As a systemic psychotherapist, I believe that human distress needs to be understood in its relational and social context. The systemic perspective offers an alternative to a psychiatric model which the Marxist cultural critic Mark Fisher argued pathologizes understandable responses to intolerable conditions, reinforcing “capital’s drive towards atomistic individualization (you are sick because of your brain chemistry).”
But in recent years it’s become clear that psychiatric diagnoses are metastasising; becoming a dominant lens through which not only distress but an ever-widening range of human experience is interpreted.
The biggest boom in diagnosis has been under the neurodiversity umbrella. Between 2019 and 2024, referrals for autism assessment in England rose fivefold, and the number of people prescribed ADHD medication increased by 51%. Every day another celebrity comes out as having been diagnosed with autism, ADHD, or both. Social media, meanwhile, is flooded with posts reframing every facet of human experience through a neuro lens; social insecurities are a sign of ‘rejection sensitivity dysphoria’; your mid-life crisis could be ‘autistic burnout’.
Professor Uta Frith, one of the world’s leading autism researchers, recently argued that the autism diagnosis has been stretched so far beyond its original conceptualization — as a lifelong neurodevelopmental condition characterized by clear social-communication difficulties and restricted behavior — that it has become essentially meaningless. Central to Frith’s critique is a concern that in the absence of biomarkers, assessment relies heavily on subjective reporting, with insufficient attention to contraindicators, such as evidence of reciprocal communication and theory of mind. The result is a significant cohort of people receiving diagnoses who may feel anxious and overwhelmed in social situations, but who do not present with the pervasive social-communication difficulties that would support a neurodevelopmental explanation.
In his book Searching for Normal, the critical psychiatrist Dr Sami Timimi traces the breathtaking expansion of ADHD in a few short decades, from a rare diagnosis affecting a small number of adolescent boys, to prevalence rates of 5% of children in the UK and 10% in the US. Genetic, neurochemical and brain imaging research has failed to identify a single biomarker for the condition. Diagnosis relies heavily on self and parent report, using subjective questionnaires which ask how ‘often’ particular behaviors occur, with no meaningful reference to what is developmentally typical at a given age. As the category widens, Timimi argues, our definition of what counts as normal keeps shrinking.
While concern over overdiagnosis is growing in the UK, perhaps the more interesting question is why so many people suddenly feel themselves to be neurodivergent, and desire to be recognized as such. The answer cannot lie in the influence of psychiatric discourse alone. That psychiatric discourse provides the meaning framework is clear, but the appeal of this particular framework reveals something deeper about how contemporary life is experienced.
As Timimi highlights, once the contested “neuro” in neurodivergent is stripped away, what remains in the demand for diagnosis is essentially a claim to difference: that the bearer of the diagnostic label has experiences and needs that diverge from the ‘neurotypical’ other.
Across neurodiversity blogs and social media posts, a remarkably uniform ‘neuro-actualisation’ script can be identified. It typically opens with a narrative of epistemic dispossession: the pre-diagnosed self is characterized by radical unknowing — of one’s needs, desires, and capacities — and experiences a persistent sense of inadequacy, of feeling overwhelmed, lonely, and persistently misunderstood.
Diagnosis functions not merely as a medical event but as an ontological one. The realisation of being neurodiverse retrospectively resolves a history of fragmentation into coherence, transforming confusion into identity.
Finally, the world and its institutions are positioned as unaccommodating to the neurodivergent self. Neuro-actualisation opens a route to resistance via a rights-based framework for identifying and meeting one’s needs.
What is striking is how closely accounts of the pre-diagnosed self, characterized by radical unknowing, resemble Marx’s concept of alienation, and in particular alienation from species-being or Gattungswesen.
Humans are inherently social, relational beings. We come to understand ourselves through shared life with others and relate to ourselves not merely as individual specimens but as representatives of the species. We become alienated from this species-being, Marx argues, when we are reduced to appendages of processes that serve ends not our own.
In late capitalism, processes of alienation have intensified to levels which can only be described as dystopian. We exist in what the sociologist Zygmunt Bauman called ‘liquid modernity’, characterized by social atomization and enforced individualisation. Distanced from each other, we increasingly default to experiencing others as external and judging.
We live in societies where community has eroded, civic participation declined and a tech-mediated, contactless existence has displaced embodied social life. Consciousness itself has become a site of exploitation: the attention economy depends on distraction, compulsion, and fragmentation — orienting us towards screens rather than toward each other, alienating us from our own inner lives. In short, late capitalism creates the conditions for feeling inadequate, overwhelmed, lonely, and misunderstood.
