I think that this term has created a complex dialogue and like all human conversations, there are a lot of layers to unpack here. I want to talk about what I agree with and what I don’t when it comes to the neurodiversity conversation.
I pretty much agree with the neurodiversity paradigm. I agree that the science has demonstrated that everyone’s brain is different which means that neurodiversity is a reality. There just doesn’t seem to be much to debate there. Everything about an individual is unique. In that manner, we all are divergent everything. I have a bit of an issue with the idea of “normal.” When we use the word normal in the world of health care, what we are really saying is “the statistical average.” This doesn’t mean that being outside that average equates with bad. When something is outside the average (or normal) but is healthy or harmless we refer to this as “benign” or as a statistical outlier. Meaning it doesn’t hurt anything.
The social dynamics that manifest in regard to neurodiversity are similar to the social dynamics that manifest in regard to other forms of human diversity. We humans have a difficult time understanding things that are different then ourselves. We, as humans, are inherently egocentric. That doesn’t mean that we don’t have compassion or the capacity to understand others. It just means that we have a difficult time perceiving the world the way that other people do. We have a difficult time imagining an experience that we have never had.
When I see the terms “neurodivergent” and “neurotypical” I get a bit of brisling fur (yes, pigs have fur). These words reinforce the idea that we are some how different then other people because we have a mental illness. We’re not. We’re different, just like everyone else. Because all of us are divergent, it is impossible for someone to be neurotypical. How do you even define neurotypical? What does that look like? So, a part of me feels like these kinds of terms are just creating more walls between groups of people. The more walls and categories of people we create, the more groups of “others” we create.
That being said, I also think that these terms are useful. They make talking about these issues a little easier. I have found that people are less over whelmed by me saying that I am neurodivergent rather then giving a list of my diagnoses. For most people, that diagnose list doesn’t mean much anyway. So, having a term that serves as an umbrella is useful and can help bridge the gap without needing to educate people on all the nuances of each disorder. Thus, I’m not opposed to the use of these terms. But I think that it is important that we understand how the use of this language changes the conversation and the way that seperating overselves can negatively impact our desire to be included equally.
The other caution that I have about the use of the terms neurodiversity and neurotypical is the implication that this means that every type of thinking is ok and should be embraced. I don’t agree with that. I believe that there is such a thing as a pathological brain. Not all differences are good or healthy differences. Some differences hurt people. Does anyone want to try to convince me that the mind of a serial killer is not pathological and that it isn’t something that we should work towards changing? How about those who are homicidal or suicidal? That is pathology. It fundamentally goes against life. I personally feel that any state of mind that would drive a person to extinguish life is pathological. Life is sacred and should never be snuffed out.
Lets consider the less clear cut pathology. There are people who are plagued by their own minds. I have met people that have hallucinations and delusions that cause them constant fear. They live in a world that they believe is trying to destroy them. I will argue that this is pathological. I saw a person who was literally peeling back their skin, down to the muscle because they believed that there was a “darkness” in their bones. That is pathological. It is also neurodivergent. But I cannot stand next to these people and tell them that they need to embrace themselves as they are. I will not tell them that they do not need treatment. I believe that this is pathology and that we need to offer them treatment that will allow them to know peace.
The Neurodiversity Movement is a social justice movement that seeks civil rights, equality, respect, and full societal inclusion for the neurodivergent. I agree that civil rights, equality and respect should be afforded to all people as a general principal. But I also agree that there are times that civil rights need to be restricted and that full societal inclusion should not always be allowed. Consider again that serial killer. Sorry, but their civil rights need to be restricted and they should not be given societal inclusion. They need to be locked up and given treatment in a manner that prevents them from causing harm. There are times that involuntary treatment is appropriate. I agree with that. When someone is trying to hurt other people, whose rights do we consider first? Do we allow them full societal inclusion and disregard the right for safety to all those around them? Sometimes giving rights to one person means taking it from someone else.
Something that we look at in the medical field is functionality. This is another hot spot for the neurodivergent movement. There are those in this movement that would argue that the word functionally really means “functioning like the neurotypicals.” That’s not what functional means. Being functional means that you can meet your every day needs in a safe way. Can you feed yourself? Can you wash yourself? Can you go about your day in a manner that allows you to meet your biological needs? If I was talking about those who’ve had a stroke, no one would bat an eye if I said that I was evaluating their functionality. There is no difference. It is my job to help people reach a point that they can be functional in this manner. It doesn’t matter if they are struggling because of a stroke or because of depression. They are struggling. That’s the part that matters.
The pathology paradigm has it’s place in this conversation. But we also need to embrace the fact that each of us are different. If we are functional and not hurting other people, then we’re ok. My brain works in a strange way. I often feel like there is a war going on in my head between my ADHD and OCD, but I can meet my needs. I can get through the day. That’s the part that matters. I’m not plagued by the strange things that go on in my head. That’s the part that matters. Embrace your differences because there is nothing fundamentally wrong with being different. But there is something wrong with hurting other people or hurting yourself or being plagued by your own mind or not being able to meet your own needs. These are the things that are problems, not being different. Trying to include all the divergent brains into a single category of “ok” just doesn’t work. Life and the universe is more complex than that.
I love that people are out there encouraging each other to embrace and love themselves as they are. That’s wonderful. I love that people are trying to ensure that all people are being treated with respect and dignity. I love that people are trying to break down the stigma that comes with mental illness. I love that people are trying to ensure that everyone is getting the things that they need to be successful and are being treated equally. These are good things to work towards. But I’m not ready to embrace the idea that there is no pathological brain. And I am not ready to accept that there are not times that people need medical care for their neurological differences.
Which brings us to one of the core questions of the Neurodivergent Movement. Should there be treatments? Should there be a cure? Personally? I think: Yes. I think that like everything else in healthcare, we need to make the treatments and cures available and allow individuals to choose for themselves if they need or want them. It is a little more complex with mental health when the truth of it is that a lot of the work we do in mental health is based on the social norms of the culture. But what other standard would you use?
What’s the solution to all this? I don’t think it’s about erasing pathology. I think it’s as simple as having compassion. Helping each other reach our maximum potential and accepting that no one else is just like us. And accepting that is alright. We need to treat all people as people. None of us are better then anyone else. Even those that have a pathological mind are deserving of respect and compassion. We need to embrace our diversity, including the diversity in our neurological functioning. None of us have any more value then anyone else. If we can remember that, we could do so much better in this world. Living with loving kindness. That’s the solution.