An Absurd Umbrella: Neurodiversity and the Autism Spectrum
Autism has become a catchall term to explain and dismiss the problem child. But it can also be viewed as a superpower.
Few debates in the mental health community have been as contentious as that over neurodiversity.
Neurodiversity is an approach that views certain mental conditions not as disabilities, but as differences, within the normal variability of human brain function. The neurodiversity framework has been applied to various conditions, but it is most commonly associated with autism, and has been prominently promoted by organizations such as the Autistic Self-Advocacy Network.
There is a core of truth to the arguments undergirding neurodiversity. Human minds cannot be whittled down to a unitary norm, and people with unusual or eccentric approaches can make great contributions to society. To “cure” autism might be said to be akin to “curing” creativity or introversion.
Yet the arguments against regarding autism as merely a benign form of neurodiversity are compelling, too. One prominent critic is Jill Escher, president of the National Council on Severe Autism. Escher has two autistic children, both of whom are profoundly impaired in their ability to perform basic life functions. As she has pointed out, the diagnosis of autism has taken on “an absurd umbrella aspect that can cover quirky people like Elon Musk, sensitive artists like the singer Sia, and even elite athletes like Tony Snell,” some of whom “are so high-functioning I would consider my kids completely cured if they had similar abilities.”
The problem is inherent in the absurdity of an “autism spectrum” that groups together highly disparate individuals and conditions. On one end of the spectrum are people who may be different from the norm, but who are perfectly capable of living full and dignified lives. For them, the notion of a cure is sinister, even dystopian. On the other end are people who are severely disabled by the condition, for whom a cure might be an immeasurable gift.
Up until 2013, it was easier to differentiate between these two groups, since individuals who suffered some of the symptoms of autism, without the accompanying linguistic or intellectual impairments, were often diagnosed with Asperger’s Syndrome. But Asperger’s was defined out of existence in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and folded into high-functioning autism, to create a single, all-encompassing autism category, with only incremental distinctions between levels of function.
Bringing back the diagnosis of Asperger’s Syndrome, however, would provide at best only a partial solution: the autism spectrum would remain a nebulous concept with poorly defined boundaries.
Rates of autism have skyrocketed in recent decades, from well below 1 in 1,000 children in the 1960s to 1 in 36 today. This is almost certainly partially attributable to a broadening of the diagnostic parameters. People who might have been considered merely somewhat abnormal in 1960 are liable to be classified as high-functioning autistic in 2024—a shift that has led to considerable confusion.
The DSM-5 criteria for diagnosing autism leave much open to subjective interpretation. The disorder is defined primarily by deficits of social communication and interaction, and restricted, repetitive patterns of behaviour. But relating to our fellow human beings is one of life’s central challenges, over which no one has ever achieved perfect mastery. Every human conflict—from the marital to the geopolitical—involves some breakdown in communication or interaction. As for repetitive patterns of behaviour: far from being pathological, these are often signs of self-discipline, as many people with productive morning routines can attest.
British autism researcher Simon Baron-Cohen has theorised that autism is a form of “extreme male brain.” In his model, male brains tend more towards systematising, and female brains tend more towards empathising; an autistic brain is just tilted unusually far towards systematising. But—assuming this is true—how much systematising is too much?
It could be said that the autism spectrum begins when one’s deficits are so extreme that they hinder one’s ability to function in everyday life. Yet many people on the autism spectrum can function perfectly well; they just prefer not to act in conventional ways. The process of hiding one’s autistic traits and behaviours in order to seem neurotypical is referred to as “autistic masking.” Some describe this as acting human; the abovementioned singer Sia calls it “put(ting) my human suit on.” This seems less a manifestation of a disorder than a facet of the ordinary tension between individuality and conformity. If you know how to row a boat, but dislike doing it, then you do not have a deficit in rowing, only a preference.
Autism, like most mental illnesses, is said to be a neurological condition, yet it is diagnosed based on psychological factors. The determination is made not by a brain scan or lab test, but by an assessment of a child’s behaviour by a mental health professional. Once a diagnosis has been applied, there is no way to disprove it, since even behaviours that go against the diagnosis can be dismissed as masking.
All of this is treading far into the realm of unfalsifiability. Once you begin actively looking for a pattern of behaviour in someone, you are likely to find it and, once found, it is impossible to unsee. That is inherent in human nature: we Homo sapiens are both skilled pattern recognizers and immensely complex, multifaceted, often contradictory creatures. It is possible to examine someone’s behaviour and connect the dots in myriad ways, to reach many different conclusions.
We can see this dynamic with astrology: the twelve Zodiac signs are described in such a way as to give the illusion of specificity, with just enough vagueness and self-contradiction that it is impossible to conclusively prove the pseudoscience wrong. Likewise, lay diagnoses of autism have become commonplace in recent years; they are as easy to dispense, and as difficult to debunk, as calling someone a typical Scorpio or Aquarius once you know their star sign.
Lucy Kross Wallace
Those who diagnose others with autism are themselves systematising, rather than empathising. Any genuine attempt to alleviate psychological suffering necessitates that the sufferer be treated first and foremost as an individual. The human soul is not easily encapsulated, and there are innumerable reasons why a person may display a certain set of behaviours. To reduce someone’s humanity, in all its complexity, to a nuance-devoid heuristic like autism is the most impersonal, unsympathetic form of systematising imaginable.