The ‘solution’ of diagnosis simultaneously articulates and reifies the experience of alienation. There is no sense that apparently ‘neurodiverse’ experiences might say something about our collective human experience, the ways we live, or the need for collective change. The site of explanation is restricted to the individual’s brain-wiring.
Indeed, the very suggestion that the experiences of those seeking diagnosis might be articulating something more universal is frequently met with anger and accusations of invalidating or erasing neurodivergent experience, which is held to be unknowable to the neurotypical other.
In this way, what might be understood as attempts to articulate the malaise of individualistic, alienated, and unembodied life end up doubling down on individualism and estrangement, leaving the conditions that produce suffering intact.
This contradiction is not incidental but a feature of liquid modernity, where distress is individualised, the self becomes the only acceptable site of explanation and identity is transformed from a given into a competitive task. As the German sociologist Ulrich Beck puts it, “how one lives becomes a biographical solution to systemic contradictions.”
Diagnosis holds out the promise of validating the individual’s experience and needs within a competitive marketplace of identities, opening up the language of disability and civil rights as a means to assert needs. This neuro-identitarianism has emerged in a broader ‘hyper-liberal’ cultural turn, which the philosopher John Gray argues has elevated self-defined identity to the point where politics is reduced to the affirmation of the self. Whether in the form of nativist ethnic nationalism on the right or the symbolic politics of representation on the left, the end effect is a fragmentation of public life into moralised contests among competing subjectivities rather than the pursuit of structural change and the common good.
This fragmentation has material consequences. In the UK, the cost of special educational needs provision is spiralling to unsustainable levels, as parents are pushed into an adversarial, bureaucratic fight against local authorities to secure support for their children. Meanwhile, the schools those children attend are at breaking point with oversized classes, exhausted teachers and universal provision stripped away by years of austerity.
Since 2012, the number of 16- to 24-year-olds claiming disability benefits has doubled to 400,000, with nearly half of that total now claiming for autism or ADHD. Diagnosis has become a sticking plaster; a route to state benefits that does nothing to address a dysfunctional labor market that fails to invest in young people and is dominated by precarious, low-paid work that in many areas fails to cover the cost of living.
Neuro-identitarianism is, in this sense, an expression of a broader pattern. As provision of basic needs — housing, health, education, employment — continues to atrophy, resistance increasingly takes an individualised, myopic form, dissipating collective pressure that might otherwise demand the system be fixed.
A sad irony is that those with the most profound needs — severely functionally impaired, often without the language to advocate for themselves — are increasingly marginalized in the din generated by neuro-influencers.
Neuro-identitarianism is an understandable response to the alienation of late capitalism. The pursuit of diagnosis reflects a human need to have one’s subjectivity recognized; a need only heightened in atomised, contactless societies where organic opportunities to be seen and understood are being eroded.
The tragedy of neuro-identitarianism, though, is that in creating special interest groups defined by difference, competing for recognition alongside other identity-based movements, it forecloses the possibility of broader solidarity. By denying common experience of an inhospitable world, it ends up estranging people from shared humanity; reproducing the very alienation it sets out to answer.
I would argue that you are not quite right and not quite wrong, either.
Autistic people are essentially the most sensitive members of the population, and less able to filter out extraneous information. The same overwhelming conditions that affect everyone affect us first and most severely, but they do also affect everyone else. It is just often possible for other people to be unaware of or ignore the effects. For example, the bright direct overhead lighting that gives me unignorable throbbing headaches definitely also effects everybody else’s stress levels and mood; they’re just unaware of it.
in a sensible world, we would recognize that these conditions are untenable generally and design around the needs of the most sensitive with the recognition that doing so serves everyone instead of placing the demand of providing proof of disability in the form of medical documentation on the most sensitive individuals. But alas, we do not live in a sensible world, and so the most sensitive have to make ourselves legible to medical systems that see us solely through the lens of deficit in order to have any hope of receiving assistance dealing with inhumane conditions that seen as neutral while we are seen as the problem.
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I agree. There are some extra sensitive people who CAN’T handle the oppressive conditions in school, for example, but that doesn’t make it any less oppressive for the average child. We should view such people as “canaries in the coal mine,” indicating that bad things are happening that are affecting EVERYONE, but that these kids are the ones who let us know when it’s beyond the pale. Instead, these kids are made to feel they are weird or different and the environment won’t adapt to them and they need to adapt to the environment. They have to be “diagnosed” as “disordered” before any changes can be made. This is simply ignoring the obvious – kids exist on a spectrum, and if the ones at the end can’t handle the stress, the others are being stressed as well but are simply better equipped to tolerate the oppressive conditions.
