Before I began to work from home full-time during the pandemic, I received an employee-of-the-month type prize called the “weirdest brain” award. It was meant as a compliment, and I mostly took it as one; I was nominated by a coworker I respected and liked, and it was a recognition of my creativity.
But something about the name of this award rubbed me the wrong way, probably because my brain and I have been called “weird” many times throughout my life. The award was a nod at how brains that work differently can be a boon, but the implication was still that I was a deviation from “normal.”
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My “weird” brain was impacting me in other ways: While I was being lauded for it, I was also reaching a breaking point when it came to having to work in-person in the office, and questioning how much longer I could reasonably do so. Forcing myself into a typical 9-to-5 schedule and trying to function in an open office setting, with all its sensory and social demands, had me approaching a familiar expiration date.
It was around this time that I first encountered the word “neurodiversity” and the neurodiversity movement. Simply put, neurodiversity is a neutral description of the naturally existing variation in minds and brains. We all know about the fact of neurodiversity from lived experience: The people we meet and interact with are not copies, but are a little (or a lot) different from one another. The neurodiversity movement argues that since this variation is a fact of life, we shouldn’t automatically pathologize mental differences and treat them as “problems” to be fixed. Instead, since mental variation is to be expected, we can accomodate for difference by creating environments in which those with differences can thrive as they are.
The idea originated in the autism community in the 1990s, and over time the term “neurodivergent” has expanded in colloquial use to include experiences we call dyslexia, ADHD, OCD, anxiety, depression, and more. Recently, the words neurodivergent and neurodiversity, like many other terms related to mental health, have spread far and wide. You can easily find them on Instagram and TikTok, where the hashtag has over two billion views; they’re being used by big tech companies that boast about hiring neurodivergent employees as a “competitive advantage”; and Google searches for “what is neurodivergent” or “neurodiversity” have significantly increased over the last five years.
I was grateful to learn these words, and I identified myself as neurodivergent. But I began to struggle to pin down exactly what I meant when I said that I was neurodivergent, or what the neurodiversity movement meant to me. This was primarily because of a question I kept circling back to: Does a movement that pushes us to accept all cognitive and mental differences actually help people feel better?
This is especially relevant now that neurodiversity is being used to describe conditions that typically are called “disorders”; in many cases, mainstream uses of the term neurodiversity just deploy it as a euphemism or synonym for mental illness. As an article in Forbes put it, the concept of neurodiversity shifts the “focus from the negative connotation of these conditions toward the positive.” This interpretation has raised questions about what the consequences of such a shift would be. In an article for Aeon called “Against Neurodiversity,” the neuroscientist Moheb Costandi wrote that this understanding of the neurodiversity movement could “romanticize” disabling conditions. He wrote that “there are now groups of self-advocates who celebrate depression and schizophrenia. This could also be related to the growth of pro-anorexia websites, as well as the more recent emergence of ‘addiction pride.’”
This brought up a difficult question for me to grapple with as a neurodivergent person: When should I try to change or “treat” my mental differences, and when should I embrace them as naturally occurring diversity? There are many aspects of the way my mind works that I don’t find positive in any way. Getting a diagnosis of a mental disorder and “treating” some of my mental differences greatly improved my quality of life. Yet, if mental variation is to be expected, that could logically mean—or at least be taken as meaning—that psychiatric diagnoses are incompatible with neurodiversity, and that aligning with a label of mental illness contradicts the ethos of the movement. This felt uncomfortably similar to me to extreme forms of anti-psychiatry, proponents of which can argue that mental illness diagnoses and psychiatric treatments are never valid ways of understanding and responding to mental differences or distress. This goes against what many people who identify as mentally ill say they want: expanded access to services and treatment that are focused on individuals.
As a journalist who writes about mental health, a person who knows what different forms of mental distress feel like, and someone whose loved ones have experienced, and in some cases died, from mental illness, I worried about the implications of accepting all mental differences without leaving the option open for people to address them if they wanted to. Could I be a neurodiversity movement advocate and still go to therapy to change parts of my neurodivergence?
