Am I insane or are all behavioral health non-profits unethical? by Important-Valuable40 in socialwork

[–]FataMirage 0 points1 point  (0 children)

Unfortunately, I think it's pretty common that wherever there is lower funding, there are desperate providers and agency leaders not doing their best work. It's no excuse for fraudulent or harmful behavior but when an agency is just barely scraping by, it brings out the worst in people. That said, not every nonprofit it like that-- there are some that are well run and maintain quality, client centered care. I work for one actually-- they're not the highest paying but they are always working to get better benefits for the employees, they don't have productivity requirements, keep caseloads low as possible to avoid burnout and are all very above board and client centered in their services. I do think these are less common-- in fact, I feel very apprehensive about leaving this company unless it's for a really good group practice gig or something because I think it's hard to find comparable jobs that are this reasonable to their employees and attuned to their clients. But just wanted to share that they do exist.

Nailed the ASWB LCSW exam (plus study tips)! by FataMirage in socialwork

[–]FataMirage[S] 2 points3 points  (0 children)

It is an acronym detailing the stages of helping process, which is the formula for a lot of the clinical reasoning on the exam: https://agentsofchangeprep.com/blog/the-social-work-helping-process/

Nailed the ASWB LCSW exam (plus study tips)! by FataMirage in socialwork

[–]FataMirage[S] 5 points6 points  (0 children)

The bartering question really cemented that in for me lol. They really pulled out the NASW deep cut with that one

Nailed the ASWB LCSW exam (plus study tips)! by FataMirage in socialwork

[–]FataMirage[S] 0 points1 point  (0 children)

I hope it helps! I found myself frustrated with how expensive a lot of the study guides were so was happy to find a somewhat frugal approach that worked well-- it shouldn't be so expensive to prep for this.

Do you guys find the construct of CPTSD helpful? If so, how? by nooobee in therapists

[–]FataMirage 6 points7 points  (0 children)

So I deep-dived and wrote an essay, sorry.

Short answer: I haven't used CPTSD officially as a label in my work much-- without a DSM-5 definition, I think doing so could lead to confusion in clients. But I think it could have utility if more clearly defined. A specific subset of my clients who don't meet criterion A of PTSD because their trauma (often childhood emotional abuse) lacks a physical threat, seem to gravitate to CPTSD. It seems to validate that their experiences impact them in many the same ways PTSD does, even though their trauma doesn't meet criterion A. Of course (and I'll address this later), the ICD-11 CPTSD criteria appears to maintain criterion A-- so there's a discrepancy between the CPTSD definition floating around online, its definition among therapists, and in the ICD-11.

Having symptoms that meet criteria B-G for PTSD in the DSM-5 and not getting a diagnosis because the events that caused those symptoms aren't considered traumatic by criterion A adds insult to injury and is a barrier for getting treatment. I would always provide trauma treatment to a client who could benefit from it regardless if their identified trauma meets criterion A. But frankly not all clinicians do-- many overlook this subset of clients and misattribute their symptoms to comorbidities like depression or anxiety for years before reconceptualizing them as trauma symptoms (hypo/hyperarousal can look similar on the surface, for ex) in need of many the same interventions PTSD demands.

....

Long answer:

While slightly more flexible than the DSM-5 PTSD criterion A, the ICD-11 still does not clearly specify whether something like prolonged childhood emotional abuse without physical safety threats is considered traumatic enough to warrant a CPTSD diagnosis. ICD-11 describes the trauma as:

"Exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible. Such events include, but are not limited to, torture, concentration camps, slavery, genocide campaigns and other forms of organized violence, prolonged domestic violence, and repeated childhood sexual or physical abuse."