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Exactly! If we need a diagnosis to treat to *some* people better what does that say about how we treat everyone else? Working from the basic assumption that all people and children are sensitive and deserve consideration and respect as individuals is a much less complicated approach than labelling kids with spurious diagnoses before they have even had a chance to fully develop their brain and sense of self.
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“For example, the bright direct overhead lighting that gives me unignorable throbbing headaches definitely also effects everybody else’s stress levels and mood; they’re just unaware of it.”
This isn’t autism. That’s precisely what Frith meant.
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Brilliant piece, thank you
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Given your “handle,” I assume you are a psychiatrist. I’m interested how you found out about and got into reading MIA, and how it has changed your practice, if it has. What’s your take on the state of the DSM and psychiatry today?
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The article says and I cite; “Across neurodiversity blogs and social media posts, a remarkably uniform ‘neuro-actualisation’ script can be identified. It typically opens with a narrative of epistemic dispossession: the pre-diagnosed self is characterized by radical unknowing — of one’s needs, desires, and capacities — and experiences a persistent sense of inadequacy, of feeling overwhelmed, lonely, and persistently misunderstood.”
I suspect it’s easy to mistake that for people trying to figure out their true selves or so when one ignores or isn’t aware of the economic undercurrents which gave rise to that phenomenon in the first place.
By now, I reckon, it’s pretty obvious that we’re dealing here with a marketing scheme, something pushed by interest groups which, as it stands to reason, benefit directly via their investments in the whole disability market. I leave it at that, although there is definitely a significant identitarian component to it where political think tanks push for polarization and “particularization” of society via ever more questionable identity groups.
On another note, I would seriously doubt that people felt that kind of attraction to the autism label if they entered regular contact with residents of disability homes and similarly.
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Great read. Nice to see the sociological perspective being given some room.
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Overmedication is an issue – not because ADHD mediation etc does not help many people, but because it is being treated as a universal panacea, and other approaches deprecated. Thank you for raising this.
But narratives that foster clinical gaslighting or the misattribution of symptoms are not the answer, especially given so many neurodivergent people also have co-morbid health conditions and functional / somatic issues affecting their ability to navigate the world and thrive.
Addressing these health conditions and issues helps hugely, which can lead to people appearing cured – no longer ADHD and Autistic. But that is as much to do with the diagnosis being deficit based as anything esles.
When health conditions are cured or put into remission -the neurotype will however remain, with both positive and negative implications.
Even though the negative may be reduced, these people are still different, and navigate the world and their own experiences in ways that do not fit the norm. We should not be fitting square pegs into round holes – that will perpetuate the trauma and stress, or even compound it.
In summary, you are right to be concerned, however the risk is under diagnosis and incomplete diagnosis- and not over.
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Yes, these diagnosis inhibit class consciouness forming.
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I think the rise of trans as a popular but controversial diagnosis with its attendent shrill political movements on both sides needs also to be considered here.
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“Trans” is not a diagnosis.
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It actually used to be a diagnosis, but has been removed from the DSM.
I think John Hoggett meant to say that the transgender identity is yet another identity in the “competitive marketplace of identities” as the author stated in the article, and that it has something to do with this neurodivergent discussion.
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This is the real difference between the critical psychiatric survivor movement and the neurodivergent movement. Neuro ideology aims simply to rearrange the hierarchy of “differences” while keeping the psychopathology paradigm intact. Because neurodivergence is literally unthinkable without the imaginary construction of the “neurotypical” Other, and unthinkable outside the psychiatric paradigm of fixed inherent brain differences.
While neuro ideology vainly tries to separate the “pathology” from a supposed medical science (which is defined by pathologies), many critical psych survivors understand that so-called psychopathologies are not based on any inherent existing “differences”, but on actions of power which arbitrarily define and code differences into fixed diagnoses (and identities).
Many critics have pointed out that the structural and systemic function of psychiatry is not care or medicine -but control – control through redefining social problems as individual problems – blaming individual biology or psychology or individual “differences” for social and political failures. Failures which affect everyone – even if they aren’t aware of them – becuse they are obscured and hidden by the false individualising narratives of psychiatry and others, like the current neurodivergence narrative.
