Neurodiversity – the new social identifier

There seems to be a wish to pathologise everyday experiences that are simply part of what it means to be human. People will often claim to be depressed when they are simply suffering from the occasional low moods that are part and parcel of navigating the vicissitudes of life; or claiming to have OCD simply because of a preference for tidiness or a penchant for organisation. When I was about 7 years old, I cried because we were going away on holiday. I was upset because I had fairly recently started to learn to play the piano and, on holiday, I would no longer be able to play my absolute favourite tune: “Matchbox”. Was that an example of OCD or simply part of being a kid? Having built sand-castles on the beach, I think that I got over my forced absence from music fairly easily. It did not leave me traumatized.

Now many commonplace experiences, however, are labelled as traumatic. Adverse or upsetting experiences, however, are not necessarily synonymous with trauma. We have specific psychiatric criteria that distinguish such events from ordinary human experiences. But, although we have official criteria for autism, there is also the vaguely related social media version. Few, if any, psychologists would say that a preference for natural lighting, doodling in class or even identifying as LGBTQ is a sign of ADHD or autism. And yet, online, there are diagnoses of such things using “symptoms” unrelated to clinical diagnostic criteria.

Videos with titles like “6 Signs You May Have ADHD.” and “Signs That You Might Have OCD.” can rack up millions of views. In them, “neurodiversity advocates” encourage us to consider which of what we had previously accepted as harmless personality quirks are in fact signs of mental illness or ‘neurodiversity’.

Of course, in the past, mental illness was regarded as a serious medical condition, often one of which to be ashamed. Now, in the welcome absence of social stigma, mental health status, using an ever-widening definition, functions as yet another category in our ever-expanding identity politics - and of the associated market in merchandise, including clothes with appropriate messages emblazoned on them.

And then there is the ‘following’ of popular ‘neurodiverse’ influencers, giving them the ultimate benefit from that merchandising. The attraction to the individual of such a label is the way it provides meaning to common insecurities. Disorganization can be ADHD; social ineptitude can be autism. This approach provides quick relief from many of the anxieties central to teenage and young adult life. Am I weird? Is this normal? When labelled, it is no longer your fault and so not something to be ashamed of. In fact, in today’s world, it gives you extra rights.

We rarely start to read a book, watch a film or settle down in front of the TV without having some idea of what we are about to be exposed to. That doesn’t mean, however, that not knowing would have a significant effect on us. We can always turn the programme off or put the book down if we’re not enjoying it. But even if we are exposed to things we don’t like or which might make us fearful, they rarely inflict lasting psychological damage on us. We are in fact far more resilient than we might think ourselves to be. I was present when each of my parents died, my father of a heart attack and my mother of old age, but I do not suffer from nightmares or flashbacks as a consequence.

For those engaged in the horrors of war there was of course always the risk that they would be badly affected, or traumatised, as we would now say, by what they experienced. This finally became officially recognised during the first world war when the number of soldiers suffering from what had become known as ‘shell shock’ became too large to ignore or write off as ‘cowardice in the face of the enemy’. Attempts were made to find out what is was about so that I could be treated - with the intention of sending the men back to the front line.

However, it was as a result of the Vietnam war that post-traumatic stress disorder (PTSD) entered the official American description of psychological disorders - the ‘Diagnostic and Statistical Manual of Mental Disorders’ - although it was not really until the ‘90s that psychologists in the UK accepted its existence. The manual describes PTSD as a ‘disorder that develops following exposure to actual or threatened death, serious injury or sexual violence’. It can occur as a result of directly experiencing a traumatic event, or from witnessing it happen to another person. It can result from events which are less traumatic but are repeated, such as amongst paramedics and police who frequently recover dead bodies.

In the early days of shell shock and then PTSD, there was the common-sense view that it would be sensible to try to prevent sufferers from being reminded of the traumatic event in question – ‘don’t mention the war’ - to avoid triggering that memory. Somehow, however, the whole idea of ‘triggering’ has over the last few years metamorphised into something very different. We are now awash with trigger warnings. Most programmes on the television come with such warnings, although to me they warn of nothing of consequence.

And it is obvious that trigger warnings have completely lost their original purpose when students demand that lecturers use them in syllabi for the courses they have chosen to study in order to forewarn them of what may be ‘uncomfortable content’. The authors of a report published by the American Association of University Professors summarises the problem in this way:

The presumption that students need to be protected rather than challenged … is at once infantilizing and anti-intellectual. It makes comfort a higher priority than intellectual engagement … it singles out politically controversial topics like sex, race, class, capitalism, and colonialism for attention. Indeed, if such topics are associated with triggers, correctly or not, they are likely to be marginalized if not avoided altogether by faculty members who fear complaints for offending or discomforting some of their students … In this way the demand for trigger warnings creates a repressive, “chilly climate” for critical thinking in the lecture-room.
I cannot understand why someone who has qualified to take a course in, say, archaeology would need to be warned that contact with old bones would be an integral part of the learning experience. Or why someone learning history or literature would need to be warned that people had different views in the past to those we now hold. O why I as a student lawyer would have needed to be warned that a case about murder related to, well, murder.

Trigger warnings were of course meant to alert individuals that what they were about to encounter might prompt PTSD symptoms (e.g. intrusive memories) – an apparent advantage. And yet we are actually told by psychologists that avoidance of triggers is in fact no part of the cure or treatment for PTSD. The attempt to avoid triggers, instead of facing up to your fear, is in reality a symptom of the disorder itself.

As Harvard’s Director of Clinical Training, has written, “Trigger warnings are counter-therapeutic because they encourage avoidance of reminders of trauma, and that avoidance maintains PTSD”. Clinical psychologists instead work with their patients to help them overcome maladaptive strategies - such as trying to avoid triggers - and instead to develop better coping strategies using evidence-based therapies such as CBT.

The empirical evidence in fact shows that, for actual PTSD sufferers, trigger warnings are either neutral or do more harm than good. In a 2020 study, 451 people who had been subject to actual trauma and diagnosed with PTSD were randomly assigned to read passages either with or without a prior trigger warning. Amongst those with a significant level of PTSD, they found that the use of trigger warnings reinforced the idea that the survivor’s trauma was central to who they were, one of the thought patterns clinicians try to break. They also found that trigger warnings were mainly neutral as regards people with mild PTSD. This was even when the passages matched the survivor’s own personal traumatic experiences.

So what about those without anything qualifying as PTSD? In another 2020 study the researchers found that trigger warnings of distressing content amongst those without PTSD actually increased anxiety among 462 students with no prior history of trauma. In the authors’ words: “Ironically, trigger warnings may (temporarily) worsen the well-being of the very people they are intended to help.”. So then trigger warnings don’t seem to help people and may instead harm them.

Should someone mention that to the Students Union?

Paul Buckingham

28 April 2023

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