Blackness x Neurodiversity X: Let’s Move Beyond the Myopia of “Narcissism”
by: Kay Salvatore (They/He) — autistic afro-realist, INTJ, 8w7w9, screenwriter sans representation.
The grip that “narcissism” has on the world is harmful to both allistic people and autistic people, and is leading us to nothing but ruin.
I say this because of the fact that “mental illnesses” (which includes “personality disorders”) are not biological illnesses, and no scientific evidence supports the idea that they are. “Mental illnesses” are social constructs used to maintain social order, and condition us to be obedient, “productive” members of society.
Despite decades of intensive research, there is still no conclusive evidence that enables any of the major categories of mental disorder, including schizophrenia, depression, anxiety and attention-deficit hyperactivity disorder (ADHD), to be considered a neurological condition in this way. The fact that there are some subtle group differences between people with some diagnoses and ‘normal controls’ in aspects of brain structure or function does not demonstrate the presence of a neurological disease. None of the findings are sufficiently specific or capable of differentiating between a person who is thought to have a particular mental disorder and one who is not.
Diagnosis is still made on the basis of behaviour, thoughts and feelings that are reported by the individual or those around them and that depend, of course, on judgements about what is ‘normal’ and what is not. [. . .]
Psychiatry and Social Control
Anti-psychiatrists highlighted that when behaviour is designated as disease, individuals’ rights and liberties can be overridden in the name of acting in their own interests. The fact that this can be presented as an objective, scientific endeavour means it is easily open to abuse, and powerful groups can define any socially repudiated behaviour as ‘mental illness’ in order to eradicate or control it. Generally agreed examples of this include the designation of male homosexuality as a mental disorder up until the 1970s, and the application of a ‘diagnosis’ of drapetomania to African American slaves intent on escaping.
Unlike anti-psychiatrists, most critical psychiatrists accept the need for recourse to coercion in circumstances where individuals are so overwhelmed, confused or desperate that they fail to cope with everyday demands or place others in intolerable or dangerous situations, and that under such circumstances lawful restraint and other related measures are justified. However, veiling these situations as ‘medical disorder’ disguises the real reasons for taking coercive action, which are usually to maintain social order and to support the dependent. A more transparent approach would acknowledge these pressures and scrutinise authorised interventions more rigorously. Legislation based on the concept of ‘capacity’ rather than the presence of ‘illness’ (or its legalistic pseudonym, ‘disorder’) is one such possibility (Szmukler Reference Szmukler and Applebaum, 2008). This would avoid the medicalising assumptions woven into current legislation and would require explicit justification for coercive and paternalistic actions. It would also challenge the extension of coercion into the community, as occurred with the introduction of ‘community treatment orders’. Most patients able to live in the community would be considered to have capacity to decide whether or not to take psychiatric medication. However, capacity-based legislation, such as the Mental Capacity Act of 2005, requires contentious and subjective judgements about the best interests of individuals and the safety of society. Replacing a medically justified system of control is not easy, but balancing the interests and freedoms of different groups and individuals is inherently fraught and deserves greater attention and transparency.
There is a substantial body of work addressing the political implications of the ‘medicalisation’ of human experience, which dates back at least to the writings of Ivan Illich in the 1960s and 1970s (e.g. Medical Nemesis, Illich Reference Illich, 1974). The widespread, pharma-funded promotion of the idea that unwanted emotions or behaviour can be understood as ‘abnormal brain chemistry’ has taken this process to a new level, encouraging large swathes of the population of Western countries to view life difficulties as brain events that need chemical correction. Several commentators, many in the Marxist tradition, have highlighted how this helps to support a pliable society in which imperfections are attributed to individuals rather than social injustice, obscuring the systemic difficulties that cause widespread misery and distress (e.g. Cohen Reference Cohen, 2016). American sociologists Conrad & Potter (Reference Conrad and Potter, 2000) discuss how the availability of the diagnosis ‘adult ADHD’ can be seen as a form of ‘medicalisation of underperformance’, which diverts attention from the increasing competitiveness and performance-driven culture of modern society. Gary Greenberg (Reference Greenberg, 2011) highlights how the concept of depression as an illness obscures social and economic hardships and discourages opposition to the structures that maintain these.
In “The APA’s Apology for Racism Omits Psychiatry’s Essential Bigotry” By Bruce Levine, PhD, Levin explains:
Understanding psychiatry’s essential bigotry means examining psychiatry’s criteria for “mental illness.” The key question is: What is the actual criteria that psychiatry uses to decide whether we are “mentally ill” or “normal”?
Psychiatry’s “mental illnesses” and their “symptoms” are voted in by the APA and listed in their diagnostic manual, the DSM, which the APA regularly revises. On rare occasions, when there have been dramatic socio-cultural changes — such as those with respect to homosexuality — a “mental illness”
has been voted out of existence. More often, socio-cultural changes have resulted in “mental illness” additions.
