Over the past few months, I’ve found myself moving further and further away from the mental health profession and its view of the world. It’s always difficult to know how these things begin, especially for someone like me, who spent many years in front of therapists. For a long time, psychotherapy helped me. It gave me a language with which to express the abuses of my childhood. It allowed me a safe place in which to work out the ways in which the trauma was affecting my life. It helped me to move beyond being a victim to a survivor, and then it helped me move beyond being a survivor to simply being Rachel.
So where did it all go wrong between the mental health profession and me? I’m not sure it did. As is my history with most large groups, I just outgrew it. And once I outgrew it, I began to see all the ways in which its definitions were still limiting me, because I hadn’t dislodged those definitions from my brain.
The process of debriefing from the mental health profession began when I was still in therapy. I had a conversation with my therapist in which I began to realize that the paradigm I was developing was altogether different from the one in which he was comfortable. We were talking about diagnoses, and I was still very much wedded to the idea of having one—or so I thought. The conversation went something like this:
Me: When you write up your paperwork about our sessions, do you include a diagnosis?
My therapist: No.
Me: If you had to give me a diagnosis, what would it be?
My therapist: Well, you definitely have a mood disorder.
Me: I do?
My therapist: Yes.
Me: How do you define that?
My therapist: Well, you’re anxious and sad a lot.
Me: That means I have a disorder?
My therapist: Yes.
Me: But look at my situation. I’m dealing with being disabled in mid-life. The world is not set up to bring someone like me into full membership. In fact, I feel invisible most of the time. It makes me sad. I’m grieving. Anyone would feel sad and upset in that situation. Why does that mean I have a disorder?
My therapist: Because it’s your problem.
Me: What do you mean it’s my problem? I live in a society that renders me invisible. Why isn’t it society’s problem?
My therapist: Because it’s your problem.
Me: But I can’t solve it alone. I realize that I have to deal with what I’ve been given, but you can’t possibly expect me to just bear up cheerfully under the weight of all this difficulty. There’s a relationship between me and the world here. What about the world’s dysfunctionality? Why is this all on me?
My therapist: [insert patronizing therapist look here]
Me: Do you understand what I’m saying?
My therapist: Yes, and it’s still your problem.
Me: I can see we’re not getting anywhere.
I left therapy soon afterward.
I’ve thought of this conversation a great deal over the past few months. To my mind, it encapsulates everything that is wrong with the mental health profession:
1) Having a human emotion such as sadness, grief, anxiety, or anger in response to an ongoing traumatic, life-changing, unjust, or otherwise maddening situation is evidence of a disorder.
2) The medications I was taking were never on the table as a cause of my anxiety and depression. (As it turns out, they played a major role).
3) We don’t need to talk about disabilism, its impact on people, and how we need to change it.
4) People become transformed into patients and put into diagnostic boxes.
5) We only need to talk about how screwed up the patient is and how we need to change the patient.
Over the course of my life, I’ve been labeled (officially and unofficially) with depression, general anxiety disorder, post-traumatic stress disorder, Asperger’s disorder (also known as an autism spectrum disorder), and sensory processing disorder. And next week, I’m going to an audiologist who will most likely diagnose me with auditory processing disorder.
I can’t tell you how depressing it is to keep collecting disorders like this. (I suppose that means that I have DODDD: Depressed over DSM Diagnoses Disorder.) All these labels have done a huge number on my head. If I’m going to live a full, happy, and empowered life, I need to send these diagnoses back to where they came from, because they are not me and they have nothing to do with me.
Let’s start with autism, since that’s what got me started thinking about this whole issue in the first place. Autism is not a disorder. It’s not a collection of impairments. It’s not a series of deficits. It’s not something that’s wrong with me. It only looks that way because I live in a society that values certain things to the exclusion of others. It values yacking about non-substantive things; I like substantive conversation. It values social chit-chat; I don’t do social chit-chat. It values being loud; I can’t spend any time in loud environments. It values going fast in every way possible; I cannot follow fast speech, fast-moving objects, or fast-moving graphics.
The society I live in is fearful of silence and deliberation. It thrives on mutually agreed upon deceptions. It abhors directness. It does not honor one’s word as one’s bond. It values appearance over substance. It tyrannizes us with the necessity for “positive thinking” above all else, as though it weren’t simply all right to give vent to one’s emotions when terrible things happen and heartbreak is the only sane response. In short, from my point of view, the society I live in is very unhealthy. Does that mean that something is wrong with me? Why? Because I’m in the minority and the majority is always right? Such nonsense.
My acute sensitivities are not a problem in and of themselves. My emotions are not a problem, in and of themselves. My post-traumatic stress issues are not even a problem, in and of themselves. All of these things can be a source of great power and heartfelt service to others if I use them properly. All of these things only become a problem when they go against an arbitrarily defined idea of “normal.” Then I get people trying to prescribe, discuss, and cure them out of me. But as a friend said to me the other day, please find me this “normal” person, because I haven’t stumbled across him yet. (And yes, the “normal” person is definitely a guy, because being male is part of the standard for “normal.”)
Of all the things that American culture values as “normal,” conformity is the most important. We talk about respecting difference, but if we respected difference, we’d just go around doing it and not talking about it all the time, now wouldn’t we? Here in America, the home of “rugged individualism,” we don’t respect difference. In fact, conformity is Job One. Here’s how it goes: You can only be a rugged individualist if you’re white, male, Christian, heterosexual, and fit into a certain unnamed place on the neurological spectrum. If you’re something else, it gets scary for those rugged individualists. I don’t know why all the rest of us on the racial, gender, religious, sexual, and neurological spectrum should make the rugged individualists faint, but apparently, we do.
