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Anna Nicholson

Rant about knee-jerk pathologisation of deviations from the neurotypical norm

I was just having a discussion with @lauravivanco about aphantasia and SDAM: mastodon.scot/@lauravivanco/11

I am aphantasic and have a very different kind of autobiographical memory from that of other people I’ve spoken to

But then this occurred to me:

Why should I accept Brian Levine’s 2015 (yes, 2015!) coining of the term ‘*severely deficient* autobiographical memory’ for this aspect of my neurotype?

Being Autistic, I’m pathologised by the medical model as having a ‘autism spectrum *disorder*’

And being an ADHDer, I apparently have an ‘attention *deficit* hyperactivity *disorder* (yeah, get two Ds in there, why not!)

Yet many Autistic and ADHD activists who subscribe to the social model of disability and the neurodiversity paradigm are making inroads into persuading at least some academics and clinicians to treat us as disabled, not disordered, not deficient – just a different kind of human, not humans that have gone wrong

My aphantasia/SDAM (I have a strong hunch they go together) may have strengths and weaknesses in comparison with the imaginative capacity attributed to the mythical ‘normal’ person

But because it’s out of the ordinary, it has to be called *severely deficient* by the gleeful (probably) neurotypical researcher, doesn’t it!

In 2015!

Still!

re: Rant about knee-jerk pathologisation of deviations from the neurotypical norm

@transponderings Something I would caution as regards this is separating a couple neurotypes from the word "disorder" doesn't help the many other neurodevergencies that are also generally considered to be disorders. Having a deficit or a disorder isn't an inherently bad thing, the same way that being disabled isn't inherently a bad thing.

I'd also point out that one of the whole points of the term "disorder" was to avoid the negative connotations of the words "disease" and "illness". If that didn't work, I don't see a reason to think that another euphemism hike will work this time.

Really, it seems to me that what should be focused on here is whether the terms are accurate. "ADHD" is an incomplete and somewhat misleading term, but ADHD is severely disabling (even moreso than most of us with ADHD tend to realize). On the other hand, autism often doesn't cause stress or disability at all (in fact I wouldn't be surprised if I'm more functional than an allistic person with ADHD), so describing autism as a disorder might be arguably inaccurate (or at least it might be said that not all autistic people have a disorder connected to being autistic). It just depends on what and who you're talking about specifically.

As far as how the social model of disability fits into this, I don't see how it implies that there's something wrong with the words "disorder" and "deficiency". If these terms aren't value-neutral, then that's a cultural issue that isn't going to be solved by a word change.

(Not commenting on aphantasia or SDAM since I have no connection to those.)

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re: Rant about knee-jerk pathologisation of deviations from the neurotypical norm

@diligentcircle I completely agree with you that we shouldn’t be trying to come up with euphemisms for things just because they have negative associations, when the right approach is to counter stigma, prejudice etc.

My rant was really about accuracy

So I embrace the word *disabled* because society does indeed disable people who are atypical in various ways

But to pathologise anyone as inherently *disordered* or *deficient* feels wrong

Suppose one person performs better at a task than another person by virtue of their neurology

Is the one who performs worse at the task disordered or deficient?

What if the person who performs worse is neurotypical, and the other person is neurodivergent in some way?

One problem is that *disorder* and *deficiency* are relative terms, and their use in the DSM is relative to an implied standard – the societal norm – so these words occurring in ASD, ADHD, SDAM etc. don’t say anything about us in absolute terms: they simply *other* us

Another problem is that the DSM focuses exclusively on those characteristics of different neurotypes that can be labelled as ‘less than’ in some sense, thus ensuring that those of us who are othered are also viewed as inferior

re: Rant about knee-jerk pathologisation of deviations from the neurotypical norm

@transponderings I was in the middle of writing a reply but my browser crashed. 😑 I'll try to reconstruct what I wrote, sorry if it's sloppy or looks kind of terse, there's no intention to direct anger at you, I just don't really have the spoons to control that after losing what I was writing for a half hour.

