The Plurality Playbook
To help employees and managers understand dissociative disorders, as well as plurality as a whole.
By FreyasSpirit (Lucia Batman) and Irenes (Irene Knapp).
Table of Contents
- Lizzes' foreword
- For teammates: Respect and Etiquette
- Detailed Overview/Glossary
- Managing Googlers with Dissociative Disorders
- For Plural Systems
- Don't be afraid to ask for help
- Coming out
- Increases in system size
- Memory issues
- Oncall shifts
- General strategies
- Being triggered
- Panic attacks
- I can’t remember how to code
- I don’t remember what I was working on yesterday, or this morning
- Someone is asking me verbally about an email I don’t remember writing
- What are some good resources on plurality?
- What is the relationship between plurality and dissociative identity disorder?
- What are some advantages of being plural?
- How accurate are representations of plurality in the media? [Spoiler warning!]
- Common myths about plurality
- How different are members of a system?
- Are system members not currently in front mostly dormant?
- Is plurality the same thing as hearing voices?
Are you curious about what it's like to work with or manage someone who is plural? Or, if you're plural, perhaps you've wondered how to get your coworkers to better understand and accept your neurodivergence. In 2016, FreyasSpirit and Irenes realized that they could write a guide to plurality for all three of these audiences and help other plural systems come out in the workplace and thrive.
This document is the product of that effort, and was published internally with the benefit of feedback from other plural systems. Hundreds of employees read this guide or used it when coming out to their teams. Personally, it was helpful for me to be a better ally at first, and even more useful after we awakened as a plural system ourselves.
The authors of this document debated whether or when to publish it to the entire world. They were worried about facing retaliation from the company for doing so without its approval. Given the publicity surrounding the #pluralgang hashtag in early 2019 and the increasing number of systems that are coming out, they have decided that now is the right time to publish, with or without management's approval, and we are proud of them for taking that risk. We and the authors hope that this document helps an even greater audience understand each other and themselves. We all hope you find it both historically interesting, and practically useful.
Liz Fong-Jones (who are also a collection of Lizzes)
For the sake of readability, this section contains only the information necessary to understand the "for teammates" section. The full section on background can be found under "detailed overview/glossary".
Plurality (also known as multiplicity) is the state of having more than one person/consciousness sharing a body. Together, the people who share a body make up a plural system or multiple system, often referred to simply as a system. The size and nature of a system varies greatly, with system size varying from two to well over 100. Some systems are highly co-conscious and as a result have very strong continuity of memory while others have more strongly partitioned memory and often lose time and access to certain skills (ie. ability to code) when they switch to a different headmate/systemmate/insider. The headmate who is currently controlling the body is said to be at front.
Dissociation is a common human experience which involves losing some level of awareness of the outside world. Staring into space during a less than thrilling lecture, daydreaming, or getting lost in your mind while taking a walk are all forms of dissociation. As with all human experiences, the degrees which someone can dissociate varies from person to person. In its extreme form, it can cause both short-term and long-term memory issues. It has a close causal relationship with plurality.
Bringing another system member to front, or switching, is a process which can take only minutes or seconds for some systems. For other systems, switching can take hours. In the worst case, often associated with ongoing trauma, system members can be gone for multiple years. Many systems have some ability to control who is fronting when, but not all are able to consciously choose to switch. Stressful situations can make controlling who is fronting harder and in the worst case can lead to involuntary switches.
This playbook focuses on advice to plural Googlers, their teammates, and their managers. It also includes background information, which can be useful in understanding what plurality, memory issues, and dissociation mean and how they affect work.
This Section will address how to be respectful when addressing or interacting with a plural system.
|Lucia||singular they/them/their||Primary front for nearly a decade. The one from the system you are most likely to interact with at work.|
|Lilith||she/her||Far more emotional than Lucia. Able to handle situations which require diplomacy with more grace than Lucia.|
|Aerie||she/her||One of the most active in system. Often exists in higher energy states than others. Has a strong ability to create changes.|
|Emma||she/her||Seeks understanding to a greater degree than others in system. More formal in speech than most others in system.|
|Astra||it||One of the best at entering a calm, meditative state.|
- Many plural systems will use plural pronouns to refer to all people in the system. The phrase "we went to a cafe to get lunch" is an example of discussing the system as a whole. It is also possible only one individual in the system went to the cafe to get lunch and may use "I went to a cafe to get lunch".
