07-11 05:37 pm (UTC)
Some chains of pharmacies are better than others about communicating throughout the network for away-from-home refills. I have heard good things that way about Walgreen's and WalMart both.

Another tactic for people who live in the Hurricane Belt might be to ask for spare original prescriptions from their MD's, to keep packed in-with their bug-out kits. Would the MD be able to write a script that is time-limited [e.g. get it written sometime in May and it is not fillable after the end of that calendar year]?
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[User Picture]From: melissajm
2009-07-11 06:29 pm (UTC)
I tend to keep one on file, though since my doctor's retiring apparently I can't right now.
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[User Picture]From: mevennen
2009-07-11 07:04 pm (UTC)
My late partner introduced me to the concept of the double bind (theory, not through practice) and I have been grateful ever since, as it taught me to really watch out for them. And there are so many kinds of double bind that people try to lay on you, as you've outlined above... Very insidious.
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[User Picture]From: e_moon60
2009-07-11 07:10 pm (UTC)
Although there are certainly control-freak abusers who try to trap people in double-binds, I think the more common occurrence is "innocent" (though no less painful): sometimes individuals who haven't thought through their own criteria (such as the clinic that has never really considered if it's possible for a mother to tell one sniffle from another) and sometimes rules made by groups who never got together and compared notes. Each may have had a reasonable (at least on the surface) goal in mind, but when both have or claim the right to make rules for the same recipients...double binds are certain to result.

At least, I like to think that most double-binds aren't intentionally placed.
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[User Picture]From: e_moon60
2009-07-11 09:04 pm (UTC)
Yikes! That sort of things sure turns on my flame-thrower.
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[User Picture]From: kengr
2009-07-11 09:05 pm (UTC)
A couple of lovelies from the welfare and related agencies.

First is back in the 70s, but I'm told this part of the rules is essentially the same.

I was trying to work thru the explanation of how they calculate your "food stamp income". First part was pretty straightforward.

Take monthly income after taxes, subtract medical expenses. That's your "adjusted income". Call it X.

Next was the odd part. You do some weird calculations (I had to sit down with a sheet of paper and treat them as an algebra problem, then simplify.

What the simplified form came down to was a shocker:

subtract the *allowable* rent and utilities (there were maximums for them) from 1.3 time your "adjusted income".

That was your foodstamp income. And to get full benefits, it had to be 0 or less.

Note that for it to be zero, your rent and allowable utilities hd o be 30% above your adjusted income!!! In other words, you had to be losing money, and not slowly!

The other one is more recent (mid 90s). Seems that on welfare (at least in this state) you are not allowed to have more than $50 is "resources". So technically, between the time you get the check and you pay your bills, you are in violation!

On top of that, if you are earning money and it's not a fixed X per week/month, you have to turn in copies of your pay stubs before you can get your check.

The catch is, they have to include the last day of the previous month. Which means it'll be several days to a couple of weeks before you can do it. Add in a few days for them to check and issue a check with the *gross* income deducted from the "normal" benefits.

Since folks trying to work their way out of welfare are apt to start out with part time jobs or irregular hours, this hits them several ways.

First, that delay means they'll be late on all their bills the month they start working. Second, they lose money because their benefits get reduced by their *gross* income, but all they get is the "after taxes" part. And I think there's another "gotcha", but it isn't coming to mind.

I seem to recall that several studies have shown that all they "make sure they don't cheat" measures cost more than the cheating they are intended to stop. (and don't get me started on the fact that much of this crap is just an excuse to rub people's faxes in just how "bad" they are to *need* help)
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[User Picture]From: jenrose1
2009-07-11 09:24 pm (UTC)
Oh god. Welfare. I was on it for 3 years from 1993-1996. Talk about gotchas.
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[User Picture]From: ldsman
2009-07-13 09:54 am (UTC)
As a guy, I have run into the same problem. I have to be sensitive or I am considered a neanderthal. Too sensitive and I am considered gay. If I open doors for women, I am "oppressing" them. And if I don't, I am ungentlemanly. I actually had a lady get mad at me for holding the door open for her.
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[User Picture]From: e_moon60
2009-07-13 07:10 pm (UTC)
I've never gotten mad at someone for opening a door for me, though I've had men get annoyed when I opened a door for them, despite their being heavily laden. That happened years ago; now they just say "thank you" and so do I when someone opens a door for me. (I don't like it if they make an antifeminist comment as they open the door, of the "I hope you don't mind if I'm not politically correct..." variety. And that's happened.) OTOH, if I'm a passenger in a car, I don't want to sit in the car and wait while someone comes around the car to open my door unless I'm wearing something that makes it difficult to get out on my own. I want out of a car as soon as it stops, unless it's pouring down rain. It's a car-specific thing...I'm often uncomfortable by the time the car stops and need to move.

Guys, in general, seem to have troubles with the awareness/courtesy/sensitivity axis.
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[User Picture]From: galbinus_caeli
2009-07-14 06:58 pm (UTC)

Feel free to delete, I just wanted to bring this to your attention

"Also, I really would like Stuart Jeffries to go up to Elizabeth Moon and call her a wimp." http://tinyurl.com/laggwa
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[User Picture]From: e_moon60
2009-07-14 08:17 pm (UTC)

Re: Feel free to delete, I just wanted to bring this to your attention

My, my, my.

I do find it amusing (and annoying: both) that the definition of "hard SF" nearly always involves only certain areas of physics. Accurate and science-based biology, medicine, etc. don't count. And it should be written by males, unless a female has a doctorate in physics.

I was on a new space opera panel years ago, the only woman on the panel, and no female writer and only one US writer were mentioned by the editors and other writers on the panel as having written new space opera. All they wanted to talk about was young, male British writers. It was like the time I was on a panel in disability in SF and another panelist claimed never to have read any of Bujold's Miles books. I have nothing against young male Brit writers, but they aren't the whole universe of space opera with or without a hard SF basis.

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From: (Anonymous)
2009-07-20 03:31 pm (UTC)

Doctors feeling smug,

Your blog entry made me remember what my poor mom went through with me and my brother. I whined and whined and my mom would take me in and they would roll their eyes and say my ears were fine (but they gave me antibiotics "just in case") my brother never complained when he was sick. We have a family portrait of him with pneumonia because he showed no symptoms other than a runny nose! You'd think with seeing a billion kids a year Docs would get that children all have varying pain thresholds:)
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