What are some different options for understanding your diagnosis?
- The Medical Model
Today, probably the most common way of understanding mental differences is that they are illnesses. Many doctors will say, for example, that your depression is an illness, or a chemical imbalance, just like diabetes. On this understanding, a mechanism in your brain has malfunctioned in some way. This of course is not your fault. Let’s call this understanding of mental differences “The Medical Model.”
However, there are other ways of understanding your mental experiences. [These may also be compatible with the Medical Model (given some modifications)]. For example:
- The Mad Pride/Neurodiversity Model
It may be the case that you are not ill, but that you instead have a mind that experiences the world differently – it might be more sensitive, or more emotional, or more prone to finding meaningful connections in the universe, or more vigilant about the dangers in the world. Thus, it may be that your mind is part of a perfectly acceptable (or, even quite splendid) range of mental diversity in our population. Let’s call this understanding of mental differences “The Mad Pride/Neurodiversity Model.” (see http://www.torontomadpride.com and other resources elsewhere in this website).
Some misunderstandings surround the Mad Pride/Neurodiversity Model, and it’s important to clear them up.
1. First, the Mad Pride/Neurodiversity Model does not mean that your mental differences don’t cause you suffering. Presumably, part of this suffering is that the world isn’t designed to accommodate or accept different minds. In fact, it’s no mystery that our world is filled with denigratory, sanist, stigmatizing, harmful, and false attitudes about mental differences. In addition, some of this suffering may come from these states themselves. Either way, it certainly doesn’t mean that your suffering is your fault.
2. Second, “Pride” can mean many things, and the meaning within the phrase “Mad Pride” is certainly not meant to imply that “madness” is better than neurotypicality, nor that one must get delight, honor, and/or a sense of accomplishment from their mental difference. Instead, the meaning of “pride” in this phrase is closer to the meaning of “acceptance,” but acceptance is too weak in our present deeply sanist society. Think of an analogy to Gay Pride. Marching in a Gay Pride parade need not mean that one thinks it is better to be gay. However, it is (at least) a public proclamation of acceptance – a statement to society that being gay is acceptable, and is as worthy of celebration as is being heterosexual. Most members of the Mad Pride movement would, I believe, think of pride that way – as a proclamation of acceptance, or as the “permission to accept.”
The above are arguably the two main understandings, but there are many others:
- The Strategic Adaptation Model: This model says that your mental difference is a perfectly healthy (and, even smart and strategic) response to averse or traumatic experiences of some sort. This doesn’t mean that it doesn’t cause you suffering, but it also doesn’t mean that anything is “broken” in your mind. (see, for example, Garson, Justin. (2014). The Biological Mind. Routledge.)
- The Dangerous Gifts Model: This model says that your mental differences are gifts. Again, this doesn’t mean that such gifts don’t cause suffering. Often, these gifts are dangerous and must be handled with care. (see http://www.theicarusproject.net).
There is no current consensus about which of these models is the “true” one. It might be that several are simultaneously true (although this might seem odd, there are ways this can happen with some modifications to each model). It might be that yet other models are true. It might be that some models are true for some people, or for some mental differences, and other models are true for other people, or for other mental differences. No matter what, though, at this point in time (and perhaps forever), there is no proof to rule out any of these models.
Thus, I firmly believe that it makes sense for you to know your options for thinking about your mind, and to realize that you don’t have to believe anything that excludes any of the above possibilities. And I further believe it is very reasonable for you, in considering your own experience, to adopt the model that resonates with you the most – which seems most helpful.
It may be uncomfortable that there is no one definitive answer, but there is usually no one definitive answer in most things in life (which, of course, may be even more uncomfortable!). On the other hand, it might be comforting to know that there are viable alternatives to harmful and negative understandings of what your mind is like.
I will say that, as someone who has researched these different models extensively, and has listened to the testimony of many mentally different individuals, I myself believe that there are several advantages to the Mad Pride/Neurodiversity model, and that it is the one that is the least sanist (stigmatizing and un-accepting). Consider an analogy. Arguably, the best way to de-stigmatize homosexuality is not to say it is a disease (in fact, it was considered one by psychiatry until 1973), but to adopt a Gay Pride model. So: I will not hide the fact that the resources I offer here focus a disproportionate amount on this model. This is not just because of my beliefs, but because this is a model that is rarely discussed, even though it has liberated many people, and I want to give it the airplay it deserves.
As I said above, this does not mean you must adopt this model for yourself. In addition, there are ways to combine the Mad Pride/Neurodiversity model with other models mentioned, including the Medical Model, so that you need not necessarily restrict oneself to one camp.
Alternative Understandings of "Mental Illness" 