Most psych survivors know that anyone can be labelled “mad” or “mentally ill”, because there is no ontological basis to psychiatric labels. Unfortunately, neuro ideology and even some Mad ideology, clings to the unfounded ontologies of difference which underpin psychiatry’s power and status. Until we deconstruct this structural base of psychiatric power – the power to code difference into social and legal hierarchies – based on false claims to knowledge – there will always be another group, another negative term, another outside the inside of authority and recognition to be reclaimed – or, like the imaginary “neurotypical” – to be vilified and Othered outside the coded hierarchy of acceptable “difference” and identities. Identity is always socially mediated, coded and constructed. Real difference and diversity is a fact of life and outside the codes of power. Rearranging values in hierarchies of difference doesn’t challenge the hierarchy itself- or the power behind it – it flattens human difference into codified classes to be manipulated and rearranged by those with the most power and the loudest voices.
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Thanks for these insightful reflections Freya!
“neurodivergence is literally unthinkable without the imaginary construction of the “neurotypical” Other, and unthinkable outside the psychiatric paradigm of fixed inherent brain differences.”
Exactly this – neuro-identitarianism could be understood as an attempt to reshuffle who sits where in psychiatry’s hierarchy of difference, leaving intact the power structure that pathologises human variation.
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Thanks Joe, I really liked the connections you made to the idea of alienation too. I’ve been reading Todd McGowan Embracing Alienation, about how Identities are an attempt to escape alienation. It seems to me that Identitarian movements are often seeking a return to imaginary wholeness and belonging which they assume is in the power of the Other to give, rather than recognising alienation as a condition we all experience, perhaps.
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I just finished reading a great book, NeuroTribes by Steve Silberman, about the history of Asperger’s/autism, and it is fascinating. With regard to neurodivergence needing to define itself in opposition to neurotypicality- one of my favorite things that stood out in the book was the description of an autism community online in the early 200s which created a satirical description of recognizing and diagnosing “Neurotypical Syndrome ” or “Allistic Spectrum Disorder”, with symptoms such as, obsession with superficial conversation, lack of sensory sensitivity, debilitating fear of non-conformity, rigid adherence to social rules etc.
I feel like people are inclined to default to these diagnostic and personal identity focused explanations because it is a cultural norm, and people simply lack the access, cognitive resources, life experiences, educational outlets, or willpower to completely upend the way they are used to thinking of differences. I think all of us who are critical of psychiatry and the mental illness framework may sometimes forget how long and circuitous a process it may have been to get to the point that we are now able to recognize the social forces, rather than individual pathology, that are the root of difference and distress. For myself it was a decades long process with a lot of back and forth of believing in psychiatry and then turning away from it, on both a personal and professional level (as a social services worker/ pre licensed therapist ).
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I often wonder if the “neurotypical” person is simply someone who has been properly cowed into behaving as society expects them to?
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Thanks Katie, I identify very much with what you say. It has taken me years to escape the power of that hegemonic narrative over my own identity. And it’s always an ongoing process, when it’s so embedded in our language and culture.
Perhaps that is why some psychiatric survivors might not be eager to embrace another would-be hegemonic (sorry, “paradigmatic” !) interpretion of our experiences?
And an equallly normative ideology (just different norms)!
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Steve, I agree – there is no way to judge anyone’s experience through arbitrarily imposed superficial behavioural and psychological concepts, which are equally as normative (and coercive) as any psychiatric diagnosis. The concept of neurodivergence actually depends on ‘pathologising’ others – (as “neurotypical” or “neuronormative” or whatever the current terminology.)
If the choice is between calling yourself neurodivergent or being labelled (pathologically?) uncaring and inherently oppressive – i question how liberating that ideology can really be.
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Presumably you’ve the 4 part series on neurodiversity by John Cromby and me (Lucy Johnstone) published on MITUK and MIA? It makes similar points.
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I for one have definitely read the series and appreciated it and I think I commented on it. My comments are mostly venting – I expect that last one was a bit incomprehensible :D.
I agree the points here are very much the same as that series which was a really comprehensive and much need analysis . I especially appreciated the way you drew out the implications of neuro ideology in the way it further marginalises people with severe disability as well as marginalises the experiences and rights of psychiatric survivors who have been fighting for awareness for so long.
I think those points can never be made too often I guess, when some neurodivergent advocates are trying to claim the epistemic ground from psych survivors and critics – distorting survivor views and experiences as well as blatantly misrepresenting critical psychiatry knowledge.
I just hope more people will recognise that psych survivor interests are not the same- are actually diametrically opposed by neuro ideology – which , despite it’s pseudo-“radical” language, is in complete lockstep with the status quo of psychiatric dominance and has no real understanding of the violent reality of psychiatry which is premised on the same unproven neuro ideology.
