Jenny McCarthy needs to learn: autistic is not psychotic or crazy

6 Aug

Last year Amanda Peet had a story in Cookie Magazine. She came out very pro-vaccine. Jenny McCarthy “jumped” on the story (delayed to be coincidental with Jenny McCarthy’s need for publicity).

This year, Cookie Magazine has a story with Jenny McCarthy. There is a lot bad in there. I am saving the worst for last (you can skip to the bottom if you want).

As to be expected in a magazine article about a celebrity, Ms. McCarthy is pushing her own business interests. In this case, her educational DVD collection:

“Through a series of entertaining vignettes featuring a cast of kids (including Evan), puppets, and dolls, the DVDs model correct social behavior and tackle everything from sharing and patience to maintaining conversations with friends to sibling rivalry. “Any parent will tell you that her kid watches a show and imitates it,” McCarthy says of her inspiration for the idea.”

I find that statement really strange for educational videos targeting autistic kids. I can think of a number of parents of autistic kids who would disagree with “Any parent will tell you that her kid watches a show and imitates it” From the book “Educating Children with Autism” by the National Academies Press:

Studies over longer periods of time have documented that joint attention, early language skills, and imitation are core deficits that are the hallmarks of the disorder.

Another quote from the Cookie Magazine story:

McCarthy’s widely publicized journey began in 2004, when her son had a seven-hour seizure and went into cardiac arrest. When he got home from the hospital, Evan was put on a heavy dose of antiseizure medication, which kept him awake for four days and induced hallucinations that made him not recognize his mom and bang his head against the wall until he bled. “I ran out of my house and into my driveway and screamed at the top of my lungs to God to just take him away, because I loved him so much and he was in so much pain,” McCarthy says of the period she describes as her “second rock-bottom” (the first being the moment Evan’s heart stopped momentarily).

A couple of observations.

First, I wish Cookie Magazine had clarified the point as to how long after his vaccination the seizure came. His MMR was at 14 months, his first seizure was after he was 2.

Now for the second. Did Jenny McCarthy really write that she had wished her child would be taken by god?

I didn’t want to blog this story. Why give Jenny McCarthy more publicity? Well, here’s the paragraph that made me want to blog:

McCarthy is leading a more normal life now, too, after having felt very alone in her first marriage, to Evan’s dad, and suffering what she calls a “breakdown” two years after Evan went into cardiac arrest and suffered those terrifying seizures. “When your kid is psychotic or crazy, you go into this place of shock so you can remain calm,” she says. “A problem a lot of moms [of autistic children] have is that they need to get out all [their emotions] later. I kept mine bottled up for two years, and then I finally released all this pent up fear, sadness, and anger. I just cried and cried and cried and cried and cried.”

“When your kid is psychotic or crazy, you go into this place of shock so you can remain calm”

I just don’t know what to say. Autism is not “crazy” or “psychotic”. Why is this woman chosen by the press to represent autism?

Maybe next year Cookie Magazine could interview a mother who is autistic or, at least, has an autistic child.

102 Responses to “Jenny McCarthy needs to learn: autistic is not psychotic or crazy”

  1. Dedj August 13, 2009 at 03:30 #

    No one has said anything remotely like that Dr Treg.

    Hallucinations and delusions are not part of the diagnosis of autism.

    This does not mean that one cannot be autistic and have hallucinations or delusions.

    What is does mean is that autism and psychosis (as you imply it) are co-morbid. Psychosis is not intrinsic to autism.

    Aside from your examples being rather poorly explained (has anyone ever explained what a car is? Does the person know the friend is imaginary? Are they confusing sub-vocalisation with another person talking?), a person who is psychotic and autistic would (in a perfect world where autism and psychosis are both fully understood and competantly diagnosed) receive a dual diagnosis, as have all of my previous autism+psychosis clients.

  2. i've a headache now August 13, 2009 at 04:40 #

    Dr Treg: Is it the same individual re: both items (car and imag. friends)? What age?

  3. Chris August 13, 2009 at 05:07 #

    The question about the age is very important.

