Neurodiversity – The Opium of the People
“There is, perhaps, no better established fact in British society than that of the corresponding growth of modern wealth and pauperism. Curiously enough, the same law seems to hold good with respect to lunacy. The increase of lunacy in Great Britain has kept pace with the increase of exports, and has outstripped the increase of population.” Karl Marx in the New York Daily Tribune 1858. (1)
Over the last fifteen years I have seen the rise of neurodiversity, and of ADHD and autism diagnoses. I have seen friends and acquaintances talk in person and on Facebook about their recent diagnosis, first of their children, now of themselves. I was gob smacked and amazed at my friends’ naivety. Then I openly mocked the concepts of ADHD, autism and neurodiversity on Facebook. I lost Facebook friends and perhaps real friends when I questioned the validity of these diagnoses, and it did not matter how politely I did this.
I stood my ground and now, in this blog, I am exploring why the concept of neurodiversity took off.
In about 1992 I started investigating psychiatry. I bought Peter Breggin’s book, Toxic Psychiatry (2). In the book he takes apart both psychiatric diagnosis and drug-based treatments. He shows that psychiatric drugs are harmful and often difficult to come off. He also shows that if you put the effort in, most people’s distress is understandable without any diagnosis and often ameliorated with sympathetic understanding. I have often seen both assertions to be true.
In Toxic Psychiatry, Breggin writes about ADHD and Ritalin. He says Ritalin is dangerous and that the diagnosis has no validity. Instead, it distracts from looking at the causes of distress in children’s lives. He presents a case history of a child who has a diagnosis of ADHD and suggests what the boy is really suffering from is DADD, Dad Attention Deficit Disorder, and that the mother is suffering from HADD, Husband Attention Deficit Disorder. He provides a psychosocial explanation of the child’s distress rather than a medical one. I was reading this before ADHD became a widespread term in the UK, so when it took off here, my understanding was very different from people who accepted the diagnosis.
I have read other sources on ADHD that echo Breggin’s ideas (3) (4), including the blogs on this site by Cromby and Johnstone (5). I am particularly impressed, but also distressed, by the long-term outcome studies which show stimulants such as Ritalin in children cause worse behavioural problems, worse educational outcomes and worse physical outcomes than for children who have similar problems but are not medicated (6). I find it hard to imagine that the long-term outcomes in adults will be different.
Getting a diagnosis of autism or ADHD can often be reassuring. In much the same way as when you see a homeopath or other complementary healer, they ask you lots of questions about yourself, pay close attention and then come up with a remedy that matches your “symptoms.” I once saw a homeopath after developing chronic fatigue following on from a very bad cold that developed after a relationship break up. I also went to a large group therapy event straight after seeing the homeopath and my fatigue went away. It was amazing but almost certainly placebo.
Being recognised for who we are and what we have struggled with is important and can sometimes be all we need to turn our lives around, and a good homeopath can provide that. An assessment for ADHD or autism can also do that, but so can a good counsellor or good friend. Good friends, homeopaths and counsellors hopefully do not tell us we have a lifelong condition that can’t be cured but rather, can be managed, and neither do they prescribe damaging drugs.
The concept of neurodiversity is based on very weak science. The “neuro” bit is contested, the brain science is weak and inconsistent, and no one’s brains are scanned or tested when people get diagnosed. It is a triumph of marketing over medicine (7).
Why, then, as a society, have we fallen for the myth of neurodiversity and mass prescribing of stimulants? I turn to politics and economics for an answer.
The political and economic context of psychiatric diagnosis and treatments
As society changes psychiatry also changes.
In the 1970s the post-war boom was over. We had full employment, strong unions and inflation which led to massive strike waves (the Winter of Discontent in the UK), rapid changes in government and the UK going to the World Bank for a loan. In 1979 Margaret Thatcher was elected Prime Minister in the UK and Ronald Reagan was elected US president in 1980. They ushered in a new form of capitalism, neoliberalism, though it had already been pioneered by James Callaghan, Prime Minister before Margaret Thatcher, and Jimmy Carter, US president before Ronald Reagan. They broke the unions, sold off public assets to create new investment opportunities and deregulated the banking sector. Manufacturing started to leave the UK, and relocated in the Far East, particularly China, because manufacturing is cheaper there – the consequences were a massive rise in unemployment.
Two psychologists, David Smail and Dorothy Rowe, noted that they had an increase in clients in the 80s as both industry and the state sector restructured. Both these psychologists wrote that it was important to include the political context in their conversations with their clients so that instead of blaming themselves, the clients could see their misery as the outcome of impersonal economic forces.
