The call is coming from outside the house
August 28, 2021 4:29 PM Subscribe
You know that *was* a good piece. I was afraid he was going to be reductive in approaching the admittedly reductive "X-chemical causes Y-disorder" line of thought - and he was to an extent - but he kind of had to be to get those approaches to fit together within the attendant systems-level hypothesis. Moreover, what a pleasant and trusting voice.
posted by DeepSeaHaggis at 6:25 PM on August 28, 2021
posted by DeepSeaHaggis at 6:25 PM on August 28, 2021
Just a note for the commenter above that Devon Price is nonbinary and their pronouns are they/them. Also their book Laziness Does Not Exist is definitely worth a read!
posted by lizard music at 6:53 PM on August 28, 2021 [7 favorites]
posted by lizard music at 6:53 PM on August 28, 2021 [7 favorites]
Oh, my bad. Nothing intentional in the mistake
posted by DeepSeaHaggis at 7:21 PM on August 28, 2021 [3 favorites]
posted by DeepSeaHaggis at 7:21 PM on August 28, 2021 [3 favorites]
That was great. Thanks for sharing!
posted by peanut_mcgillicuty at 9:40 PM on August 28, 2021
posted by peanut_mcgillicuty at 9:40 PM on August 28, 2021
Interesting. It's helpful to tease apart proximate [mechanistic, neurotransmitter] causes from ultimate causes. RD Laing is 32 years dead but he tried to shift the the angle of attack: "Insanity - a perfectly rational adjustment to an insane world." and "A child born today in the United Kingdom stands a ten times greater chance of being admitted to a mental hospital than to a university ... This can be taken as an indication that we are driving our children mad more effectively than we are genuinely educating them. Perhaps it is our way of educating them that is driving them mad."
posted by BobTheScientist at 1:00 AM on August 29, 2021 [6 favorites]
posted by BobTheScientist at 1:00 AM on August 29, 2021 [6 favorites]
This is a great, compassionate article that would have been very useful in the comments on this post, where we struggled with how to both express sympathy and parse how a mechanistic view of mental illness is another expression of the societal drivers behind the illness itself.
posted by q*ben at 7:49 AM on August 29, 2021
posted by q*ben at 7:49 AM on August 29, 2021
I really appreciated this article, thank you for sharing it!
posted by stellaluna at 8:51 AM on August 29, 2021
posted by stellaluna at 8:51 AM on August 29, 2021
I think they make a fine point. But it can be taken further. The external world has an impact on our internal world, yes. It also loops around. Your internal world affects your external world. I find it valuable therefore that the premise of mindfulness and meditation is to break or weaken the force of the external world on the environment of the internal world.
The inability of many of us to change our external circumstances especially those who are underpowered, would otherwise impose a burden of despair and stress that makes things worse.
posted by storybored at 8:54 AM on August 29, 2021 [2 favorites]
The inability of many of us to change our external circumstances especially those who are underpowered, would otherwise impose a burden of despair and stress that makes things worse.
posted by storybored at 8:54 AM on August 29, 2021 [2 favorites]
It was a very interesting article, and had a lot of good points. I didn't know the thing about fMRI research prior to 2015 being tainted from a software bug (that's wild!). I also think the distinction that the presence of chemical disregulation doesn't mean its the cause of the illness is a good one.
As someone with ADHD, I did take issue with their framing of the section regarding ADHD and Ritalin:
When Jesse initially shared this research online, they were met with a barrage of outraged and defensive responses — almost exclusively from ADHDers who use stimulants and think of their disability as purely biological.
I clicked through to the Instagram post they were referencing. The post had some interesting points that I'd like to read the original research on. But the comments were not "outraged" and "defensive." There were a number of comments pointing out the limited selection of studies that were included (very focused on children with ADHD) and pointing out that its irresponsible to tell people to take "drug holidays" without knowing their background. Many posters were commenting that they had severe side effects or SI behaviors when off their ADHD (or other meds), and the IG poster seemed to double down on their take. Comments are now turned off on the post.
