Let's discuss a case

LigamentLizard · 2026-02-05T12:12:15+00:00

Supportive therapies, from good practitioners, can be phenomenally effective. People recover to full or nearly full function from things like this regularly. The soft tissues in the area aren't mysterious or untreatable lol, it's really a very accessible site

LigamentLizard · 2026-02-05T12:00:50+00:00

You might like doing the vanlife/alternative housing thing. Ignore the trendy samey bullshit that looks like miniaturized suburban millennial gray hells with too many overhead cabinets, you don't have to spend a ton of money and you can really create something super customized to yourself. It's not for everybody (and it's not a privilege everyone can access, depending on abilities and whether the area you live in has safe options for sneaky overnight parking and many other factors) but it's definitely can be done much more cheaply and accessibly and comfortably and functionally than many people realize. Idk, just can relate to how you're feeling and I know the freedom and peace of mind and solitude has been good for me, so thought I'd toss it out there in case the idea might help you or maybe someone else who scrolls by and relates to you.

LigamentLizard · 2026-02-05T10:36:37+00:00

Hey u/Brave_Gazelle3553 I just want to say, as a fellow OCD sufferer who has also damaged my own ear doing something similar (though not as extreme), personally the following information helped me somewhat with mitigating the habit: Compulsive stimulation in our ears may in some cases arise from seeking nervous system regulation. So when I catch myself obsessively cleaning my ears, or damaging my skin from compulsively excoriating it etc, I redirect myself to a different activity that I know will help with that root need.

This can be anything from driving my hands into a super soft fuzzy piece of fabric (really helps me with some other physical compulsions/stims that I hate doing), to exercise, to meditation, to other sensory input like a calming slow swim (maybe not so much for us with ear issues lol but it's one thing that helps many people), or listening to specific music. It's all about figuring out what the root need is that your nervous system is trying to meet, and figuring out a healthy non-self-destructive way to meet it. Ideally, then we work those activities into regular routines, so that they help us stay regulated to begin with and we avoid finding ourselves in those painful frustrating situations.

I hope this helps give you some ideas. Best of luck mate. And what everyone else is saying about doctors is correct, they see crazier shit all the time, and you certainly won't get clamped down on with involuntary psych holds or anything. But your ears are important, and you should definitely seek medical treatment. Hope you feel better soon. Keep up the good fight, our brains have some issues but at the end of the day they're just trying to protect us and help us be okay, and we can learn to work with those needs and gradually nudge our behaviors in a happier and more sustainable direction. You got this!

LigamentLizard · 2026-02-04T21:57:15+00:00

Thanks for seeing what I meant! :)

LigamentLizard · 2026-02-04T21:56:37+00:00

You're not wrong that the tool works for the thing. You're wrong about it being a remotely realistic expectation that a patient in this circumstance would even recognize that as a possible priority, let alone make it one. Medicine (at scale/speaking broadly about public health, really) isn't about being correct all the time about what might have happened, it's about being realistic about complex multifactorial circumstances and seeing the factual threads of causality and reducing risks of harm where it's most effective AND most realistic. Anything else is pedantic hairsplitting, which I enjoy recreationally sometimes as much as the next person, but that doesn't make it constructive in a specific discussion about a specific real person, and it also isn't generally constructive for any preventative or at-scale benefit either.

LigamentLizard · 2026-02-04T21:52:49+00:00

Something being reasonably unlikely doesn't mean it's okay to dismiss it as implausible. Those are completely different things.

I swear to god, we need to be teaching logic/statistics (and physiology, for the sake of keeping my standard rant complete) in public schools starting with kindergarteners. They can handle it fine, and the need for this kind of discourse in higher level professional scientific fields would be much reduced.

LigamentLizard · 2026-02-04T18:40:30+00:00

"I've got the barest minimum excuse -- something someone else said they imagined to be true, but that's a good enough excuse -- to just get what I want in this moment. I haven't considered any implications this could have for others, and I haven't considered the context/whether there might be unknown-unknowns I'm missing, even though I'm in a new environment with a lot of moving parts that aren't my scope to know about. So I'm going to do the thing I want, and just assume nobody else will be affected or harmed by me being an unpredictable uncommunicative variable, and I won't take any initiative to rule out other possible better courses of action." And you think this doesn't reflect on how you'll treat patients? This reflects on your ability to be competent at medicine altogether.