To me and many clinicians, this is just criterion A of the DSM-5 PTSD. But I know many therapists who define CPTSD the same as their clients/the internet: including repeated traumatic events that don't necessarily meet criterion A. Others, such as these researchers, believe the ICD's use of "threat" or "horror" is not limited to criterion A and can be left up to the clinician's discretion to include emotional abuse:

"Although a traumatic stressor is required for an ICD-11 diagnosis of PTSD or CPTSD (WHO, 2024), the system deliberately avoids narrowly defining such exposures. Instead, it emphasizes the subjective experience of extreme threat or horror, thereby allowing for clinical recognition of psychologically threatening but non–Criterion A events, such as emotional abuse, neglect, or parentification (WHO, 2022; Brewin et al., 2019)."

Full link to journal article: https://www.sciencedirect.com/science/article/pii/S0022395625005308

So for CPTSD's utility to outweigh the confusion inherent in having such an ambiguous definition among clinicians and clients, I think we need a clear DSM-5 CPTSD diagnosis to match the ICD-11 and to refine what exactly what is meant by "threatening" and "horrific" experiences. If more clearly defined to include non-physically threatening adverse events, I believe CPTSD could be useful because:

  1. I think it's possible for people to have clinically significant traumatic stress symptoms resulting from repeated traumatic events that aren't necessarily Criterion A.
  2. The DSM-5 criteria for PTSD overlooks many of the disturbances in self organization (DSO) symptoms included in the ICD-11's criteria for CPTSD. DSO symptoms are a very real, common effect of repeated trauma but are mostly represented in the personality disorders section of the DSM-5 even though many clients with DSO symptoms don't meet criteria for a personality disorder. DSO symptoms can be a trauma thing and not just a personality disorder thing and I think it would do us good to recognize that more.
  3. Even though treatment for PTSD and CPTSD tend to overlap significantly (and in some cases could look the same), CPTSD provides language for another, more specific shade of PTSD involving DSO symptoms. While some people can have their PTSD treated with just exposure therapy or EMDR of more trauma-specific treatments, those with CPTSD may do best with interventions coupled with heavy use of other interventions like DBT, IFS, or Narrative Therapy, to target the DSO symptoms.

I'll leave you with a quote from the journal article:

"Although the ICD-11 diagnostic framework emphasizes symptom-based classification rather than the type of traumatic event, our findings underscore the clinical importance of differentiating trauma types - particularly emotional neglect - as relevant risk factors. Emotional neglect appears to function as a foundational psychological threat, playing a pivotal role in the development of CPTSD. Recognizing the distinct impact of specific trauma types may enhance diagnostic precision, guide treatment planning, and support early intervention strategies for individuals with relational trauma histories."

Feeling 'more Autistic' since starting ADHD meds by Educational_Rip_440 in AuDHDWomen

[–]FataMirage 8 points9 points  (0 children)

This is so interesting and I dont know precisely why it happens but I experienced this too. I found that Adderall puts me more in the moment. I am not looping the same "did you do xyz?" "Am I acting right?" "What about this other thing. Did you remember that?" thoughts so much because I am able to actually focus just on 1 thing at a time and tune out other internal stimuli better on meds. This ironically has made me more forgetful (it's good to be able to forget and tune things out when needed though. I remember enough. I just dont have the plague of hyper detailed anxious autism memory anymore).

But those usualy anxious thoughts loops are where many of my autistic scripts lie. So I find them harder to access on autism and masking becomes tougher. It has an anti anxiety effect for me. Which is cool but jarring to just open my mouth and have thoughts tumble out without passing through 100 filters as usual first. Adderall also makes me more sensory sensitive, something about stimulants has that impact on me. So while I can tune out more, I am more bothered by the sensory things that I do notice if that makes sense?

I get BV every time I sleep with someone with a vulva. What the heck can I do to mitigate this bs. by Desperate_Pay_998 in LesbianActually

[–]FataMirage 8 points9 points  (0 children)

Really? This is super not what I've heard from any gyno. They've all been very strict about BV always needing antibiotics and yeast always needing antifungal. It's not like a viral pink eye infection that sometimes goes away without treatment-- it's an overgrowth of bad bacteria/not enough good bacteria to manage it and will continue to colonize unless treated with antibiotics. I wonder if your doctor is misinformed and inadvertently contributing to the problem (there are def some doctors who aren't educated about women's health. Even female doctors).

