Self-advocate, silenced

I am autistic and take issue with those who silence autistic voices. We are abused into compliance and silence, stuffed into neurotypical boxes, and denied agency and self-advocacy. Those who silence self-advocate perspective in a disability support group for students—where connecting kids with an identitytribe, and voice are vitally important—will not receive silence in reply. They will hear my voice. They will hear it in the song of our systems as we move to the social model for minds and bodies.

Those who do not respect identity should not moderate a disability group. When you block the voices of self-advocates and their families, you fail inclusionNothing about us, without us.

 

Neurodiversity and Gender Non-conformity, Dysphoria and Fluidity

Gender nonconformity, dysphoria, and fluidity are oft discussed in neurodiversity communities. Neurodivergent people are more likely than the general population to be gender non-conforming. Many prominent autistic self-advocates identify as intersex, asexual, and genderqueer.

The broadest definition of neurodiversity is a social model umbrella that includes LGBTQIA and genderqueer.

Spectrums and rainbows, double rainbows.

Autistics and LGBTQIA share some dark history—and some bad actors. Chapter 7 of NeuroTribes, Fighting the Monster, shares the legacy of Ole Ivar Lovaas, the twisted father of Applied Behavior Analysis (ABA) and conversion therapy. He applied his abusive, torturous techniques to autistic kids and “sissy boys” to make them “indistinguishable from their peers”. He had little regard for their humanity—they were engineering projects.

“The fascinating part to me was to observe persons with eyes and ears, teeth and toenails, walking around yet presenting few of the behaviors that one would call social or human,” he wrote. “Now, I had the chance to build language and other social and intellectual behaviors where none had existed, a good test of how much help a learning-based approach could offer.”

He explained to Psychology Today, “You see, you start pretty much from scratch when you work with an autistic child. You have a person in the physical sense— they have hair, a nose, and a mouth— but they are not people in the psychological sense. One way to look at the job of helping autistic kids is to see it as a matter of constructing a person. You have the raw materials, but you have to build the person.”

Source: Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 285). Penguin Publishing Group. Kindle Edition.

ABA and its conversion therapy kin are with us still, all too alive and well.

#ActuallyAutistic reject ABA. I don’t know a single autistic person who supports it.

Protecting LGBTQIA kids protects also neurodivergent kids—and vice versa. The fight is for inclusion and acceptance—for all operating systems, for all of our different ways of being human. Supporting our kids means supporting all of their possibilities and expressions.

Children on the autism spectrum are more than seven times more likely to show signs of gender variance, according to a study led by New York University.

The study, published last month in Transgender Health, recruited the parents of 492 autistic children ages six to 18. When the researchers asked these parents whether their children often “wish to be the opposite sex,” a little over five percent of participants said yes, compared to less than one percent of the general population.

Bolstering these findings is the fact that a previous study from the Children’s National Medical Center in 2014 found almost the exact same results. The NYU study found that 5.1 percent of children on the autism spectrum showed signs of gender variance. The 2014 study put that number down at 5.4 percent.

Both studies show that counselors working with autistic children should ask about their gender identity. Being both autistic and gender non-conforming, some children face a double-challenge in responding to society’s biases.

Study: Autistic kids more likely to be gender non-conforming | PhillyVoice

Ollie’s parents wondered if his gender nonconformity — behavior that doesn’t match masculine and feminine norms — might have something to do with his autism. Ollie had been diagnosed with sensory processing disorder at age 2: An extreme sensitivity to sounds, light, the texture of some foods or the feel of a particular fabric can send children like Ollie into a meltdown. He also had difficulty falling asleep and staying asleep. It would take his parents four more years to find a doctor who recognized the classic symptoms of Asperger syndrome — above-average intelligence combined with social and communication deficits, and restricted interests. (Ollie was diagnosed with Asperger syndrome before the diagnosis was absorbed into the broader category of autism spectrum disorder in 2013.)

Ollie’s parents are not alone in pondering this puzzle. A handful of studies over the past five years — and a series of case reports going back to 1996 — show a linkage between autism and gender variance. People who feel significant distress because their gender identity differs from their birth sex — a condition known as gender dysphoria —have higher-than-expected rates of autism. Likewise, people with autism appear to have higher rates of gender dysphoria than the general population.