    The illusions, including imaginary friends, is very common among NT children. Up to the time my younger NT son was almost eleven years old the mirror in his room had to be covered because the reflections frightened him. When my daughter was a preschooler, and up through age five she had a fascination with Disney’s 101 Dalmatians. When we went anywhere we had to hold the car door open to let all the imaginary puppies in or out of the car. My disabled son did see UFOs in the sky often (due to watching silly programs on certain cable channels), but he grew out of that by the time he was in middle school.

    Compare that to a shirt-tail relative who was perfectly normal up until her late thirties. That is when she saw things that were not there, and had a paranoid delusional break-down that put her into a hospital. After treatment and finding appropriate medication (over about a ten year period of ups and downs), she is doing quite well now.

    There is a vast difference between the imagination of normally developing children, and those children with developmental issues who also have imagination but grow out of them a bit later and the very real mental illness of an adult.

    I suspect that “dr treg” has not dealt with real children, nor read any kind of literature on child development.

  4. Liz Ditz August 13, 2009 at 05:26 #

    Yanking the conversation back to the starting point, re Jenny McCarthy:


    “When your kid is [in a painful place — her words were “psychotic or crazy”] you go into this place of shock so you can remain calm,” she says.

    I don’t think that McCarthy is far off.

    I actually have had the experience of not my kid, but my mother in a psychotic episode, and indeed, I “went into this place of calm”. Not shock, but a sort of “I can’t afford to feel about this now, I have to do the thinking and deciding.”

    And I’ve had the experience of my kids experiencing what we call “bleedy injuries” in my family, and my experience has been similar.”I can’t afford to feel about this now, I have to do the thinking, deciding, and acting.”

  5. i've a headache now August 13, 2009 at 09:25 #

    I think her son was actually coming out of a major epileptic seizure for which he was hospitalized…so clearly psychotic and crazy are inappropriate terms and…autistic did not even apply at the time. Ms McCarthy going into a “place of shock…[to] remain calm” is not what I see as ‘calm’. She, admittedly, went from screaming (at the top of her lungs) for God to “take him away”, to then “bottling” up her emotions and then next ‘releasing’ her “pent-up fear, sadness and anger” — whereupon she “cried and cried and cried.” None of that seems very calming. Meanwhile, she was also busy shilling for Indigo then TACA and then onto GR. In reality, she may have been in such a state of ‘shock’ that many of her statements/decisions/choices were, well, perhaps not…the best.

  6. David N. Brown August 13, 2009 at 09:47 #

    I suspect that autistics hallucinate (in terms of sensory perception) more often than the general population. A thought I have had is that a hallucinating individual can remain rational, if he a) rejects them as unreal or b) accepts them as real and responds to perceived reality in a logical and organized way. I’ve created a hypothetical description of “delusional aspie” based on my own experiences and a fictional character of mine named Zaratustra.
    As far as the general description of psychotic, I think it can apply well enough, all too often. But, I am sure such behavior is mostly brought on by frustration, stress and abuse by “normals”. I have summarized the issue with an essay title: “vicious when poked with a stick”.

  7. dr treg August 13, 2009 at 09:47 #

    So if a 4 year old with the diagnosis of autism has
    1. Loss of connectivity to reality.
    2. Thinks cars are monsters after explanation.
    3. Has an imaginary friend who they talk to
    it is worth seeking another opinion for the dual diagnosis of autism-psychosis and not autism alone as these psychotic features do not appear in autism.

  8. David N. Brown August 13, 2009 at 09:59 #

    “Psychosis” isn’t a useful psychological term. If schizophrenia is being argued, I think the key question is the capacity for “rational delusion” (see above). A less appreciated aspect of schizophrenics is that the actions often don’t make much sense even in the context of their delusions.

  9. dr treg August 13, 2009 at 10:08 #

    Whether the delusions are primary or secondary they are still delusions and by their nature irrational. Is there an element of denial in the field of autism and no-one accepts that it may just be another type of “psychosis”?

  10. Dawn August 13, 2009 at 12:59 #

    @Dr Treg: DO you have any children? You say
    “So if a 4 year old with the diagnosis of autism has
    1. Loss of connectivity to reality.
    2. Thinks cars are monsters after explanation.
    3. Has an imaginary friend who they talk to it is worth
    seeking another opinion for the dual diagnosis of autism-psychosis and not autism alone as these psychotic features do not appear in autism.”