When it comes down to it, autistic people, or bipolar people, or schizophrenic people, or traumatized people, or anyone in any other group of people, are just different from a mythic “norm” that simply doesn’t exist. There isn’t a person on the planet who won’t fit into a DSM diagnosis if you look hard enough—or who can’t be misdiagnosed into one if you don’t. They’ve got a diagnosis for everything a human being can possibly go through, which makes life itself a pathology and human beings nothing but walking disorders.
Well, I don’t believe that life is a pathology and that people are walking disorders. To heal this kind of mindset, I’m starting with my own distorted sense of myself as disordered—a distortion I’ve taken on as though it’s a clear reflection of who I am. It’s not. I know that now.
© 2010 by Rachel Cohen-Rottenberg




I love this post so much. I disagree about one thing but, I love the points you make and I feel the same exact way!
This was just thrilling and empowering to read. My overwhelming response is simply, “Oh, *hell* yeah!”
To give *some* context, here is an excerpt of an email I wrote to a family member about a meltdown I had at work:
“I’m so sick of chattering, giggling, insipid coworkers. I’m so sick of people giving me *urgent* tasks because no one thought ahead and realized I needed to be told and communicated with me. I’m so sick of feeling like my hard work is not appreciated.
I’ve broken down crying at this job too many times. It happened again this week: too much crashing down on me, too many stimuli in the environment to try to block out.”
The family member then responded with an email that–however well-meaning–made me feel that she saw me as broken.
I’ve heard it said and seen it written several times: a world that was better for autistic people would also be *much, much* better for everyone, neurotypicals included!
Another good post Rachel. Your blog reads like a woman bravely unshackling the chains of society and living your life the way it was meant to be lived.
It’s inspiring!
Some of what you are grappling with has been a theme from great literature: man vs society. Looking at society in a broader context means looking at American society in the throes of a major change. One implication of this change is that people are banding together in front of the campfires. In the minds of the group, how you play in that circle around the fire is more important the skills that you bring to the group (even when those skills greatly enhance the survival of the group). People are frightened these days and want to find a target to channel their fears and angers. Unfortunately, the easy targets are those who are different. On the other hand, where I see hope is that in this turbulence is that there are many people from a variety of perspectives whether it is from autism or disabilities, giftedness, race, gender, or sexuality are arguing for a wider, more fluid definition of inclusion into groups.
how beautiful. i don’t even know where to begin, but yes, i think one of the main reasons i’ve always been drawn to your blog is because of that ferocity of self-acceptance in the face of incredible odds– and the sheer courage of that. it’s no secret. i’ve had similar thoughts about therapy and the DSM. sometimes i think, “well, i’m just crazy—so what right do i have to these views?” it gets under the skin, the labels, the definitions, the insistence that if i don’t simply accept something that isn’t in my heart, i’m being a terrible “client.” (or patient, or consumer, or whatever the current accepted word for it is.)
most of all, i’m tired of thinking of myself as defective in some way because i’m in pain, because i process the world differently, because i don’t always gauge social norms and expectations in the way that others do. it’s a post that goes straight to my heart.
Welcome to my world!
I have for years avoided experts and doctors and lived a life which seemingly mostly consists of sitting on the sideline of a great battle raging all around and about me but never wanting me actually involved.
glad for you and glad for me that you write this to us.
it’s funny how often you end up writing about something that i’ve been cogitating on for weeks.
Rachel
That beautiful face on the cover of your book is how I see your soul.
Jennifer: Wow! I’m so glad I chose that photo!
I was six years old when it was taken.
a bit OT: did you get my e-mail about buying your book?
I did, and I replied right away. I’ll resend.
Thank you for this post. I believe you are more on target than you know! The NT world is incredibly cruel to so many. I dream of a world that lives by Aspie rules…
[...] Cohen-Rottenberg’s No More Disorders: Debriefing from DSM Diagnoses first appeared at Journeys with Autism, and is republished here with the author’s permission. [...]
nope, didn’t get the re-sent e-mail either
I just tried sending e-mail from a different address. Hopefully this will work!
It worked!
Rachel,
“I just outgrew it.”
That is a good summation. I do think these labels can be useful, when used by the individual to find like-diagnosed individuals and more information. But that usefulness does wear out. The label isn’t you, it is simply one form of short-hand a particular discipline uses to describe how they perceive you–which makes these labels both subjective, imprecise, incomplete, and sometimes just plain wrong.
As for the mood disorder thing–there’s a difference between grieving or feeling anxious regarding situations, and having that grief and anxiety smother other emotions. When in a depressive episode, I know hope, joy, pleasure, and other emotions are there, but they elude me even when they shouldn’t. When not in a depressive episode, I can experience hope, joy, pleasure, and grief, sorrow, and anxiety. That is how I make the distinction. But that’s from one who never felt comfortable with therapy.
Rachel, I have no idea how I just ran into your blog, but after reading this post, I think I know why. I am a pediatric OT and a children’s yoga instructor, working primarily with children from 3-18 years of age. When working with children and their families, I always refrain from looking at the evaluations with diagnoses highlighted. I try to teach the parents, that the label really doesn’t matter. Every child that I have EVER worked with, has had a great gift. I always felt that my role in the relationship was to help the child recognize their gift, their true essence and help the parent to appreciate that gift. It is so important to hear from you how this feels, because many of the children I work with can not express this, but I sense that they feel the same way. In April, I am teaching a yoga teacher training for teachers who want to learn more about working with children possessing these special gifts. I would love to read this particular blog to them. You powerfully express the realization that we are ALL blessed beings just the way we are, not the way people want us to be. Thank you.
Allison, I’d love it if you’d share this post. You bring a wonderful spirit to your work!