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What is normal? Re-introducing neurodiversity

Hannah Kierspel quote

 Article first appeared on Intent Health's website.

“But I don’t want to go among mad people," Alice remarked.

"Oh, you can’t help that," said the Cat: "we’re all mad here. I’m mad. You’re mad."

I recently had the opportunity to pitch for an ADHD campaign. As someone with ADHD I loved being part of the process start to finish rather than as a focus group participant. And what I found is that while there is general awareness of ADHD and neurodiversity, knowledge of the community and our values and views is scarce. I would tentatively blame the neurodiversity clickbait floating around during this pandemic. “Leveraging the power of neurodiversity”, anyone? As with most buzzwords, neurodiversity has become increasingly detached from its original intention and community and witnessing this has been...frustrating. Not only because we’re being talked over and about, but because we are having important conversations that have wider relevance to everyone. So this is my attempt at re-introducing us, who we are, where we are and why we’re relevant.

There are infinitely diverse ways of wiring a brain and it makes no sense to label one as “correct”. That’s the neurodiversity paradigm, in a nutshell. You’d think it’s not a huge revelation, but, historically, the pathological paradigm used in psychiatry assumed a “normal” brain type and then went about categorizing and fixing “abnormal” ones. “Abnormal” brains were identified by how they failed to “fit in”.

Neurodiversity, on the other hand, shifts the focus away from what we struggle with. Talking about differences (rather than abnormality) allows for a more holistic view of our traits (rather than symptoms) - the good, the bad, the quirky, the inconsequential. It recognizes that these genetic variations are inseparable from our sense of self and as such should not be “managed” or fixed. I would not be me without my ADHD. Not because I reduce myself to it, but because there is no part of my personality that is not touched by it. If I am my brain, then I am my ADHD. “Fixing” the traits that make functioning in this society hard for me will always come at the cost of who I am.

TikTok for everyone

As a consequence of this ‘othering’, neurodivergent people have always flocked together in self-help forums and support groups, but were segregated (naturally) by disorder. Under the umbrella term of neurodiversity we are now becoming a cohesive community. And, lately, there has been a bit of a boom.

Somewhat unexpectedly, we have TikTok to thank. For those of you who know TikTok as that dancing app for kids - think again. The neurodivergent community there is vibrant, age inclusive and welcoming; filled with creators translating new research in layman’s terms and making relatable content. For the first time newly diagnosed are coming to terms with their neurodivergence without being scarred by stigma first. Learning from each other has not only fostered solidarity and the confidence to get diagnosed, but helped misdiagnoses be rectified and mitigate the gender gap.

There have been some hiccups, of course. Information is great, but context and perspective can often get lost in 60 seconds. The distinctions between diagnostic criteria, symptoms, disorder commonalities, and things that just happen to be relatable characteristics are easily blurred.

This article by James Greig does a great job of explaining the pathologizing craze that swept TikTok recently. To summarize, the app was briefly flooded with content construing everyday behaviour as signs of either mental illness or undiagnosed neurodivergence - like reading a lot in childhood meant you were dissociating (yeah, it was weird...). Psychiatrists on the app have since stepped in and TikTok has moved on.

The short-lived craze was a mess, but it’s telling that so many people feel overwhelmed enough to feel ‘disordered.’ Neurodiversity presents a solution that supports those who feel lost enough to seek a medical answer where there may be none. Created in response to the pathology model, neurodiversity locates the cause of friction outside the individual and within society.

Sanity is a social construct

If more and more people are relating to the symptoms and the same symptoms in different people can be diagnosed differently, then disorders don’t reflect actual biological variation in brain structure so much as the ways in which we disrupt societal expectations of “sane” (often synonymous with “useful”). As such they are determined by society’s far from stable gendered, racialized and biased definitions of “sanity”. This is far from a new insight (Foucault, anyone?), but the neurodiversity community has been seminal making it accessible and spreading it.

What determines whether you are disordered or not, then, becomes a question of how suited you are to the societal role into which you were born. But, it is only once you become sufficiently disruptive that your disorder is recognized. This is reflected in as small a thing as how we name these disorders. This tweet about ADHD puts it succinctly:

“ADHD is the most poorly-named affliction ever. like hi do you have a profound physical inability to accomplish your goals specifically because they're your goals and also the thought of your friends not liking you makes you want to die? you may have Trouble Sitting Still Disorder”

Disorder recognition is reflected in how neurodiversity is being talked about generally (thinking in particular of the articles I mentioned that “celebrate” us by highlighting our new profitability).

First of all, we’re not the latest productivity hack. We are not Rudolph the Red-Nosed Reindeer, shunned until Santa realized he could save the day. And, secondly, we are not a monolith. It feels like neurodiversity has been interpreted as the next “politically correct” term to use for people with autism (the poster child of “socially inept genius”). But neurodiversity includes many other disorders (think dyslexia, mood and personality disorders). These articles, while they look like great PR for us, are still perpetuating the old paradigm (normal vs. abnormal) while using the new buzzword (and including some of us, on condition of our “usefulness”, in the new normal).

So...what then?

To be clear, we are not advocating for an erasure of labels. For many of us diagnosis is still a relief. But embracing the paradigm does mean we think about them less as “disorders” and more as differences that are described by conceptual frameworks. We are all different to a degree so it makes sense to create flexible frameworks that help us (all of us - including you!)  function in this particular society. Which means several things.

Firstly, it means acknowledging that as society and our conception of “sanity” changes, so will the barriers of participation. Who is (in)sane is relative and so it doesn’t make sense to organize society around a phantom ‘normal’ and pathologize the rest. We need to remove the stigma around labels and acknowledge that no one is consistently well, able or the same! Secondly, we need to interrogate the society that necessitates this labelling - and change it. For example, our modern world is designed to distract. It makes sense that many are struggling with ADHD-like behaviours and the ADHD community has resources ready to help. The neurodivergent community is about support, not pathology - and certainly not gatekeeping.

Thanks to TikTok’s algorithm this message is being spread far and wide. We are, however, still a “niche” community, if you will. We are still being written about rather than listened to - the neurodiversity in the workplace articles are a testament to that.

As for campaigns talking to us: there is nothing more eye-roll inducing than an “awareness” campaign years behind the community. If you’re going to hire us because of our neurodivergence, let it be to better understand us and engage in the conversations we are having now. Like I’ve said, we are well beyond thinking of our disorders as “superpowers” and aren’t really interested in integrating and being “normal”. No one is normal. We’re all mad here. And we think it’s about time everyone realized.