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Thanks Freya – my comment was directed at Joe Cottrell Boyce, not you! I agree we need a number of different attempts to challenge aspects of the ND narrative. I’m guessing Joe isn’t a regular MIA or MITUK reader and hadn’t seen the earlier series.
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Hello Lucy, thank you for taking the time to read my article! I certainly read your comprehensive series a few years back and thought it was an excellent, rigorous rebuttal of Chapman’s “neurodivergent Marxism” (which has nothing to do with Marx) and an important warning against the rebranding of pathologising diagnoses as ‘neurotypes.’
My article was a modest attempt to add to the conversation started by you and others on MiA from a slightly different angle — more focused on the specific concept of alienation, within broader critiques of neoliberalism you and others have made, and grounded in a more sociological perspective. I think theorists like Bauman and Beck, less commonly discussed on MiA, have useful insights to offer to the important discussions on this site.
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Thanks, Joe, and yes, I can see how relevant the concept of alienation is. I am glad we are starting to be able to have these conversations. For a long time it has felt like a taboo – and indeed, questioners and dissenters have been targeted quite brutally. That in itself is a very worrying sign. Two colleagues of mine have started a podcast ‘Let’s talk Neurosense’ in which they open up discussions with people from all perspectives – an achievement in itself.
https://podcasts.apple.com/gb/podcast/lets-talk-neurosense-the-psychology-of-neurodiversity/id1883007944
Part of the problem is that people mean such different things by ‘neurodiversity.’ This topic comes up on the Facebook group ‘Drop the Disorder!’ where people who have signed up on the explicit understanding that the site is for those who want a change to the diagnostic paradigm, often seem completely taken aback when anyone challenges the diagnosis of ‘ADHD’ – or the concept of neurodiversity itself. It has somehow managed to sneak in through the back door by claiming to be a ‘neurodevelopmental disorder.’ I find this very odd indeed.
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I so completely agree! We need to lose the “neuro” and just call it being “diverse.” I am sure I fit the “neurodiversity” paradigm but I’d much rather just be thought of as “diverse.” Or even just “weird.” I don’t want to be labeled based on some assumed neurological distinction that no one has ever shown really exists. It’s a subtle back-door opening to more discrimination. It’s not a question of who qualifies as “diverse,” it’s a question of why it’s OK to discriminate against ANY people just because they are who they are!
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We are collectively having different conversations. I’m familiar with this entire body of sociological theory and can see what you’re arguing. But I am also familiar with thinkers who have offered much richer and deeper analyses of what neurodivergence as a paradigm is doing.
I wonder if you have engaged with Bayo Akomolafe’s work (“These Wilds Beyond Our Fences” is a truly brilliant letter to his autistic daughter)? Or Janae Elisabeth (aka Trauma Geek)? Their work is deeply rigorous and resonates potently for me. Or Nick Walker (who was the author who helped me understand the ND paradigm shift – they are one of the paradigm’s key thinkers, NOT Uta Frith, who is not thinking within the ND paradigm, but replicating an older pathology paradigm)? I could list more but they all deserve careful reading.
I recognise there are many of us in the world of critiquing the medical model and building alternative ways of thinking and relating through distress and extreme states who have very different relationships with the emerging neurodiversity/neurodivergent paradigm. I guess I’m just saying we are not actually arguing what you think we are! And yes, colonial capitalism has grabbed onto ND analyses for its own replication. But that’s what it does to ALL alternative paradigms (like offering us Frida Kahlo jigsaw puzzles, when she would’ve turned in her grave at such capitalist drivel. And yet I love my Frida Kahlo merch. We are entangled in capitalism, it’s not a thin story).
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I would argue the (conceptually expanded) ND paradigm trades on unproven claims about “neuro” difference while operating at a cultural and identity level. It displaces the medical model rhetorically, but retains a positivist premise—that there is a stable, underlying neurological distinction—without providing clear, falsifiable evidence for it.
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The ND paradigm is neither positivist nor unable to offer clear, falsifiable evidence (which, I note is also an incredibly perverse intellectual demand on your part – essentially a demand that proponents of the ND paradigm simultaneous demonstrate that it’s not positivist, and also that it can conform to positivist standards of evidence. Thankfully, it’s rigorous enough to respond to both accusations).