Ok, so, a problem I see with your argument is that I don't think the word "disabled" is any different from "disordered" in that regard. Note that "disabled" means literally, not being able to do something that most people can do.

I would also contend that while it gets overused (not just connected to neurodivergence), "disorder" is the most accurate term to describe something sometimes. In the post I lost I went into a whole explanation of how we tend to apply this in the plural community, but basically, some plural systems are disordered and some aren't (we're in the latter camp). Disorder meaning that it actually inherently makes things more difficult, as opposed to a difference that's discriminated against. For me, I consider ADHD to be a disorder because it just limits my ability to control attention. (Like how right now I'm having trouble gathering and writing my thoughts because I'm distracted by how frustrated I am that my browser so often crashes after hanging up from a Discord call, or how I've got a gamedev project on the backburner that I can't focus on.)

And as far as the word "deficient" goes, I don't think it's used very much in like, neurodivergence related things and I think it uses the common dictionary definition of lacking something. That's inherently value-neutral; it only gets stigmatized by ableist attitudes. In the case of ADHD (which is the only thing in the DSM I'm aware of that uses the word "deficit") I think that description is inaccurate, but I wouldn't think so if it was called something like "focus control deficit disorder" or whatever. It's like a nutrient deficiency or whatever, just a value-neutral way of saying you lack something important.

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re: Rant about knee-jerk pathologisation of deviations from the neurotypical norm

@diligentcircle I think we’re very much on the same page (and I sympathise with you having lost a long post – that kind of thing is incredibly frustrating and can really throw me!) 🙀

Three quick(ish) comments:

1. Your understanding of the word *disabled* seems to align (mainly) with the medical model (as well as with most dictionary definitions of the word), but under the social model, it is society (and its conventions, infrastructure etc.) that disables people – I tend to prefer the latter framing

(Of course, any society’s conventions, infrastructure etc. will disable some people, perhaps in different situations)

2. Talking of a *deficiency* or *deficit* as a lack of something important doesn’t stop it being a relative term, because importance itself is subjective

I do consider my difficulty focusing (to the extent that I’d like) to be a deficit in relation to an ideal version of me, but that ideal version of me is something I’ve conceived of because other people around me seem to be able to focus much better – if everyone had ADHD, I probably wouldn’t think twice about it

3. Words like *disorder* and *deficit* may be considered to be almost value-neutral – though I think many, if not most, words end up having some sort of positive or negative association conferred upon them by a language community

Even if their value is only very slightly negative, I find it interesting that those terms (indicating lack of something) are used in the DSM (which is in turn positively valued by a lot of medical professionals and others)

The Autistic/ADHD ability to hyperfocus on something of interest, just to give one example, isn’t included (unsurprisingly, because it’s not a problem, and the DSM is all about problems that people have), but we get assigned the label that only deals with the (relatively) problematic part of our neurotype

I hope that makes some sense – as I say, I don’t think we’re talking completely at cross purposes here! 😊

re: Rant about knee-jerk pathologisation of deviations from the neurotypical norm

@transponderings We may not experience ADHD the same way because I don't experience hyperfocus as an ability, I experience it as something that gets in my way. That's pretty much how I experience ADHD in general.

I don't disagree with the social model of disability, but etymologically, I don't think the word "disability" is so different from the terms "disorder" and "deficit". "Disability" is just a combination of the prefix "dis" (meaning "reverse of") and "ability". "Disorder" is formed the exact same way, except with the word "order" instead of the word "ability". And I don't think the social model of disability requires an exclusive attachment to only the word "disability".

I also don't think it's necessary to reject the idea that there are disorders which, as experienced by those who have it, are inherently detrimental, or the idea that there are people with less ability than others. In fact, I think it's necessary to accept both of these. Genuinely, there are disabled people who don't have any skills to counteract their disability and will never be productive no matter how many accommodations they get, and they're just as important as people who do have skills and can be productive with the right accommodations. The particular emphasis on productivity which tends to leave such disabled people behind is one of the most pernicious aspects of ableism in our society.

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