Between 8 and 10 percent of children and adolescents seen at gender clinics around the world meet the diagnostic criteria for autism, according to studies carried out over the past five years, while roughly 20 percent have autism traits such as impaired social and communication skills or intense focus and attention to detail. Some seek treatment for their gender dysphoria already knowing or suspecting they have autism, but the majority of people in these studies had never sought nor received an autism diagnosis. What’s more, roughly the same numbers of birth males and females appear to be affected — which is surprising, given that in the general population, autism skews male.

Over the past decade, people with gender dysphoria have developed new ways of expressing their sense of self. Whereas many once identified as transsexual or transgender, some now call themselves ‘genderqueer’ or ‘non-binary.’ Rates of autism and autism traits appear to be higher in those identifying as genderqueer. Like Ollie, these people generally say they don’t feel fully masculine or feminine, and explicitly reject the notion of two mutually exclusive genders. The word ‘trans’ is often used to encompass all of these identities and the phrase ‘affirmed gender’ to convey a person’s sense of self.

Inspired by the Dutch study, Strang and his colleagues approached prevalence from another angle. Instead of measuring the incidence of autism among gender-dysphoric children and adolescents, they assessed gender variance — defined as a child “wishing to be the other sex” — in children with autism. “We found rates that were 7.5 times higher than expected,” Strang says.

Still, she cautions that sometimes, what looks like autism may actually be untreated gender dysphoria. “So much of the experience of being trans can look like the spectrum experience,” she says. People who don’t want to socialize in their birth genders may seem to have poor social skills, for example; they may also feel so uncomfortable with their bodies that they neglect their appearance. “That can sometimes be greatly alleviated if you give that person appropriate gender support,” she says.

Others agree with these insights. A 2015 study by researchers from Boston Children’s Hospital reported that 23.1 percent of young people presenting with gender dysphoria at a gender clinic there had possible, likely or very likely Asperger syndrome, as measured by the Asperger Syndrome Diagnostic Scale, even though few had an existing diagnosis. Based on these findings, the researchers recommend routine autism screening at gender clinics.

Source: Living between genders | Spectrum

Gender norms should not be imposed on people with autism to make the rest of the world more comfortable. Why teach girls with autism how to apply makeup, dress in a feminine manner and shop? Therapists, educators and parents only consider these to be important goals because our society imposes strict gender norms.

As a member of the LGBTQ community who is also autistic, I encounter inequality based on my gender identity, my sexual orientation and my disability. Societal barriers in housing, employment, transportation, healthcare and education systematically exclude queer, gender-queer, transgender and disabled people; outdated and negative attitudes about gender, sexuality and autism affect our social relationships.

Queer environments don’t often account for our sensory processing issues or social differences, whereas autism services don’t often recognize that we may identify beyond the gender binary or have queer relationships. Shifting the focus from the tired narratives of delayed diagnosis and sex differences can help the autism community take responsibility for improving our day-to-day quality of life, whatever our age at diagnosis or gender identity.

Source: Focus on autism must broaden to include non-binary genders | Spectrum

Nearly a quarter of young persons diagnosed with gender dysphoria, or who are transgender, screened positive for Asperger syndrome, a form of autism, according to a new paper in the academic journal LGBT Health.

The study was a small retrospective review of intake files of 39 children at Boston Children’s Hospital. Lead author Dr. Daniel E. Shumer explains, “We found that 23 percent of kids fell into the ‘possible, likely or very likely category’ when using the evaluation tool to screen for Asperger’s.”

“Having autism is a burden; a lot of things in the world change when you have autism,” says Strang. “But adding transgenderism, or maybe some of them aren’t transgender but they are just exploring gender, that is complicated in itself.”

“Knowing how to navigate in a world that is not really friendly with people who are trans can be tricky when you are missing social cues.”

Shumer says it is important that parents and medical providers be aware of the increased possibility for co-occurrence of autism and gender variance. If treating patients for one condition, they should screen for the other and be prepared to treat it.

“There also may be implications for how to provide informed consent for things like hormonal interventions,” he adds.

Source: PrideSource – Transgender Youth More Likely to Have Autism

Lovaas’s crusade to “normalize” deviance was not limited to autistic children. In the 1970s, he lent his expertise to a series of experiments called the Feminine Boy Project, the brainchild of UCLA psychologist Richard Green. After interviewing one hundred men and women who applied for gender reassignment surgery, Green became interested in tracing the roots of sexual identity back to childhood. He teamed up with Lovaas to see if operant conditioning could be employed as an early intervention in cases of gender confusion to prevent the need for reassignment surgery in the future.

