Simo Vehmas, Professor of Special Education, University of Jyväskylä, Finland, President of NNDR
In this blog entry, I will discuss very briefly two related and controversial questions that, in my view, arise from the neurodiversity perspective: first, whether neurodiversity has an organic basis, and secondly, whether it is a significant factor regarding responsibility for one’s actions.
Many neurodiversity activists argue that, for example, autism, ADHD, bipolar disorder and schizophrenia are real conditions, with an organic basis (while some neurodiversity/anti-psychiatry activists say exactly the opposite). Autism, for example, is a matter of different form of brain wiring, something that is very much real and has consequences to one’s behavior. In this respect, neurodiversity has a somewhat different outlook on disability than disability studies perspective, which emphasizes primarily the social nature of the definition of bodily and mental differences. Some scholars and thinkers representing a ‘postmodern’ viewpoint go as far as questioning the definite reality of impairment: everything’s socially constructed, so it makes no sense to talk about impairments as ‘real entities’ that exist independently of our interpretations about them.
Neurodiversity perspective seems to go against the grain in that it acknowledges the objective reality of bodily phenomena. To some extent, I have no quarrel with this conviction. It seems clear and evident, that often impairments are real but that their significance depends on social circumstances. And to an extent, I agree with the Neurodiversity Movement when it endorses that psychiatric definitions and interventions are based on social conventions of so-called appropriate behavior: the ‘neurotypicals’ (as the Neurodiversity Movement ironically calls so-called normal people) randomly enforce their social and behavioral rules and expectations on those whose ways of experiencing themselves and the world differs from the accepted norm. This seems obvious – expect for one crucial question: are all social norms and expectations random, and completely arbitrary? I think not.
Most of us probably see very good reasons for endorsing virtues such as justice and prudence or principles such as equality and autonomy. In other words, our social norms are supposed to be based on ethics – on ideas of right and wrong, good and bad. Whether this actually is the case, is a separate matter. Whether our ethical ideals are appropriate, is also a separate matter. And, whether certain impairments imply the kind of behavior that may conflict with these ethical ideals is most certainly a separate, empirical matter.
Some forms of neurodiversity are seen to have direct ethical implications in the sense, that the impairment may ‘force’ individuals to act in a certain way. Because of this, various psychiatric conditions have traditionally been seen to exempt people from culpability (in case they have done something reprehensible) because, arguably, these conditions make people act in ways that are out of their control. So, it can be argued that the acts of someone with, say, Antisocial Personality Disorder are merely involuntary reactions that stem for his or her brain functions; they are a bit like a sneeze or seizure (an issue that is to be determined, for example, in the ongoing Breivik trial in Norway). And surely, we cannot be blamed for our sneezes and seizures, can we?
Consider the following example: a pupil in Wisconsin vandalized two elementary schools with his two fellow pupils causing 40,000 dollars worth of damage, avoided expulsion ‘as a disabled student’ after his mother had acquired a private psychologist’s statement that her son had ADHD. The two other students only escaped expulsion by withdrawing from the school. According to the court’s verdict ADHD invalidated the pupil’s free will and accountability.
The court’s decision reflects a medical understanding (and perhaps to some extent the neurodiversity perspective as well) where psychological impairments are seen as real, objective entities with unavoidable consequences to one’s conduct. This implies that the behavior of someone with, say, ADHD or Asperger’s is seen to be based on illness-like condition. This being the case, their problems are recognized as real, and perhaps as painful and debilitating as illnesses can be, and as unlikely to be wished away. But where neurodiversity view departs from medical view, is its notion that the undesirability of, for example, autism can and should be explained by social factors; society often makes the life of autistic people miserable, not autism as such. Organic factors make people with autism or ADHD to act in a certain way, but that is a problem only because it has been made a problem by other people. Accordingly, the neurodiversity movement demands a world ‘where it is okay, even admirable, to be autistic’ (http://archive.autistics.org/library/love.html).
Perhaps the mother of the boy who vandalized school buildings sincerely thought that her son couldn’t control his actions, and that our institutions should consider his culpability accordingly. However, suppose that this boy had artistic gifts and often experienced long, excited states of inspiration accompanied with hyperactivity, tantrums and behavior that could be depicted manic, but which resulted in good art. If art is central to the life and identity of this young man, telling him that his state of inspiration is actually a mild form of mania and results from his ADHD, he (and his mother) might feel insulted. That would seem like a natural reaction to being told that the meaningful activities of your life are like sneezes or seizures. It is tempting to ‘externalize’ unwanted behavior and see it as involuntary, and equally, to ‘internalize’ admirable behavior and see it as a voluntary expression of one’s personality.
The fact that someone has a neuropsychiatric diagnosis doesn’t automatically mean that he or she isn’t blameworthy or praiseworthy. Neurodiversity may very well prompt some actions, but this doesn’t imply that these actions cannot be controlled. Evidently, the nature of impairment, the social context, and the nature of actions that are seen disruptive by others are crucial considerations regarding responsibility and control.
Finally, imagine a student who has a tendency to interrupt other student’s presentations during lessons, and make loudly rude remarks about them. He says that he can’t help it because he’s neurodiverse and he should have the right to exhibit his personality freely. This, perhaps, isn’t a grave offence and, to an extent, should perhaps be tolerated. But having said that, this student’s actions can justifiably be seen disruptive and offensive to those students who, understandably, are interrupted and intimidated by the manifestations of his neurodiversity.
To conclude, neurodiversity perspective celebrates the principle of ‘live and let live’, and that is something that any liberal society ought to respect. But the principle concerns all of us, despite the nature of our brain wiring, and that implies that all of us should fulfill this principle as best we can.
Further reading
Boundy, K. (2008). “Are you sure, sweetheart, that you want to be well?”: An exploration of the neurodiversity movement. Radical Psychology 7(2). Online: http://radicalpsychology.org/vol7-1/boundy.html
Vehmas, S. (2011). Disability and Moral Responsibility. Trames 15(2). Online: http://www.kirj.ee/public/trames_pdf/2011/issue_2/Trames-2011-2-156-167.pdf