In 1987 Prozac was launched onto the market. Prozac was a new type of antidepressant, an SSRI, a Selective Serotonin Reuptake Inhibitor. Other similar drugs followed. The myth of the serotonin theory of depression was thought up in some drug company marketing department. That myth was repeatedly debunked but no one was listening and it became ubiquitous (8). SSRI’s main effect is to numb emotion. These drugs can be hard to come off, it may double the suicide rate, and can numb the sex organs, sometimes permanently (9).
Bruce Cohen, a socialist commentator on health, thinks that in the 1970s there was a battle between capital and labour, in which labour lost. Prozac was a useful tool which ‘cooled’ the losers, ie the main effect of the diagnosis of depression was to stop people thinking about how they had been harmed as neoliberalism took hold, and that the drug anaesthetised them to their suffering.
Now about one in six in the UK are taking antidepressants, yet they have been shown to be only slightly more effective than placebo (11). There are an awful lot of losers.
There have been even more ‘losers’ since the 1980s. In 2008 we had a banking crash that rivalled the 1929 Wall Street Crash. Wages were low but business needed so sell, and deregulation of the banking sector allowed people to live on credit. Eventually the poor couldn’t pay back the loans on what were euphemistically called ‘Subprime Mortgages’. Big banks went bust, governments took out massive loans to bail out banks, the poor were evicted.
After the crash and the so-called Credit Crisis, global capital needed to restructure. The state cut back welfare services, and homelessness increased, as did zero-hours contracts. The benefits system was changed to become a system of ritual humiliation, designed to encourage the poor to accept low wages and poor working conditions, and increasing numbers of women turned to sex work to pay the bills (12). The era of post neoliberalism is emerging, spearheaded by Trump’s tariffs.
The education budget was also cut after 2008 and the education system became more authoritarian with more targets, less autonomy for teachers, strict discipline codes for pupils and increased privatisation via the academies. Academies like to employ young teachers because they are cheaper than experienced ones, but they have often not learnt classroom control skills. Afternoon break has been eliminated in many secondary schools, and sometimes lunch break is only half an hour, so children have no time to socialise and de-stress between lessons. Parents use apps which tell them the homework the children need to do, in addition to any disciplinary measures taken against the child. There is no escape from school discipline even when the children go home.
It is easier to refer a child who is struggling with school for a mental health assessment than for the school to get to know the child and adapt teaching to the child’s needs. I think neurodiversity, ADHD and autism diagnosis are ways of ignoring children’s needs and the psychosocial causes of their distress. Children I know who have this diagnosis have obvious challenges: divorce and battling parents, fathers with drug problems, parents who have experienced a variety of challenges such as early loss of their own parent, child sexual assault and family violence and unresolved family conflicts – all of which could affect their ability to parent their own children. Possibly, underfunded schools rely on this diagnosis to get extra money, perhaps because they lack the time and resources to get to know their students and make provision for what they need.
To summarise, I think the spread of the concept of neurodiversity in adults after the 2008 crash is another way of ‘cooling the losers’ while the economy restructures. Since 2015, politics has been dominated by culture wars including Black Lives Matter, Me Too and now controversies about transgenderism. They flare up, die and achieve little. The left has almost completely ignored the working class. In such circumstances antidepressants and neurodiversity provide a degree of solace in this increasingly harsh world, just as gin and laudanum did in Victorian England.
WHAT IS OUR HISTORY – WHERE DO WE FROM HERE?
Psychiatry has been criticised as long as it has existed. In 1845 the Alleged Lunatics Friends Society was formed (13). Their complaints were similar to those made by modern psychiatric survivors: false imprisonment, harsh treatment and a diagnostic system that made no sense. There have always been humanitarian alternatives to psychiatry such as the York Retreat started by a Quaker family, the Tukes, in 1796 as a reaction to a Quaker dying in York Asylum due to brutal treatment (14). Karl Marx in an article in the New York Daily Tribune in 1858 about psychiatry wrote, “There is, perhaps, no better-established fact in British society than that of the corresponding growth of modern wealth and pauperism. Curiously enough, the same law seems to hold good with respect to lunacy. The increase of lunacy in Great Britain has kept pace with the increase of exports, and has outstripped the increase of population.” (1)
The height of the critical psychiatry movement was in Italy in the 1960s – 1970s where psychiatrist Franco Basaglia spearheaded a movement that eventually closed most of the asylums in Italy and successfully instigated community psychiatric institutions where forced treatment hardly exists (15). Basaglia was riding on the radicalism of the 60s New Left and he had support from a strong left in Italy. The New Left were about politicising the margins: the civil rights movement in the USA, second wave feminism, gay rights, anti-colonialism and it included anti-psychiatry. The New Left, 50s – 70s, were a reaction to the Old Left, 30s – 50s which was Stalinism, a belief in socialism in one country enforced by brutal regimes. Soviet psychiatry was brutal and repressive; dissidents were locked up and forcibly drugged with major tranquilizers.