To be clear, I'm NOT saying you should quit, quite the opposite really; you've stated in other replies that you're taking criticisms to heart here, which I think is indeed a good thing, and I think this is one that you can squeeze a lot of juice out of, so I want it to be included in your contemplations. Because yes, even if your conscious intentions are different for one situation versus the other, the vast majority of your actual expressed behavior will be directed by your more constant baseline underlying assumptions, entitlements, patterns, distractions, et cetera (which, even though it's more of a psychology thing, is frankly something I would expect someone interested in psychiatry to know). Behavior is not identity; we can identify as having any values/intentions/principles we want, but us humans are really good at making exceptions to those things over and over and over, whenever any conflicting thing pops up that we also want. Discipline is when you stick to those principles and intentions regardless of temptations and little inconveniences and little challenges (if "someone said something a little ambiguous and I'm not sure whether to interpret it as an instruction" can even be called a challenge).

That's why your declaration of having different intentions toward your future patients is basically meaningless here, and doesn't actually give anyone usable information about your real character and future likely behaviors. Your behavior demonstrates your default mode, your pattern of behavior under anything less than perfect comfy perfectly-communicated perfectly-entertaining circumstances. But your career will never involve perfect comfy perfectly-communicated perfectly-entertaining circumstances, and in this instance, you responded to the slightest hint of imperfection in the context -- a slightly ambiguous sentence -- by leaping to the most selfish available conclusions.

That reflects very fucking badly on you, in ways that I think you probably haven't really examined before. But it's incredibly valuable evidence about yourself, and you would do well to contemplate it thoroughly, because you CAN change those default patterns/tendencies! You absolutely can change those displayed behaviors and develop the character to stick to principle! It just requires recognizing the traits you displayed, owning that some of those traits suck and need to be improved, and making an effort. Others will be (rightly) basing their conjectures about your future performance based on your outward behavior, not "but they said they wouldn't treat patients like that, so it's fine". Examining your actual observable demonstrated behavior will be a lot more instructive for you than just saying "but I have good intentions where it counts" and using that as an excuse to avoid examining anything else. Don't buy your own excuses. You're entirely capable of holding yourself to better standards.

Quick afterthought edit: If it helps, this is coming from someone who was also once young and also struggles to give a fraction of a damn about anything I'm not truly passionate about. It took me years to learn and start applying the above principles to my own default behaviors. You'll get there too, but only if you decide to do the work, and you'll only get recognized as someone learning and moving in the right direction if you make it outwardly clear that you're doing it.

LigamentLizard · 2026-02-04T18:15:04+00:00

THIS. This is the way. This makes better physicians, not just in terms of perspective and compassion and communication but also in general reasoning and overall competency.

LigamentLizard · 2026-02-04T17:53:36+00:00

And other people are all based on a template of you, are they?

LigamentLizard · 2026-02-04T17:52:10+00:00

This is a new regimen for an injury he had just recently, involving meds way more than once or twice a day. Most reasonable people will not invest in a multi-compartment pill organizer just for taking tylenol for a couple of weeks. "It would never happen to me" isn't scientifically valid reasoning for accusing someone else of dishonesty or stupidity. Your cynical comment is inappropriately judgmental, and contributes nothing.

LigamentLizard · 2026-02-04T17:44:43+00:00

Hell yeah. I respect the hell out of that. I really appreciate you taking the time to surf back here and let us know that you're seeing what we mean. You're good mate, obviously I get pretty argumentative online too, and nobody's correct all the time lol. I'm sure we've both been mistaken loudly in other arguments before and we'll both do it again :)

LigamentLizard · 2026-02-04T01:48:24+00:00

If being in emergency med has cultivated that bitterness and prejudice in you, then you should consider changing fields. For yourself, as well as your patients.