- Do not be surprised if a plural system uses a combination of singular and plural pronouns. Respect the choice of pronouns the system chooses to use.
- It is not uncommon for different system members to identify as different genders and use different pronouns as a result.
- When addressing plural systems, there are a variety of ways to say "you". Some systems are comfortable with "you" while others would prefer more explicitly plural versions such as "y'all" or "you&". When in doubt, ask what pronouns they would prefer and respect the choice they make.
- Some systems prefer a gender-related pronoun for third-person use, while others prefer either the plural or singular "they". (These are not mutually exclusive, nor exhaustive.) Feel free to ask about pronouns.
- Systems comprise many individuals, each with their own name and preferences.
- For some systems, referring simply to the system using a single name may be the preferred option either for convenience, or because they may not want to expose the internals of their system publically. For many in this situation, their legal name may serve as a public API to refer to them by.
- For others, it is important for each individual to be recognized. In this case, it may be helpful to have a mechanism to signal who is fronting and which name should be used. One possibility is a necklace with each system member's name on it which can be rotated to broadcast who is fronting.
- In email communication, follow the system's lead. Some systems may choose to be out to smaller groups such as an individual team, but have their own reasons for being private in larger groups.
- For some systems, it may be difficult and stressful to have to determine who is fronting. Before asking questions like "who are you right now", determine if asking would be helpful or harmful. Try to take your cue from the bullets above before asking.
- Plurality is a sufficiently stigmatized condition that many plural systems are not open about it, resulting in a perception that it is rarer than it is. A common perception is that it exists only in Hollywood. The DSM5 estimates the prevalence of Dissociative Identity Disorder at over 1% of the population in the US. As a reference point, the portion of the population with red hair is estimated at 2-6% in the US.
- Unfortunately, it is not uncommon for others to not believe a system when they share their experiences. Listening to the system and believing their experience is important. Any other reaction can decrease feelings of psychological safety. Even if you do not believe it is real, this greatly affects the way the system views and interacts with the world. Respecting the system regardless of your belief or disbelief is necessary to build and maintain a working relationship with them.
- Use the pronouns and naming scheme requested by the system.
- Being openly plural is a considerable risk, which you may safely assume systems have weighed for themselves. Understand the vulnerable position they are in, and let them decide the scope and pace of how they proceed.
- This is analogous to coming out about one's sexuality or gender in terms of the emotional weight that went into the choice and trust that it requires.
- In general, coming out as plural is at least as risky as coming out as LGBT+ as there are no legal protections and less of a broad social acceptance of plurality. Treat the plural status of someone with the same consideration and care as you would treat their LGBT+ status.
- Seek explicit clarification of the contexts in which your teammates would like to be addressed and referred to as plural. Be careful not to out them unless you are certain they wish to be out in that specific context.
- If you know a plural coworker outside of work, remember that it’s possible they are more open at Google than they are externally, and treat it like any other context as far as making sure of their expectations.
- Some systems experience significant differences in who is able to interact, depending on the form of communication being used. For example, one system member may find it easiest to communicate by email while another finds it easiest to interact in person. In this case, it is likely you are interacting with a different system member through email than you are in person. A system's ability to have an in depth conversation may depend on the communication mechanism.
- If this applies, systems may let you know their preferred modalities. While all forms of interaction are necessary at times, try to accommodate their preferred communication modalities when practical. Small changes in forms of communication can create significant improvements to a system's life.
- Unless specifically asked to, never use the term "alter" to refer to a system member. Some systems use this term to describe system members, but many systems find the term offensive. This is due to its medicalized history.
- Due to memory issues, you may have to re-explain yourself if the previous memory of your explanation is not accessible at the moment. Do so patiently and allow time for the knowledge to return. An alternative would be to provide a written summary which the system can use to refresh their memory.
Dissociative Disorders, namely Dissociative Identity Disorder (DID), Multiple Personality Disorder (MPD), and Other Specified Dissociative Disorder (OSDD) are strict subsets of plurality. Under the DSM5, plurality can only be classified as a disorder when "the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." It is important to recognize that not all plurality will meet this criterion. For many, including the authors of this document, their plurality is a core part of their identity and is a very positive thing.