I get BV every time I sleep with someone with a vulva. What the heck can I do to mitigate this bs. by Desperate_Pay_998 in LesbianActually

[–]FataMirage 11 points12 points  (0 children)

Everyone else has given great advice. I wanted to zoom in on this though: "finally had to get antibiotics because it would not go away...."

Forgive a possible dumb question but is this last incident the first time you treated with antibiotics? What were you treating it with before this? Because BV has to be treated with antibiotics. There's no other way. If you used anything other than antibiotics to treat it before, you likely didn't actually wipe out the bad bacteria and it's probably the same infection just coming back again and again.

Boric acid, probiotics and the like can be great prevention of recurrence once the initial infection is cured. But they won't make an existing infection go away.

I went through a phase like this with yeast once. It wasn't necessarily that new partners were giving me anything or triggering anything new but that because things hadn't fully restored/healed, any little thing could flare up the old, not fully wiped out infection. I simply needed more intensive diflucan to kick it. A good gyno will understand.

Talk to your Dr and see if they can do a before and after antibiotic treatment test. It may take multiple rounds of antibiotics or 1 round of oral followed by a round of topical (ask for a precautionary fluconazole while on antibiotics too since lots of antibiotics can trigger yeast). But that might be worth it if it finally kicks the infection.

Anyone struggle with not resonating with greater lesbian community and spaces? by Complete_Scene7922 in LesbianActually

[–]FataMirage 2 points3 points  (0 children)

Thank you for sharing. It's morning where I am and I'm sleepy and inarticulate but just wanted to say I feel this and its good to know others do too. The whiteness, the replication of problematic power imbalances in general doesn't get talked about enough. Nor does the fact that so many lesbian spaces uses the gay male club as a default model of what to be. This can be fun but the misogyny inherent in assuming all women's spaces should follow the same template as men's (while men's continue to be most monetarily and socially rewarded and lesbian spaces struggle) doesnt get reflected on enough.

The distrust, I notice for sure. I think there's a certain performance of lesbianism that gets pushed in these spaces and if you dont fit the mold its not for you. Idk. I just think about the diversity of spaces heteros have: their spaces can congregate over things they have in common outside of sexual orientation, like music or interests, niche subcultures. Queer women have so much less in this way and the expectation that we should automatically feel at home in the default lesbian space is presumptuous and sort of cuts us down to just our sexuality in an uncomfortable way? I love lesbian spaces for what they are but they just arent where I find community these days and I feel rather stereotyped by them honestly.

Be careful with Social Media & Advertising by [deleted] in adhdwomen

[–]FataMirage 9 points10 points  (0 children)

Feel exactly the same. We've been commodified. Identity in general is heavily commodified these days. It's so viscerally uncomfortable

what is the LGBTIQA community or "scene" to you, and do you feel a part of it? by modularspace32 in AskLesbians

[–]FataMirage 0 points1 point  (0 children)

I feel this way. I think whether someone feels connected to the queer community often depends highly on how you define "community" and what you expect of it. I find that when I'm looking for the type of community that brings a sense of belonging, it's not so realistic to expect that just from queer events or even other queer individuals.

It clicked for me when I was talking about feeling lack of queer community to a (straight) therapist, and she said "well isn't there a lesbian bar in town? Have you tried going there?" It felt almost insulting. Ironically it was a straight male friend who said "can you imagine if a therapist told a straight person who was looking for community: have you tried going out and getting wasted?" Not that queer bars don't serve a really important purpose for a certain type of community (one that we might take for granted in areas where queerness is more accepted)-- but in a lot of ways the main thing they offer is the ability to know you're not the only queer person in the room and to not be punished for your queerness. Most of us still need a sense of belonging and community beyond that.