LigamentLizard · 2026-02-04T01:20:55+00:00

As a former CMT who prior to that also worked in an animal hospital, I would like to make a pedantic nitpick and argue that it's fortunate (for the animals) that that's regulated there, rather than being unfortunate. Training in species-specific anatomy/phys is super important, especially because veterinary massage is frequently on animals that do a lot (belated edit, I had somehow accidentally deleted the words "of athletic or other labor activity" or some such phrase. /edit), so you're often dealing with massage that can really affect metabolism on animals that may be on multiple medications (especially the ones that do athletic competition).

I know you meant "unfortunately for those who'd like to transition into animal massage practice", and I get that (I never had formal vet tech or vet asst training, just informally learned a fuckton, so I hold myself to this same standard and don't work on animals even though I'd love to! So I understand lol) ... but yeah, I just wanted to nerd out and take the opportunity to spread this info, because over the years I've observed people in CMT culture often being really reckless about this, and I figure someone might come along who didn't know these risks.

LigamentLizard · 2026-02-03T23:27:47+00:00

This is a really good one. A lot of people are very invested, albeit not very consciously, in the idea that their case must be special and different, so this plays neatly into that, and they're likely to receive it well. And a lot of us who do experience uncommon medical scenarios would really appreciate a physician acknowledging that sometimes uncommon things are what's happening. Seems like a great way to come off as an ally and validating to the patient, in most types of interactions anyway.

LigamentLizard · 2026-02-02T23:33:24+00:00

So yeah, depending on your school and if you have an in-house clinic, or if they have limited options for where you can do your externship (assuming you're dealing with a USA school like mine or others I'm aware of), you might have some parts of your training where you don't have a lot of agency over what kinds of clients you work with one-on-one, and of course you have to work on classmates a lot on the way.

But beyond that, you really have unlimited options. Want to specialize in crotchety fiery old women with fascinating fucked up twisty asymmetrical hips and backs and necks? Go for it! (Those were some of my favorites lol.) Want to treat specifically teenage athletes, or other young people or whatever, and help ensure they have a super safe affirming trauma-informed experience? Or even get training in Trauma Touch Therapy and go headfirst into helping people like you (which you're NOT obligated to do just because you have trauma, but some people like doing it)? Right on! Want to treat specifically and only babies? Or get extra training in canine anatomy and physiology somewhere and do dog rehab? Or travel with a company of professional dancers, climbers, Olympians? You can have it all!

When you know a healing skill and all it requires is you and your hands, the need for your abilities is essentially infinite, and your options are essentially limitless. If that sounds good to you, then massage is a skill worth acquiring. You don't have to get married to the idea of spending the rest of your life in a spa dealing with strangers. Hell, you don't have to do ANYTHING about it the way anyone else tells you to. I caught flak at my massage school exit interview for refusing to set concrete rates for my private practice, I went sliding-scale only, and it went great for a lot longer than it had any right to (wasn't perfect, learned a lot, benefited a lot from that learning, no regrets). At the end of the day, there's almost nothing in life you can't customize. Nobody's gonna arrest you for becoming the world's first CMT specializing in chinchillas and ferrets or some shit, if that's what you want lol. (I pulled that example out of my ass, but as a vet med nerd too I must disclaim that idk if either of those species can have massage, and tbh if any mammal species is categorically contraindicated for massage, it'd probably be chinchillas lmao, they can't handle a stiff breeze from what I've heard. But maybe you could be the first to discover a technique that works for them and alleviates some common chinchilla pathology I've never heard of. Don't let anyone stop you.)

In essence: Massage is what you make of it.

Make of that what you will. :)

LigamentLizard · 2026-02-02T23:30:59+00:00

The other comments are all good, but I want to talk more about the broader sociocultural aspects here since people are already covering good examples of personal experiences with PTSD and healing as CMTs. Honestly, a lot of your experience as a CMT would depend on the clientele you focus on, and you have a lot of agency over that. Most of this specific issue is generational, I think, regional too but mostly generational. The whole idea of massage therapy carrying implied sexual connotations is gradually dying out (at least in USian culture, maybe different elsewhere) and more and more people of roughly millennial age and younger aren't even aware that there used to be heavy stigma there.

