I have been reflecting on the value of transposing ‘recognition’ in preference to ‘diagnosis’ in relation to neurodivergencies, in the context of avoiding the ‘othering’ of people and demedicalising difference. This follows on from my suggesting it during time in a breakout chat room during an autism in therapy online conference.
As I explained to fellow attendees, my ADHD diagnosis was very recent – March this year – and that word, diagnosis, has never sat well with me. I have fibromyalgia. Now that, as a disability that is an illness with treatments, albeit no cure, was something diagnosed. I just don’t feel in my bones that any neurodivergency should ever be placed alongside fibromyalgia, measles, HIV – any illness that may disable or disfigure but is imposed, by viruses or bacteria or genetic inheritance. Okay, there is evidence neurodivergencies can run in family lines, but not always. And, more importantly, seeking cures for what are effectively mutations society should work with and for rather than against is, well, wrong. It’s just wrong.
I want to be recognised as ADHD. That’s it. See me. Accept me. Help me when I ask for help navigating this world but don’t treat me as weak or faulty. My neurodivergent ways are often good for me, and others as well. Regardless, I’m content to be me. Don’t like it? Don’t like me? Leave me alone, then. I’m not down to be treated. I might consider medication to help my focus but that’s it. I do like me.
Using the term ‘recognition’ acknowledges and validates the unique neurodivergent experiences of individuals without framing them within a medical context. It emphasises understanding and acceptance rather than pathologising or labeling individuals. It helps us to shift the focus from perceived deficits or abnormalities to the diverse strengths and perspectives that neurodivergent individuals bring to society. And we do bring a great many benefits – when we are allowed to, when we are not marginalised and denigrated.
By reframing the conversation around recognition instead of diagnosis, we would foster and express that we value a more neurodiversity-inclusive and respectful environment. This shift, if engaged with conceptually and in practice on a sufficient scale, would encourage a change in attitudes, away from viewing neurodivergent traits as problems to be fixed and instead recognising them as valid variations within the multi-spectra of human experience. This approach would align with the broader movement already working towards destigmatising and demedicalising neurodivergencies.
A more holistic understanding of neurodiversity would encourage society to give support, environmental and communicative accommodations, and acceptance without prejudicial bias and, instead, based on the needs and preferences of individuals rather than rigid and cold diagnostic criteria.
The more pessimistic among us might say this being a far-reaching proposal means it is doomed to fail. I disagree. There are no determined outcomes when ideas are first put to others to consider and reflect on for themselves, and language is important. We know this. Why else is there a manufactured ‘war on woke’?
There is a war – although, let’s be clear here, it is the grumbling of ancient patriarchal power – because, in part, there are those among us who feel threatened by our choosing to substitute new descriptives for ourselves in rejection of traditional old labels we never chose but had imposed – I might even say inflicted – on us. For anyone to claim a change like this – from diagnosis to recognition – is simply about a word change and therefore pointless, they would be missing the point. The point is, the words we choose – the language we populate our discourses with – not only matter but are capable of generating further change on change.
This is about more than neurodivergence, of course. I made the point at the conference that, in many countries, trans people are required to be diagnosed with gender dysphoria before they can legally have access to hormones and surgeries. Again, trans people need to be recognised rather than diagnosed – seen and accepted, not labelled to be allied with or marginalised. ‘I see you’ is a powerful start to finding out from others what they need. To be trans, same as neurodivergent, is not to be sick – so why diagnose where there is no disease or mental illness to be confirmed?
To say, ‘I recognise you’ to anyone is a powerful statement, made all the more so by not carrying with it any expectations or assumptions. It encourages us to listen to, support and value our fellow humans with kindness, affording dignity and respect to those we meet as prerequisites to working and living together on this world.
I was recognised as ADHD, as I said earlier in this reflection, not long ago – but that recognition is liberating and supports me as I find ways forward with this new knowledge while examining my past life in all its messy, broken, discontinuous states peppered with victories and failures, traumas and joys.
Diagnosis, in contrast, is a word that contains. It does not break the glass jar, it puts a lid on it. And nobody is ever going to put a lid on my life ever again unless it is when I am in my coffin. Learning I am a person with ADHD was not in any way like learning you have cancer. I was glad to know, not devastated. It did not mark the end of my life but rather the beginning of it anew in many ways, not least of all by giving me the powerful self-knowledge I needed to rid my head of so much shame and guilt and perceived failure, from all those times I did not live up to the conditions of worth imposed on me by neurotypical family, the state education system and many, many employers. I forgave myself for not fitting in. I now embrace it. Not fitting in is, for me, an amazing thing. I am free and my potential contributions to society are limitless.
A question I’ve heard posed is, ‘can autistic people and those with other neurodivergencies be counsellors?’ – and my answer is not only yes, we can, but we are desperately needed to get out there and practice as therapists in order to inform new and better ways of working with clients who are neurodivergent themselves.
xph therapy offers integrative counselling, which means working with multiple therapy types, including CBT, psychotherapeutic and person-centred to develop a therapeutic pathway just for you, whatever outcome you’re hoping to achieve. Get in touch in a variety of ways. See the contact page for more info.