Stalinism was a reaction to the failure of the Second International which formed in 1889 and which believed in working towards socialist revolutions in the core capitalist countries. (15) The Russian revolution of 1917 was the height of working-class organization but quickly followed by the failed German revolution at the end of the first world war (17). That failed revolution in Germany left Russia isolated which is why Stalinism developed, but socialism in one country was never going to last, capitalism is international and socialism needs to be too, for it to survive. The history of the 20th century is about the failure of the socialist movement that culminated in the crushing of the revolution in Germany.
The left regressed during the twentieth century, and we are left with just a remnant of the critical psychiatry/survivor movement. It has been well researched but achieves little.
My conclusion is that psychiatry is intimately tied up with capitalism and that a successful critical psychiatry/survivor movement might well depend on a renewed proletarian movement for socialism. A strong socialist movement offers real support to people who are struggling which makes it less likely that they will turn to damaging services and could also educate people about the dangers of traditional psychiatry. More economically equal countries use their psychiatric services less, with smaller numbers of both voluntary patients and those who are forced to use them. Economic equality depends on how well organised the working class are. The left is almost dead (18), but in a few places, seeds of working-class solidarity exist. I point to the Campaign for a Socialist Party in the USA (19) (20), which has organised renters unions, resistance to ICE and various mutual aid projects in various cities in the USA and its associated organisation, the KSP in Germany (21), the Class Work Project in the UK (22) and D Hunter’s reports on working class mutual aid on estates in the UK (23) -all examples of working-class solidarity. I think critical psychiatry and survivor movements can be a crucial part of this. Whether these projects grow into real and powerful movements only time will tell.
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Mad in the UK hosts blogs by a diverse group of writers. The opinions expressed are the writers’ own.
- https://www.marxists.org/archive/marx/works/1858/08/20.htm
- https://harpercollins.co.uk/products/toxic-psychiatry-peter-breggin?variant=32552342487118
- https://www.madintheuk.com/2020/11/insane-medicine-chapter-3-the-manufacture-of-attention-deficit-hyperactivity-disorder-adhd-part-1/
- https://www.worldscientific.com/worldscibooks/10.1142/12752?srsltid=AfmBOoq-EeIDyPDk3iHiRbrx01_mOBXg2rBnxCVlHATxJAuJWHLedXM5#t=aboutBook
- https://www.madintheuk.com/2024/12/part-1-neurodiversity-what-exactly-does-it-mean/
- https://www.madintheuk.com/2020/11/insane-medicine-chapter-3-the-manufacture-of-adhd-part-2/
- https://research.birmingham.ac.uk/en/publications/the-problem-with-neurodiversity/
- https://www.nature.com/articles/s41380-022-01661-0
- https://www.madinamerica.com/2023/05/critical-psychiatry-textbook-chapter-8-part-one/
- https://www.madinamerica.com/2017/03/psychiatric-hegemony-marxist-theory-mental-illness/
- https://pharmaceutical-journal.com/article/news/antidepressant- prescribing-increases-by-35-in-six-years
- https://www.theguardian.com/commentisfree/2019/oct/26/a-welfare-system-that-drives-mothers-into-prostitution-is-not-a-safety-net
- https://en.wikipedia.org/wiki/Alleged_Lunatics%27_Friend_Society
- https://en.wikipedia.org/wiki/The_Retreat
- https://www.versobooks.com/en-gb/products/79-the-man-who-closed-the-asylums?srsltid=AfmBOopUKrnyh9DlOdBqGJwslGZhrV5t-aHc9jeICHC3bTTA-niHPJ-i
- https://en.wikipedia.org/wiki/Second_International
- https://www.youtube.com/watch?v=qFLDv4NO8xE
- https://platypus1917.org/about/the-left-is-dead-long-live-the-left/
- https://www.sublationmag.com/post/socialist-unity
- https://campaignforasocialistparty.substack.com/
- https://kampagnesozialistischepartei.de/
- https://theclassworkproject.com/about-us/
- https://dhunterorganising.substack.com/
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