I understand what both the article and IG post are trying to get at, but I came away from both feeling like the ultimate message was, you don't need meds! And yeah, maybe I don't. But I want them. They can't fix the underlying source of my issues (be they relational, circumstantial, societal, or biological) but meds give me space to cope with them, and to work on changing the things within my power to change.
posted by bluloo at 9:51 AM on August 29, 2021 [8 favorites]
As someone with ADHD, I did take issue with their framing of the section regarding ADHD and Ritalin:
When Jesse initially shared this research online, they were met with a barrage of outraged and defensive responses — almost exclusively from ADHDers who use stimulants and think of their disability as purely biological.
I clicked through to the Instagram post they were referencing. The post had some interesting points that I'd like to read the original research on. But the comments were not "outraged" and "defensive." There were a number of comments pointing out the limited selection of studies that were included (very focused on children with ADHD) and pointing out that its irresponsible to tell people to take "drug holidays" without knowing their background. Many posters were commenting that they had severe side effects or SI behaviors when off their ADHD (or other meds), and the IG poster seemed to double down on their take. Comments are now turned off on the post.
I understand what both the article and IG post are trying to get at, but I came away from both feeling like the ultimate message was, you don't need meds! And yeah, maybe I don't. But I want them. They can't fix the underlying source of my issues (be they relational, circumstantial, societal, or biological) but meds give me space to cope with them, and to work on changing the things within my power to change.
posted by bluloo at 9:51 AM on August 29, 2021 [8 favorites]
I've spoken a number of times with Price on Twitter and had some really good conversations with them about autism. I'm consistently really impressed with their depth of thought.
I'm not familiar with their friend with ADHD, but my read of that Instagram post is more akin to, mmm... someone who is used to interacting with ADHD cultures that ascribe to a purely biomedical model of disability trying to problematize the common narrative of "take stimulants, fix ADHD--it's diagnostic!" and nudge some societal model into the way we discuss things, WITH an explicit discussion of some of the ways that meds can fail us.
For example, if your ADHD meds stop working or being as effective (which is the main thing being discussed), and you need to take a break from them in order to let them reacclimate... which is a pretty common thing for everyone I know on long term ADHD meds to occasionally need to do--will you have the support and resources to do that if the common narrative is "meds fix it"?
ADHD and autism are really interesting in that you have this very powerful cross pollination between disability communities (in part because so many people do have both, hi), but the most popular disability activism models within each community are on wildly different extremes of the social/medical model spectrum. Autistic folks, who pull much of our activist framework from the Deaf community, are very clear about disability framework being about restructuring society to allow autistic people to participate in it rather than modifying ourselves to fit. By contrast, ADHD activism such as it is really does tend to be intensely about modifying ourselves to better participate in the society that already exists. Insofar as I see ADHD approached from a social model, it's usually in the context of talking about access to meds only.
Bear with me, I am going somewhere with this.
The thing is, meds are a tool, and a fairly blunt tool at that. Bluntly, we don't understand the neuroendocrinology of the brain well enough for psychiatric medication to work as effectively as meds for other tissues can work. This is not to say that meds aren't useful (she says, absently rifling through her purse for the med case), more that psychiatric meds are way more complicated than we're often led to believe, and the neuroendocrine systems that people often reference blithely as having One Function usually do a vast number of different things depending on where they are acting and in what levels.
Which means we should maybe think of meds less like a cure for the system and more like assistive technology (glasses, canes, service dogs, etc): they don't make you Just Like Nondisabled people, they have specific costs and benefits associated with them, and they have limitations that we should keep in mind and ideally talk about so that we can receive support for places where meds fall down on the job.