    My answers as a parent: 1. Yes, probably needs to be reviewed
    2. No. Many children are scared of loud noises and will take more than 1 explanation to accept that a car is not a monster (if the child has not been exposed to a car on a regular basis). My eldest hated the vacuum cleaner for many years and would scream and cry if I used it when she was around. Took some time to get across to her that it wasn’t a monster, since it a) made very loud noises and b)sucked up things and you would not see them again.
    3. Many children have imaginary friends that they talk to for YEARS. If pushed, normal children will admit that their friends are “just pretend”, psychotic people cannot do this. So the imaginary friend is not the problem. The problem is if this friend is seen to be real or not.

    I hope this helps…

  11. passionlessDrone August 13, 2009 at 13:29 #

    Hello friends –

    This discussion strikes me as absurd, and seems like a perfect illustration of why so many parents, when initially exposed to sites like this come away thinking you (or perhaps just your ideas) are damaging to their children, or at the least, your experiences are so far from theirs, that ‘your autism’ can’t be anything like ‘their autism’.

    The parent watching their child injure themselves, spin for hours on end, or refuse to look them in the eye doesn’t give half a shit as towards the clinical minutia between psychotic, autism, schizophrenia, or just plain crazy. Further, the notion that these are the salient points to debate seems like a massive waste of energy, time, and indeed, displays a fundamental difference in prioritization.

    Now here comes Jenny who who claims to have experienced the same feelings they have and seems concerned with finding concrete ways to help children; poorly defended or not.

    Parents of newly diagnosed children coming across this thread likely aren’t going to leave with the message you’d like them to.

    Ironically, this study came across pubmed for me this morning.

    Comparison of social cognitive functioning in schizophrenia and high functioning autism: more convergence than divergence

    – pD

    • Sullivan August 13, 2009 at 16:31 #

      pD–

      if people do’t give “half a shit” about the minutia between psychotic, autism, schizophrenia, or just plain crazy:

      I would ask that they use terms which don’t stigmatize my kid. With apologies to those with true psychoses, those terms carry the stigma of being a potential danger to others.

      Since they don’t give “half a shit”, they shouldn’t give “half a shit” about changing the terms they misuse. Otherwise they are showing that they don’t give “half a shit” about the other autistics in the world.

  12. Clay August 13, 2009 at 13:37 #

    So says another of our persistent trolls. If you don’t like it here, why do keep coming back? Just so you can act out being the (!) you are, I’d say.

  13. Joseph August 13, 2009 at 14:02 #

    So if a child has an imaginary friend, that means they are delusional and hallucinating?

    Pure crap.

  14. dr treg August 13, 2009 at 14:03 #

    It seems that when patients with autism develop hallucinations referral for exclusion of schizophrenia or psychotic depression is suggested.
    http://abcnews.go.com/Health/AutismLiving/story?id=5387923
    However it is quite clear that autism and schizophrenia have many overlapping symptoms/behaviors with hallucinations, delusions and loss of connectivity less frequent or not typical in autism – but they do occur.
    Following on from this why isnt autism a psychosis?
    As PD says who cares as long as research into genetics, the immune system and structural changes in the brain especially the dendritic spines is pursued in order to try to improve the quality of life of the patient.
    This thread has demonstrated the amount of energy wasted on
    1. Current outdated psychiatric nosology
    2. Arguing about whether McCarthy is completely right or completely wrong again.
    It is highly possible that in 100 years the terms “autism”, “psychosis” and “schizophrenia” will be obsolete.

    “The moment we want to believe something, we suddenly see all the arguments for it, and become blind to the arguments against it.”
    GB Shaw.

  15. dr treg August 13, 2009 at 16:58 #

    You seem to be showing your true colors i.e. you dont want the stigma of “psychosis” being attached to a loved one, but unfortunately you further stigmatise schizophrenia which is only associated with a small increase in the relative risk of “being a potntial danger to others”.
    http://www.ncbi.nlm.nih.gov/pubmed/11261644?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed
    Your selfish ignorant comment is on a par with McCarthy`s. It is unfortunate that in 2009 all psychiatric diagnostic terms are stigmatising.