Homosexuality as a mental illness was abolished by an APA vote in 1973, and it was no longer catalogued as a mental illness in the APA’s 1980 DSM-III. However, in that same DSM-III, we see the addition of so-called “child disruptive behavioral disorders” of attention deficit disorder (later renamed attention deficit hyperactivity disorder or ADHD) and oppositional disorder (later renamed as oppositional defiant disorder or ODD).
“Symptoms” of ODD include: often argues with authority figures, actively defies or refuses to comply with their requests or with rules, loses temper, and easily annoyed and angry. Eventually, these young “disruptors” would be heavily drugged, including with antipsychotic drugs; as the Archives of General Psychiatry reported in 2012, “From 2005 to 2009, disruptive behavior disorders were the most common diagnoses in child and adolescent antipsychotic visits.
This necessarily means that a fundamental part of how we’ve been taught to understand “narcissists” is wrong, and we need to significantly shift our perspective — especially if we are serious about being the change we want to see in the world, building community, and learning to be in community with people.
There’s also the fact that most victims of abuse are called “narcissists” by their abusers to further pathologize them and subject them to more abuse of all kinds.
I also don’t think it’s particularly useful or helpful to categorically define people as inherently evil or anything like that. Not because I don’t believe that evil exists; it’s just because labeling people as fundamentally evil makes it easier to dehumanize them and establishes convenient narratives to reaffirm their beliefs about said “evil people”. These beliefs are likely based entirely on the opinions of a few people who are allegedly experts on “narcissists.”
To quote Gary Greenberg:
[Calling someone “mentally ill” is] our characteristic way of chalking up what we think is “evil” to what we think of as mental disease. Our gut reaction is always “that was really sick. Those guys in Boston — they were really sick.” But how do we know? Unless you decide in advance that anybody who does anything heinous is sick. This society is very wary of using the term “evil.” But I firmly believe there is such a thing as evil. It’s circular — thinking that anybody who commits suicide is depressed; anybody who goes into a school with a loaded gun and shoots people must have a mental illness. There’s a certain kind of comfort in that, but there’s no indication for it, particularly because we don’t know what mental illness is.
We can still call abusive people abusers, and talk about the tactics they use to abuse people; however, I think saying all “narcissists” are abusive on such a fundamental level in such intentional and conscious ways is cruel. It renders them inherently incapable of changing in any significant and meaningful way. Treating “narcissists” as being unable to learn how to be empathetic is not only a useless framework to operate from, it is also very likely quite literally impossible to be true (since it would be impossible for all and only “narcissists” to be born fundamentally incapable of being anything but consciously, intentionally cruel, abusive people intent on ruining the lives of everyone around them for their own benefit, as a form of entertainment, and to exact revenge on anyone who makes them feel inferior in even the most slightest, unintentional way humanly possible.)”
Unfortunately, we live in a society with people and, for better or worse, “narcissists” are part of the aforementioned people who live in the same society we do. And that means we have to understand that we are all human beings, which means we are all capable of change, learning better ways to exist in and navigate the world, being empathetic, and understanding each other.
If we want a world where “narcissists” don’t exist for the sole purpose of ensuring the continued existence of abuse, we also have to be willing to understand, acknowledge, and accept the fact that “narcissists” are as capable of becoming better people and not abusing people as anyone else, and not treat them all as if that is impossible. Simultaneously, “narcissists” have to be willing to understand, acknowledge, and accept the fact that they are as capable of becoming better people and not abusing people as anyone else and not believe this to be an impossibility for themselves.
This doesn’t mean we now have to go back and forgive our previous abusers, subject ourselves again to their abuse and commit ourselves to our previous hobby of hoping that maybe one day they will learn to do and become better people, no longer abusing you or anyone else. Nor does it mean we have to be willing to be abused by new “narcissists” in hopes that maybe one day they will learn to do and become better people, no longer abusing you or anyone else. It just means that if we want “narcissists’’ to change and for people to no longer have to endure abuse, we have to help create the conditions in society that will allow that to become a reality. We need to inspire a deep desire to change in “narcissists” who want to be better people, no longer be abusive, and only be seen as an abuser or abuser-in-training by being people who do not abuse others and do not allow abuse to happen or continue in our presence.
I know many people will disagree, misunderstand and misinterpret what I’m saying, etc. since that’s an inevitability because we live in a society with people. However, if this is something that you deeply and genuinely believe is impossible and cannot in good conscience support, do you think that because we’re all indoctrinated into racism, white supremacy, anti-Blackness, antisemitism, Islamophobia, misogyny, queerphobia, transphobia, fatphobia, ableism, classism, colorism, ageism, etc. and are consciously and unconsciously taught to think, act, engage with the world, etc. in racist, white supremacist, anti-Black, antisemitic, Islamophobic, misogynistic, queerphobic, transphobic, fatphobic, ableist, classist, colorist, etc. ways that we are all incapable of ever unlearning those was of thinking about, acting, engaging with the world, etc. and creating a better world?
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