Ten years ago I read an article about a woman who was diagnosed with autism at the age of 21. All her life she didn’t quite fit in. She excelled academically but frequently missed subtle non-verbal cues, such as facial expressions, glances, and nods that are so common and sometimes key to communication. At a young age, she refused certain foods and had an aversion to clothing with seams. As she got older, she was easily bothered by bright lights and had a difficult time clicking with other people. Someone suggested this woman be evaluated for autism, and sure enough, she was diagnosed with autism spectrum disorder. She said, “I never had cause to think I was any different than anyone else, and so with every new failure, I had to conclude I was at fault. When I got my diagnosis, I started to let go of my need to ‘just be NORMAL!’”
If you’ve ever struggled with chronic illness, either mentally or physically, where you knew something was “off” but a diagnosis was elusive, then you know the relief that comes with a formal diagnosis. It’s not that we want to be sick or want something to be wrong, but rather we acknowledge that the symptoms are there, and a reason for those symptoms can help us to come up with solutions for those symptoms.
But I’ve also noticed that a diagnosis can cause a sense of relief because of social grievances, of feeling too “different” or “weird”. And here’s where I think things get challenging.
What’s Wrong with Different?
Many of us have been shamed or bullied because we weren’t able to do things the way we were “supposed to”. We’ve proven ourselves to be a “struggle” for someone else. Perhaps we made them uncomfortable with our differences. Maybe they were shocked or even appalled by our thought processes. Maybe we expressed things they didn’t want to hear. Maybe we just couldn’t do what they wanted us to do.
I think a lot of the issue stems back to people’s fear of differences. We don’t understand something, so that something is deemed “bad”. It’s actually rather black-and-white thinking, which, ironically, is something neurodivergents are claimed to do. I don’t think it’s as unique to neurodivergence as we believe.
An immature view of relationships can also be a factor. If we view someone only by how they can help us or do what we expect of them, we’re not able to have a real relationship with them. This can lead to stress and frustration when someone doesn’t “perform” as we wish. And let’s face it, people weren’t meant to be controlled, so someone with immature relational skills will always end up frustrated and confused.
These things can cause people to think that anyone who doesn’t behave the way we’ve deemed a “normal pattern of behavior” in society is a threat.
A Standard Is Needed
On the apparent flip side, we do have standards for things for a reason (it’s how we make diagnoses!). We do expect certain behaviors in public. We do need to be able to recognize real and true threats to our safety and livelihood.
I know it’s a complex discussion, especially when forming the criteria for a diagnosis. What makes behaviors “normal”? What makes someone autistic? How do we know someone has ADHD? What are the standards for “normalcy” that we weigh disability against? We have to know what is “normal” or common as far as physical wellness and patterns of behavior in order to be able to recognize what is abnormal (the same way we Christians can recognize what’s spiritually healthy when we weigh it against what the Bible says).
I can only imagine the difficulty faced with trying to diagnose something that is so heavily rooted in social abilities. Much of autism’s diagnostic criteria is based on the maturity and uniformity of social interactions, such as social approach, conversation, sharing of emotions or interests, response to social interactions, eye contact and body language, use of gestures and facial expressions, making friends, and so much more. 1 How does a person even calculate that? (Yet another reason why clinicians should never diagnose on the first visit!) This requires a complex understanding of not only the outward behaviors but the reason behind the behaviors.
This particular topic is far too intricate and involved to be fully explored here. Ultimately, I feel the biggest issue is that the more we pull away from each other on a personal level in society, the less chance we have to really get to know someone and learn why their behaviors might not fit the expected norm. (And the more we fight on social media, the more we see others as a threat.2) All types of diagnoses require a personal touch, and I’d argue that mental health diagnoses require an even deeper association with a patient than physical diagnoses. You’re getting into someone’s mind; that can be quite a mystery.
Do We Need to Be Normal?
The question is, Should we feel relief that we no longer have to be “normal”? What kinds of pressures are we facing from our families, schools, places of work, and society as a whole that make us feel we have to live up to a standard of “normalcy”? Or rather, at what point in our lives do we become a “threat” to others’ comfort? Is mere discomfort the biggest complaint, or do others truly feel that those with a disability are ruining societal functioning? Is it our lack of ability to be controlled? Is it the threat to efficiency and productivity? Is there a real problem?
And perhaps the bigger question: Why are all of those things okay as long as we determine that something is “wrong” with someone? What fears are we assuaging by labeling our behaviors with a diagnosis? Why do we feel a sense of relief when we know someone is acting “off” because of the fact that they have a mental illness?
My hope with this post is that it will encourage us to consider the role of diagnoses in society, both for mental and physical illnesses. Perhaps we can consider what it is that is so distressing to us about other people’s differences. I’d love to hear your thoughts in the comments.
Chronic in the Midwest 