In terms of the “neuro” part, I would encourage readers to engage with Janae Elisabeth’s work on the vagus system. It offers incredibly rich scientific analyses, paired with an incredibly rich theoretical critique of normativity. Essentially, it argues that human variation is real, and patterned, and that colonial capitalism rewards certain forms of human variation. It’s not that people are essentially ND or NT, but that we do vary, and under certain sociopolitical conditions that variation is understood through a deficit lens.
And the ND paradigm is as from positivism as I’ve ever experienced an intellectual body of work! (Ok. Maybe if I paused I could think of others, but it’s incredibly far from positivism). The ND paradigm recognises that neuronormativity is intimately constructed and maintained by capitalism, patriarchy, heteronormativity and the entangled products of colonial binary thinking.
I reiterate, I wish folks would actually engage with the depth and rigor of ND thinking instead of these shallow inaccurate characterizations.
I actually struggle to understand why folks are so committed to critiquing a paradigm without actually understanding its logic. It’s a form of epistemic injustice, in my opinion – the ND paradigm was theorized in autistic community. To be attacked like this by folks who I would’ve thought were our intellectual and political allies is troubling. I honestly can’t recommend more highly folks actually engage with the thinking – it’s delightfully potent and rigorous!
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Vagus theory debunked on this site
https://www.madinamerica.com/2026/05/your-vagus-nerve-is-not-in-control-the-problem-with-polyvagal-theory/
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Flick, this is one of the few spaces where critical perspectives of psychiatric survivors and advocates can be shared and discussed freely and seriously. I would hate to see this vital function shut down through the kind of misuse of terms like epistemic injustice I suggest you are making here.
To claim that simple disagreement with your beliefs is a form of injustice is very harmful in my opinion. In your usage, epistemic injustice can be applied to any situation in which our beliefs are challenged. This is a trivialisation of the concept of injustice.
Preventing the discussion of ideas in the name of “justice” for one group is exactly why identitarian ideologies like ND are problematic. I suggest this kind of usage of the idea of epistemic injustice does not actually support the sharing of alternatives, it suppresses important debate.
I would argue, that psychiatric and institutional power, in fact, overwhelmingly supports neurodivergent ideology including substantial academic advocacy, economic influence, huge popular uptake, as well uptake by specialist discourses like psychology. I suggest this is because it does not threaten the dominant psy-industry narratives. Whereas critical views which threaten psychiatric dominance are demonstrably suppressed, discredited and silenced in public discourse.
People subject to psychiatric power depend on access to critical thinking and ideas to demystify the effects of a psychiatric ideology which often binds them in false and degraded identities, as well as life-destroying mis-treatments. We don’t have to agree with them, any more than someone with a diagnosis of ADHD or Autism has to believe in ND ideology. But we have right to discuss them openly and to be challenged on them equally.
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Flick, you have referred to this “alternative” ( and somewhat hermetic), neurodivergent knowledge before, however I would like to see the ideas actually spelled out one day. I sometimes think there is an aversion to real debate in neurodivergent ideology? Unfortunately this can look very authoritarian, and can end up cultivating its own exceptionalism through imaginary opposition. How would anyone know?
If you decline to explain how the neurodivergent paradigm differs from the psychiatric biomedical paradigm it’s impossible to know what you are actually saying or what alternative you are actually advocating?
I have read a lot of the people you reference and am not any the wiser. Their ideas seem to be founded on linguistic mystifications – massive generalisations based on very scant, selective cherry-picked “evidence” Politically, their ideas are exactly as this article describes – a retreat into simplistic binaries of good and evil, lacking any structural analysis of how difference is constructed and classed except by an appeal to some unproven innate “differences” which seem to cover the entire range of human experience and behaviour. This kind of politics is just us v them – it’s entirely dependent on the reification of simplistic psychological differences into fixed essentialist identities – with extremely morally coercive overtones.
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Thanks for your thought-provoking article Joe. Since you’ve seen the series that Lucy Johnstone and I published, I imagine you’ve also seen John Hoggett’s MiTUK article on neurodiversity from a few months ago. Like you, JH talked about alienation and I found his arguments compelling and informative, as are yours.
At the same time I feel they could usefully go further. Specifically, some psychological nuance and differentiation would be helpful if we are to use these ideas to understand the distress upon which neurodiversity is parasitic. But if we turn to history, two obstacles quickly become apparent.
First, modern psychology is usually said to have begun in 1879 when Wundt opened the first laboratory. Obviously, it then took some years to establish an entire discipline. But Marx’s concept of alienation was formulated in 1844: long before a nascent psychological science could be mined for theories, methods or findings. Marx couldn’t draw on modern psychology when he wrote about alienation because it didn’t yet exist.
