Unboxed Minds
The Fallacy of “Neurotypical” & The DSM
Last week, in Are We Just Surrounded by Assholes, I wrote about the overuse of the word narcissist on social media and how that undermines mental health treatment. This week, I turn my psychology geek lens on the word neurotypical and the DSM itself.
In the never-ending quest to understand the human mind, tools like the Diagnostic and Statistical Manual of Mental Disorders (DSM) play a crucial role. This manual, developed by the American Psychiatric Association, serves as a comprehensive guide or framework for diagnosing mental health conditions and mapping out treatment plans for effective mental healthcare.
While its utility in clinical settings is undeniable, the DSM also reinforces a binary framework that distinguishes between the “neurotypical” and the “neurodivergent.” When this diagnostic map is used inappropriately, especially in public forums like social media, it generates the perception of a false binary rather than viewing mental health as a spectrum. This division, though a convenient shorthand for diagnosis and treatment, risks oversimplifying the vast scale of human cognition and promoting ableism, thereby undermining efforts towards genuine inclusivity in the larger social landscape.
The concept of “neurotypical” refers to individuals whose cognitive functioning falls within what is considered a standard range, free from the specific deviations identified as disorders in the DSM. In contrast, “neurodivergent” describes those whose cognitive processes differ significantly from this standard, encompassing conditions such as autism, ADHD, and dyslexia. This binary framework implicitly suggests that there is a “normal” way to think and behave, and deviations from this norm are labeled as disorders, or worse, mental illness.
However, the reality of human cognition is far more complex. Just as there is a wide variety of physical traits in the human population, there is also a larger breadth of cognitive and emotional experiences. By categorizing certain patterns as disorders, a layperson’s use of the DSM risks perpetuating a false binary that does not account for this diversity. This simplification can lead to a narrow view of what it means to be mentally healthy, potentially marginalizing those who do not fit into the prescribed categories of “normal.”
Moreover, the binary of “neurotypical” versus “neurodivergent” can promote ableism—a belief system that devalues individuals who deviate from normative standards. Ableism manifests in attitudes, policies, and practices that unfairly discriminate against people with disabilities or differences. By framing neurodivergent individuals as deviations from the norm, misuse of the DSM can inadvertently contribute to a perspective that sees these individuals as lesser or in need of correction. This view can foster environments where neurodivergents are stigmatized, and their unique perspectives and strengths are overlooked. As a psychotherapist who works with children, I see this play out with parents of children diagnosed with ADHD, Autistic Spectrum Disorder, and Dyslexia. This can lead to unnecessary pressure on the child and create a tense family environment and undermines the uniqueness that neurodiversity brings.
To foster genuine inclusivity, it is essential to move beyond the rigid classifications of “neurotypical” and “neurodivergent.” This involves recognizing that cognitive diversity is not merely a series of standard deviations beyond the mathematical mean on the infamous Bell Curve, but a fundamental aspect of human variation. Each individual's cognitive profile is unique, shaped by a combination of genetic, environmental, and experiential factors. Embracing this diversity means valuing all ways of thinking and processing, not just those that fit into conventional frameworks that parents often bring into my psychotherapy office.
The limitations of the DSM's binary approach become particularly evident when considering the lived experiences of neurodivergents. Many who are labeled with conditions such as autism or ADHD report feeling that their cognitive differences are integral to their identity, not deficits to be corrected by their parents or mental health professionals. (Disturbingly, social media is rife with stories of people being overmedicated and misunderstood, fueling distrust of the mental health profession. This point is essential.) Neurodivergents often possess unique strengths and perspectives that can enrich society in meaningful ways. By focusing solely on diagnostic criteria and pathologizing differences, we risk ignoring the contributions that neurodivergents make, and hence receive the backlash in the form of an anti-psychiatry movement.
One step towards a more inclusive perspective is to shift from a deficit-based model of understanding neurodiversity to one that recognizes and celebrates differences. This approach aligns with the principles of the neurodiversity movement, which advocates for the acceptance and inclusion of all cognitive variations. Instead of viewing neurodivergent traits as problems to be solved, the neurodiversity perspective encourages us to see people with these traits as valuable differences that contribute to the richness of humanity.
In practical terms, this means re-evaluating how we use tools like the DSM. While diagnostic categories often provide support and validation for those seeking understanding and treatment, they’re not to be used to enforce narrow definitions of normality. Healthcare professionals, educators, and policymakers should be aware of the diversity within the cognitive spectrum and strive to create environments that accommodate and celebrate human diversity. This means that effective mental health treatment needs to be/is a collaborative process rather than a top-down authoritarian one.
Ultimately, moving beyond the binary of “neurotypical” and “neurodivergent” requires a fundamental shift in how the general public views human cognition. It involves recognizing that there is no single way to be “normal” and that cognitive diversity is a natural and valuable aspect of humanity. By challenging the limitations of frameworks like the DSM, and its misuse by the general public, we can work towards a society that truly values and includes all individuals, regardless of how they think or perceive the world. Just as a map provides a useful tool for navigating a complex landscape, the DSM can be a helpful guide. However, it's crucial to remember that the map itself is not the territory. Human cognition exists on a vast spectrum, and true inclusivity requires embracing this diversity in all its richness.
Resources:
Two Heads: A Graphic Exploration of How Our Brains Work With Other Brains By Uta Frith, Chris Frith & Daniel Locke
The Legacy of Autism and the Future of Neurodiversity By Steve Silberman
Why Elite-College Admissions Matter - A conversation with Annie Lowrey about how to diversify these schools—and by extension, America’s elite By Isabel Fattal
Odd Girl Out: An Autistic Woman In A Neurotypical World by Laura James
I agree that the binary mindset of the public misconstrues the intention of diagnosis.
The intention of diagnosis is to aid the patient in responding to the way their mind is functioning.
Recently I have witnessed patients of other therapists using their diagnosis in the neurodivergent category as a pass to being a responsible self determined adult.
It is a shame that the public in general is not aware of the degrees to which a person can inhabit a diagnosis. In truth, many can have a diagnosis which is a very mild case, while others hold the full spectrum of symptomology.
There is much more subtlety to mental health diagnosis than “is this bone broken or not”.
Great article. Thanks, j e moyer.