The project’s most celebrated success story was Kirk Andrew Murphy, enrolled at UCLA by his parents at age five. Bright and precocious, Kirk would ask for his favorite snacks by their brand names at the supermarket. But after seeing Green interviewed on TV about “sissy-boy syndrome”— his term for early-onset gender dysphoria— Kirk’s parents became concerned that he was exhibiting behavior that was inappropriate for a little boy. One day, his father caught him posing in the kitchen in a long T-shirt and saying, “Isn’t my dress pretty?” Children with this syndrome, Green claimed, often grew up to become transsexual or homosexual. Lovaas assigned a young graduate student named George Rekers to become Kirk’s behavioral therapist.

In a case report that would go on to become a classic in undergraduate psychology courses, Rekers and Lovaas wrote that Kirk (called “Kraig”) possessed “a remarkable ability to mimic all the subtle feminine behaviors of an adult woman.” They framed his “offer to ‘help mommy’ by carrying her purse” as an example of the boy’s devious manipulation of his mother to “satisfy his feminine interests.” Their descriptions of the little boy’s behavior, compared with the transcripts of Green’s intake interviews with Kirk’s parents, were decidedly more extreme, as if the boy were clearly a world-class drag queen in the making at age five. They claimed that he had an elaborate “history of cross-dressing” that included plundering his grandmother’s makeup kit for cosmetics and “swishing around the home and clinic, fully dressed as a woman with a long dress, wig, nail polish, high screechy voice, [and] slovenly seductive eyes.” (In family photographs, Kirk more resembles a Mouseketeer.)

Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 320). Penguin Publishing Group. Kindle Edition.

In a case report that would go on to become a classic in undergraduate psychology courses, Rekers and Lovaas wrote that Kirk (called “Kraig”) possessed “a remarkable ability to mimic all the subtle feminine behaviors of an adult woman.” They framed his “offer to ‘help mommy’ by carrying her purse” as an example of the boy’s devious manipulation of his mother to “satisfy his feminine interests.” Their descriptions of the little boy’s behavior, compared with the transcripts of Green’s intake interviews with Kirk’s parents, were decidedly more extreme, as if the boy were clearly a world-class drag queen in the making at age five. They claimed that he had an elaborate “history of cross-dressing” that included plundering his grandmother’s makeup kit for cosmetics and “swishing around the home and clinic, fully dressed as a woman with a long dress, wig, nail polish, high screechy voice, [and] slovenly seductive eyes.” (In family photographs, Kirk more resembles a Mouseketeer.)

Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 320). Penguin Publishing Group. Kindle Edition.

In a case report that would go on to become a classic in undergraduate psychology courses, Rekers and Lovaas wrote that Kirk (called “Kraig”) possessed “a remarkable ability to mimic all the subtle feminine behaviors of an adult woman.” They framed his “offer to ‘help mommy’ by carrying her purse” as an example of the boy’s devious manipulation of his mother to “satisfy his feminine interests.” Their descriptions of the little boy’s behavior, compared with the transcripts of Green’s intake interviews with Kirk’s parents, were decidedly more extreme, as if the boy were clearly a world-class drag queen in the making at age five. They claimed that he had an elaborate “history of cross-dressing” that included plundering his grandmother’s makeup kit for cosmetics and “swishing around the home and clinic, fully dressed as a woman with a long dress, wig, nail polish, high screechy voice, [and] slovenly seductive eyes.” (In family photographs, Kirk more resembles a Mouseketeer.

Source: Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (pp. 319-320). Penguin Publishing Group. Kindle Edition.

To nip the little boy’s inappropriate behavior in the bud, they devised a program of total immersion based on Lovaas’s work on autism. This time, instead of hand-flapping, gaze aversion, and echolalia, the behaviors targeted for extinction included the “limp wrist,” the submissively yielding “hand clasp,” the notorious “swishy gait,” the girlish “hyperextension” of the limbs in moments of exuberance, and prissy declarations like “goodness gracious” and “oh, dear me.”