Second, the emergence of anarchism as a distinct movement is usually traced (slightly arbitrarily) to the 1871 meeting of the First International. Simplifying greatly, for Marx politics is most fundamentally about economics. But for anarchists, whose perspective was forged in the same class struggles, politics is most fundamentally about power. This distinction still holds even today: radical economic analyses are most often labelled as Marxist, and radical analyses of power as anarchistic.
So the concept of alienation emerged before Wundt set up his laboratory, and before anarchists elaborated their analyses of power. The Marxist concept of alienation is not informed by modern psychology, nor by analyses of power.
This second point matters because the psychological effects of power can be differentiated and nuanced in ways that appear difficult for a concept of alienation rooted in a mode of production. For example, the ‘Power Threat Meaning Framework’ (PTMF: Johnstone & Boyle, 2018) divides power into multiple forms that include financial, legal, coercive, embodied, social capital, cultural capital and ideological powers. Since these vary in influence, flexibility, reach and subtlety, each has different psychological implications. This insight seems especially useful given the massive changes that capitalism has undergone since 1844.
In short: analyses of alienation are vital and informative. But as anarchist analyses and the PTMF both illustrate, elaborating alienation in conjunction with the effects of power might be even more useful.
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I am not disagreeing that power is more than economics, the epidemiology of distress shows that to be true, eg Read and Bentalls work on adverse childhood experiences and psychosis. However the major change since the explosion in nuerodiversity diagnosis happened as major changes in the economy happened.
The anarchy argument reocured with the New Left which bought us second wave feminism, the civil rights movement, the Gay Liberation Front, anti colonialism and Black Power. These regressed into Rainbow Capitalism and Critical Social Justice with its shrill, more right on than thou attitudes while class politics are sidelined. As capital tuned away from Diversity, Equity and Inclusion “Nuerodiversity,” is now taking over in the acadamy from Critical Social Justice and as a marketable commodity.
https://www.madintheuk.com/2026/04/a-tale-of-two-ideologies-part-ii-critical-social-justice-and-neurodiversity/
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Many thanks John. Likewise I’m not disagreeing that the proliferation of identities has damaged class politics and obscured the effects of economic and material forces. I mentioned the Marxism/anarchism divide, not to reinforce it, more to suggest that perhaps now – 150 years after it became a problem – we might be able to begin moving beyond it. Specifically, I was wondering if alienation could be described with respect to different modes and distributions of power, as well as with respect to economic factors.
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Many thanks John. Likewise I’m not disagreeing that the proliferation of identities has damaged class politics and obscured the effects of economic and material forces. I mentioned the Marxism/anarchism divide, not to reinforce it, more to suggest that perhaps now – 150 years after it became a problem – we might be able to begin moving beyond it. Specifically, I was wondering if alienation could be described with respect to different modes and distributions of power, as well as with respect to economic factors.
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Thanks John and John for these thought provoking responses, which I probably won’t do justice to in this rushed reply…
I agree a more granular analysis of power enriches what is an admittedly wide-angle argument. I think the PTMF is transformative in making visible the effects of power on lived experience. And agree on value of anarchist thought; Bakunin more clearly engaged with alienation as inseparable from oppressive power.
I enjoyed John H’s piece and agree that neurodiverse diagnoses can function as a technology to pacify those who fare worst. But I do think the neuro discourse is more pervasive than this. And I think this highlights the shift in experience from productive to consumer capitalism.
Power is central to all of this. When human agency and relationships become subservient to our function as consumers, that is disempowerment in the most basic sense. As Bauman points out, the technology of power has shifted — from the panopticon to the synopticon; all watching all. The alienation this produces isn’t only visited on those in most acute material distress.
On the conceptual genealogy both Marx and the psychological discipline share a deep Aristotelian inheritance — ideas about what it means to be human, about the conditions under which distinctly human capacities are realised or foreclosed. This is key, as the contemporary malaise is fundamentally dehumanising.
I suppose the point I’m trying to stress is that the dehumanisation of late capitalism is more insidious than its most acute manifestations — this isn’t only about the production of distress but alienation from the full range of human experience.
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“shift in experience from productive to consumer capitalism.” Intetesting point, it echoes Timimi seeing psyche diagnosis as brands.
