Neurotypicality Is Not the Goal

Disclaimer: the person and tense in which I write in this post change throughout because I found myself fairly distressed trying to figure out who I was speaking to. Basically if you’re anyone who has any influence over someone who is neurodivergent and their treatment, pay attention.

Earlier this week I posted about some of the downfalls of ABA and was rightly called out on the fact that I forgot to include one that is incredibly important: ABA often pushes autistic people to behave more “normally” just for the sake of being less autistic.

This is a larger issue than just the autistic community. This affects everyone who is neurodivergent or mentally ill in any way. Because while the goal of therapy is ostensibly to help people live content and healthy lives, many therapists often forget that what they perceive as “good” or “happy” isn’t necessarily what their clients want. That means that acting neurotypical often becomes the goal. This is especially true for kids or other populations that can’t easily advocate for themselves, like people who are nonverbal.

Think for a second about treatment for people with autism. This is one of the easiest examples to use, because many “autistic” behaviors are very visual and obvious, but don’t do any harm to anyone. That includes things like hand flapping, spinning, or rocking. Many treatment plans include a goal to decrease these behaviors. Why?

Well there might be a few reasons. If someone is in school it’s true that these things can be distracting to other students. But NOT doing them is distracting to the student with autism. So why do neurotypical needs get prioritized over neurodiverse ones? And some stims aren’t even distracting but are still seen as bad because they make the person look different.

There should be one guiding principle in all treatment: has my client communicated that this behavior is something that makes their life worse? VERY occasionally this comes with the addendum that if a client can’t see that something is harming them you still might need to try to get rid of the behavior, but I can only see that applying in physically dangerous cases like self harm, extreme caloric restriction, purging, drugs, etc.

But the point of therapy isn’t to “cure” people. It’s to make them healthy. Healthy is not the same as normal, and often doesn’t mean living without any kind of mental differences. Healthy means that you can live your life in the manner you like and mostly achieve your goals. It means your life is the way you would like it to be, at least in the really big ways. Most if not all people who deal with any serious neurodivergence do that while also continuing to live with their neurodivergences, because a brain that is wired for anxiety or depression or OCD or a personality disorder doesn’t stop being wired that way. At best a person can hide it.

Hiding the way your brain works and trying to behave in ways that are counter to the way your brain works is painful and unpleasant. So again, let’s go back to the goal. WHY do you want to change a behavior? Is it because differences make you uncomfortable? Is it because you think that it must make the person unhappy? Is it because you think it’s making their life more difficult?

I have two words for you: communication and consent. I think many treatment programs forget to communicate with the client. Because that communication can help you find out why someone is doing something. What purpose does it serve? Do they like it? If so, leave it alone. If not, you still need to help them find a way to serve the same purpose. And if your client doesn’t want to change something then you don’t get to decide for them. Just because someone is neurodivergent or mentally ill does not mean that they cannot make their own choices, or that they don’t have preferences, or that they can’t tell you what upsets them and what doesn’t. Your perception of better or worse is irrelevant.

Being “normal” does not necessarily mean better. What is important is making sure that people are doing things that make them happy, that aren’t held back by their brains, that they aren’t hurting. It’s to give people the best life possible, which does not mean the most neurotypical life possible. It means a life that makes THEM happy.

Now of course for some people sticking out is unpleasant, and if they don’t like being different then by all means it’s no problem for their treatment goals to include looking more normal. But consent is the basis for all of this. Do not try to change someone’s brain without their consent. That’s called manipulation and it’s abusive and cruel and unnecessary.

The end goal isn’t neurotypicality. It’s happiness and fulfillment. It’s a life that someone with neurodivergence likes.¬†What providers miss when they prioritize neurotypicality is that they might be actively hurting someone finds it easier to behave in a different way. If you need to stim and you can’t, it’s uncomfortable and sometimes painful. If you have extreme anxiety and socializing outside of your social circle is intensely anxiety provoking, it makes sense that you’ll want a small, close group of long term friends instead. If those people are forced to behave like “normal” people, they will be less happy and less capable of functioning.

This is why providers need to learn to ask questions more often: what do you want? Why? And then they need to learn to give their clients the time and space to give informed consent to their treatment. Even people who are non verbal. Even people you assume can’t understand. They still deserve the basic respect of having their desires for their life heard. Always. And your assumptions about what makes them happy are not more important than what they actually want, even if that means they’ll look autistic or anxious or delusional for the rest of their lives.