But many of my concerns stemmed from an incorrect and incomplete understanding of the neurodiversity movement. Clarification on this is important because people with all kinds of mental differences—some of whom identify what they experience as disorders, illnesses, or disabilities, and others of whom do not—will encounter the word “neurodivergent” from bosses, mental health professionals, and on social media. If the neurodiversity movement is mischaracterized as being dogmatically against certain concepts, it might alienate people who could benefit from its ideas.
It’s worth saying that the neurodiversity movement is a broad one: It’s a leaderless and flexible paradigm that can have many interpretations depending on who is doing the interpreting. At its core though, neurodiversity is not incompatible with the concepts of impairment, or individualized treatment or medication, leading neurodiversity scholars, many of whom are neurodivergent themselves, told me.
It is a justice movement, advocating for the rights and inherent dignity of people with any mental differences. It is also a profound way to look at the world: where mental differences are not automatically pathologized, and, importantly, dysfunction isn’t assumed to be the fault of an individual person and their supposed deficits, but can be viewed as something that emerges from interactions with others and the environment. Thinking this way could shift the way we measure and respond to mental differences overall, but doesn’t necessitate erasing access to the individualized tools at our disposal. It can also be incredibly useful for people who, like me, have come up against the limits of trying to modify themselves, and provide a new way for thinking about oneself and others that goes beyond just the binary of “weird” and “normal.”
In the late 1990s, people in online autistic communities began to ask each other a question: Why do we have to have the idea of a “normal mind” at all? Why can’t there be many different kinds of minds, which are healthy or functional in their own right, and some of which are less common?
The autistic sociologist Judy Singer was the first to publish on the concept of neurodiversity and in the 2010s, the autistic scholar Nick Walker wrote a number of influential blog posts on the topic, which defined the distinction between the neurodiversity paradigm and pathology paradigm. In those essays, and her later book Neuroqueer Heresies, she wrote about how the pathology paradigm presented a normal mind as its ideal, and the abnormal mind as pathological. In contrast, the neurodiversity paradigm states that diversity itself is normal.
There are some kinds of minds and ways of thinking that are statistically more common than others—the term coined for this was neurotypical. Being neurotypical isn’t a synonym for being “normal,” though, just like “straight” doesn’t mean normal compared to “gay.” Neurotypical means having a brain and way of thinking that is more frequent and amenable to how society is currently set up.
“Once we’ve thrown away the concept of ‘normal,’ neurotypicals are just members of a majority—not healthier or more ‘right’ than the rest of us, just more common,” Walker, now a professor of psychology at California Institute of Integral Studies, wrote.
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Neurotypical is the opposite of “neurodivergent,” a term coined by autistic activist Kassiane Asasumasu. Neurodivergent means any kind of divergence from dominant cultural norms of neurocognitive functioning. By definition, it is a very inclusive word, and when people use it broadly, it’s not incorrect to do so. This is why it can include autism, experiences like ADHD or OCD, and also epilepsy, synesthesia, or left-handedness.
The word paradigm means “world view,” or a way to understand the world around us. “The value of a paradigm lies in what it enables us to do,” Walker wrote. “For instance, a heliocentric paradigm (Earth and the other planets in our solar system orbit the Sun) enables us to interpret astronomical observations more usefully than a geocentric paradigm (everything orbits Earth).”
What the neurodiversity paradigm does is offer a framework for understanding and responding to mental differences besides seeing them as individual dysfunctions, or deviations from supposedly “normal” functioning. In 2021, Robert Chapman, an autistic philosopher and senior lecturer at Sheffield Hallam University, proposed one way to do so which they called the “social ecological model” of neurodiversity.
Chapman’s model suggests that we can look outside individual people to think about functioning; rather than saying that a person is functioning or dysfunctioning, dysfunction can exist relationally. One example of this is the “double empathy problem,” coined by Damian Milton, an autistic sociologist. He argued that rather than autistic people having social difficulties compared to neurotypical people, non-autistic people also play a role by not exhibiting any empathy or understanding toward autistic people’s differences. Social dysfunction doesn’t only arise from the neurodivergent person in this case, but from the relation between neurodivergent and neurotypical people.