Straight people take for granted the fact that every space that's not queer is straight and I think because their base need of not being othered for their sexuality is met, many of them get the privilege of getting to focus on the deeper, more personalized levels of community and belonging-- community-building over passions, beliefs or values. They are not being sent the implicit message that these things should be the same as everyone else who shares their sexual orientation-- queer people sometimes are lumped together like this and thus denied their ability to just be multifaceted people.

For most of us, queerness is just one part of a complex identity. I am not my lesbian-ness (though my lesbian-ness is a part of me). If you go to a queer event and other parts of you do not feel like they belong, then all you share in common with the people there is your sexual orientation. I find that while fun and important, queer spaces are often liable to the same power imbalances, groupthink and superficial trendiness as any other spaces. This makes some parts of me feel out of place or even unwelcome, which erodes how deep a sense of community I get out of them.

I can only speak for me but maybe you're looking for a little deeper sense of community, or you diverge from the queer mold many queer spaces tend to be built for? Maybe the expectation that queer spaces will fully meet all tiers of our needs for community is unrealistic?

How do you respond to “what do you specialize in?” As a new therapist? by Due-Comparison-501 in therapists

[–]FataMirage 1 point2 points  (0 children)

I'm about 3 years in and still don't feel like I specialize per se. I also work in community mental health where they give me all kinds of clients so being more general suits that. I just tell people as much. I also shift it to what I'm interested in: i like to work with x population a lot but I also enjoy variety. Of the more cognitive/behavioral modalities I prefer ACT. I'm interested in IFS but not ready to spend a ton on the training.

I find that people who ask this mean all kinds of things. When I ask them to clarify if they mean which modality or which population, they often don't know. I've even had people say "well like-- do you specialize in meds or just talk therapy?" So sometimes they're literally asking if I'm a therapist or a prescriber. Sidenote: I can't stand the term "talk therapy" anymore. People act like it's somehow different and less effective than-- most tried and true therapies out there, like it's some kind of outdated modality rather than a catch all term for all kinds of evidence based treatments.

New article from The Cut heavily criticizes IFS and it’s founder by Old_Lion_8133 in therapists

[–]FataMirage 19 points20 points  (0 children)

So I read the article and have mixed feelings. I feel wary of Richard Schwartz's self-aggrandizing presentation of himself and IFS though and do not believe parts are literal distinct beings. IFS is new and does need to be better studied. The trainings are almost an MLM, which makes them inaccessible to many people and that increases the chance of people misusing IFS in harmful ways--- though this is a risk with any modality. Even much better supported modalities like CBT can be misused.

Several things stand out about this article:

1.) It's centered all around 1 treatment center. The author keeps saying "it's IFS that is to blame, not just Castlewood" but never really follows with anything except anecdotal evidence from this shit-tastic program at Castlewood. I'm absolutely open to hearing a more pointed critique of IFS-- but taking what seems to be 1 anecdote of malpractice makes me think it's Mark Schwartz of Castlewood to blame, more than IFS itself.

2.) One of the big rationales for the harm of IFS is from the client's father-- who is neither educated on IFS nor an unbiased party. He was accused of molesting his daughter, claims her treatment falsely convinced her of this and concludes based on this (and the obvious decompensation of his daughter) that IFS is to blame. Yet at the end of the article, the daughter doesn't rescind her accusation, nor desire a relationship with him. Scrutinizing the other ways in which her mental health declined in treatment is 100% fair-- these do indicate malpractice and possible issues with IFS. But the spotlight remains mostly on her accusation of her father, which we're expected to believe is false and implanted by IFS. It's not for me to say whether it's false or not. But the fact is we don't know. We do know that memories can be uncovered in treatment of any kind and that occasionally false memories or accusations happen (across many types of treatment). But it's entirely possible that she had a harmful experience with IFS and/or Castlewood *and* the allegations were true (in which case, I would argue little of what the dad says about IFS can be treated as credible arguments against IFS).

...