Post-Traumatic Stress Disorder (PTSD) and complex PTSD (defined below) have a very high comorbidity with dissociative disorders. It is likely managing the symptoms of a dissociative disorder will involve managing PTSD symptoms. Having a dissociative disorder almost always comes with past traumas which left the system with [c]PTSD. As a result, small additional stressors will often have a much larger impact on an individual with [c]PTSD than they would on a neurotypical person. Learning to respect trauma victims heavily overlaps with learning to respect plural systems.
Dissociative Amnesia is a separate diagnosis often comorbid with other dissociative disorders, but occasionally separate. It is characterized by an inability to recall important personal history, above and beyond what ordinary forgetting would explain. This can entail gaps in factual memory (people’s names; passwords), in emotional memory (this place is safe; this person is a friend), or in procedural knowledge (how to ride a bicycle; how to debug software). This sometimes means that the system member who holds those memories is not around at the moment. When memory issues happen as a result of being triggered, the specific trauma often has more to do with which memories are available than system topology does.
PTSD and complex PTSD are conditions which have similar symptoms, but different origins. For PTSD, the original cause was a small number of extreme events, such as witnessing violent deaths. For complex PTSD, it was a large number of lesser events over a period of many years, such as childhood abuse, extreme poverty, or food insecurity.
Fugue states and emotional flashbacks are dissociation-related memory issues, akin to dissociative amnesia but shorter-term in duration, most commonly occurring as a result of trauma triggers. Although not all plural systems have a history of PTSD or complex PTSD, they are commonly associated conditions, and this document will explain them as necessary.
Either of [c]PTSD can lead to flashbacks or emotional flashbacks many years after the original traumas. The experience of these is described as re-living the original events and sometimes, the emotional context without a specific event. These flashbacks sometimes occur with dissociation, and are occasionally accompanied by a fugue state. The obvious strategy of thinking about how those events were long ago doesn’t always help, since memories with that information aren’t always available.
For both PTSD and complex PTSD, triggers are events, ideas, sensations, or other stimuli which are reminders of the original trauma. Most flashbacks start by being triggered.
- The fact that a system is working for Google means they have many coping mechanisms to handle any gaps in functionality their dissociative disorder may leave them with. If significant symptoms are reappearing, additional stressors are the likely cause. Work with the Googler to determine what can be done to reduce the impact of these stressors while understanding that these stressors may cause a temporary decrease in productivity, but productivity will return as stressors are removed. The way you handle this situation can make the difference between the Googler becoming productive again and having to leave Google for mental health reasons.
- What is most helpful when triggered varies from system to system. Ask the system if they want to provide any instructions for what to do if triggered, up to and including a personal runbook. Understand if they are not comfortable sharing this and wish to give more generic or no guidance here.
- One way to write a personal runbook is to answer many of the questions found here.
- Provide an environment in which the Googler can be productive. Stressors which may seem insignificant to you may have a huge impact on the Googler's sense of psychological safety. There are many small changes such as increased screen privacy and quieter environments which can lead to increased feelings of psychological safety and therefore greatly increased productivity. See the section on "accommodations for people with [c]PTSD" below.
- A Googler's default position will be to push themselves to complete a large volume of work. Even productive Googlers often feel they are not being productive enough over periods as short as a day. Often, a mental health day for recovery followed by a productive day leads to more work accomplished than two mediocre days. Managers should recognize that self care is critical to long term performance and should encourage Googlers to take time and space for recovery when needed.
- Mental health is health and mental health days are sick days and should not require you to burn vacation.
- Recognize that not all systems share skills perfectly. For example, some systems may have some system members who can code and some who can not. The fact that the system works at Google means they have mechanisms to overcome any skills which are not shared. If a system suddenly loses access to skills, it is probably in response to stressors. Ask if there is anything you can do to help remove stressors while recognizing there are many potential stressors which you cannot help with.
- Some systems may have memory issues and take extra steps to enhance their ability to remember and recall. For example, some systems may carry around a notebook with them everywhere as a necessary tool.
- As a manager, you are familiar with respecting your reports’ privacy. Remember that plurality is both a very personal identity issue and a medical topic, and treat it with appropriate respect. Ask your report whether they want others to know they’re plural, and how they’d like to be addressed and referred to.
- Treat the plural status of someone with the same consideration and care you would treat their LGBT+ status.