There are similarities here to the “social model of disability,” a way of viewing disability as more than the characteristics of an individual, but as society’s failure to accommodate. Take someone who is in a wheelchair—are they disabled? If there are no ramps to enter into buildings or get off street curbs, then they are. But if there are ramps, then they are not.
A social-ecological model of neurodiversity reminds us that we rarely think or act alone, but function in groups in all parts of our lives. And because we rarely evaluate group functioning, there could be positive aspects of neurodivergence that aren’t being recognized by focusing solely on individuals. For instance, a group of neurotypical people may be inferior compared to a neurodiverse group, which multiple studies have now shown. This is why tech companies have launched programs to hire neurodivergent employees.
Walker sees Chapman’s model as weaving together ideas that have been important to the neurodiversity paradigm since the beginning: that there’s a social-relational perspective to functioning, as well as the idea that neurodiversity can be a source of creative potential.
But it’s a common misunderstanding that the neurodiversity paradigm, or a social ecological model of neurodiversity, would never view any individual differences as disabilities or impairments. Ryan H. Nelson, an assistant professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine, said that it’s easy to mischaracterize neurodiversity proponents as saying that medical intervention is never permissible, or that the disadvantage that can be associated with neurodiversity is only due to a lack of social accommodation. Instead, Nelson thinks that most or all neurodiversity proponents are just opposed to the default response to mental differences.
Nelson agreed that rather than always seeking to change people to fit society, we should also change society to fit a broader range of individuals. But Nelson doesn’t think that it’s a mistake to call some forms of neurodivergence “disorders,” or that individual interventions can’t also be helpful at times. Ultimately, individuals should be able to embrace the characterization of their condition that allows them to better make sense of themselves, and better access services that they need to get along better in the world, he said.
“This is where things get most interesting for me in reading Chapman’s work,” Nelson said. “You can certainly understand function and dysfunction at the level of groups, but you can also understand it at the level of individuals, and how they function relative to their environment and others. I take it that there are just two difference lenses through which to look at the same question. Which one should we prefer? Should we prefer a more individualistic understanding? Or a broader ecological understanding?”
What’s typical now, however, is to pin dysfunction on individuals. When I was diagnosed with OCD, my individual functioning was compared to a baseline norm or average—this is how disorders are often measured using assessment tests.
This approach is largely based philosophically on work from academics Christopher Boorse and Jerome Wakefield in the 1990s. Wakefield told me that his and others’ attempts to clarify and define disorders in this way was a reaction to the emergence of anti-psychiatry, a movement that argued that mental disorders weren’t real at all. By anti-psychiatry, he doesn’t mean the ideas that there should be more focus on social influences on mental distress, or that psychiatric practices can be and sometimes have been harmful or coercive—but the more extreme notion that all diagnoses and categorizations of mental disorders are conceptually invalid. This is the view put forward by the psychiatrist Thomas Szasz, who wrote The Myth of Mental Illness, and whose thinking has had some resurgence today, in varying degrees.
Anti-psychiatrists accused the dominant paradigm of psychiatry as it existed in the mid 20th century of being a tool of social control camouflaged as a medical discipline. “Having treated mental disorders and having had mental illness in my family as well, I thought it was just plain nonsense that there is no such thing as a mental disorder,” Wakefield said.
In response, he proposed that mental illnesses, like physical illnesses, could be defined as “harmful dysfunctions.” Wakefield saw it as an attempt to compromise: What’s considered harmful is largely determined by the world and culture around you. But there was an “objective” piece to it—the dysfunction part—that is based on a deviation from normal-range psychological functioning, as defined by the “mental functions that human beings were biologically designed to have by natural selection,” he said.
Wakefield said he sometimes sees patterns of anti-psychiatry thinking in the neurodiversity movement today: The ideas, for instance, that it’s incorrect to classify any differences as mental “disorders,” and that societal interventions are always superior to individual treatment.
But the neurodiversity movement can provide something different from the “harmful dysfunction” paradigm of the mainstream medical model and from anti-psychiatry, Chapman told me, even though people can mistakenly view anti-psychiatry and neurodiversity advocacy as the same thing.