And that's really not how we talk about meds or even symptoms in ADHD culture. Take rejection sensitive dysphoria, for example. I've spent some time talking here elsewhere about why rejection sensitive dysphoria is most likely to be a chronic post-traumatic syndrome resulting from extremely common traumas associated with having ADHD rather than a "natural biological feature of the ADHD brain." But if you surf on over to the way that this phenomenon is being promoted and framed by William Dodson, you'll notice that the discussion of the experience is framed a hell of a lot more like the later framework than the former there. I think that's what the Instagram article is trying to get at.
Overall there is so much internalized shame and desire to think and be "normal" in ADHD circles specifically, and I think that comes from a certain amount of fear and shame about our abilities to keep up or to have our failings understood and not be triggers for frustration and rage in the people around us. At some point that probably needs to be grappled with. (Fuck knows I'm still grappling with it; if I figure out how to come to peace with that, I'll share it.)
posted by sciatrix at 11:09 AM on August 30, 2021 [6 favorites]
I'm not familiar with their friend with ADHD, but my read of that Instagram post is more akin to, mmm... someone who is used to interacting with ADHD cultures that ascribe to a purely biomedical model of disability trying to problematize the common narrative of "take stimulants, fix ADHD--it's diagnostic!" and nudge some societal model into the way we discuss things, WITH an explicit discussion of some of the ways that meds can fail us.
For example, if your ADHD meds stop working or being as effective (which is the main thing being discussed), and you need to take a break from them in order to let them reacclimate... which is a pretty common thing for everyone I know on long term ADHD meds to occasionally need to do--will you have the support and resources to do that if the common narrative is "meds fix it"?
ADHD and autism are really interesting in that you have this very powerful cross pollination between disability communities (in part because so many people do have both, hi), but the most popular disability activism models within each community are on wildly different extremes of the social/medical model spectrum. Autistic folks, who pull much of our activist framework from the Deaf community, are very clear about disability framework being about restructuring society to allow autistic people to participate in it rather than modifying ourselves to fit. By contrast, ADHD activism such as it is really does tend to be intensely about modifying ourselves to better participate in the society that already exists. Insofar as I see ADHD approached from a social model, it's usually in the context of talking about access to meds only.
Bear with me, I am going somewhere with this.
The thing is, meds are a tool, and a fairly blunt tool at that. Bluntly, we don't understand the neuroendocrinology of the brain well enough for psychiatric medication to work as effectively as meds for other tissues can work. This is not to say that meds aren't useful (she says, absently rifling through her purse for the med case), more that psychiatric meds are way more complicated than we're often led to believe, and the neuroendocrine systems that people often reference blithely as having One Function usually do a vast number of different things depending on where they are acting and in what levels.
Which means we should maybe think of meds less like a cure for the system and more like assistive technology (glasses, canes, service dogs, etc): they don't make you Just Like Nondisabled people, they have specific costs and benefits associated with them, and they have limitations that we should keep in mind and ideally talk about so that we can receive support for places where meds fall down on the job.
And that's really not how we talk about meds or even symptoms in ADHD culture. Take rejection sensitive dysphoria, for example. I've spent some time talking here elsewhere about why rejection sensitive dysphoria is most likely to be a chronic post-traumatic syndrome resulting from extremely common traumas associated with having ADHD rather than a "natural biological feature of the ADHD brain." But if you surf on over to the way that this phenomenon is being promoted and framed by William Dodson, you'll notice that the discussion of the experience is framed a hell of a lot more like the later framework than the former there. I think that's what the Instagram article is trying to get at.
Overall there is so much internalized shame and desire to think and be "normal" in ADHD circles specifically, and I think that comes from a certain amount of fear and shame about our abilities to keep up or to have our failings understood and not be triggers for frustration and rage in the people around us. At some point that probably needs to be grappled with. (Fuck knows I'm still grappling with it; if I figure out how to come to peace with that, I'll share it.)
posted by sciatrix at 11:09 AM on August 30, 2021 [6 favorites]
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That was a much more interesting article than I expected from the pull quote. Incredibly easy to fall into that trap instead of examining our environment and our lives.
posted by simmering octagon at 5:33 PM on August 28, 2021 [5 favorites]