- Treat the plural status of someone with the same consideration and care you would treat their medical status.
- Understand that the decision to confide in you is the result of a great deal of thought, and is hopefully a lifting of weight. It is appropriate to express your support.
- This is a list of suggestions which may be helpful and is certainly not exhaustive. For any specific case, the best way to determine what accommodations would be most helpful is to ask.
- Increased screen privacy. The stereotype about the PTSD patient sitting with their back to the wall has a basis in truth - it is worth considering seating arrangements that allow the Googler to feel relaxed that nobody could be behind them without their knowledge.
- For more details on accommodations, a conversation should be started with your HRBP and the benefits team.
- Many systems who work or worked for Google have broken badly enough that they could not hold a job for several months. There are also systems who have successfully worked at Google for many years. Take steps to prevent yourself from becoming a statistic.
- If you feel comfortable being out at work, it can be immensely helpful to preemptively let your manager or others you trust know about your plurality so you can have support systems in place in case anything goes wrong.
- Even if others do not fully understand your experience, they can help you implement your coping strategies. This can be any level of detail from vague instructions like "give us time to recover context if we seem a bit absent minded" to a detailed personalized runbook of how to handle situations.
- Trust your own feelings on whether to come out, when, and to whom. Though there have been several openly plural systems at Google, there is too little data for anyone to have meaningful advice on how outside perceptions might affect your career.
- It is worth weighing fears and risks against the cognitive and emotional load of staying in the closet. For some, the fears and risks will outweigh the costs of staying in the closet, while for others the opposite may be true. Hopefully as more systems come out and stay out for longer, Google will prove itself as a safe space for plural systems.
- If you do choose to come out, remember that you don’t have to do it all at once. You might feel more comfortable telling your immediate team, or you might start with coworkers you know from distant areas of the company. [Internal plurality mailing list] is a safe space for systems who wish to be out to a small audience or wish to see others who are out.
- Plurality is deeply entwined with disability for some systems, and is the kind of thing HRBPs are nominally expected to help with. However, there is not any data on this yet.
- [Various disability and health-related internal mailing lists] have had occasional threads where people have anonymously related their experiences with disclosing neurological issues and disabilities that affect their work. You may find reading these to be helpful in reaching a decision.
- Increases in system size, especially rapid increases can be an indicator that something else is going wrong in your life. Increased stress can lead to dissociation which can lead to less familiar mental states, including new fronters.
- If you do find new system members fronting as the result of external stressors, this can be a strong indicator that reducing stressors should be a priority. Eliminating stressors in your personal life as well as at work are candidates for reducing stress.
- Many responsibilities can be reduced in the short term and others can be dropped entirely. For work, this can mean taking sick days for mental health reasons and includes options such as short term disability if your mental state does not improve.
- If your dissociative disorder involves memory issues, you can ask for notes to exist in written formats. For example, you can request written meeting notes and write summary emails of discussions you have.
- Keeping todo lists can be very important.
- Being oncall involves an inflexible schedule and an interrupt-based workload.
- It is recommended to only do interrupt driven work, not project work, during your oncall week since context switches can be expensive. In a plural system, the costs of context switches can be amplified by memory partitioning.
- Setting aside time after a shift for recovery can be helpful. Just knowing there will be time for rest and recovery afterwards can help with a tough week of oncall.
- In an especially bad week, it is perfectly reasonable to ask to trade oncall time with a teammate. You are a high value production system and your system health is at least as important as the health of the Google system you are running.
- The policy for emergency oncall swaps explicitly states that you are not required to find a replacement while handling your emergency. If you are unable to handle an oncall shift, it is your manager's job to find a replacement.
- If you’re in a strange mental state, try to analyze what it is. Are you dissociated? Do you feel adrenaline, with or without its characteristic emotions? Did something stressful just happen, that you’ve forgotten? Are you experiencing a feeling of dread that something terrible is going to happen soon?
- Once you have figured out what emotions you’re feeling, try to check whether they’re a rational response to the situation. Emotions don’t go away simply by being contradicted, but it can be helpful to realize if they’re based on incorrect beliefs.
- Take a walk. This will let you take time and space away from potential stressors and will also let your mind wander which can be useful for internal debugging. Dissociation can be a relaxing experience if you use it to introspect and admire the trees, rather than being stressed because it won’t go away.
