Neurodiversity or Mental Health?

I was talking to a friend today about this topic, and I thought I’d share the results of our discussion.

Who decides what is an illness, and what is an acceptable, but non-mainstream psychology? After all, homosexuality used to be classified as a psychological disorder back in the 70s. There are quite a few people on the Internet who think that Asperger’s syndrome ought to be re-classified to discourage stigmatization and promote neurological diversity in today’s society. The White House recently proposed a re-wording of the security clearance question regarding psychological counseling in an effort to lessen the job-related barriers to individuals seeking mental health treatment. And, I can’t count the number of times I’ve heard people decrying the proliferation of ADD and ADHD classifications among children.

The fundamental problem with all this discussion is that on the one hand we have a clear social stigma against people labeled with any “mental disorder” while on the other hand, professional counseling and treatment can have a profound positive impact on a person’s life.

While you can debate the morality of the stigma, it’s never going to go away in the real world — unless you teach kids abnormal psychology (but don’t call it that!) since kindergarten. If someone thinks and acts in a way that is completely incomprehensible to you, you will treat that person differently (and often more poorly) than you treat more “normal” folks. A disorder classification, or knowledge of mental health treatment in general can provide the general public with a semblance of deep knowledge about the way a particular person thinks, while short-circuiting the requisite learning process that is involved in making a personal connection with the individual. Unfortunately, most people will fail to recognize the ridiculously incomplete nature of this information “packet” and thereby unwittingly perpetuate that particular stigma. So, maybe the solution is to just avoid diagnosis entirely, convince everyone that he/she is “fine,” and do away with notions of “mental health” entirely!

It’s not quite that simple. In fact, the mental health professionals that this plan would put out of work would tell you that their goal is precisely that! More specifically, the goal is to help the patient live out his or her interpretation of a normal life — or simply put, to reduce their suffering. If something about the way someone thinks or acts causes a person distress, most psychiatrists and psychologists want to help him or her to change that. I have yet to hear of any successful “treatments” of some characteristic that the patient him/herself did not view as a problem. In this context, the stigmatization issue is often seen merely as an annoying sociopolitical foible that is best addressed by changing terminology and utilizing education propaganda targeted to help soothe the currently loudest group of unhappy recipients of discrimination. The fact is, that some people will always get more fulfillment from changing what they don’t like about themselves than from sociopolitical lobbying and trying to force people to accept them for “who they are.” I, for one, am thankful that there are people who have devoted their lives to helping folks through this process.

So, what’s the solution to this conundrum? We decided that the following changes ought to do the trick. What do you think?

  1. Social activists should work to make mental health checkups as normative as (and probably more frequent than) dentist visits.
  2. Mental health professionals should discuss diagnosis in terms of the particular human cognitive/behavioral model that they are utilizing. Not only will this present a more accurate view of the uncertainties involved in the diagnosis, but it will also serve as a barrier against misinformation and hearsay. The public is much less likely to misuse classifications and concepts if they know there is a very precise technical meaning behind them (for example, how many times have you heard someone make a totally inane statement, after clearly defining terms and stating his/her assumptions).

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