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Neuroqueer: Depathologising psychiatric “conditions”

This article was co-authored by David Gray-Hammond and Katie Munday

Trigger Warning: Ableism, pathology paradigm, sanism, use of words insane and madness, medication, therapy and trauma.

Neuroqueer theory evolved out of the neurodiversity paradigm. It was a logical progression in the field of depathologising natural variations in the human bodymind. This concept appreciates the neutrality of neurodivergence, as neither good or bad, it simply is.

While this concept has been widely explored in the area of intrinsic neurodivergence, (such as autism and ADHD), there is less discussion regarding acquired neurodivergence; neurodivergence that is typically acquired through trauma or the intentional alteration of ones bodymind (such as through the use of psychedelic drugs). Specifically, we wish to discuss the concept of psychiatric “conditions”.

Psychiatry itself is one of the youngest branches of medicine, first mentioned by name in the late 19th century. Due to its infancy the field still remains fallible, and is largely governed by the contents of a single textbook; the Diagnostic and Statistical Manual of Mental Disorders (DSM) currently on its fifth edition, and the recipient of a recent text-revision (DSM V-TR). Unsurprisingly, this textbook is based entirely in the pathology paradigm, with all bodyminds described in its pages as “disorders”.

The use of the word “disorder” is important. This word places a level of responsibility on the individual to return to a more “ordered” state, dictated by cultural norms. This has historically been achieved through the use of psychoactive drugs, which are often prescribed before the use of talking therapies.

Psychiatry has a place in the world, but currently relies too heavily on the use of medication, without understanding the context around individuals. This is why it is important for psychiatrists to take a more trauma-informed, neurodiversity-affirming approach. There is a balance to be found between the use of medication, and the introduction of talking therapies that encourage the individual to co-exist with the traits of their neurodivergence.

It is important to understand and work with people holistically to reduce their distress, as many of us are seeking support due to ongoing trauma.

We are living in a world that overwhelms our senses, ignores our social communication differences, and treats us as second class citizens. Autistic people are made to adapt to norms that are both uncomfortable and harmful, and this creates complex-trauma for an increasing number of us. Once we experience bullying, isolation, and neglect, our self-worth takes a nose-dive. Often we mask our Autistic differences for fear of ridicule, perpetuating the low self-esteem that arises from forced conformity and assimilation. This becomes a cycle of shame that encourages us to hide our true selves, in return for a semblance of dignity.

So where does neuroqueer theory fit into this?

Cultural expectations of mental health are based heavily in sanist ideas of “normal”, and define our understanding of “madness” as anything that departs from these expectations.

Taking a neuroqueer approach allows us to embrace our differences, whilst appreciating that many of us still need accommodations. This is why emerging talking therapies that teach co-existence (rather than interventions that aim to change us) are an important step forward.

Subverting the expectations of our societies predominant culture, we reclaim ourselves, and learn to co-exist with our “psychiatric” self. No longer are we “insane” by normative standards, but neurologically queer, and refusing to be ashamed of that.