- In some cases, it may be more productive to take the remainder of the day off as a mental health day to give yourself more time and space to debug your mental state. Google focuses on productivity across quarters rather than consistent day to day productivity. Take advantage of this to allow yourself a full recovery, even if it means taking the next day as a mental health day as well.
- If somebody else triggered you, apply general conflict resolution skills and try to avoid it happening again. It’s likely it wasn’t deliberate, especially since it can be hard to know what someone else’s triggers are. If necessary, involve your manager or HRBP.
- If you triggered yourself by doing something that was more stressful than you expected it to be, in addition to these other steps, try to be more aware of that limit in the future. It may be that you can handle that task better if you’re expecting it to be difficult, or it may be better to avoid it.
- If you do not understand why you were triggered, take time to understand it better.
- Once you understand why you were triggered, add additional rules to your internal monitoring system so you get alerted earlier next time.
- A panic attack is an adrenaline feedback loop: You feel frightened because the sensation of adrenaline is unfamiliar, and so you release more adrenaline.
- This can be a particularly surreal experience if you’re dissociated enough not to experience the fear in any familiar way.
- Changing the context may help - move to another room or building; spend ten minutes talking to someone on your team, or to someone socially; attempt a different task; take a walk.
- Try to have arrangements in place about which system members will handle day-to-day work to avoid winding up in this situation.
- When it does happen, try to switch to someone who is better at coding, but be mindful of each others’ differing stress levels.
- If all else fails, try to pretend you’re learning how to write software for the first time, and look up details of the text editor you have open, and poke around with [various internal tools] etc as though you’d never seen them. Some of the knowledge may come back as you do this, but if it doesn’t, [internal site] makes it very easy to learn - and then you’ll have redundant copies when the others get back.
- Be aware that not all of your capabilities or interests are equal, and try to find sustainable arrangements that don’t place too much burden on any one system member. At the same time, recognize that members who are highly enthusiastic about work may want to front more during the day, and try to let this happen.
- Leaving yourselves written notes can be very helpful in re-establishing context.
- Google Keep is one nice product for random sentences that are too short to fit into any organization scheme.
- Snippets can be useful for staying oriented on a longer timescale.
- Whenever you stand up, try to write down both a larger goal you were working towards, and the immediate problem you were having.
- How verbose you need to be about this is up to you, experiment with it.
- Browser tabs are useful for keeping what you are working on around.
- Adding calendar entries or writing detailed snippets indicating how you spend each block of time can be helpful to recall what you have been working on.
- It’s more sustainable to be open with them that you don’t remember at the moment, rather than to try to bluff - the latter can be embarrassing, and doesn’t help them.
- You might say something like “I need to refresh myself on the details of that, can I take a moment to re-read it?”, then open it in front of them.
- Even if they’re surprised that something you wrote apparently contains new information to you, they’ll appreciate your ability to respond thoughtfully to their questions. Singlets have imperfect memory and everyone here is busy. If you act like it is normal, others will probably interpret this as normal.
- https://sarahkreece.com/ — Sarah K. Reece’s blog, an excellent resource about plurality, trauma, healing and mental health.
- https://healthymultiplicity.com/ — An excellent collection of plurality related resources.
- https://tulpa.io/ — A resource which primarily focuses on tulpamancy, but also covers many types of plurality. The site’s resources and are welcoming and inclusive of all types of plurality.
- tulpa.io glossary — Having the language to describe an experience is incredibly valuable. This is a good glossary for plural systems to put their experiences into words as well as learn what else is possible with plurality.
- Many people with DID and dissociative disorders in general identify as plural. Plurality also comes in many other forms including naturally occurring plurality and various forms of intentionally induced plurality including tulpas and soulbonds.
- load balancing
- N+2 redundancy
- Media representations vary in accuracy. Always keep in mind that The Internship is the media representation of your job.
- Freyas' personal favorite fictional representation of plurality is Echo from Dollhouse as Echo's plurality matches their experience of plurality very well.
- Irenes’ favorite portrayal is the character of Garnet in the cartoon Steven Universe, who is, in that show’s terminology, a fusion of the characters Ruby and Sapphire.
- Garnet chooses to exist most of the time as one being rather than two, because of Ruby and Sapphire’s romantic love for each other, and because it’s a deep form of intimacy.