Szasz believed that the concept of mental illness was a mistake because there was no biological proof for it. Because of that, his definition of illness was that it’s a structural or functional deviation from normal biology. “From a neurodiversity perspective he has a conservative understanding of what it means to be healthy or pathological because he just associates it with the biological norm,” Chapman said.
According to Szasz, mental illnesses were purely political constructs that existed to control people. But bodily or brain-based differences that did have biological bases were thought to be objective illnesses and apolitical. “From a neurodiversity perspective that’s both wrong and harmful,” Chapman said. “Neurodiversity is challenging not whether mental illness exists, but the idea of the normal body mind, normal brain, normal cognition and so forth.”
Chapman thinks that Szasz’s ideas lead to injustice in two directions. The first has to do with the assertion that mental illness isn’t real. “I think that leads to mass gaslighting of people who identify with the term or find it helpful,” they said. It also leads to the conclusion that any disability or health condition which does have some sort of biological and neurological basis is automatically an individual’s disease or disorder, because it’s a deviation from the norm.
Patrick Dwyer, an autistic Ph.D. student in developmental psychology at UC Davis, said that he finds anti-psychiatry to be ableist, or discriminatory against disability, in its refusal to acknowledge inherent mental differences or disabilities. “There’s a discomfort with disability that is revealed by these attempts to just eliminate these categories,” he said.
The neurodiversity paradigm, as Chapman interprets it, would say instead that there are many different cognitive and neurological variations, and some of them might be illnesses while others may not be. But it pushes back against the “harmful dysfunction” idea that there is one definition of normal functioning, and that it’s always a bad thing to fall outside of that.
Under a neurodiversity paradigm, I can have differences in mental functioning—perhaps with a biological underpinning, or perhaps not. Neurodiversity doesn’t seek to erase those differences, or say they’re not real, and I’m free to consider some of those differences to be impairments. What is suggested is that I don’t automatically consider differences as disorders or the cause of dysfunction solely by comparison to an objective definition of “normal.”
Wakefield said he doesn’t consider a “dysfunction” an automatically bad thing in his model, and doesn’t think that’s implied. But he agreed that discrimination, stigma, and mental health diagnoses have all been conflated, and that the neurodiversity movement can help step in to address that.
“The neurodiversity movement usefully sensitizes us to the fact that people are more different than we may assume, and that these differences aren’t always necessarily harmful or pathological,” Wakefield said. “Whether or not these differences sometimes can be useful is a wholly different question in my mind from whether these differences are actual mental disorders or not. But should we treat all people with respect and give all people rights and try to optimize everyone’s life? Of course.”
When I was diagnosed with OCD, I did exposure and response prevention (ERP) therapy which actively tried to challenge and change what I considered to be individual dysfunctional ways of thinking and acting that interfered with my life. In my case, accommodation of my anxiety could make me feel worse because it reinforced maladaptive avoidance patterns or compulsions. Though I never took medication, I was prepared to, if the ERP wasn’t helpful.
But at the time that I got my “weirdest brain” award, I had been in therapy for my OCD for a couple of years, and had gotten it under control according to my own desires and goals. Yet there were elements of my cognitive functioning that were still neurodivergent, and seemed untied to anxiety. They were just a part of, well, me.
Working in an open office setting is awful for lots of people, not just those who identify as neurodivergent. But the constant visual movement of others, sounds of people eating, and having to sit in one location while on display caused me a lot of distress that couldn’t be alleviated through techniques I had learned in cognitive behavioral therapy. I have never been evaluated for autism, but I also find the concept of “masking,” or having to perform certain behaviors in social interactions and being exhausted after having to do so, resonant.
In talking to my therapist about these concerns, we agreed that it wasn’t useful to view them as my own problems, or a matter of disorder. I didn’t feel the need to change individually; the issues stemmed more from the environment not working for me. Rather than seeing such difficulties as pathology, the way I viewed and treated my OCD, the neurodiversity paradigm helped me to see these parts of myself as just another way of being.