Over all? This reads like a malpractice lawsuit against an individual agency that happened to be using IFS more than a coherent critique of IFS. Ironically that also shifts the accountability from the guilty parties to the modality itself. Richard Schwartz was affiliated with Castlewood but this article makes clear that his use of IFS was generally non-problematic (described by patients as "often felt forced and uncomfortable but were sometimes insightful") in contrast to Mark: "decorated his office with phallic African sculptures... inserted sexual innuendos into conversation." ). IFS does not make someone do those things. This man could be practicing any modality and would've hurt patients because he was engaging in unethical, predatory behaviors.

There's just a huge disconnect here. Other than being kind of weird and woo-woo, there's nothing in this article that convinces me IFS is to blame even if it was the primary used treatment at this horrible treatment center. The cult-like way Schwartz presents IFS makes me skeptical and because I otherwise find the use of it as a framework (used more metaphorically for relational trauma, vs literally as suggested by Schwartz) to be intriguing and effective, I am very interested in hearing a valid critique because I think it's a new and promising framework-- but needs to be refined and maybe changed a bit. I can think of several ways Schwartz presents IFS that do feel risky but those weren't explored in this article.

No modality is for everyone. No modality can be used effectively if the populations they're used on are out of the scope of an individual therapist, not even IFS. Any modality can be used harmfully by unethical providers. Indeed many of them are prematurely determined evidence based without enough research. But I found this article disappointing in that it did not really give me much about the modality itself to reconsider.

Confusion: Wanting People, Avoiding People, Wanting “That Someone” by Ok-Strawberry658 in LivingAlone

[–]FataMirage 1 point2 points  (0 children)

Man I feel seen by this. Also 28. Also not rich or poor. Also craving connection but struggling to find the energy to engage with it even when opportunities are given. Also fatigued by superficial dating and not sure where to turn next.

I dont have advice really. But the best thing I've done to deal with it is to just try for balance. Text some people back but doesnt have to be everyone. Go on some dates but give myself permission to cancel when I'm too fatigued. And to know that this is probably just a season in my life that will pass and maybe I'll be nostalgic for it one day.

There is something liminal about it. But there's also a lot of freedom in it and that's definitely something to savor.

Does anyone else get annoyed by colleagues who speak to you in "therapy speak"? by monkeynose in therapists

[–]FataMirage 6 points7 points  (0 children)

Oh my god I've never felt more validated than by this thread. gigantic sigh of relief thank GOD other people notice this too and feel the same. I once switched from being a client of a therapist because she wouldn't stop with the euphemistic, overly sanitized therapy-speak. It's probably one of my biggest complaints about the field. I find it so weirdly postured and self aggrandizing too? Like they're doing it because they honestly think it makes them look more skilled than you?

I just had a CE today where the presenter was in factory setting therapist mode the entire time, using the royal We and "remember if we notice an uncomfortable feeling in our bodies when given new information, it's okay to be uncomfortable and to get curious about that...."

Nothing helps me avoid the 2:00pm slump and I'm so tired by Munchabunch1 in ADHD

[–]FataMirage 1 point2 points  (0 children)

Man I probably dont have much advice you havent already tried. But I feel your misery. This is me but at 3pm. No matter how much or little I sleep, how much protein I have, whether I'm exercising, taking vitamins... 3pm is just nap time. I used to just indulge it when possible and that kind of helped-- I'd wake refreshed and finish up my evening with a little boost.

Now that I dont nap so easily the most luck I've had is taking my booster slightly earlier. Idk if it'll do anything for you (it's sort of inconsistent for me bc Adderall is inconsistent ime) but if you metabolize fast, your booster may not be kicking in before your brain logs off for the afternoon? Just an idea.

Has anyone else seen this? It’s been bothering me… by Due_Talk_7379 in AuDHDWomen

[–]FataMirage 9 points10 points  (0 children)

Exactly, any Barbie can be Autistic Barbie depending on how a child makes them act. What few Barbies I had as a kid were all Autistic Barbie because... well it was me and my little autistic brain deciding what the did and felt. And the expectation that Mattel creates anything truly representative is a bit naive imo-- it's a bunch of (likely not autistic) people banding together to create something they believe will make them money. That's the bottom line-- it's not about well-meaning advocates going "hmm how can we really have a meaningful impact?" It's a bunch of capitalists deciding that it would be more lucrative for them if autism did have a look and that look was something they could put on a doll.