The autism diagnosis also has the potential to be abused as a tool of authoritarian social control. Its criteria, as listed in the DSM, include such items as “abnormal social approach and failure of normal back-and-forth conversation,” “difficulties adjusting behaviour to suit various social contexts,” and “fixated interests that are abnormal in intensity or focus.” Autism is defined here in relation to societal norms, and within the confines of autism treatment, conformity is viewed as an aspirational value, while nonconformity is addressed as a shortcoming.
There is precedent for mental diagnoses being weaponised as tools of oppression. One example is the concept of sluggish schizophrenia, which was deployed in order to silence dissidents in the Soviet Union. After all, who but a lunatic would deny the self-evident glory of the USSR? Another notorious example is drapetomania, a disease proposed in 1851 by American physician Samuel Cartwright as the cause of slaves running away. Here, again, was an attempt to impose a moral paradigm via diagnosis: slavery, in Cartwright’s view, was rational, and so only an insane slave would flee captivity.
The construction of “sluggish schizophrenia” was clever because it was based on a legitimate disorder, and there are genuine grey areas surrounding schizophrenia. As many as 15 percent of the US population may have had auditory hallucinations. More broadly, most of us have an internal dialogue and many people—perhaps most—hold some beliefs that could be called delusional. These penumbrae are not entirely dissimilar to the ones surrounding autism. If psychiatrists were inclined to create a “schizophrenia spectrum” to encompass these cases, they might be somewhat justified in doing so.
Yet, unlike sluggish schizophrenia, high-functioning autism has been enthusiastically embraced by some—and not just by talented celebrities, either. The term has become oversaturated, used so frequently that it is now a repository of multiple meanings. “Autism” and related terms like “autist” have taken on a broad range of uses in layman-speak: they can be deployed insultingly, affectionately, or self-deprecatingly. Some of these usages are reminiscent of the way in which a racial slur might be reclaimed by minority group as a badge of pride.
What ADHD was to a previous generation, autism has become to this one: a catchall term to explain and dismiss the problem child (and particularly the problem boy). But what makes autism unusual is that it can also be viewed as a superpower. There have even been attempts to retroactively diagnose figures like Albert Einstein and Isaac Newton with autism.
Given the paradoxical cachet of being diagnosed with autism for some, all this smacks of social contagion.
An anecdote from Carl Jung’s Memories, Dreams, Reflections suggests one possible benefit of claiming to be autistic. When Jung was 12 years old, he relates, he was shoved by another boy and hit his head on a stone. “At the moment I felt the blow,” Jung writes, “the thought flashed through my mind: ‘Now you won’t have to go to school anymore.’” For the next six months, Jung was afflicted with fainting fits whenever he tried to do any schoolwork. He was allowed to stay home and pursue his own private interests, which he thoroughly enjoyed, although he could not shake a nagging sense of guilt.
One day, Jung heard his father lamenting, “What will become of the boy if he cannot earn his own living?” Frightened back to reality, Jung immediately got out a textbook and began to study. He suffered three fainting fits in the first hour, but he forced himself to keep going. After that, the fits went away and never came back. Jung had not been faking, but the power of the subconscious mind and the tendency to malinger run deep.
How much of high-functioning autism may be just such a coping mechanism, to avoid facing things which one would rather not face? How much could be powered through with sufficient determination? I suspect the answer is greater than zero.
Bryna Siegel
One hundred years ago, someone of ordinary intelligence who could not complete school or hold down a job would not have been called mentally disabled. He would have been called lazy. His failure to provide for himself would have been taken as a shortcoming of character, not of neurology, and he would have been encouraged to power stoically through the discomfort, and gain greater self-mastery in the process, as Carl Jung did as a child. Taken to an extreme, such expectations can be callous, yet perhaps in our modern society, we have drifted too far in the other direction.
In his book The Myth of Mental Illness, Thomas Szasz cites a passage from Shakespeare’s Macbeth in support of his central thesis. Lady Macbeth, stricken with guilt over having helped her husband commit murder, is descending into madness. Macbeth calls for the doctor, demanding a cure for his wife, but the doctor says, “More needs she the divine than the physician.” In other words, her affliction is moral, not medical.
Unlike Szasz, I would not dismiss all mental illness as a myth. Yet it is true that modern psychiatry has expanded the domain of medicine into realms that were previously considered the province of religion and philosophy. This is doubly dangerous: it can rob those who have been medicalised in this way of dignity and personhood, while simultaneously affording them undue moral licence.
Here, perhaps, autism intersects with what Warren Farrell and others have called the “boy crisis”: the increasing tendency of men in their 20s and 30s to fail to complete school, hold down a job, or move out of their parents’ homes. Their struggles are not with learning to speak or use the bathroom, as with the severely autistic, but with building independent and meaningful lives. For some of these young men, an autism diagnosis may simply provide them with permission to avoid the painful task of self-improvement. More need they the divine, perhaps, than the physician.
It is difficult to say where the boundaries of autism should be drawn, but they almost certainly ought to be much narrower than they currently are. Definition creep has cheapened the diagnosis, making it harder to identify those who genuinely need help. Until we can differentiate between the moral and the medical, all the arguments over neurodiversity will lead nowhere.