The neurodiversity paradigm gives us this chance to look at dysfunction through different lenses, depending on the situation. I consider my OCD to be both a form of neurodivergence and a disorder or impairment, while other parts of my neurodivergence I see as leading to dysfunction more because of an incompatibility with my environment or other people, like an open office simply not working for me. I chose to partake in interventions or learn individual adaptive skills for some parts of my neurodivergence, while seeking out accommodations or interactive solutions for others.
Dwyer has written that learning skills that don’t seek to change a person’s core personality doesn’t go against the neurodiversity paradigm. When I tried to manage my OCD, it didn’t make me less of a neurodiversity advocate to dislike how certain of my qualities caused me distress.
Still, because there is so much societal stigma towards mental health, having a neurodiversity approach towards those diagnoses can be particularly helpful, Dwyer said, even if people do consider them to be disorders. It could help them view their neurodivergence in a more complex way. For ADHD, for instance, there could be medications that people find helpful in their day to day lives, and at the same time there could be positive aspects of ADHD that people want to embrace, from hyperfocus to creativity.
But for things like policies, research, or workplace accommodations, the neurodiversity paradigm also opens the door for looking at how functioning interacts with and affects communities and ecosystems. Dwyer said that with a little flexibility of thinking (something neurotypical people are supposed to be good at) we can find ways of accommodating people without making them feel like there’s something wrong with them.
“We can provide support to people and we can recognize the very real challenges and disabilities that people face and how a lot of that disability is not caused solely by society, but reflects contributions from the individual,” Dwyer said. “But I don’t think it’s necessary to discuss these things in such an offensive way or to pathologize everything.”
Why did I think that the neurodiversity movement might be against me going to therapy for OCD? Walker said that a lot of the confusion comes when people jump into the discourse on neurodiversity without fully understanding the difference between the terms neurodivergent and neurominority.
“A neurominority is a group of people who all share a similar form of commonly-pathologized neurodivergence which is largely innate and constitutes an intrinsic and pervasive factor in their psyches, personalities, and fundamental ways of relating to the world,” Walker explained. “Autistics and dyslexics are examples of neurominorities, whereas people with PTSD or traumatic brain injuries are neurodivergent but don’t fit the definition of neurominority groups.”
The neurodiversity paradigm doesn’t imply that neurodivergence should never be pathologized; most proponents of the neurodiversity paradigm maintain that it’s the neurominority groups that shouldn’t be, Walker said. Dwyer thinks that once this misconception can be cleared up, there are more important conversations to be had around neurodiversity, like about which interventions are just teaching people how to comply with neurotypical demands, or how the variability within autism should be conceptualized, and what words and terms to use for them.
“There are a lot of innovative ways where we can combine the ideas of the neurodiversity approach with a more medically oriented approach,” Dwyer said. “And if we get out of this crude and simplistic dichotomy of medical versus social models and move to something more like Chapman’s social ecological model, that makes it a lot easier for us to recognize these nuances, which in practice, people are already recognizing anyway.”
I’m aware that none of this concretely answers the question of what a mental disorder is, and who gets to decide. But maybe that’s okay, from the broader neurodiversity movement’s perspective—especially one that’s set up to include so many kinds of mental variation.
Nelson argued that pushing for a more inclusive world, a world that better accommodates a broader range of human beings, has nothing to do with whether conditions are disorders or not. “We can say that autism is a medical disorder, while at the same time saying we should be more accommodating for people with autism,” Nelson said. “I guess the upshot of my view is that we don’t need to get into this controversial debate about what a medical disorder is. I think that can sometimes distract from the political project of making the world better for many people.”
Determining what is or isn’t a disorder is a complicated issue that Chapman thinks should be made more democratic, “in the sense that it’s something decided by how people feel, and what people feel is helpful for them,” they said. “And that’s a really complex process, and that might change over time as well.”
Chapman used to think that the concept of mental disorder or illness was antithetical to the neurodiversity paradigm, but they’ve changed their mind about that. “After listening to people more, I think that illness should be included within the neurodiversity paradigm, but just a different one, which is not based on the norm,” they said. “I just don’t don’t see a problem so far as illness is included within neurodivergence.”