At home, Kirk’s “masculine” behaviors were rewarded with blue chips that could be redeemed for candy and other treats, while his “feminine” behaviors were punished with red chips that were subtracted from the total. In interviews conducted by blogger Jim Burroway, who undertook a thorough investigation of the case in 2011, Kirk’s brother, Mark, recalled their father punishing the boy— with Rekers’s approval— by converting each red chip into a “swat.” Mark broke down sobbing as he confessed to hiding red chips from his brother’s pile so that Kirk wouldn’t have to endure the abuse.

Source: Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (pp. 320-321). Penguin Publishing Group. Kindle Edition.

Misperceptions about what it means to be transgender or about autistic people’s ability to understand their gender or make decisions about their bodies often prompt service providers or family members to stand in the way of transgender autistic people’s attempts to live life with authenticity and dignity. This can include denying transgender autistic people access to transition-related care, subjecting them to “normalization” treatments aimed at suppressing their gender expression, or placing them in guardianship or institutional settings that restrict their decision-making power. While research suggests a large overlap between transgender and autistic communities, trans autistic people often lack access to services and supports that understand and respect all aspects of their identity.

“Too frequently, autistic people are denied basic rights to make decisions about our own bodies and health care, including when it comes to expressing our gender identity,” said Sam Crane, Legal Policy Director for the Autistic Self-Advocacy Network. “Whether we’re transgender or not, autistic people’s gender identities are as real as anyone else’s and should be respected and supported, not dismissed based on baseless stereotypes.”

Source: Autistic Self-Advocacy Network, LGBT Groups Release Statement on Needs of Trans Autistic People | Autistic Self Advocacy Network

Don’t use this information to “blame” trans identity on autism. Don’t threaten identity or reduce agency.

To blame trans identities on autism is to say that autistic people cannot understand or be aware of their own gender. If an autistic person cannot know they are trans, how can they know they aren’t? How can they know anything about themselves?

When a person’s gender is doubted because they are autistic, this paves the way for removing autistic people’s agency in all kinds of other ways. If we can’t know this central aspect of our identity, we surely can’t know how we feel, what we like, or who we are. In short, it implies that we are not truly people, and that our existence, experiences, and identities are for other people to define. This is just another facet of dehumanising autistic people, and gender is certainly not the only area in which this happens.

In itself, the very urge to find a ‘reason’ that someone is transgender is a result of believing that being transgender is a problem, and that it would always be better not to be. The fact that clinicians like Zucker are focused on why someone is transgender, instead of focusing on what kind of help they need and how to best provide it, demonstrates clearly the belief that it is fundamentally bad to be transgender.

Not only that, but the belief that it’s even theoretically possible for anyone besides the individual in question to know what someone’s gender is. That’s just not how gender works! No-one really understand what gender is, or what it means, or where it comes from. The only thing we know for sure is that it’s internal, subjective, and personal. You can’t prove or test someone else’s gender any more than you can prove or test their favourite colour. The idea that it can be tested is constantly used to invalidate trans people. Our genders are doubted or disbelieved if we fail to adequately ‘prove’ ourselves to everyone else – if we express too many or too few gender stereotypes, if we are too old or too young, if we claim to be nonbinary or our description of our identity is too complicated or confusing.

The best option is to allow someone to explore their feelings, support them in gaining self-understanding, and accept their identity whatever it turns out to be. It is not complicated, and it’s only scary if you are still holding onto the belief that being either autistic or transgender – or, perish the thought, both – is a terrible thing to be. Which it’s not. I am, along with countless others like me, living proof of that.

“A common misconception is the assumption that gender and sexuality are irrelevant to autistic people, or that our sexuality and gender identities are symptoms of our autism,” said Bascom. “These beliefs are not only inaccurate but also profoundly harmful to autistic people and are often used to prevent autistic LGBT folks from accessing LGBT spaces, authentic relationships, and transition-related health care. The reality is that autistic people can have a beautiful diversity of gender identities and sexualities, and we have the same right to self-determination as anybody else.”

Source: How doctors’ offices and queer culture are failing autistic LGBTQ people.

Studies:

Harm reduction, addiction, tough love, 12 steps, neurodiversity, and the troubled-teen industry

If addiction is like misguided love, then compassion is a far better approach than punishment.

Source: Can You Get Over an Addiction? – The New York Times

Maia Szalavitz poses addiction as a neuro-developmental learning disorder—one often developed while trying to cope with trauma, poverty, or an over reactive nervous system, particularly during adolescence.

