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World Autism Day 2023: A reflection on the work still to do

The date is April 2nd, 2023. This means another World Autism Day (part of the wider Autism Acceptance Month) has arrived, and as the month progresses, we will, as a community, share in the triumphs and comfort one another in our losses.

This month can be a bitter tasting pill for many, with World Autism Day representing a day that should be ours. Sadly, it is often claimed by those whose agenda does not align with the very Autistic people that they claim to support. Today, and all of April, for that matter, serves to remind me of the Autistic people who have left us. The ones for whom this world was simply too cruel to withstand. I often see positivity that change is slowly happening; the change isn’t fast enough, there are no acceptable losses on the road to liberation. Every Autistic person we lose is a scar on our history, and an indictment of the world we live in.

Yes, perhaps the days of asylums is coming to an end, but what of the countless Autistic people here in the UK who are locked away and abused in psychiatric institutions? Can we truly say that the asylums are gone when one can be placed into carcerative care, simply for being Autistic and in distress?

What of the CAMHS crisis that has been ongoing in perpetuity? Can we really say that Autistic people are liberated while our children are being denied their identities and/or turned away from help for being Autistic? Every single day, Autistic people are fighting to exist. While the nature of our fight might be becoming less overtly life-threatening, we still have to recognise that our dramatically reduced life expectancy lists filicide and suicide as to of the biggest factors.

Yes, the world is changing, but it’s not changing fast enough.

Speak of normativity and structural oppression to the average person, and you will be met with blank stares or even gaslighting. To create a truly inclusive world we have to start from the bottom up. We have to consider the foundations that our world’s power structures are built upon. You don’t destabilise oppressive regimes from the top, you foment revolution amongst the people it rests upon.

If I can ask one thing of Autistic people this World Autism Day, through out Autism Acceptance Month, and moving into the future; be resolute in your commitment to shifting the views of the masses.

While change at government and legislative level is vital, it ultimately will fail if we do not change the hearts and minds of our similarly downtrodden friends, family, colleagues, and loved ones. We have to recognise that we are all sharing in oppression and that we have the collective force to cut free from the chains of normativity. We can, together, create a neurocosmopolitan society. We can lay a new foundation for those that come after us to build upon.

I am Autistic, I am proud, and I refuse to accept the way that things are.

Drug-use and harm reduction: what does it look like?

When we consider harm reduction strategies for drug-users, we often think about education on the safer use of drugs. Things such as safer injection practices and “tasting the hit” to reduce accidental overdoses. While things such as safe consumption rooms and needle exchanges can reduce a lot of the surface level harms, there is a wider conversation about the factors leading to drug-use and the fall out from drug-use once it has initiated.

Here are some of the things that, in my opinion, are important factors to consider when trying to reduce the harms from drug-use.

1. Trauma-informed practice

First, we need to stop viewing trauma through a normative lens and realise that trauma can be experienced from just about any source. As I discussed with Tanya Adkin in the Creating Autistic Suffering Series, trauma is a subjective experience.

Once we have shed our misconceptions of what constitutes trauma, we need to recognise the role that traumatic experiences play in the harms associated with drug-use. Anyone supporting people around harm reduction needs to remember that they are more than likely working with traumatised people.

2. Responsible prescribing practices

The pathologisation and subsequent medicalisation of distress has done many people a great deal of harm. For many people, myself included, it has meant trading addiction to illicit drugs for addiction to prescription drugs. In my case, prescription drugs were more dangerous than the illicit ones due to ease of access.

People don’t like to admit it, but doctors often end up being a person’s main supplier of drugs.

3. Move away from current diagnostic models in psychiatry

Distress doesn’t have to be centred as a problem in the person. In fact, I would argue that it’s necessary to externalise it by looking to the environment, and subsequent experiences of people in distress. We need to consider that if we want people to be safer in the use of drugs, we need to think about what in their life has brought them to using them.

For a good example of this, check out the power threat meaning framework.

It is also important to embrace neurodiversity models. It’s not just Autistic people that are Neurodivergent. Neurodivergence can be acquired in a number of ways, or you van be born with it. It is important, though, to recognise that “mental illness” as a concept has not improved outcomes in psychiatry in over 50 years. Recognising Neurodivergent people in distress will take you much further.

4. End prohibition

The war on drugs is a lie. It has not stopped drug use, and neither has abstinence-based education. Making drugs illegal does not stop their use, it empowers clandestine markets to exploit the distress of vulnerable people, for profit, and increases harms through the lack of regulations around purity and age restriction.

This is a non-exhaustive list. We need to have a wider conversation about racism and other bigotry, socioeconomic status, housing, access to healthcare, and myriad other factors. I do not believe I could do this justice in a short blog.

I hope that we can move into a world where we support people rather than criminalise and institutionalise them. I hope that medical professionals can take a moment to acknowledge the harm their profession has done. I hope that we can all assess our own internalised ableism towards drug-use and addiction.

We may not be able to solve this issue over night, but little by little, we can make the waves that will sweep away the old models and make space to replace them with something that works better for every one. The greatest thing we can do is have a little compassion for others who are suffering.

How “mental illness” disempowers the average person

Over the past decade or so, we have seen a surge in the awareness of so-called “mental illness”.

While the concept of telling people you are struggling has served a good purpose, the concept of “illness” has actually disempowered people who have these particular neurodivergences and the people around them.

Human suffering, as it stands, is a heavily medicalised field of study. It has become the realm of doctors and nurses, and this is where we become disempowered. When we experience suffering, we believe that only doctors have the responsibility to remedy that. The average person is made to feel as though they are “out of their depth”.

In fact, the responsibility for reducing human suffering is on all of us. Medication can take the edge off, but to see a true reduction in trauma that litters our society, we all have to do work. Doctors are not responsible for the environments and people we grow up with, and yet we assume they are the answer when we experience suffering as a result of those things.

Society is structured in such a way that we are likely to encounter trauma throughout our lives. It is important to move beyond normative standards of trauma and recognise the subjective nature of this abstraction. What is traumatic for me may not be traumatic for you. It does not make it any less valid.

This is why we need to listen to minorities about minority experiences, ot allows us to root out the traumatic experiences occurring in society, and not just those which we recognise. When we invalidate another person’s experience, we are contributing to the immense suffering that is currently happening in our world.

Perhaps then, it is pertinent for us to take responsibility for the role we each take in the suffering of others and ensure that we are doing good with the limited time we have on earth.

Our psychological well-being is far from being solely the realm of medics. We each play a significant role in other people’s worlds.

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