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    Monday, May 10, 2004

    Alternate States: There's a movement afoot to stop labeling those who think differently as disabled, but instead to think of them as neurally diverse:

    As the number of Americans with brain disorders grows, so has skepticism toward the grab bag of syndromes they are being tagged with, from A.D.D. to Asperger's to bipolar I, II or III.

    But in a new kind of disabilities movement, many of those who deviate from the shrinking subset of neurologically 'normal' want tolerance, not just of their diagnoses, but of their behavioral quirks. They say brain differences, like body differences, should be embraced, and argue for an acceptance of 'neurodiversity.'

    And as psychiatrists and neurologists uncover an ever-wider variety of brain wiring, the norm, many agree, may increasingly be deviance.

    'We want respect for our way of being,' said Camille Clark, an art history graduate student at the University of California at Davis who has Asperger's syndrome, a form of autism often marked by an intense interest in a single subject. 'Some of us will talk too long about washing machines or square numbers, but you don't have to hate us for it.'

    And we don't have to medicate their eccentricities away, either, or label them as diseased:

    In an effort to rein in the number of diagnoses, the American Psychiatric Association imposed a new criterion in its latest edition of the Diagnostic Statistical Manual: an individual must now suffer from "impairment" to qualify as having one of its 220 psychological disorders. "We're not adequately differentiating normal from pathological if we just use the criteria that are in the syndrome definitions," said Dr. Darrel A. Regier, director of research for the American Psychiatric Association.

    ...But the most humane approach, some experts argue, may lie in redefining the expanding set of syndromes as differences rather than diagnoses.

    "We're doing a service on the one hand by describing many more of these conditions and inviting people to understand themselves better," said Dr. Edward Hallowell, a leading authority on A.D.D. "But when we pathologize it we scare them and make them not want to have any part of it. I think of these as traits, not disorders."

    And that's the way we should think of them. For too long we've been labeling everything that doesn't fit a preconceived "norm" as diseased, where the definition of normal is a Lake Wobegon standard of "all the women are strong, all the men are good-looking, and all the children are above average." And where everyone thinks and feels the same.

    It's refreshing to see a movement to shift away from the medicalization of differences, especially when it comes to the way the brain works. For people's brains don't work the same, and it would be a very dull world if they did. Some people are visually oriented, others language oriented. Some are pattern oriented, some oriented to the abstract, and some think only in the concrete. Those who are oriented toward visual cues and language have the easiest time of it in the world socially. They understand and are understood better by society at large because our society is more visually and languisticly oriented. While those who think in terms of the abstract have a tougher time understanding others and being understood themselves.

    This difference in thinking is astutely portrayed in the novel The Curious Incident of the Dog in the Night-Time by Mark Haddon. The narrator is a fifteen year old autistic boy who is very comfortable in the abstract yet logical world of math but acutely uncomfortable with the more subjective, messy, emotional world of language. His teachers at school don't have to teach him how to interpret or perform complicated math problems, but they do have to teach him how to interpret other people's body language, and what is and what is not socially acceptable. Here's his explanation of what it's like to navigate a languisticly and visually oriented world with a concrete, pattern-oriented mind:

    I find people confusing.

    This is for two main reasons.

    The first main reason is that people do a lot of talking without using any words. Siobhan says that if you raise one eye-brow it can mean lots of different things. It can mean "I want to do sex with you" and it can also mean "I think that what you just said was very stupid."

    Siobhan also says that if you close your mouth and breathe out loudly through your nose, it can mean that you are relaxed, or that you are bored, or that you are angry, and it all depends on how much air comes out of your nose and how fast and what shape your mouth is when you do it and how you are sitting and what you said just before and hundreds of other things which are too complicated to work out in a few seconds.

    The second main reason is that people often talk using metaphors....The world metaphor means carrying something from one place to another...and it is when you describe something by using a word for something that it isn't....

    ...I think it should be called a lie because a pig is not like a day and people do not have skeletons in their cupboards. And when I try to make a picture of the phrase in my head it just confuses me because imagining an apple in someone's eye doesn't have anything to do with liking someone a lot and it makes you forget what the person was talking about.

    And yet, he has an intuitive grasp of such problems as the infamous Monty Hall problem or how to tell whether or not a number is a prime number. And what's more, when he's feeling overwhelmed by the real world of language and emotion, he finds solace in solving math problems.

    Now, let me be frank. I am not a mathetmatically oriented person. I am much more comfortable with the world of language and visual cues than I am with the abstract world of math. When I was a little girl, trying to learn the multiplication tables made me cry. Throughout my education, whenever I came to a mathematical equation in a textbook, I would skip it. It was like a foreign language to me. I could never convert those numbers to an image I could understand. Adding more than one or two digits is still a bit of a challenge for me. But thanks to my choice of a spouse, I now live in a family that is very comfortable in the world of numbers. My kids and my husband have an intuitive grasp of things that I have to work very hard to comprehend. There are times, when they are discussing things like how to always win the game of Nim, when I feel like I'm in a foreign country. And it is those times when I think, this is what it must feel like to be mildly autistic, to live in a world that thinks and expresses itself differently than you do.

    But thankfully, the real world is a friendlier place for someone like me. Now, if we can just make it a little friendlier for people like these.

    posted by Sydney on 5/10/2004 08:02:00 AM 0 comments


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