    • Sullivan August 13, 2009 at 17:47 #

      dr treg,

      I don’t want the stigma of psychosis being attached–since it is unwarranted.

      As you ignore–I noted with apologies that there is a stigma.

      You are a troll and uneducated and you have a big axe to grind. Your science is unsound.

      You may join Harold Doherty and John Best soon.

  16. David N. Brown August 13, 2009 at 17:55 #

    To Dr. Treg,
    When I say “rational”, I mean mainly the ability to respond to PERCEIVED reality in an organized way. As far as “social cognitive functioning”, one element of my “delusional aspie” profile (for whatever it is worth) is that the subject can remain communicative and intelligible, where a schizophrenic likely would not. Also, your example of “cars as monsters” does not involve any abnormal sensory perception. If the car is really there, and is perceived as a car, there is no “hallucination”. The problem is better described as a phobia.

  17. Stephanie Lynn Keil August 13, 2009 at 18:07 #

    I love that when some people don’t agree with a rational point of view or a fact (always something negative) that they don’t like a person automatically gets labeled as a “troll.”

    To Harold Doherty and other parents of severely autistic children who need intensive treatment your rhetoric is nothing but a waste of time and a “troll” to them.

    Perhaps people should learn to listen from both sides and not slap every person and opinion they disagree with as being a “troll.”

  18. Clay August 13, 2009 at 18:32 #

    It seems this post is a troll magnet.

  19. Joseph August 13, 2009 at 18:35 #

    If people don’t give “half a shit” about the minutia between psychotic, autism, schizophrenia, or just plain crazy, why have multiple labels at all? Why not just use “crazy” as an umbrella term and study “crazyness” as one entity? In the old days, it was kind of like that.

    That’s a surprisingly naive observation by pD.

  20. dr treg August 13, 2009 at 18:38 #

    Rational is defined as “having or exercising the ability to reason”.
    The belief that the car is a monster and will eat people is a delusion not a hallucination.There seems to be uncertainty in your entry about the clinical features of schizophrenia.
    As mentioned above the main reason why the opening post doesnt want to accept the fact that autism patients may have psychotic features is
    1. Denial
    2. The stigma of the word psychosis.
    3. Hatred of McCarthy.
    It is easy to start entering offensive comments when someone disagrees with your viewpoint.
    Which part of the science of autism do you need information on?

  21. Dedj August 13, 2009 at 19:04 #

    SLK – Dr Treg is not getting slapped with ‘troll’ for his disagreement. He is getting labelled a ‘troll’ because he continues to disagree with a statement that has not been made, that he continues to disagree with strawman arguements he has made from commentors posts, and that he continues to assert some form of maliciousness or ill-will is motivating the OP and the commentators, rather than the actual ICD/DSM diagnostic criteria.

    As an aside, I have witnessed Harold:

    Dismissing Kristina Chew as ‘anti-treatment’ because of her criticism of ABA, despite the fact that she has discussed several treatments on her website.
    Dismissing a director of a national autism charity as being ‘a know-nothing and do-nothing’ depite this persons involvement in researching video as a treatment tool and involvement in several advocacy agencies.
    Dismissing a advocate and lecturer on autism (and published authour) as a ‘biased know-nothing’ because of her criticism of ABA, despite her research record in ABA extending into the 90’s.
    Dismissing research as worthless purely because it disagrees with his own perception of his sons abilities.
    I’m not even going to mention his treatment of Michelle Dawson, suffice to say she has handed him his ass on a plate multiple times. He does not need to be embarrased further.

    In short, Harold doesn’t meet the strict defintion of ‘troll’, but that doesn’t mean his overall behaviour isn’t disagreeable.

    • Sullivan August 13, 2009 at 20:24 #

      In short, Harold doesn’t meet the strict defintion of ‘troll’, but that doesn’t mean his overall behaviour isn’t disagreeable.

      Just to be clear–I wasn’t bringing up Mr. Doherty as a “troll” but, rather, as a person who has lost his privilege to comment on this blog.

      (note: comment edited shortly after published)

  22. Sullivan August 13, 2009 at 19:06 #

    Stephanie Lynn Keil,

    There are many people I disagree with. Very few get labeled “troll”. There are some people I agree with whom I have called “troll”.

    dr treg meets the criteria. His comments most often do not offer actual information.