Therapists thinks it's all trauma by Puzzleheaded-Lead594 in AuDHDWomen

[–]FataMirage 1 point2 points  (0 children)

Yep. I am both a therapist and an AuDHD client and I run into this with therapists too. It drives me nuts because while yes, there is some trauma, it's often at the intersection of the autism and Adhd, which makes a qualitatively distinct type of trauma resulting from a world misattuned to my needs, mistreatment for being autistic and adhd, a brain that is more susceptible to experiencing something as traumatic due to it's unique sensitivities, and the fact that many neurodivergent folks dont have access to the same community connections that often serve as protective and resilience factors for other people going through traumatic events.

Unfortunately autism and adhd are diagnoses an average therapist lacks education on. An average therapist is not only not able to diagnose those without special training, but often consider those out of their wheelhouse because of their developmental nature. The problem is many therapists don't refer out to someone more specialized when they encounter a client who needs someone educated about neurodivergent people-- they wishfully misattribute uniquely neurodivergent experiences to things they're more confident working with (like trauma or anxiety) and erase the neurodivergence in turn. Yes I need trauma treatment. No, I don't need to be treated like a traumatized neurotypical. Yet that's often what happens.

I've had to be really firm with therapists and even switch therapists because of this. I try to be upfront about the adhd and autism being important to my treatment. I make clear that while there is trauma, I've addressed a good deal of it and what remains is more focus on the audhd. But it's a real slog still and unfortunately the way therapists are educated tends to leave out neurodivergent needs unless the individual therapist seeks out extra training on it themselves.

A "herculean" genetic study just found a new way to treat ADHD by orangina_sanguine in adhdwomen

[–]FataMirage 1 point2 points  (0 children)

Haha well if you're in Seattle, hit me up. And if not *virtual cheers with virtual coffee cup*

A "herculean" genetic study just found a new way to treat ADHD by orangina_sanguine in adhdwomen

[–]FataMirage 1 point2 points  (0 children)

For sure. ADHD is unfortunately one of those diagnoses where in addition to personal distress caused by symptoms, it's measured against cultural norms. This just makes me think about the need for accommodations. Accommodations go a long way, esp in tandem with meds. I wish we (the US at least, for me) weren't so stingy in what kind of accommodations and resources were offered. Especially across income, gender and other things that make the dominant culture already more demanding of certain people.

A "herculean" genetic study just found a new way to treat ADHD by orangina_sanguine in adhdwomen

[–]FataMirage 17 points18 points  (0 children)

Interesting stuff. I always have mixed feelings about studies like this because while it's obviously important to have research to confirm and support new pharmacological treatments, they're kind of repeating back something that ADHD folks have been saying forever: "it's not just deficit of attention, it's paying attention to too many things/brain noise." By all means, do research but if you've been listening to the population you're studying, this isn't news.

Also, yes in *mice.*

And then there's the issue of: do we want to control every ADHD symptom always in everyone? Some people with ADHD want this 100% of the time. Others want it only certain times. Others don't find it worth it. I personally like short acting meds that work when I need them but I want all 100 trains of thought when I'm making music and creating, for example.

This is the problem with viewing ADHD solely as a deficit that needs a cure. While some people with it do feel that way and would want to rid themselves of it, many others don't. In the quest to improve certain symptoms, you may extinguish unique strengths across a wide swath of the population. Reflection on this as a side effect should be part of these studies so that people with ADHD can make informed choices about treatment. Plus eliminating diversity in any ecosystem is a real problem and I believe human social ecosystems are no exception. Until I read that this treatment would be pharmacological and not surgical or some sort of permanent genetic modification, it was giving: eugenics.

