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WELLNESS REFLECTION

Why the concept of neurodiversity should firmly be a part of our language

Why the concept of neurodiversity should firmly be a part of our language
Exploring the concept of neurodiversity (Image: DALL-E)

Many people might not have often read about or heard the word ‘neurodiversity’. On the relative timescale of human science and culture this word is still merely taking its first steps.

In fact, one could pinpoint its debut in wet ink to a 1998 article in The Atlantic, referencing people with autism spectrum disorder. For the next 20-odd years it thrived in a set of related, but narrow niches. It was adopted by parents, educators, healthcare professionals and activists: an alliance of the concerned, people battling to change our minds about the abilities and potential of children and adults with conditions like autism, ADHD and dyslexia. 

Now the term appears to be hitting the mainstream. Based on data from Google Trends, a tool for analysing search queries, global interest in the word “neurodiversity” has grown at a compound annual rate of 47% since the beginning of the pandemic. If you were an early investor in “interest in neurodiversity”, you might have hit the jackpot.

Maybe there is no greater indicator of a concept’s growing importance than that a major academic institution has decided to create a whole new project devoted to studying it – the landing page of the Stanford Neurodiversity Project gives us a working definition to follow: 

“Neurodiversity is a concept that regards individuals with differences in brain function and behavioural traits as part of normal variation in the human population. 

“The movement of Neurodiversity is about uncovering the strengths of neurodiverse individuals and utilising their talents to increase innovation and productivity of the society as a whole.”

Like with many ideas that are in a protean form, the exact boundaries of neurodiversity are fuzzy. 

Generally speaking, neurodiversity would include ADHD, autism spectrum disorder (ASD), dyslexia and dyscalculia, various kinds of intellectual disabilities, as well as schizophrenia. 

Some neurodiversity specialists like Dr Thomas Armstrong, author of The Power of Neurodiversity, would put anxiety disorders like OCD, and mood disorders like bipolar disorder into the neurodiversity rainbow as well. Some would argue for the inclusion of an even broader set of neurological conditions such as cerebral palsy, dementia and Parkinson’s disease.

Depending on who you are, you may fall somewhere on the spectrum between two casts of mind when it comes to the idea of neurodiversity. 

Some will see this as a total no-brainer. It’s simply part of a modern, open-minded and humanistic view of people and their natural variety: a wonderful, wholesome and life-affirming view of human beings. 

For others, especially those who have come in close contact with the devastating effects of conditions like schizophrenia or psychotic depression, your view is probably far less charitable. You may see these conditions as blights; they’re diseases that ought to be destined for eradication, in the same vein as smallpox, cancer or coronavirus.

In this writer’s view, it is critical to view the concept of neurodiversity as an attempt to correct an imbalance that is implied by this second, disease-based view. 

Different neurological conditions

The origins of our inquiry into, and understanding of, different neurological conditions comes from the traditions of medicine and pathology. When it comes to mental functioning our instinct is to fix things that seem broken. 

We see the fingerprints of this in our language; we label behaviour as disordered, disabled and deficient. The system of healthcare and wellness attempts to either alleviate the suffering of individuals, or correct behaviours that are socially unfavourable.

It is hard to understate the pervasive and pernicious power that this medical approach holds on our thinking and our perception. 

Dominant paradigms are dominant for a reason, and they form the basis for our mostly unconscious attitudes, beliefs and judgements about ourselves and others. 

There are two fundamental aspects of the medical model that are up for debate. The first is that there is such a thing as a “normal” or “neurotypical” nervous system. The idea of “normal” works very well when we are observing relatively simple phenomena and we want to get a sense of what “average” is. 

The thinking breaks down a bit when we look at highly dynamic systems like the human brain and the complex behaviours they produce. When we ask ourselves what is “normal” in terms of human characteristics like sociability or mood, we will generally find that either we can’t actually define what normal is specifically, we can define it but it’s highly reductive, or that the distinction between “normal” and “abnormal” has been drawn in a way that seems essentially arbitrary. 

Commentators like Armstrong argue that the categorical divide between neurotypical and neurodivergent nervous systems is a false dichotomy. According to this view we are all part of a neurodiverse network of differing human abilities, and we exist at different places along various continuums of competence.

