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3 April 2007

Designer labels?

James Medhurst examines an increasing tendency to seek diagnosis and self-diagnose conditions like a

By James Medhurst

In his latest documentary series called ‘The Trap,’ shown on BBC2, Adam Curtis made some remarkable claims about the increasing self-diagnosis of psychological impairments alongside his equally imaginative ones about the benign effects of state bureaucracy.

He suggested that while, in the 1960s, sociologists and self-designated ‘radical’ psychiatrists rejected diagnostic categories as tools of oppression, people in the twenty first century are now oppressing themselves by embracing these labels out of choice.

There is no doubt that diagnoses of anxiety disorders, clinical depression, autistic spectrum disorders, and ADHD are all on the rise, and many result from enquiries made by people on their own behalf or by concerned parents. However, there are many other possible explanations.

One popular approach will be considered only briefly to prevent it from being given more credibility than it deserves and this is the one that rates of these conditions are actually increasing. For example, autism is said to be caused by childhood vaccinations, watching too much television or lax parenting, although none of these theories can withstand any degree of scientific scrutiny.

There is ample evidence that historical figures as diverse as Sir Isaac Newton, Ludwig Wittgenstein and Andy Warhol had traits in their characters which resemble autism so it is not a new phenomenon.

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Admittedly, some of the clinicians who retrospectively diagnosed the above have also got rather carried away with the idea that autism is linked in some way to intelligence or creativity. What is rather more likely is that there have been autistic people at all levels of the social scale throughout history.

The viewpoint taken by Adam Curtis is that people adopt these labels out of a desire to be normal, to learn what is wrong with them and to get it fixed with medication. Perhaps this is true for a minority but it does not apply in the case of autism for which few chemical treatments are available.

Indeed, many self-diagnosed people proudly resist any attempts to make them like everyone else. Another suggestion is more sinister and that is the idea that self-diagnosis is a means of gaining a few of the benefits of being disabled, such as social security and employment rights.

This particularly unconvincing explanation must have been devised by someone with no experience of job hunting while openly admitting to be disabled. I consider it worthwhile to accept myself as autistic, despite the economic balance, only because of other key factors, including a wish to be honest towards myself.

Nevertheless, the shift in political attitudes towards disability is important in one respect and this has to do with the tactics of our not-quite-benign state institutions. In the past, as Adam Curtis failed to note, anxious and depressed people may have regarded themselves as normal but others tended not to share this view, and sought to foist labels upon them.

Therefore, special schools were set up to allow mainstream educational establishments to discard their more troublesome pupils. Naturally, parents resisted by rejecting the labels. After the dawn of inclusive education, this all changed. It was now unlawful for schools to reject children for being disabled and so it became easier to expel pupils who did not come with a label attached.

Suddenly it was in the interest of parents to obtain diagnoses where they may have been reluctant to do so in the past. It would not give their children an easy ride in life but would allow them a mainstream education as well as a little self-knowledge. Too many remain in denial and so I only hope that the increase continues.

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