That’s kind of what I’ve suspected all along… our drive to set a “norm” for anything and then punish everyone outside that norm is killing us… well, I guess it’s not “our” drive, but all the institutions that shape our world pushing that idea…
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I’ll argue that the start of any discovery is to find patterns around which things vary. However…
Economically? It’s also the drive to take the power of variation and diversification, which is an immense free lunch of resources for society, out of the hands of the majority and extract more economic value by increasing their predictability and reducing the low-dimensional, narrow-minded, goal-specific costs of uncertainty.
There’s math for that.
@chgoliz FTA: “We therefore need to focus on finding and remedying the aspects of the environment which are disabling for the individual, rather than pathologizing the individual.”
Bingo! That’s what “costs money”. Part of my natural variation, one which is paid lip service constantly as a positive, makes it 50% to 100% more expensive to buy clothes or fly somewhere, restricts my other transportation choices, and constantly puts me at risk for concussions. Other parts of my natural variation are considered by some to be highly valuable, often lip service again.
I feel a rant coming on, but have things to do today. Math things. I will play long-form ambient through my over-ear headphones and do my math things now.
FTA: Neurodiversity is natural and makes us stronger. It would be of benefit to all humans if the special skills and talents of neurodiverse people were recognised and fostered.
We’ll go with that for now.
@chgoliz Super article, thank you for sharing, will share further… 
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The discussion here put me in mind of this dank meme
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Hate Filling out Forms? We Can Make Bureaucracy Less Confusing
Figuring out tax filings and school applications can be a struggle, harder for some neurodivergent people. There are fixes.
Katie Hyslop, Jan 27 2025, The Tyee
Bureaucratic processes like these can be complicated, time-sucking tasks that at best leave many people frustrated. But what is it like for neurodivergent people?
To their credit, my daughter’s institution has done a big clean-up of their on-line portal. It at least matches the “design expectations” of millennial users now.
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My design expectation is that any redesign will add more pain, and remove more usability.
But of course, if you run into trouble with the website they have a pain number, and if you run into trouble with the pain number, they have a website, and never mind that neither is accessible because the website uses standard web design practices, with migraine inducing multiple columns and pop-ups for “ease of navigation,” while the pain number requires a pain call, and enduring migraine-inducing hold music, before the line drops or the loop circles back and you have to start over.
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ProPublica doesn’t always do all of the necessary research, unfortunately. Everyone has blind spots.
Response:
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This is so common a first diagnosis for girls/women who are actually autistic that as soon as I read the headline I thought “I’ll bet it’s actually autism”:
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That’s absolutely horrible.
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The only time I saw a therapist, he told me I’m borderline after less than ten minutes.
He didn’t know abt my childhood ADHD diagnosis, nor that I’m gifted - altho the latter is soon obvious to other intelligent people.
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My ex, my daughter’s mother, has had various diagnoses, including bipolar her whole life, and has been therapized and medicated up the wazoo as a consequence. She just got diagnosed as autistic last year and it makes so much sense. It makes me so sad that she’s been through like, a half century of shit to get to this point.
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That might be the saddest thing I have ever read. I am very sorry for your past abuse and the lack of empathy from those in my profession. I try my hardest to make sure my patients never feel this. (Although I have had parents insist I am not listening when what they mean is “he disagreed with me.”)
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I think my mother was once diagnosed with borderline personality disorder. She liked to talk about it because it fell neatly into her narrative of martyrdom. She really does tick all the boxes for that particular diagnosis, but I couldn’t say if she was being truthful. She lied a lot.
Her treatment seemed mostly focused on the PTSD, anxiety,nand bipolar diagnosis. What treatment she accepted anyway. She would take medication but refused addiction or eating disorder treatment or life style changes. She would do therapy for 3-6 sessions and then quit. Which seemed to be how long it took the psychologist or counselor to start pushing back a bit on her lies and start asking her to do some introspection.
BPD always seemed to be a label used when someone has a lot going on. Any combination of a whole bunch of other diagnoses. It doesn’t seem useful to do that instead of simply identifying the PTSD, depression, bipolar, or whatnot and treating the group of issues holistically. It is a very stigmatizing label and overused at the very least
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Yeah my family member with that diagnosis definitely has problems, that I don’t dispute. And I do think it is a holistic thing and more than just meds could deal with. I just also think the methodology used to address any of the personality disorders is questionable and borderline specifically because it is a catch all that often translated to “girl or woman I dislike/distrust.”
The system is already gamified. Like no one should go to a mental health consult without reading the DSM, which puts people unable to read it at a disadvantage of course. One has to be wary of language/translation errors too even if you are a native English user, etc.
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I agree. It’s a diagnosis that doesn’t seem to lead to any more meaningful treatments than just diagnosing a person with several less stigmatizing diagnoses and treating them.
My mother definitely engaged in pretty much every behavior on the list for BDP. But if it was true she was diagnosed with it, it didn’t seem to lead to any difference in treatment. though maybe she was offered something different and just refused to do it. Hard to tell with her.
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Far too many women have been diagnosed with bpd because we’ve been forced to put up with all sorts of societal and personal abuse for So Goddam Long we’re just about ready to scream!
And how on Earth could anyone with a functioning brain and heart blame us?!
“It’s not that you’ve had to mask and put up with misogyny and bigotry and abuse and ignorance, it’s all YOU!”
All healing to you, @tornpapernapkin , @Kii , and all of us who need it!
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GODDESS.
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It’s stuck in my mind the last 24 hours that I legitimately feel bad for making you sad. It’s just kind of hit or miss chasing the multitudes of things that can go wrong in the mind/body and how they intersect. TBH I’ve had some really good doctors, especially the ones who were willing to look at my thyroid or take my actual physical problems seriously. I don’t express myself very well around these subjects largely due to the fact that I don’t talk about them much and even when I do it’s mainly just to vent because as most of my family is dead or gone one way or another I find I’d rather remember the fun times in the liminal space where life exists in me.
In reality I have a lot of objectively accurate perceptions that I make over time that are more fair. Like for instance i realize how poor medical information gathering really is. How many times have I seen some rando doc been given a useless script and never have seen them again. How would they even know and how would they know for the next patient too?
That kind of thing.
We’re all just trying to survive a broken system and I think the fact that it’s doctors like you that get hurt by some one like me talking about it…it just makes it worse.
I grew up ok and from my perception my family dysfunction wasn’t really that much worse than my peers but I think some of them really were particularly unfortunate often due to issues of race and class or level of disability, and other factors, etc. I kind of see how this happens, how it concentrates problems on the weakest people, how some people might consider that working as intended.
For some reason I feel I was simply compelled to become a person who was not allowed to remain as naive or privilege blind as some but who nonetheless had some definite privileges and options. And I have to admit also that my upbringing did honestly make me uniquely adaptable and resilient.
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Please don’t feel badly. You don’t make me feel bad, the inconsiderate docs you interacted with do. And if folks who have those experiences don’t speak about them, then we tend to think we are doing just fine. You were hurt by someone who is in the same field (broadly speaking) that I am. That makes me angry. That is also not your fault. Any group of sufficient size is going to have assholes. Part of the problem in my field is that we also have a tremendous pressure on us to see more patients in less time to generate more RVU’s. The end effect is that providing good care winds up costing us money. Which sucks ten ways from Tuesday. So please, do not feel like you should not talk about this. You can and should, if only to try to make us better docs. It’s also not terribly healthy to bottle that kinda stuff up. It does make me sad that you were mistreated. I hope that makes me human, it certainly does not make you a bad person.
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Doc, you are such a fuckin mensch .
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