Disability: Being Broken

Much of the time I feel broken. A fair amount of the time I don’t simply feel that way, I’m told that I’m that way. Not overtly, no, but in the way that people talk about mental illness, the way that people talk about people who don’t have good jobs straight out of college, in the way people talk about women who have experienced any sexual trauma…these things tell me that I’m broken. I once had a friend tell me that he could never be the parent of a disabled child because you would sink your whole life into them and they would still be subpar. As someone who has multiple birth defects and major mental illness, that fucked with me.

I’m told that I need to fix things about myself. I need to be less judgmental and more accepting. I need to stop reacting so quickly and harshly to things. I need to make my anxiety go away, and make my depression go away. I need to change how I feel about the world and myself, change how I perceive everything in order to be “happier”. I’m told that I need to change myself, fix myself, retrain my brain so that it’s different from what it is now and so that I behave differently in order to be whole and acceptable. I have been bribed and threatened by people who are well-meaning to get me into therapy to “fix” me.

And I now work in an autism program. And I hear the same kind of language. I’ve been reading blogs about autism and hearing about the ways that children are asked to ignore their own perceptions, feelings, and understandings so as to act in a way that is acceptable to others. I have begun to understand that in many ways, people to help those with autism still view autism as a disease that infects someone, a broken piece of their child that needs to be banished so they can have the real child back.

That’s how I feel when I talk about my eating disorder. People have literally told me to view the disorder as something separate from me, almost like it’s possessing me, like it’s broken and if I can just fight it away then I will be back and the disease will be gone. I’ve been broken or taken over by this bad thing, but if I could just get past it, throw it away, change it, then I would be normal and ok again.

Except that that’s not how mental illness or disability works. The way someone who is autistic views the world isn’t broken: it’s different. What is broken is the way that we treat those who see things differently or act differently. We expect them to move 99% of the way towards what we view as normal so that we can be comfortable, and then we make a 1% accommodation to adjust to them. We don’t allow that some people might be far more happy if they were allowed to act and think in a way that is radically different from the way we do.

As an example, I will always be more comfortable thinking in terms of my own safety and trying to avoid things that will be triggering for me: I will probably never be able to spend much time in a kitchen making food on my own. I will never cook for others. I will always feel more comfortable if others will simply accept what I say about my disorder and don’t question my experience. I will always feel more comfortable if I can move my hands when I’m anxious, or if I can twitch a body part when I have too much energy. Asking me to stop that doesn’t make my anxiety go away: it simply gives me no way to deal with it.

To take a more extreme example, for a lot of kids with autism, they have extreme sensory sensitivities. They can hear or feel things you or I never could. So they may never feel comfortable being in crowded or noisy places. And that doesn’t mean their broken. It doesn’t mean we should force them to deal with those situations. It means that we should accept what they can deal with, accept how they perceive as legitimate.

Instead of asking those of us who might perceive or experience the world differently from you to force ourselves into mental contortions so that we can look and act the way you might expect, maybe people should consider that we’re not broken. There is absolutely nothing broken about the fact that my brain likes to organize things A LOT, and thus it tends towards black and white thinking. There are useful elements to this and unhelpful elements to it. Telling me that it’s wrong will not make it go away, and even if I COULD stop acting in a black and white fashion it wouldn’t necessarily make me happier.

Making adjustments so that I can have time to think before jumping to black and white thinking, or encouraging me to rely on it in areas where categorization is useful but giving me some other tools to check it in my personal life: THOSE are helpful. They don’t try to fix me. They don’t tell me I’m broken or wrong in any way or that if I could just be more like other people or adjust my thoughts and my life everything would be ok. They do tell me that since I function differently than a lot of people I might need some help fitting myself and my perceptions into the larger scheme of things. Society is set up for the “norm”. It’s not set up for me. Which means I need some help getting myself to fit into the way society works. I need help functioning sometimes. But I can do that and still not give up the pieces of me that others view as broken. I can retain my mind and simply try to shape self and world to fit together.

Neurodivergence. We diverge from the norm. We’re not broken. We just fit differently. And it’s not all our job to make ourselves the right shape to fit into society, because sometimes we’re not that flexible. Sometimes society has to be flexible as well. I don’t want to feel broken anymore. I don’t want people to tell me I’m broken anymore. I have some more work to do to be able to function and to fit myself to society, but so do most people. I want that to be ok. I want it to be ok if I’m at a party and I say that I have to leave because it’s too noisy for me or because people are talking about diets. I want it to be ok if I show up to a party wearing fuzzy footie pajamas because I had a rough day and I need the sensory calming (see me up there in my onesie? That was the best party I’ve ever been to). There is nothing WRONG with these things. They don’t make me unhappy. What makes me unhappy is when people can’t accept that that’s how I cope. I am not a problem.