I’m drawn towards thinkers who have flexibility in their ideas, because I’ve seen firsthand how different labels and approaches work differently for different people, or even how imperfect labels can be useful in an imperfect system—they can be necessary to access care, insurance coverage, or find community.
For instance, the category of autism is what allowed autistic people to come together to name and conceptualize the double empathy problem, among many other shared experiences that involve both individuals and their relationships to the outside world.
The world should be more accommodating to a wider array of people, ways of thinking, body types, communication types, and more. But in the meantime, people should be able to do what they need to do. “If that involves taking prescribed medication, great, that involves seeing a medical doctor, great, if that involves none of those things and something else altogether, great,” Nelson said.
Despite everything that still needs to be worked out about the neurodiversity movement and what it means for neurodivergent people, the core concepts can be incredibly meaningful right now: That we can question the idea of “normal,” or that impairments can exist, but dysfunction doesn’t always rest solely on your shoulders. We can challenge the fact that people are automatically pathologized and discriminated against while also questioning how we relate to others, and ask what the sources of dysfunction are when people aren’t thriving according to their own wants and needs.
It can be a relief, and also bring some much-needed levity, to turn the tables on neurotypical people, who are a part of neurodiversity too. The Twitter account Neurotypicality Research Inc playfully calls out the ways that neurotypical behavior could be seen as “weird” by neurodivergent people. The satirical website called “The Study of the Institute for the Neurologically Typical,” described “neurotypical syndrome” as “a neurobiological disorder characterized by preoccupation with social concerns, delusions of superiority, and obsession with conformity,” mimicking the way neurodivergent people are often talked about.
The neurodiversity paradigm can also offer a moving account of a potential future to work towards, which, in Walker’s book, she described as “neurocosmipolitanism.”
“Neurocosmopolitanism consists of approaching neurodiversity in the same spirit in which the cosmopolite approaches cultural diversity,” Walker wrote. “Neurocosmopolitan seeks to actively engage with and preserve human neurodiversity, and to honor, explore, and cultivate its creative potentials, in a spirit of humility, respect, and continual openness to learning and transformation.” The opposite of this would be “neuroprovincialism” which favors one “normal” way of being over others.
I asked strangers on social media to answer questions about what they thought about the concept of neurodiversity, and in over a dozen responses, this was the overarching idea that shone through: that the movement offered a vision of a kind of world where having a mental difference did not automatically mean a person couldn’t thrive.
Learning about the neurodiversity paradigm helped Myra, a 39-year-old from the UK, be more kind to herself, and stop blaming herself for social issues she’s long struggled with. It changed the way that Frank, a 42-year-old from Texas thought of others. “It made me happier to know that not all disorders are being couched as a handicap and leveraging it as a means of understanding that everyone can bring something to the table of importance,” he said.
Having the neurodiversity paradigm include not only autism does require more flexibility on everyone’s part. While the overall philosophy can remain intact, there will be different considerations for austistic people than others, just like there will be for those with OCD or ADHD. Chapman thinks that the neurodiversity paradigm can be epistemically useful, even if its definition and uses evolve throughout time, meaning it can be useful in terms of what we know and how we come up with new knowledge about ourselves and others.
At the end of the day, I think it’s always helpful to not be disdainful toward oneself. Some labels have proven incredibly helpful and empowering for me; for others, not so much. Spending two years working outside of a typical work setting because of the pandemic has been an insightful way for me to learn where those lines are, and revealed to me the relational parts of my neurodivergence that were invisible before. Of course, I do also hope that there will be ways of exploring neurodiversity that aren’t solely related to work and productivity, but instead to joy, creativity, and relationships.
My “weirdest brain” award came with a little plastic medallion, which I threw out a few months after I received it. At the time, it was an unfriendly reminder of how I was struggling to do things that other people seemed to do easily. Now, I’m not as put off by the word. For me, this is the way that the neurodiversity paradigm has been most beneficial. It’s been a way to reclaim for myself something that I always knew: I do have a different brain. But I can recognize this neutrally, without falling into a “normal” and “not-normal” dichotomy. From that starting point, I can seek out new skills, consider some parts of my neurodivergence disordered, and others not—just part and parcel of my weird brain.
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