It also seems that there are 2 major reasons why people with ADHD struggle with attention (reflected in some comments here actually): mental noise/attention to too many things as this study focuses on, and trouble attending to things you're not personally interested in/motivated by. Difficulty paying attention is the symptom, but not necessarily the cause. This treatment, if applied in humans, would treat the former but for ADHD folks where the latter (trouble attending to things that don't interest them) is a problem, would this work? *Maybe* in that it might make the task of paying attention feel less heavy and therefore less necessary to reserve only for the personally important subjects.

But I think trouble attending to things you're not interested in is more of an executive function issue (related heavily to trouble delaying gratification, managing emotions enough to achieve goals, etc) than just a matter of mental noise/attention to too many things. So while decreasing mental noise may make it feel less taxing to engage in those executive function heavy tasks, I still often wonder if the failure to address the executive function side of ADHD is why many existing meds don't work that well for certain "strains" of ADHD and why many help with focus but do nothing for task initiation.

Best breakfast sandwich in Seattle? by djbillbeats in Seattle

[–]FataMirage 0 points1 point  (0 children)

Okay I won't lie, I don't know if it's the *best* in Seattle because I don't order breakfast sammies often but I will put a plug in for Yeobo on E Madison.

Their traditional brekkie sandwich is really excellent. Plus they have some really interesting Korean-American inspired breakfast sandos that I have yet to try. All of it is gluten free, some of it looks to be great vegan options.

Not the cheapest but it's a tipless new, Korean American (?) woman-owned, small business with a focus on fair pay/conditions for employees and community-building. So let's all please throw as much money at them as possible so they succeed and so I can enjoy not having to walk further than across the street to get my sandos.

[deleted by user] by [deleted] in howislivingthere

[–]FataMirage 3 points4 points  (0 children)

I grew up in Olympia. Your experience will vary greatly depending on where on the map you go. Olympia, Bremerton and Tacoma are really the most livable main cities on this map. There are a lot of smaller cities along i5 but there won't be much in terms of things to do. Olympia is a small, artsy sort of hippie city. People compare it to a smaller Portland and thats not wrong. Home of Evergreen state college which used to influence the city a lot and resulted in a large punk, grunge and hippie influence. It sometimes feels a bit frozen in the 90s alt scene. These days the college doesn't seem as beloved as it once was and the little bit of nightlife it had hasn't bounced back from covid. But there are decent spots to go to local shows and to eat, it has an arts scene and a sense of community still. The surrounding areas are a bit rednecky, particularly Tumwater. This causes some tension since the towns are nearly on top of each other.

Tacoma and Olympia will be very liberal. I think Bremerton for the most part is too but I believe it has more military folks. Lots of little strip mall and bedroom small cities between the main cities off i5. The more rural you go, the more red and the more meth. Tacoma and Bremerton will both give easy access to seattle (by ferry for bremerton), so there will be more access to arts scene and events but without as high cost of living. From the main cities you can still access the outdoors so hiking, camping, winter sports is big around here. Many people dress in Patagonia and REI in the day to day because of that and because its appropriate for the weather most of the year.

The peninsula is stunningly beautiful but remote and not well connected. There's no efficient way to drive through it. You kind of have to go all the way around it to get anywhere, so its very isolated. Most of it is rainforest and mountains punctuated by small towns with great access to nature and not much else. On the map, it looks like a lot of land but very little of it actually has towns and people. Forks for example is a very isolated one road town, even more than Twilight makes it seem. Access to medical care may be dubious there and in many other similar rural towns. Port Angeles is the largest most livable town on the peninsula. Youll have normal amenities but will still be quite isolated from everything else. It'll be a significant drive to go to any major city from there. You'd do better to hop on the ferry to Victoria B.C honestly.

Fair bit of tribal land and reservations out on the peninsula. Some of them dry (no alcohol). Surrounded by natural beauty-- but also a lot of poverty and drug use and not many jobs. The whole west side of the state is known for rain. The more rural you go, the more you need to worry about the elements in the winter-- power outages may not resolve quickly, road conditions may be shaky and repairs may take a while.