"It is important to realize that throughout all these changes in the mind of psychiatrists, the diagnosis hs always been grounded solely on "soft" symptoms. It has been based not on independent medical tests but reather on a collection of symptoms, none of which is unique to the disorder."
Ritalin Nation- Rapid-Fire Culture and the Transformation of Human Consciousness (1999)
Richard De Grandpre
On January 31rst, the NYT ran an interesting op-ed:
FOR a brief, heady period in the history of autism spectrum diagnosis, in the late ’90s, I had Asperger syndrome.
There’s an educational video from that time, called “Understanding Asperger’s,” in which I appear. I am the affected 20-year-old in the wannabe-hipster vintage polo shirt talking about how keen his understanding of literature is and how misunderstood he was in fifth grade. The film was a research project directed by my mother, a psychology professor and Asperger specialist, and another expert in her department. It presents me as a young man living a full, meaningful life, despite his mental abnormality.
The author, Benjamin Nugent, is now the Director of Creative Writing at Southern New Hampshire University. He contends that he was misdiagnosed by his own mother- and other assorted professionals- all obsessed with the latest psychiatric fad:
The thing is, after college I moved to New York City and became a writer and met some people who shared my obsessions...and then I wasn’t that awkward or isolated anymore. According to the diagnostic manual, Asperger syndrome is “a continuous and lifelong disorder,” but my symptoms had vanished.
Today Mr. Nugent indicates that he leads a normal, satisfying life. But he remains haunted by his earlier misdiagnosis:
The biggest single problem with the diagnostic criteria applied to me is this: You can be highly perceptive with regard to social interaction, as a child or adolescent, and still be a spectacular social failure. This is particularly true if you're bad at sports or nervous or weird-looking.
(As an adult who is bored to tears by sports and regards large social gatherings with loathing, please excuse me while I leap to my feet and applaud this statement. Wildly.)
But my experience can't be unique. Under the rules in place today, any nerd, any withdrawn, bookish kid, can have Asperger syndrome.
This is the thought that should bring everyone up short.
Over the years I have watched the criteria for "spectrum disorders" stretch and broaden until it threatens to label anyone who ever made a teacher or therapist feel uncomfortable. Sometimes I think the definition of Asperger's has become so broad and diluted that it has more in common with a puddle after a rainstorm than an actual psychiatric/medical diagnosis. Like the puddle, it can cover the cracks and pits of a difficult personality with the thin sheen of 'science.' But, as with Mr. Nugent, it can quickly evaporate under changing conditions.
And what does that say about our culture? Consider this: NPR recently ran a story called "Quiet,Please: Unleashing the Power of Introverts." They interviewed Susan Cain, who recently authored a book examining the place of introversion in American culture.
Her conclusion? There's no place for it:
"It's quite a problem in the workplace today, because we have a workplace that is increasingly set up for maximum group interaction. More and more of our offices are set up as open-plan offices where there are no walls and there's very little privacy. ... The average amount of space per employee actually shrunk from 500 square feet in the 1970s to 200 square feet today.
Ms. Cain remarks on the worship of outgoing, socially-adept personalities in U.S. culture:
"We moved from what cultural historians call a culture of character to a culture of personality. During the culture of character, what was important was the good deeds that you performed when nobody was looking. Abraham Lincoln is the embodiment of the culture of character, and people celebrated him back then for being a man who did not offend by superiority. But at the turn of the century, when we moved into this culture of personality, suddenly what was admired was to be magnetic and charismatic.
"... we're at a point in our culture, and in our workplace culture, where we've gotten too lopsided. We tend to believe that all creativity and all productivity comes from the group, when in fact, there really is a benefit to solitude and to being able to go off and focus and put your head down." [my emphasis.]
Which brings us back to Mr. Nugent and the ever-broadening definition of spectrum disorders. Yes, there are children and adults with serious neurological problems, and we should strive to help them. I don't question the existence of spectrum disorders.
But we've created a cottage industry devoted to defining 'normal.' And every time the criteria for spectrum disorders expands, the definition of normal gets a little narrower.
If introversion is redefined as pathological, then what kind of society do we consider desirable? Is extroversion now considered as basic and necessary as a healthy immune system? Is our ideal society a mass of sports-loving, glad-handing, sunny-side-up partiers?
Here's a cranky, contrarian thought: what if more extroverts are the last thing we need? What if the steady coarsening of our culture, with its crude pop lyrics, vapid reality TV, dumbed-down cinema, sexting and sports riots is the direct result of constantly sorting for extroversion? After all, you have to be a little, erm, outgoing to circulate digital pictures of your nakedness or have your private affairs aired on national television.
Be careful what you wish for. You may get it- and then find it difficult to undo, once we're all alike.