The second problematic part of the traditional medical approach is the assumption that neurological conditions represent damaged or disorders nervous systems, a broken-down system that needs fixing. 

But here, again, the claim is at least partly dubious. At least since the Enlightenment humans have conceptualised brains as machines. We think of the “hardware” of neurons and the “software” of memories, or habitual patterns. 

Machines have a purpose, and when they fail to fulfil their purpose we can assume that they are broken and need to be fixed. But what is the purpose (really) of a human being? 

Armstrong codifies this idea as his first principle of neurodiversity: The human brain works more like an ecosystem than a machine. Ecosystems don’t break, they adapt to their situational context: growing, compensating, rebalancing and decaying dynamically. 

Viktor Frankl, the psychiatrist and Holocaust survivor, had an intuitive grasp of this sentiment when he said: “An abnormal reaction to an abnormal situation is normal behaviour.” 

Certain experts on ADHD, for example, like Dr Bill Dodson, are proponents of the idea that ADHD represents a second variety of nervous system: one that responds on the basis of interest in stimuli, rather than being able to discern the importance of stimuli. Different, yes, but far from damaged or disordered.

Conceptual problems aside, by engaging in deficit-based thinking, we crowd out a discussion around the strengths of neurodiverse individuals. 

If the genes for these conditions are still moving down the evolutionary line, then perhaps they represent human traits that are advantageous under the right circumstances, or they represent necessary trade-offs between different brain-based capabilities. People with dyslexia seem to compensate for challenges with writing by boasting greater visual-spatial skills, while people with certain intellectual disabilities, measured with standard IQ tests, may exhibit extraordinary musical abilities.

Robert Sapolsky, the famed Stanford biologist, warns us about the drawbacks of this kind of categorical thinking. 

He points out that we often try to comprehend complex phenomena effectively by cutting them up with arbitrary boundaries. They might make sense to us, but not because of anything that is innate about the distinction that we’ve made. Worse, we tend to overrate the differences between categories we have created: them or us, well or unwell, good or bad. 

This is why, even though we are still talking about mental health phenomena that can be devastating to our individual and collective quality of life, it still makes sense to balance the medical paradigm with a neurodiverse one. They are complementary, and together they help us towards a more holistic understanding of people, and to address some imbalances in the ways of thinking that we may no longer be questioning.

Why should this matter to me?

On this question I am not impartial: I found out that I had been living with undiagnosed ADHD at the age of 28 and it was a watershed moment in my life. 

An unfortunate by-product of both social messaging and a traditional medical approach is that you can have strong internal resistance to getting the therapeutic or medicinal help that you need, because we are often taught that mental deficiency is weakness. 

At the same time (and maybe paradoxically) the kinds of stories that we are told about how “these things are just a part of life, everyone deals with them, you’ll have to learn to deal with them too” never sat straight with me. 

There is a tacit assumption in these ambiguously vague and unhelpful platitudes: “You are the problem, and nothing else is.” I knew this wasn’t the case, even if I didn’t have good answers as to why that was. 

Neurodiversity was the first system of thought that provided an answer, and imbued me with hope and agency.

Being successful as a neurodivergent person means ambidextrously adapting your brain to the challenges and the harshness of the world (for example with drugs, therapy and other interventions), while simultaneously transforming your environment into one that is more hospitable for you: you have to construct a niche for yourself. None of that is possible without understanding how neurodiversity works.

We need to pay attention to neurodiversity

There are a few reasons that we need to be paying attention to neurodiversity. 

First, as one of the objectives of the Stanford neurodiversity project illustrates, neurodiverse strengths can be a boon to the innovation and productivity that drives our economy and our society. 

Our history shows us that not only are we not unlocking this potential, but that our current approach has an atrocious social (and financial) cost. The Neurodiversity Centre, operating in the Western Cape and KwaZulu-Natal, is an example of a local organisation of psychological professionals whose work is based on a deep understanding of this fact. 

They focus on screening, early intervention and creative interdisciplinary approaches for assisting neurodiverse individuals, who are more likely than others to enter the prison and destitution pipelines.

