Pathologising Resistance

Not just as an anarchist, but as a gay man and psychotherapist, I’ve spent most of my life either not fitting in, or working with people who feel for some reason that they don’t.

My work initially was with sexuality, identity and gender dysphoria, focusing over the last 20 years on complex trauma and more recently, neuro-diversity and ‘spectrum disorders’. 

If there is one overwhelming insight I’ve gained it is the state’s obsession with pathologising difference, generally described as dysfunction or disorder.  Differently functional is seen as ‘abnormal’, sick or deviant.  Whatever the politico-medicalised framing of well-being intervention: medication; supervision; care in the community; case management etc, the end product for the individual is generally repression.

Government itself doesn’t walk round slapping people and nor do the bosses.  At work this is left to HR algorithmic management methods, on the street it’s left to the police and mental health services, economically, the slap is disenfranchisement and poverty, and in childhood, to schooling and discipline.  At home, the nuclear family struggles from the start by its own experience of this machine, neither educated nor supported in how to respond. 

But how did these conditions – unreferenced until the industrial era, suddenly appear? And what is this supposed ‘normal’ neurotypicality that these deviations are supposed to threaten? 

It’s no accident that we don’t have any attempt to define psychological disorder until the advent of industrial revolution. The industrial revolution made being human more complex than it had ever been.  Until the 18th century there had been no shared concept of universal time, time could vary from village to village and county to county. Science didn’t just create the technology of accuracy but did it to meet the need for the new class of exploiters to utilise it.  

Many misinterpret dating inconvenient change to the industrial revolution as imagining a fantasy longing for primitive times past.  That fundamentally misses the point. Nobody craves a return to painful dentistry and toilets that don’t flush!  But the experience of being human fundamentally changed with the clock, the factory, wage labour and profit. 

Henry Stanley Miller’s study of pre-Industrial peasant working conditions (‘Life on the English Manor’ 1987), concludes that a day’s work was considered to be the period from morning to lunch. This averaged about 6.5 hours of work during the peak of summer.  Even for the self-employed proto-capitalist artisan class, rarely exceeded 8 hours.  Life may be hard for sure, but took place in the context of settled communities where each was known and mutually essential to survival. 

There was no such thing as an aspergic midwife; a dyslexic baker; an ADHD blacksmith or an autistic ploughman.  Instead differences were the character components of a community, some the wise, some the truth speakers, some the visionaries   some the listeners and so on. 

Then, the advent of capital, the creation of credit, investment, land clearances and mass impoverishment feeding the factories in which waged labour replaced craft and occupation. 

It also brought the discipline of the factory clock and its overseers. 

Functionality became redefined for financial necessity and social control: clock on time; permitted breaks only; stay to the end of the working day defined neither by self nor season.  Demand nothing, eat sleep repeat until squeezed dry. 

In addition to the generational trauma caused and the need for standardisation in labour practice (or at least behaviour and expectation), difference became subversive and characters to be judged dysfunctional.  The refuseniks, habitual malcontents, fantasists and dreamers.  Ultimately the outcasts, anti-socials and unemployables. 

In preindustrial society communities were historically rural and geographically stable.  In industrial society, the experience of community at least reproduced itself in the form of industry and (re)location. 

Post-industrial society however has presided over its virtual abolition where almost all collective concepts of community, whether it be clan, extended family, geography, trade or work have ceased to exist.

Thatcherism made material the experience that there is “no such thing as society.” This has further atomised the human experience to a point where many feel excluded or at the edge of exclusion. 

Struggle for belonging and community has more and more expressed itself in individual terms, in identity often in isolation.  In some ways our natural human instincts to make communities where we can, have left us transient with a lack of permanence with those we feel have shared interests.  While understandable, it is desperate and economically without power.  It makes us more easily dividable and targetable setting one to go against the other. 

The democratic construct necessities the acceptance of this ‘individuality’ whilst pointing the finger at those who refuse to accept.  The angry black man; the hysterical woman; the troublesome Unionist; the selfish gay; the ‘safe-space’ threatening trans, the crazy anarchist. 

The reality is that diognoses often serve to blame the individual for psychological dysfunction.  That dysfunction being essentially distress.  This is the new norm – deep unhappiness and the necessary cognitive dissonance of telling ourselves a story about our lives to make our experience sound acceptable despite what we actually feel.  This incongruence, the suppression of our emotional life, is the universal price we pay to stomach our imposed existence in capitalist society.

Professionally I’m unsure if I’ve genuinely encountered normal or authentic ‘neurotypicality’.  Instead I see people forced to change shape to conform, those who struggle less consequently defining functional, and those for whom changing shape can be unmanageable and traumatic defining the dissident.  The temperamentally unsuited to capitalism at an advanced stage of social decomposition! 

Increasingly I am seeing people diagnosed with PDA (Pathological Demand Avoidance) or ODD (Oppositional Defiant Disorder).  The latter, mostly diagnosed in childhood are defined as uncooperative, defiant, and hostile toward the demands of peers, parents, teachers, and other authority figures.  The former describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent.  Refuseniks of externally applied order. 

None of this is to underplay the reality that some people are significantly vulnerable and debilitated by some aspects of neurological divergence from birth, but most falling into the diagnostics are simply different.

For liberalism it is expedient to demonstrate acceptance, though generally in the form of toleration, itself an insidious form of oppression.  This acceptance doesn’t sit easy with them – witness to somersaults over conversion therapy, faith endorsement of same sex relationship or the furore over gender recognition.   Where diagnoses occur, consequences follow. 

Neuro divergent activists point to the ‘Triad of 70’:  People living with these diagnoses are 70% more likely to attempt suicide; 70% more likely to be unemployed and 70% more likely to die before the average age of mortality.  Difference is manipulated to lead to exclusion and creates vulnerability and a sense of powerlessness.  An experience shared across marginalised or minority communities, it is the lived experience of racism, sexuality, gender and identity, and class. 

This experience breeds rebellion and is consequently described as such and pathologised (Emotionally Unstable Personality Disorder currently popular).  Despite that over time the target groups and diagnostics may change with changing context and political need, the establishment concepts of normality, mental health, work and functionality remain the platform from which dissidence and resistance is diagnosed and the rebellious dealt with. 

Article by Dreyfus