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Comment by thewebguyd | Hacker News Reader

> I need lots of forced, external structure

Me as well, which is a really "fun" time when my specific blend of neurodivergence also causes me to immediately resent said authority and external structure and view it as removing my agency.

What I've learned as I've gotten older is just how much of our struggle comes down to our social model of disability. A lot of these "symptoms" are only disorders because we've built such rigid, uncompromising systems for interacting with and participating in society.

Modern psychology has a tendency to pathologize an individual's ability to conform to this rigidity instead of doing the hard work of promoting the building of flexible environments that are more accommodating of different ways of thinking and working. Instead, we work really hard to force a square peg into the round hole.

Its incredibly isolating, tbh.

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> view it as removing my agency.

I completely understand you. I hate rigid structure, and tend to rebel in subtle (and not so subtle) ways. However, I cannot function without it. It's like electronics relying on electricity. Too little current, things do not work. Too much current, things explode.

> A lot of these "symptoms" are only disorders because we've built such rigid, uncompromising systems for interacting with and participating in society.

Absolutely. What makes things worse that the pathologies are definitionally tautological. You have a disorder because you exhibit certain behaviors. But you behave in such ways because you have a disorder. That logic has never truly been stratifying to me. I also feel like many pathologies are highly contextual.

I honestly believe Dr. Tomas Szasz was right about some things (and wrong about plenty). I do agree with him that clinical psychology/psychiatry often serve as enforcers of social expectations. It's never the systems that are broken, it's always us that are broken.

> Instead, we work really hard to force a square peg into the round hole.

The worst part is no matter how hard the peg is rammed, it never truly fits.

> Me as well, which is a really "fun" time when my specific blend of neurodivergence also causes me to immediately resent said authority and external structure and view it as removing my agency.

I was never very bad at that, but it can happen in ADHD because you lose interest in everything you're "supposed" to do and get stuck on random other things like commenting here. Especially if the "supposed" tasks are hard or give you anxiety.

So I was quite surprised when going on Intuniv made that basically disappear.

My advice is that there are interventions for things like this, but they're never the obvious ones and you'll be surprised what might work. And it's worth trying meds.

It's a lot harder to change the shape of the hole. But I do agree that there is too much emphasis on the pathology of it. I think therapy needs a major rebranding and it shouldn't be seen as something that we do to "fix" "broken" people.

It should just be about more deeply understanding ourselves as individuals, and understanding the world around us (particularly other people), so that we may navigate it better.

I saw a video of a comedian (a woman) doing crowd work, and kind of playfully bullying someone (a man), asking them about their therapy. I thought it was funny, but a lot of the comments were along the lines of "that's not cool, how dare you."

But that audience member was at a comedy club, where comics do that kind of thing. Going to therapy isn't about collectively making sure the world babysits and coddles everyones needs. It's about giving you the tools to handle what you can't change.

> I think therapy needs a major rebranding and it shouldn't be seen as something that we do to "fix" "broken" people.

I feel like that is more of a cultural impression. I am not certain modern therapy ever truly endorsed such claims. Take the "chemical imbalance" explanation of mental illness. Many people believe and use that explanation, but mainstream psychiatry never supported nor endorsed the hypothesis.

> It should just be about more deeply understanding ourselves as individuals, and understanding the world around us (particularly other people), so that we may navigate it better.

That is also the fundamental issue I have with therapy as a whole. I understand myself very well -- perhaps too well. I also understand the world around me. More importantly, I understand the world and I are very incompatible. When one realizes such, there is little that can be done.

> It's about giving you the tools to handle what you can't change.

People perpetually parrot that statement. However, every time I ask for examples, it seems no one ever has an answer. I do not discount that therapy can sometimes help with conditions that people find themselves in, however, I think therapy is quite ineffective for conditions that people have.

I personally think therapy as an institution has and uncanny amount of resemblances to religious faith and institutions -- predominately in public perception. Much like religion, therapy seems to be most effective for those that you truly believe it will be effective.

I once asked a long-term partner, point blank, "do you think you're not long for this world?" That person remains one of the deepest connections I've ever had. There is a great amount of variance in human brains and how they react to the time and place they find themselves in, and it is statistically true that a good number are going to have a harder path to walk. Just as with any kind of predisposition to health issues. In that case medication may be the best answer we have at this point.

> People perpetually parrot that statement.

Funny, I thought I just made it up, but it did sound pretty good! I don't know what you mean by examples, but it can be as simple as words that can help you identify your feelings and understand your reactions. If you feel like you're good on that (and I can empathize, I don't have a therapist), there may not be much there for you.

I would guess that you have expectations of the world -- perhaps visions of what it could be -- that are unrealistic, which sets you up to be consistently disappointed.

> mainstream psychiatry never supported nor endorsed

Oh, but they most certainly do!

The Chemical Imbalance issue was always the first and last and best explanation from the lips of the psychologists, psychiatrists, pharmacists, researchers, friends and family. All who unanimously urged me and others to take medications that would somehow magically resolve these imbalances and thus put me and my mind on the straight-and-narrow. And that was the be-all, end-all of treatment. Correct the imbalance and inherit the kingdom, unambiguously!

It still is. The myths continue unabated. Don't try and make it past-tense! Nobody can tell them that it’s junk science. It sells pills and it sells hospital admissions and it sells followup visits. How could it possibly be wrong?

Sometimes in my medical questionnaires, I write "lithium deficiency" or "fluoride deficiency" to remind those fucking superstitious zealots about their idiotic pseudoscientific religion that they mindlessly follow. Jesus never wanted this. In fact, Jesus warned about these false prophets and magicians.

It has fueled DSM diagnoses, it has fueled prescriptions and insurance payments, and it has driven hospital-based rehabilitation like no other therapy before or after it.

While I certainly sympathize with your distaste for certain institutions and traditions within the medical industry, I feel compelled to share that you do seem -- if ever so slightly -- imbalanced.

That seems like a high horse you’re on, how did you get up there?

It’s all in good fun, brother. One has to have some awareness of how unhinged they are (and yes it does take one to know one).

It had better be all in good fun—-or else

I mean...from "superstitious zealots" to follow Jesus in the same line is a sign that something is not working and it isn't all in fun, right? Would you expect zero ongoing issues to arise from years of pharma-funded tough love messaging?

FWIW, I took the Jesus stuff to be "part of the joke."

You said I was on a high horse, I said I was just having fun.

Now you're just agreeing with my original assessment? What do you want me to do? They seem like they've got a handle on it.

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