Neurodiversity also offers us a road to richer understanding of ourselves and others. 

Martin Heidegger, the German philosopher, wrote that “language is the house of being”, a recognition that our language is highly influential to our sense of self and how we see the world and the other people in it. 

An unlikely champion for this idea is the esteemed psychologist and recipient of the Nobel Prize in Economics, Daniel Kahneman. Kahneman and his intellectual collaborator, Amos Tversky, produced work that overturned the academic orthodoxy of their day, by designing experiments that demonstrated that our perceptions, judgements and choices have predictable patterns of error. 

Their work profoundly shifted the path of science and research in a wide array of domains and is still some of the most influential and well-cited research in the social sciences.

Kahneman’s highest ambitions for his groundbreaking work are surprisingly modest. In the introduction to his 2013 book Thinking, Fast and Slow, he tells us that he would ideally like people to use his ideas to improve the way they gossip around a fictional “office watercooler”. 

It’s only a little bit facetious. It can be read as a subtle and powerful illustration of the power of new words. Kahneman knows that when we change the way that we talk about others it prompts a reflection back on ourselves, which is where real change is possible.

If neurodiversity is something that we should care about, the best thing that we could do is to become more fluent when talking about it and using its concepts. 

Once neurodiversity is firmly a part of our language, our view of the world will be enriched. We will have better tools to heal ourselves, grow our knowledge, and, hopefully, fulfil our collective human potential. DM

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Comments - Please in order to comment.

  • Ted Baumann says:

    Awareness of neurodiversity and ways to avoid stigma are easier in developed economies. There are many spaces for neurodiverse people to gain support, camaraderie, and suitable livelihood strategies. For most people in the developing world, this doesn’t exist.

    Societies with resources and time to think about neurodiversity produce opportunities that suit many neurodiverse people. But not in less abundant societies.

    Consider a mildly autistic teenager transitioning into adulthood. In an environment of abundance, such a person could find support to engage the job market in a way that could provide rewarding employment. That’s because there are people who understand what’s going on and can apply their minds to trying to match the individual to the situation.

    But in much of South Africa and the developing world—and in much of the developed world too—those things don’t exist. To say that attempting to assist our autistic teenager to adapt to the world as most people around her understand it constitutes “abuse” is not only unhelpful, it’s classist.

    One aspect of level one autism is a lack of executive function. The ability to plan, to organise it, and to focus until completion is extremely difficult for people on the autism spectrum. Which is worse: refusing to try to help that person develop skills that will allow them to survive in the world as it is, or helping them to find sensitive and knowledgeable therapists who can help them learn the tricks to survive in it?

  • Mark Widdicombe says:

    Perhaps we should think about dropping the ‘disorder’ part of AS(D). Difference does not equal disorder.

    • Guinivere Pedro says:

      I’ve often wondered about the disorder word too and it’s for that very reason I have been hesitant to disclose it. Because disorder = problem.

    • A P says:

      It’s a good thought, and in my opinion the truth. However in South Africa it could be a double edged sword.

      Many parents of kids on the spectrum have to get their kids classified on the spectrum in order to access disability tax claims, which in turn helps fund the cost of specific schooling and a disproportionate amount of medical consultant costs.

      SARS has tried to limit disability tax access many times, and I absolutely know it’s not what you are saying, but I fear they would jump on “difference does not equal disorder” in the case of neurodiversity and read it as “difference does not equal disability”.

      As for the article. I totally agree with spreading the language and understanding, and it has many great observations, but it is quite one dimensional, it falls into the trap speaking about people in a part of the spectrum. Spectrum is a word so often ignored when speaking to Autism, ADHD, etc. The gap between High Functioning and Low Function are massive and the steps in between are massively diverse. For instance and individual can have both Autism and ADHD, and each of those could fall on their on parts of the spectrum.

  • Barbara S says:

    An investigation into how life and income protection policies are biased against neurodivergent people could be an interesting follow up. Once you’ve had an ADHD diagnosis, you are no long et eligible for cover for stress or burnout while “normal” people are. My experience is that ADHD people are more resilient to stress so this prejudice almost certainly not scientifically or statistically justified.

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