We don't know what normal is anymore
We don't know what normal is anymore
My contribution to 'Neurodiversity to gender dysphoria: a problem of over-diagnosis?'
My son has ASD (Autism Spectrum Disorder). He also has ADHD (Attention Deficit Hyperactivity Disorder). ‘Doesn’t everybody?’ you might ask. It’s ADHD Awareness Month at the moment. I’m not sure if that means we are ‘aware’ or that we’re not ‘aware’ enough, but it’s certainly very in vogue. Then again, it’s also Black History Month, LGBT History Month and Menopause Awareness Month. There was a World Mental Health Day, World Homeless Day, and World Coming Out Day last week. And it was World Vegetarian Day the week before. To name but a few. If you look hard enough, we all have a day or a month we can identify with - whatever our affliction might be.
Autism is not an identity
Sadly we missed Neurodiversity Awareness Month, which was in April, but those who were there for it were keen to ‘celebrate the differences in the brain as strengths’. As a headline in Psychology Today put it: ‘Neurodiversity is an Identity, Not a Disorder’. While, I have all sorts of doubts about ADHD (one of the neurodivergent identities), there’s one thing I can be sure of. My son doesn’t identify with autism. He is autistic. It isn’t something that he puts on like a new pair of shoes. It is a part of him - it runs through him like a stick of rock - whether he likes it or not.
Of course, there are some remarkable things about having autism - some people are highly intelligent, or have obsessions that lend themselves to remarkable feats of memory. But some of us don’t feel especially celebratory. Some of the behaviours associated with autism can be very troubling and have a profound effect on children and their families. Nobody in their right mind would want to identify with or celebrate autism. Some autistic people can struggle to cope with the demands most of us deal with on a day-to-day basis. They might respond by withdrawing, shutting down or having an aggressive outburst or meltdown. For obvious reasons this can make schooling difficult if not impossible.
While the term is much disputed (not least by psychiatrists), some in the special educational needs industry will routinely refer to PDA (or Pathological Demand Avoidance). It may be of dubious diagnostic value but that word ‘pathological’ is important. It makes a distinction between a quite normal resistance to doing stuff we don’t want to do, and to more extreme behaviours that constitute a problem or condition. A distinction that is under some strain these days.
There is a paradoxical co-existence of a refusal to pathologise, on the part of advocates of a neurodiversity outlook; and yet a drive for constant labelling - whether by self-diagnosis or referrals to professionals - in as far as it recognises difference kinds of ‘neurocognitive functioning’ . The result is ever more acronyms with which to label more and more perhaps quite normal behaviours. It is to confuse the everyday with the clinical. Having said that, it does seem that some of the traits and behaviours associated with Autism and ADHD have been let loose on the wider population.
Do we know what normal is anymore?
It’s not just our kids who are having meltdowns and shutdowns, eating only ‘beige’ food, and struggling with social situations. Other kids are apparently struggling with these things too. The same language is used: masking, dysregulation, sensory issues. I’m often struck by the number of kids wandering around wearing their noise-cancelling headphones. Behaviour problems, school exclusions, and mental health issues are all widespread.
Local authorities are struggling to cope financially, and schools with the increasingly challenging behaviour and complex needs of children, as the numbers with SEND (Special Educational Needs and Disabilities) continues to grow. Indeed, those needs are getting rather less special. Record numbers are taking up benefits - particularly since lockdown - because they or their children are sick or are classed as disabled because of a mental health problem or condition like depression or ADHD.
Parents can seem oddly eager that their children be neurodiverse or have a SEND. We do it to ourselves too. We’ve all had that conversation with somebody who claims to be a bit OCD. One Liberal Democrat Councillor was reported last month as having a ‘diagnosis of PTSD over Brexit’. We all seem to want an acronym of our own. Or a day or month of our own. Something to identify with or fall back on. But what are people looking for and why are they finding it here?
They can’t all be sick. Surely there’s something else going on. That’s not to say people seeking a diagnosis or a neurodiverse identity don’t have a genuine problem. Sometimes it can feel like a contagion and you can see how the rapid-scrolling TikTok generation might be susceptible. I do think that is a big part of it.
Are they making it up?
But it might also be that a behaviour problem at school, for instance, can be better understood in a different way. They might have ‘gone off the rails’ as we used to say because parents or the school aren’t able to control them. But this is difficult to say and harder to address. Perhaps there’s just one parent. That’s harder still. Who wants to have a go at single parents? So instead, the talk is of conduct disorders like ODD (Oppositional Defiant Disorder).
In this sense, it becomes a way of not facing up to things. That, for me, is the problem. We can’t keep inventing new disorders. We need to ask what it is that we are doing that is creating this generalised sense of vulnerability and identity-seeking. Why would anybody want to identify with a disabling condition, an inherited characteristic or a feeling that they are in the wrong body? It is quite perverse. But the clues are there.
For some time now, we have been encouraged to think of ourselves as, in some fundamental way, vulnerable. There is also, I think, a constant looking for explanations - even if we ignore the ones right under our nose. And a search for meaning. The neurodiversity lobby, the special educational needs industy, identity politics - they are responding to and, no doubt, generating this demand. The tyranny of awareness is promoted by those who seem remarkably unaware of how awful being ‘neurodiverse’ can sometimes be. Until we lay down some boundaries, and regain our sense of what is and isn’t normal, this can only get worse.
The above is the text on which I based my contribution to Neurodiversity to gender dysphoria: a problem of over-diagnosis? a debate at Battle of Ideas on 19 October.