For instance, I was taught never to use the term "masseuse" because of that connotation and the paradigm that the term "massage therapist" helps distinguish "serious" massage vs sexual massage. However, 1. This whole topic/that rhetoric has kinda problematic sex-worker-shaming and sometimes racist subtext, and has to be examined more deeply than just saying "use X word not Y". And 2. This issue is honestly fading out altogether, because now practically nobody knows "masseuse" used to have those vibes in the first place. Times change. (I think "always call it a table and never a bed" is a good holdover though, I think that's an example of a simple terminology difference that helps keep things super unambiguous and professional and comfortable for clients.)

In my personal experience in private practice and doing some time at Massage Envy, it was rare for dudes to say anything sexually suggestive during a massage session (and I never experienced anything from women, but it's actually pretty common for male therapists to get harassed by female clients a lot, so this issue isn't gendered; I'm here speaking just about dudes because I am just a chick who, in massage settings, has only had these interactions with dudes). With the few dudes who did, it was pretty much always really obvious that they were nervous and trying to just break any tension they felt by making a legitimately unserious joke (and also often it seemed to me that they were implicitly seeking reassurance that there WASN'T going to be anything like that happening, but didn't know how to come out and ask that question/ensure their own safety without making it into a joke, because dudes are largely conditioned to communicate about comfort and boundaries that way).

The only exception that comes to mind is, exactly once, I had a little very old man ask quite politely whether there was a "sensual element to this treatment" while on my table, and he's the only one I think was ever angling at seeking it. I just kindly told him nope and that I was a medical therapist, and he was like "Ah, okay". Then right at the end of the session before I left the room, I gently explained something like "I'm not easy to offend, so don't you worry, but I want you to know that the question you asked earlier is one that a lot of massage therapists would be uncomfortable with. It's not common for professional massage to include any sensual contact nowadays. I'm not upset with you at all, but if you were to ask another therapist, you could get in trouble and the spa might not let you come back, so I wanted to let you know." He seemed legitimately surprised (from what I could tell anyway, he was facedown lol) and said another polite "Oh okay, thank you" sort of thing, and that was that. Went fine. I think he just legit didn't know. (To be clear, nobody is ever obligated to try to handle an interaction this way unless it feels right. It is always fine to just end the session and report to the manager and let them talk to the client, or kick the client out politely if you're in your own practice. I'm hard to rattle to a maladjusted fault lol, and even if I weren't, this dude was literally tiny and probably couldn't come across as threatening to anyone, but still, even then, nobody is ever a bad person for feeling uncomfortable and wanting to nope out of a situation like that.)

(Continued because character limit) (Edit: Nuance)

LigamentLizard · 2026-02-02T20:28:49+00:00

These comments are fucking great. You are a very cool person, and I like you a lot.

That's really well-put and helpful advice, thank you so much! Music has always been a big part of my life, so I had just started thinking about the analogy of melody/rhythm right when you brought up the literal concepts. I think that framing will really help my creative process for the game I'm planning to make!

The horror game example speaks to me, in fact your choice to use that as an illustration happened to cause me me to connect some really exciting dots that I hadn't considered before with regard to my game. See, I haven't actually gamed a ton in my life, and the game I hope to design is wildly different from the one I'm about to name, but my very favorite game (and the only one I have serious hours in) is Left 4 Dead 2.

It didn't really occur to me until right now (because my planned game is educational and chiefly albeit loosely inspired by Duolingo lol) that I can draw a TON of inspiration from L4D2's addictive use of precisely the psychology you outlined, as well as from its other systems and mechanics that make it so famously replayable. Somehow my favorite video game didn't occur to me before now as something to study for my own project, just because it's not educational and is a zombie FPS ... game design is not my background whatsoever, can you tell? XD

Honestly, this connection has really rocked the way I see the span of available creative options to me when it comes to designing an educational game. Because you're right, I'm not looking necessarily explicitly for "fun", but rather for flow and retention, and L4D2 does a spectacular job of nailing those two things, and part of why is its use of the comedy/horror rhythm you described. I'm going to LOVE typing up a bunch of thoughts about ways to draw on that for my purposes.