Many neurodivergent have hyper-reactive nervous systems. Anxiety and sensory overwhelm flood the senses. A substance that eases anxiety and sensory overwhelm offers relief and escape.

I’m autistic. Much of autism is anxiety and sensory overwhelm. A widely available—and destructive—tool for coping is alcohol. Compulsive damping of my reactive neurology with alcohol compromised my health.

There are less harmful ways to medicate. Cannabis is a neuroprotectant and powerful harm reducer that is friendly to neurodivergence.

Cannabis is the least harmful way for we humans to cope with the burdens of sentience, senescence, and mortality. Cannabis is popular in STEAM cultures, at least the ones I’ve inhabited. It is part of the process of living, creating, and coping. I think the neurodivergent have long used it to regulate and cope in a world that does not accommodate. If your neurodivergence is accompanied by tics, seizures, paresthesia, fasciculations, panic, anxiety, or self-harming stimming, as but a few examples, then cannabis is a tool and ally. There are as many human operating systems as there are humans. The endocannabinoid system is a useful interface to our operating systems for which we have a natural, easy-to-grow key. All humans and their mammalian kin share this interface and this plant. We plucky prometheans figured out how to decarboxylate with fire.

Source: On cannabis and neurodiversity

The drug war’s perverse notions of addiction, addicts, and coping limit our vocabulary, stifle our empathy, and harm us all–especially those with neurodivergent operating systems and those enduring poverty and structural racism and ableism.

Through compassion, the social model, and respect for neurodiversity and structural disadvantages, we can improve our views of addiction.

Follow Maia Szalavitz on Twitter and read her book.

Addiction as a learning disorder

More people than ever before see themselves as addicted to, or recovering from, addiction, whether it be alcohol or drugs, prescription meds, sex, gambling, porn, or the internet. But despite the unprecedented attention, our understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as brain disease, and in equally outdated treatment.

Challenging both the idea of the addict’s “broken brain” and the notion of a simple” addictive personality,” Unbroken Brain offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention and policy. Like autistic traits, addictive behaviors fall on a spectrum — and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture and chemicals come together to create both illness and recovery- and why there is no “addictive personality” or single treatment that works for all.

Source: Unbroken Brain – Maia Szalavitz

Addiction is indeed a brain problem, but it’s not a degenerative pathology like Alzheimer’s disease or cancer, nor is it evidence of a criminal mind. Instead, it’s a learning disorder, a difference in the wiring of the brain that affects the way we process information about motivation, reward and punishment. And, as with many learning disorders, addictive behavior is shaped by genetic and environmental influences over the course of development.

The studies show that addiction alters the interactions between midbrain regions like the ventral tegmentum and the nucleus accumbens, which are involved with motivation and pleasure, and parts of the prefrontal cortex that mediate decisions and help set priorities. Acting in concert, these networks determine what we value in order to ensure that we attain critical biological goals: namely, survival and reproduction.

In essence, addiction occurs when these brain systems are focused on the wrong objects: a drug or self-destructive behavior like excessive gambling instead of a new sexual partner or a baby. Once that happens, it can cause serious trouble.

If, like me, you grew up with a hyper-reactive nervous system that constantly made you feel overwhelmed, alienated and unlovable, finding a substance that eases social stress becomes a blessed escape.

The learning perspective also explains why the compulsion for alcohol or drugs can be so strong and why people with addiction continue even when the damage far outweighs the pleasure they receive and why they can appear to be acting irrationally: If you believe that something is essential to your survival, your priorities won’t make sense to others.

Recognizing addiction as a learning disorder can also help end the argument over whether addiction should be treated as a progressive illness, as experts contend, or as a moral problem, a belief that is reflected in our continuing criminalization of certain drugs. You’ve just learned a maladaptive way of coping.

Moreover, if addiction resides in the parts of the brain involved in love, then recovery is more like getting over a breakup than it is like facing a lifelong illness. Healing a broken heart is difficult and often involves relapses into obsessive behavior, but it’s not brain damage.

If addiction is like misguided love, then compassion is a far better approach than punishment.

This makes sense because the circuitry that normally connects us to one another socially has been channeled instead into drug seeking. To return our brains to normal then, we need more love, not more pain.

