TʜᴇʀᴀᴘʏGⒶʀʏ⁽ᵗʰᵉʸ‘ᵗʰᵉᵐ⁾

Being a bodyless head with a freak long tongue is not only okay—it can be an exciting opportunity

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Joined 8 months ago
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Cake day: August 29th, 2025

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  • I’m a therapist and I use SimplePractice for my practice. They recently added an AI note taker that is HIPAA compliant, and the consent form they suggest giving to clients sounds okay, but I read the actual privacy policy and the language used is way too vague for me to trust, so I don’t use it.

    In your position, I would:

    1. Ask if you have to sign that, or if you can opt out. Your specific provider may be open to just not enabling the AI note taker for your profile, and they may be able to remove that form from the app for you on their end. This may not be in their control, but if they’re a good person who cares about you, they’ll make an effort to get it done anyway.

    2. If not, ask for a link to the actual privacy policy and see if it sounds acceptable to you. Not the practice’s Privacy Practices, not the Patient Portal privacy policy, but the actual privacy policy for the AI note taker (whoever you ask might have to do some digging to actually find it)












  • Hmm. I think maybe I have a fundamental misunderstanding of anarcho-antirealism? I’d suspect a large theoretical overlap between the former and illegalism, egoism, critical/anti-psychiatry, etc, but I’m surprised to see that we seem to have a fundamental difference of perspective here, on a narrow subject that manages to encapsulate all of the above

    Maybe it’s my tankie bone telling me that those ASPD-identifying people don’t know what’s really in their own self interest. You respect their perspective as their reality (and demonstrate that by adopting it? or no?), whereas I would, at most, agree to disagree with those people. The latter, to me, feels antirealist, but I can see how this maybe isn’t in the true spirit of anarcho-antirealism.

    I’m curious what You think about this

    (2 narcissists try to determine who’s right: impossible edition)


  • To be clear, I absolutely agree that NPD is/has a real pathology, and is a disability. Under the hood, it’s most often a trauma-related disorder of self-security. Like Trump, I only don’t meet NPD criteria myself bc it doesn’t impair my life

    I guess I’m mostly just surprised to see You taking ASPD at face value in the first place, unlike the critical way You approach NPD. I would expect that if one takes an anarcho-antirealist approach, the conclusion would be that the ASPD diagnosis doesn’t serve the individual, but rather serves the state, and ought to be discarded. I worry that normalizing the ASPD label is likely to subvert the notion that smashing the state is good and that people should do so without remorse.

    I imagine, however, this difference in perspective comes down to a macro lens vs a micro lens. For an individual stuck with the diagnosis on their medical documentation, leaning into it and wielding it might be in their best interest. As their provider, however, I would encourage them not to identify with that label, and to let me write a rule out diagnosis for their file, removing the label from their documentation. Of course, if they disagreed, I would just pivot to trying to further foster the empowerment of it.

    If I met someone like You described, finding themself acting without thinking, regretting it, and wishing they could better mind social boundaries to improve their wellbeing, but without an existing ASPD diagnosis, I would likely explore other relevant diagnoses, like ADHD, ASD, BPD, etc.


  • I’m curious how You reconcile this perspective with anarcho-antirealism…? Specifically with regards to Your apparent realist view of the law and psychopathology, it seems incongruent to me.

    Regardless of how You manage that, however, as an anarchist psychotherapist who (still, currently) meets dx criteria for ASPD (and yet has never been apolitical), I honestly find this kinda problematic.

    ASPD isn’t a disability- it’s a made-up label created to pathologize criminality. Pretty much any anarchist or ADHDer who’s been to jail will meet diagnostic criteria for ASPD (and in fact up to 2/3 of prisoners meet the criteria)

    Being apolitical, even in the sense that complicit centrists mean it, is arguably much worse than meeting ASPD criteria. Your article has a tone of standing up for the disabled, but ends up further demonizing ASPD imo

    I’ve read and enjoyed 3 or 4 of Your articles on NPD, but I was disappointed not to see a similar approach to / perspective on ASPD. Why the difference?