    You, for example, I have just disagreed with. However, your comment added something new to the conversation, and you took the time to flesh out your assertions.

    I made a mistake by bringing up Mr. Doherty. He is unable to partake in discussions on this forum, so for the most part I consider it bad form to discuss him here. However, he has moved beyond troll in some of his recent activities.

  23. Clay August 13, 2009 at 19:26 #

    I say that “being a troll” is a state of mind. If a person’s intent is trollery, s/he can be a troll even on his own blog. Such is the case with the other exiled bestard, who’s a troll 24/7, wherever he happens to be!

  24. David N. Brown August 13, 2009 at 19:30 #

    To Dr. Treg,
    I consider the core diagnostic criteria of schizophrenia (at least as “classically” defined) to be (sensory) hallucination, delusion and disordered thought processes and actions. To the extent that “psychotic” is diagnostically useful, I think it suggests violent, frenzied and/or disordered behavior. Overall, subjects with the same or different mental abnormalities differ in degree and kind as to how their perceptions and reasoning depart from a common framework of logic and reality. It can be taken as a rule of thumb that “intermediate” cases, where a highly deluded subject is able to carry out complex and effective plans based on his delusion, represent the greatest danger.

  25. i've a headache now August 13, 2009 at 19:49 #

    My dear Dr Treg: It’s not ‘delusional’ for a four year old to have a monster fear. Period. Moreover, the opening post had to do, in part, with Ms McCarthy’s imprecise use of language and its effect. One hardly thinks her use of ‘breakdown’, ‘psychotic’ and ‘crazy’ were meant clinically. However, Ms McCarthy, as putting herself forward as as spokesperson, could really do with being more responsible in how she uses language. Announcing to the whole world that you screamed for God to ‘take’ your child, because he had a [successful!] stay in the hospital due to an epileptic seizure, is, well…I shall simply refrain from elaborating….

  26. Joseph August 13, 2009 at 21:52 #

    Harold is not a troll? Nonsense. Read the comments of this post, starting at #4.

  27. Dedj August 13, 2009 at 22:25 #

    I’m well aware of Harolds habit of taking sentences out of context, or of misattributing offensive intentions and arguements to his opponents .

    I remain firmly convinced that Harold totally believes in his interpretations (even after repeated corrections) and is motivated to respond due to his self-image as a serious advocate.

    Typical troll behaviour is to respond to rebuttals with further troll like behaviour. Harolds typical response to rebuttals is to demean his opponents (always by comparing them disfavourably to his apparently unvalidated self-image), provide a quote that doesn;t say what he thinks it does, and then co-incidentally disappear when his rebuttals are shown to be ill-informed or easily refuted (as they were with his dismissal of Larry Arnold).

    Harolds intent is not to disrupt or ‘troll’, but to act as an advocate for autistic children (does anyone have any evidence of Harolds actual offline contribution to autism advocacy? If so I’d like to see it).

    The fact that he does this through inaccurate, often irrelevant, statements heavily influenced by his experiences with his son and in a condecending manner does not neccisarily qualify him as a ‘troll’.

    He certianly isn’t very well informed, and is quite possibly a nicer person in real life than he comes across on the blogs he infests, but he certianly isn’t worthy of disrupting this thread.

  28. MJ August 14, 2009 at 02:02 #

    Very apropos –

    Pervasive developmental disorders and psychosis.

    Pervasive developmental disorders (PDDs) and infantile schizophrenia were initially thought to be the same condition, but distinct differences were described in later research. However, attempts to identify psychosis in individuals with PDDs continue to be challenging and controversial. The two disorders share many similar features, including perceptual abnormalities, thought disorder, catatonia, and deficiencies in reality testing…

    http://www.ncbi.nlm.nih.gov/pubmed/19470280?dopt=Abstract

  29. dr treg August 14, 2009 at 19:28 #

    It seems that from recent entries
    1. Many do not know that much about psychotic delusions and hallucinations
    e.g. not agreeing that a child with autism who believes that a car is a monster that will eat people is delusional and not aqgreeing that a child with autism who talks to an imaginary person is hallucinating.
    2. Many do not accept that autism can be associated with psychotic symptoms e.g. delusions and hallucinations.
    As the reference in the last entry confirms the prevalence of psychosis in autism is difficult to assess.
    The fear of the opening post is that their child will be called psychotic and be perceived as being a danger to others. This fear renders the opening post closed minded.

