This is Part 4 of the four-part series on neurodiversity that is being jointly published by Mad in America and Mad in the UK. The series was edited by Mad in the UK editors, and authored by John Cromby and Lucy Johnstone and one anonymous contributor. Part 4 was originally published on August 5, 2024.
This is the fourth and final part of our blog series on neurodiversity. Part 1 outlined the history of the neurodiversity movement, along with some of its implications, limitations and contradictions. In Part 2, we suggested that the rapid rise in the diagnoses most commonly associated with neurodiversity, ADHD and ASD, can be understood as consequences of neoliberalism – both in terms of the specific behaviours thus described, and their subsequent commodification and marketisation. Part 3 then showed the very damaging effects that the concept of neurodivergence and associated diagnoses can have in clinical practice, including limiting therapeutic work to the affirmation of identities.
In Part 4, we will examine the implications of the various strands of the neurodiversity movement for the medical paradigm of distress – the narrative that, from the point of view of Mad in the World, has failed, and needs to be replaced. To what extent does the concept of neurodiversity offer a new, inclusive, non-pathologising way forward, as some (including the founder of the movement, Judy Singer) intended? This will include addressing claims from one strand of the neurodiversity movement, that critiques of the kind often hosted by Mad in the World are ‘reactionary and outdated’, and based on extreme right-wing, supremacist, and ableist positions.
We remind readers that we wholeheartedly respect and uphold people’s personal right to describe their difficulties and differences in any way they find helpful (although we argue that clinicians do have a duty to use concepts that are in conventional terms evidence-based). While our stance toward neurodiversity and associated concepts remains critical, none of what follows either limits or changes that personal right, or imposes alternatives.
Neurodiversity and psychiatric diagnosis
As we have seen, the relationship between the medical/diagnostic paradigm and the neurodiversity paradigm is confusing and contradictory. The term neurodiversity itself, as originally put forward by Judy Singer, was intended to embrace everyone and thus de-pathologise our natural individual variations. In this sense, ‘neurodivergence’ does not necessarily imply any kind of disorder, disease or disability – only ‘difference’ of some kind.
Within this, some parts of the neurodiversity movement take an uncritical or neutral perspective on the validity of psychiatric diagnoses such as – but not limited to – ASD and ADHD, backed up by unsubstantiated claims about biological and genetic causal factors.
Others who describe themselves as neurodivergent see these terms as indicating identities: the kind of person you are, not the kind of ‘disorder’ you have, and as such, exempt from the critiques directed towards other psychiatric labels. These essentially arbitrary decisions are supported by some researchers in both critical psychology and disability studies, even while they dispute pathologisation and discrimination in general.