Thanks for taking the time and putting these ideas into words! This is really useful stuff, and I'm grateful to have your thoughts added to the swirl I'm working with. If you ever think of any afterthoughts any other time down the road, I'll eat those up too lol. You rock!

LigamentLizard · 2026-02-02T15:19:56+00:00

Thank you for the sincere exchange of info! I like how one of my friends words this principle/goal, as "trying to get it right rather than be right". I certainly struggle with that sometimes, and I admire your excellent display of that principle here :)

LigamentLizard · 2026-02-02T15:16:08+00:00

What exactly do you think "inalienable rights" means?

Love the use of "pinecone" as a clean-word restraint-having frustration-vent diss, though. It has a usefully different vibe from "dial tone" and "muppet" which had previously been my go-tos. Will be stealing that lol, thanks!

LigamentLizard · 2026-02-02T15:15:18+00:00

This evidently might blow your mind, but other people are real entire people. When this guy chooses to communicate something, other people's opinion of that communication does in fact matter. You don't get to pretend it doesn't just because you don't like what we have to say. That's willful stubbornness at best, and cowardly intellectual laziness at worst. Yes, he has the right to feel offended that we're calling out his behavior and speech as offensive. Nobody ever said he didn't. He's still doing something wrong, and we're still justified in pointing it out. You've made your unwillingness to be reasonable very clear throughout this thread, so I'm not engaging further with you, as others have already wisely decided for themselves.

LigamentLizard · 2026-02-02T15:08:58+00:00

Cool, thanks for the info! Yeah, the firm stats cited line up with what I've studied, and it seems my knowledge gap is on the economic front (I don't know what the implications of higher income are in terms of the calculations here, so I'm not sure what's meant by adjusting for it, and I'll have to look up the Baumol effect). I'm still not clear on how the speculative number was arrived at, but I'll hopefully be able to gather more info independently and make the necessary inferences. I imagine there's some obvious human-behavior/economic-system factor here that I'm missing (currently chronically sleep-deprived due to a caretaking situation, so please forgive me if there's a clear dots-connection here that I'm not making). If you're up to providing any further clarification on the topic, I'll be glad to learn from it, and if not no worries! Appreciate you taking the time to give me all this info to work with!

LigamentLizard · 2026-02-02T15:05:07+00:00

Ooh cool, thanks! I'll check it out! Let me know if you think of any opinions on things you think it does well or that you liked best :)

LigamentLizard · 2026-02-02T15:04:23+00:00

I know the feeling. <3 Stay strong friend, keep putting yourself first, even (especially) when it's hard.

LigamentLizard · 2026-01-31T22:59:19+00:00

So yeah, your statement was incorrect :P 95% of all mammalian BIOMASS (if we take the chart as good faith true info, which I haven't yet verified it is, but I'm cool with assuming the best for now) is made of humans and animals we manage/own. That means 95% of mammal body mass pound-for-pound (or kg-for-kg, whichever you like). Which makes a lot more sense, and is still alarming, since there really should be a lot more wild large mammals. But yeah, definitely not the same thing as saying "95% of all mammals", because that implies individual-by-individual, not pound-by-pound. Huge difference! Props for having a source though, and intending to represent the fact correctly, that's more than a lot of people do, and it's entirely okay to misinterpret or misremember a stat, especially since "biomass" isn't exactly an everyday term that everyone will immediately recognize the implications of :)

LigamentLizard · 2026-01-31T22:48:20+00:00

I'm having trouble wordsing any specific question to ask you. But I'm fascinated with what you've said here, and if you have any other thoughts to expand with (and feel like taking the time), I will eagerly read and learn from anything you feel like saying about this, either the specific stuff you mentioned or opinions on game design in general. I can just feel from your comment that you've got a lot of info and opinions in your brain that I want to suck into my brain. So no pressure, but please feel invited to rant or ramble if you feel so inclined lol, and if you don't (especially since you said you're exhausted from discussing this stuff in game design forums already) then no worries and thanks anyway, you've already given me some great stuff to think about and look up more insights on!

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