People with addictions are already driven to push through negative experiences by their brain circuitry; more punishment won’t change this.

But it’s equally possible that I kicked then because I had become biologically capable of doing so. During adolescence, the engine that drives desire and motivation grows stronger. But unfortunately, only in the mid-to-late 20s are we able to exert more control. This is why adolescence is the highest risk period for developing addiction — and simple maturation may be what helped me get better.

At the time, nearly all treatment was based on 12-step groups like Alcoholics Anonymous, which help only a minority of addicted people. Even today, most treatment available in rehab facilities involves instruction in the prayer, surrender to a higher power, confession and restitution prescribed by the steps.

We treat no other medical condition with such moralizing — people with other learning disorders aren’t pushed to apologize for their past behavior, nor are those affected by schizophrenia or depression.

Once we understand that addiction is neither a sin nor a progressive disease, just different brain wiring, we can stop persisting in policies that don’t work, and start teaching recovery.

Indeed, if the compulsive drive that sustains addiction is directed into healthier channels, this type of wiring can be a benefit, not just a disability. After all, persisting despite rejection didn’t only lead to addiction for me — it has also been indispensable to my survival as a writer. The ability to persevere is an asset: People with addiction just need to learn how to redirect it.

Source: Can You Get Over an Addiction? – The New York Times

I want people to understand that addiction is a learning disorder. If you don’t learn that a drug helps you cope or make you feel good, you wouldn’t know what to crave. People fall in love with a substance or an activity, like gambling. Falling in love doesn’t harm your brain, but it does produce a unique type of learning that causes craving, alters choices and is really hard to forget.

It’s compulsive behavior that persists despite negative consequences. Once you realize that that’s the definition of addiction, you realize that what’s going on is a failure to respond to punishment. If punishment worked to stop addiction, addiction wouldn’t exist. People use despite their families getting mad at them, despite losing their jobs and being homeless. And yet we think the threat of jail is going to be different? Addiction persists despite negative consequences. That doesn’t mean that people don’t recover through coercive means, but that doesn’t mean it’s the best way to get there.

My problem with addiction memoirs has always been that this is a deeply political problem and none of them have any political consciousness. They typically tell the story of sin and redemption, an individual story that can stand in for everyone else’s story. That’s just not true.

People who become addicted are wired differently, and it affects the manner in which they learn. We see people with addiction as valueless—literally, pieces of junk. But the interesting thing with different types of brain wiring is, they don’t bring only disadvantages. They can also bring advantages. Sometimes there are blessings hidden inside of curses. The compulsive drive that set me up for addiction probably also makes me a good journalist.

Having the ability to persist despite negative consequences is a plus in many ways. You could never parent or be in a relationship without that ability. Diaper-changing is not fun. There’s a lot of stuff in life where you just have to stick it out. When those same systems that give us motivation get misdirected toward a drug, that’s problematic. It doesn’t mean you’re broken, it just means you fell in love with the wrong thing.

If addiction was genuinely a disease that got worse and worse, it should be harder to recover the older you get. But the data say differently: by their early thirties, half of people who have addiction, excepting tobacco, no longer meet diagnostic criteria. They learn to cut down on their own—and only 10 percent ever get treatment.

Language is power, and it’s important not to dehumanize people who have addiction. The term “addict” is stigmatizing and demonizing. The stereotype of the “addict” is also a stereotype we have for people of color. We have to move away from that language in order to move away from that racism.

Also, when we use the word “abuse,” it connotes really awful behavior, like domestic abuse, child abuse, sexual abuse. Nobody’s abusing a poor little drug. They might be misusing it, but they’re not abusing it.

And the very point of making something a crime is to stigmatize it. You want it to be stigmatized so people don’t do it. Yet you can’t say on one hand that you want to destigmatize addiction while you criminalize certain drugs. And the other thing that undermines the argument about addiction being a disease is that the only disease in America where 80 percent of the treatment is meeting, confession, and surrendering to a higher power.

We should decriminalize all drug possession, legalize marijuana, use the money we save to fund evidence-based treatment. We need to get rid of the cap on suboxone prescribers, (the law allows doctors to prescribe to only 100 patients) and use it as harm reduction as well as a path to recovery. We’d have fifty percent fewer deaths if we relied on medication-assisted therapy. People have to be alive to recover.