- The personality blending Garnet is portrayed with is not reflective of Irenes’ own topology, but there are real systems who experience blending phenomena similar to it.
- The show’s concept of fusion corresponds to the concept of integration in the medical literature; its appropriateness as a treatment goal is discussed below under “common myths”, but it has been much discussed.
- Irenes are also big fans of Inside Out, which is a lighthearted and creative interpretation, not as true to life as Dollhouse but with a central and very important theme of system members learning that they are all important and real, and that working together is the path to a sustainable future.
- The movie notably portrays each system member as being strongly associated with a particular emotion, and it’s worth noting that while real systems do, in many cases, fragment in part along emotional lines, what those lines are varies profoundly from system to system.
- Another thing that varies far more than the movie portrays is how much of a “complete person” each system member is - many real system members are more well-rounded than Joy, Sadness, Anger, and the other characters.
- It’s worth noting that in reality, the maintenance workers portrayed in one scene of the movie would be as important as system members as any of the characters from “central”. So would the imaginary-friend character.
- Plural systems need to integrate (ie. become a singlet) to be able to live a healthy life.
- Even those with a dissociative disorder do not need to integrate to lead a healthy life. Many can function via time sharing and even the medical literature recognizes that integration is not necessary for healing.
- http://dx.doi.org/10.7790/ejap.v1i2.21 - "Multiplicity is not a problem; it is a wonderful thing, individually, socially, and culturally. The problems from which multiples suffer do not derive from the existence of their personality states, their many ways of being in the world. That is their strength."
- Plurality is always caused by trauma
- There are many plural systems who have no trauma history. These systems are referred to as endogenic rather than traumagenic. Recently, the tulpa community has grown dramatically. The tulpa community seeks to induce plurality by creating a "sentient imaginary friend". Many tulpamancers have no trauma history and instead become plural as adults.
- Plural systems come with a dangerous system member
- Asking a plural system if they have a dangerous member is invoking a media stereotype and is similar to asking someone whether they have a cousin who is dangerous. While it is true that some people may have a cousin who is dangerous, assuming they do or asking if they have a cousin who is dangerous is not ok. Similarly, doing the same of a plural system is equally not ok.
- This varies considerably, both across systems and within systems.
- Procedural memory, factual memory, language habits, and so on may be shared, partitioned, or somewhere in between. Different systems share different things, to different extents, at different times of their life.
- Some system members have different life goals and worldviews, requiring them to cooperate and find a way to create a life that all find worthwhile. For example, one might care about solving interesting problems with technology, while another might prioritize helping people on an individual level, and still another might care most about living a stable life with space to heal.
- Some smaller differences include:
- Some headmates like different numbers of spaces after periods.
- This depends heavily on the system. Some systems tend to have exactly one system member conscious most of the time, others tend to have many system members around at the same time. The degree of communication possible also varies.
- In some topologies, system members co-front to a high degree. Freyas' often has over half a dozen system members around and can change who is speaking every sentence. Others may have a single “front” slot, where some of the others are still aware of what is going on and able to react to it, either internally or externally. Members not in front may have a harder time controlling the body than the one in front, but may still be able to do so.
- In other topologies, system members not in front are not able to communicate with each other or with the member in front, other than by leaving physical notes to be seen later. These topologies tend to be associated with time loss, though it can occur without them.
- The degree of communication may vary among pairs of system members within a system, in complicated ways deeply related to their personal history. This complexity is why the word “topology” is used. For example, a set of system members who all were around for college may have strong communication with each other, but weaker communication with those who were around during middle school.
- The degree of communication within a system may change over time. Most systems are able to learn to do more of it, as they understand their brain and each other better.
- The amount and nature of memory sharing is different from the amount of communication, but the intricate reasons it can vary are similar.
- Sometimes shared memories are factual rather than experiential, and do not feel like they happened in the first person, except to the system members who were fronting when they occurred.
- Sometimes memories from other system members are inaccessible, temporarily or permanently.
- Sometimes memories are shared sufficiently seamlessly that system members do not notice an issue with it.
- Plurality is distinct from hallucinated voices.
- See this page by the Dissociation Initiative for more reading.
- An outsider not inclined to pay close attention could easily confuse the two.
- Somebody else would have to write a document like this for schizophrenia and related conditions; these authors aren’t comfortable speaking on behalf of that group.