2025/11/02
In response to this video: https://youtube.com/shorts/iEFvH-PHCbE?si=jKb8JkSTwHnbrUSk
This is why the paradigm shift from the medical model to neurodivergence is so important. It’s so clear in my head, but I often struggle to explain that to people who are still in the medical paradigm (really need to put effort into it because I think it would be a valuable explanation for people that would help them through the imposter phase).
Let me try briefly now.
I believe that when he says “I’ve drawn comfort from my mannerisms and social directness being because of autism,” he is thinking in medical model mode, similar to alcoholism being called a “disease”. There is an element of permission granted because “the disease made me do it”. That is:
diseases are inherently negative
diseases are not my fault
I no longer have to feel the guilt that society has imposed on me because my behaviour is not my choice.
Freedom from guilt allows me to develop self-acceptance and insight.
The fear is that if I don’t “qualify” for this “disease”, then:
I have to take responsibility for my impulses,
I’m the same as everyone else, which means
2.1. they have the same struggles but are just better than me at coping,
2.2. I am not as unique as I thought I was, so
2.3. my sense of belonging has disappeared because I’m not part of the oddballs, but I’m also not part of the normals,
the guilt will return.
I believe the medical model of autism is something like
figure A (or at least this is the perception of it).
Autism is a “thing” that lives in a person’s body.
But when you look at the way autism is diagnosed,
it’s not actually like that at all—it’s a collection of
observable behaviours/symptoms. Because we’ve
grown up learning more about diseases than we have
about populations and statistics (science/biology/going
to the doctor vs. demographics and statistical analysis), the medical model is baked into our brains (at least in the Western world). So shifting to a neurodiversity model is difficult. Or at least it might be easy at first, but when we have uncertainties we will often default back to the medical model and try to make the new information fit into our old, well-established neural pathways of understanding the world and ourselves.
But they don’t fit together, because true neurodiversity doesn’t even recognise the categories of ASD and ADHD etc. The model basically looks at traits on a population level and says “you fit somewhere on the outer parts of the population for this trait expression” (figure B).
So to “diagnose” neurodivergence would,
in this model, mean that you need to be on
the outskirts of multiple different traits to
qualify.
I think that a lot of people try to meld the
two models by doing Figure C—Inserting
where they sit on the population graph
into themselves as various trait levels. And
that’s cool, it kinda works, cos it gives
someone insight into themselves and how
they function/respond to environment.
But there’s still the element of category
and needing to be “neurodivergent
enough” to give their experience meaning. We have been conditioned to believe that we need external confirmation of our worth. And I believe that that’s the problem—the fear that we’re not “enough” to fit into a socially constructed category negates the whole point of neurodiversity, which is: ALL people/brains are necessary for functioning ecosystem.
The medical model has made us deeply believe
diagnoses are the best option to develop understanding
and acceptance. And to an extent, diagnoses are helpful
because they offer a label with a shared understanding
to communicate with others. For example, “I am direct
in conversation and hate small talk because I am
autistic” is easier than “my communication style is on
the outskirts of population norms due to being
disinterested in topics that are not of value to me”.
But the problem is that the shared understanding of
ASD and ADHD isn’t all that shared to begin with. It
used to be very restricted (boy in the corner rocking
playing with trains) and now it’s become so much
broader that everyone’s understanding is different.
So my contention, and why I love the neurodiversity model, is that we don’t actually need the labels of ADHD and ASD for developing self-insight. If you know that you are sensitive to light, you don’t have to tell someone “I am sensitive to light because I am autistic”, you can just know, “I am sensitive to light”. Because it’s the same thing. This is obviously coming from my experience of having gone through the “because I am autistic” phase and having moved into self-acceptance where my priority is self-understanding over explaining myself to others. So I acknowledge that there is a massive bias based on where in the process you are, and that the process of insight is different for everyone.
But my point is that this guy doesn’t need to abandon his insight into his traits just because he misses the criteria for autism by a point or two. His understanding of himself has vastly come from the neurodiversity model (well, probably TikTok actually 🤣), whereas the diagnostic criteria come from the medical model. And while there is obviously value in checking things with a reliable source (not TikTok), all insight into the self is valuable, and one should not discount the work done in self-discovery if it doesn’t fit neatly into a box. You are a person first. You belong to the world and you belong to yourself, the rest is gravy.
And lastly, but very much not least, I have never met a neurotypical person that has ever wondered if they are autistic, so it is quite safe to say that if the question is there, you can pretty much slap on a diagnosis on the spot. (Don’t quote me on that, I’ll get fired from the HPSCA! 😆 Even though it’s true..)
Jessica Prinsloo