  30. Sullivan August 15, 2009 at 00:59 #

    Dismissing Kristina Chew as ‘anti-treatment’ because of her criticism of ABA, despite the fact that she has discussed several treatments on her website.

    The “anti-treatment” argument is a major straw man in online discussions. A common example–if you side with actual toxicologists and say “I think chelation challenge testing and chelation as a treatment for autism is unwarranted given the science” you can expect a response of “you are anti treatment”.

  31. Dedj August 15, 2009 at 02:27 #

    “1. Many do not know that much about psychotic delusions and hallucinations”

    Including you it seem. You did not provide sufficient context for your original scenerio – i.e. that the belief was irrational, non-cultural and absolute – that is, the belief does not go away with rational explanation from a trusted authourity. Mistaken beliefs are not delusions.

    Try reading what is actually written. It’s the polite thing to do.

    “Many do not accept that autism can be associated with psychotic symptoms e.g. delusions and hallucinations”

    Indeed not, for this wasn’t the actual arguement – nor has anyone actually made it – that psychosis is not an essential criteria for autism.

    It is not, as per the DSM and ICD.

    Case closed, move along now.

  32. Dedj August 15, 2009 at 02:32 #

    Indeed Sullivan, you will find many people in the ‘ND movement’ who opposed many biomed and ABA type interventions, yet are not anti-treatment.

    How can you tell? Well, there are many people in the ND movement who have researched, delivered, advocated for or otherwise help support autism therapies. Many got into ND through their work in autism services.

    Strange how these people never get a mention from anti-ND bloggers. Strange how pro-ND professionals never get a mention. Strange how anti-ND people stick almost exclusively to what is on the bloggosphere.

    It’s almost as if they don’t actually know about the offline ND world at all.

  33. David N. Brown August 15, 2009 at 06:32 #

    To Dr. Treg,
    As far as your examples, I think you have a fair point as far as “cars as monsters” qualifying as a delusion (though I think it’s a strong term to use). Imaginary friends is another matter. A child may act out interactions with an imaginary friend, without sensory hallucination or a belief that the “friend” is real. Probably only a thorough and trained clinical observer would have much chance of distinguishing very effective “play-acting” from actual hallucination and delusion. Incidentally, even if the latter is the case, it’s most likely to have started as play acting. In any event, the fundamental question is not whether autistics are subject to hallucination and delusion, but whether they are at unusual risk. As I have mentioned, I consider this a strong possibility, but something that must be considered is whether such behavior simply draws more attention when the individual is known to be autistic.

  34. NightStorm August 15, 2009 at 18:02 #

    Indeed Sullivan, you will find many people in the ‘ND movement’ who opposed many biomed and ABA type interventions, yet are not anti-treatment.

    and there are those like me who thinks ABA has some merit but needs to be remastered to suit the needs of the autist than the parent.

  35. James Gavin November 8, 2010 at 17:33 #

    @ dr treg

    Here’s a good basic reference for you try. It should hopefully clear up some of your confusion about what actually constitutes a delusion or hallucination.

    http://books.google.com/books?id=CGGqvUTJXEYC&printsec=frontcover&dq=symptoms+of+the+mind&source=bl&ots=VWoN2-g9Lp&sig=QRkPdawijrk92U8aPE6Ncp4sx1g&hl=en&ei=1iHYTLijHNSwhQe3r-XwBA&sa=X&oi=book_result&ct=result&resnum=4&sqi=2&ved=0CCgQ6AEwAw#v=onepage&q&f=false

    Clearly an autistic child can also experience psychotic symptoms (in the same way that a child with a broken limb can experience such symptoms…)

    http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000255958

    A systematic review in 2009 (looking at psychiatric co-morbidity with autistic spectrum disorders) found that the strongest association was between ASD and anxiety disorders. Depression also appeared common but the evidence regarding psychotic co-morbidity was contradictory.

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