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The alienation of society and self so well described here is, like all things Marx addressed, rooted in material conditions of our lives. We live like slaves because we are alienated from abilities to maintain our lives apart from capitalist control. We work to reproduce conditions of our survival and well-being, yet the means of production are owned by the few who deny these conditions for the many as mere resources of profit and power. Ruling institutions of modernity still oppress us as surely as ancient and feudal predecessors did under divine authority and royal blood lines, only now enforcing ideological illusions of freedom and democracy, enlightenment and progress, to hide in plain sight a constant class war of “creative destruction” (Joseph Schumpeter) for wealth to be gained by the few at the expense of the many.
Among modern ruling institutions, medicine has become the biggest bizzness racket of all in the U$, exceeding even the military industrial complex, with which it is routinely aligned, as with weaponized biotech and chemical warfare. The miracle of modern medicine is that it’s gotten away with so much mass murder itself as humanitarian health care, beginning with its eugenicist origin among robber barons like the Rockefellers. Not just psychiatry but all of Health Care, Inc. rests on fraudulent marketing of snake oil synthetics replacing natural healing for a permanent customer base of human lab rats, more like prisoners than patients of expertise monopolized by a priestly caste practicing superstitions of germs and genes as causes of illness while we sink deeper in the toxic social ecology of industrial capital.
Science has replaced religion as the opiate of the masses. Its (fascist) corporate state control is central to engineering the techno-barbarism of modern civilization. Biotech like vaccines, pumping a plethora of poisons into people without their informed consent and in violation of their autonomy, rests on never proven theory of pathogenic viruses and prevention. Yet as one of the pharmafia’s primary money-makers its market expansion has consistently correlated with increasing diseases, or iatrogenic harm, like ‘autism’. Don’t look for any real search for the truth in this case and others from bought and paid for liars who rig research for profit and power. They’re out to hoodwink victims with more make-believe like ‘neurodiversity’ to once again turn human suffering into their gain. It’s about keeping us sick so they can get richer.
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I have to agree – neurodiversity is also big business. The medicalisation of every inch our lives is enthusiastically supported by an explosion of traditional and alternative health “solutions”. I see the explosion of so-called “neurodevelopmental disorders” as closely related to this too. Commodification has always been the capitalist “solution” to alienation – we are just being sold more imaginary solutions and identities as inequality and precarity intensifies – it’s all part of the same neoliberal capitalist logic.
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Thanks Lucy — it really worries me how increasingly difficult it is to express any scepticism about the neurodiversity paradigm. In CAMHS and social care it’s become the first explanation reached for, even where contextual and relational dynamics are clear.
It’s also strange that neurodiversity is treated as somehow separate from the wider diagnostic paradigm — particularly as ADHD is directly tied to a medication boom. It makes me genuinely sad to see the refrain online from people starting stimulants: “is this what normal feels like?” — as if emotional blunting and tunnel vision were the authentic human condition rather than its suppression.
I’ve listened to the podcast — really impressive to have created space for dialogue on such a polarised subject.
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Mea Culpa. I coined and developed the term “Neurodiversity”. I am a sociologist, not a diagnostician. While my work is based in the “Social Model of Disabilty” I advocate for taking on the best of both the above and the “Psycho-Medical Model”. You will be aware of the dialectical process of change: Thesis – Antithesis – Synthesis. When the “antithesis” comes from different paradigms, yours and mine, we need to get on the same page if we want to communicate. You may be aware of Communications Theory: the message sent may not be the message received, particularly if the sender and receiver are not operating within the same paradigm/model. Was there ever an idea that didn’t divide people? I am confident we can find that common ground. In the meantime, you or anyone else interested can see my discussion on this on my website below.
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I forgot to add, that while Neurodiversity is Big Business, I am living at the bottom income percentile, actually subsisting on the Australian Age Pension and some meagre royalties from my book. It seems to be a common trope that inventors live in poverty, while entrepreneurial types harness the profits from their inventions. And I put it to you that it may be because so many inventors are autistics, and entrepreneurs are the opposite.
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It just occurred to me to add, Joe, that the proliferation of medical labels is an artifact of the Welfare State. Its distinctions between the “Worthy Poor” and the “Unworthy Poor” are still as relevant as they were during the era of the Industrial Revolution and the Workhouse. As you mentioned Marx, you will know that our economic system depends on a reserve labor of the unemployed to function efficiently, including to frighten the population into accepting unfair conditions. Thus we have given more power to the psychomedical professions
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PS. Many years ago, I gave a presentation on what I called “The Commodification of Neurodiversity”. I must see if I can dig it out and post it
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Spot on. All that reading and getting nowhere, ultimately finding it’s meaningless gibberish. Might as well persue something real.
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