Source: Why Addiction Is a Learning Disorder – The Daily Beast

Addiction, in your view, is a neuro-developmental learning disorder. What does that mean?

It means that for one, addiction can’t occur without learning. When I say that, what I mean is literally if you don’t learn that the drug comforts you, makes you feel euphoric or allows you to cope in some way, you cannot be addicted to it—because you cannot crave it, because you don’t know what to pursue despite negative consequences. And that’s important, because people have often thought addiction is just this physiological process that hijacks your brain. That’s really not quite accurate. It involves learning, it involves interacting with the environment, interpreting the environment, and it involves making choices.

The other reason that I think it’s important to see addiction as a developmental disorder is that 90 percent of all addiction occurs between the teens and 20s. That is similar to other developmental conditions such as schizophrenia and depression, which tend to start at that age. That suggests there is a particular period of vulnerability that the brain has and also probably has to do with your life history, as well. When you hit your teens or 20s you’re learning the coping skills you need to handle the adult relationships that are necessary for survival and reproduction. If you are using drugs to escape during this time not only is your brain developmentally vulnerable to not being able to control the use of the drug, but you’re also missing out on developmental experiences that allow you to create other methods of coping.

Unfortunately, in the addictions field, we’ve developed this idea that one size fits all, and whatever works for me is going to work for you, and we can extrapolate from my experience to be the experience of all people with addiction. That’s why I like the saying from the autism community, which is: if you met one person with autism you’ve met one person with autism. We should be saying that about addictions. I find it really annoying when people say “all addicts do X or Y.” Well, maybe you do X or Y, but don’t speak for me.

Imagine I’m trying to argue that the medical condition I have is a disease. But, everybody who has that medical condition can be locked up for having that medical condition, and, if they’re not locked up, they are sent to treatment that involves prayer and restitution.

So, am I going to believe that’s a disease? If I go to cancer treatment and I get told I’m going to be locked up if my tumor grows or I’m going to have to pray to a higher power and surrender in order to get better, I’m going to definitely think that I’m not in mainstream medicine. I’m definitely going to be thinking that this is not a medical condition, that it’s some kind of sin. The 12-step people don’t see any contradiction in saying addiction is a disease and the treatment is prayer, meeting, and confession. But, from the outside that sounds completely absurd. It does not bolster the disease argument at all.

When I talk about addiction being a learning disorder, I’m not saying that it isn’t a problem of the brain, obviously. I’m saying the kind of problem it is is more like ADHD than it is Alzheimer’s. And I think that fits the data. If addiction is actually progressive, it should be harder to recover as you get older and that is not actually true. It also gives a much more hopeful message. Because when people hear “chronic progressive brain disease” they think dementia. When they hear hijacked brain they think: oh my god, these are zombies who are dangerous and we better lock them up for the protection of the rest of us. They think of people who have no responsibility for their actions so therefore we can treat them like children.

If addiction is a learning disorder, fighting a ‘war on drugs’ is useless.

In terms of marijuana: it should be legalized. It is the least harmful, not completely unharmful, but the least harmful psychoactive substance that is regularly used. It makes absolutely no sense to give that profit to the mafia.

Where you end is a comment on neurodiversity, the idea that people with different wiring do not only have impediments, but also assets that ought to be celebrated and respected. Can you explain how this relates more to your work?

It’s quite obvious for some people on the autism spectrum that they’re quite good at things like programming but quite horrible at socializing. I think the neurodiveristy movement is really cool in valuing everybody and letting people see that what may look scary or different or totally weird on the outside may, from the inside, make total sense. It expands the world for everybody.

It’s not just that people who have disabling conditions benefit from the world being friendlier towards us, but we also benefit from being able to function and offer things that we are uniquely equipped to do. I think with addictions in particular, you can’t succeed as a writer if you can’t persist despite negative consequences.

Source: Addiction is a learning disorder: Why the war on drugs is useless, AA undermines treatment, and addiction studies can learn a lot from autism

Many of us grew up with antidrug programs like D.A.R.E. or the Nancy Reagan-inspired antidrug campaign “Just Say No.” But research shows those programs and others like them that depend on education and scare tactics were largely ineffective and did little to curb drug use by children at highest risk.

The traits that put kids at the highest risk for addiction aren’t all what you might expect. In my case, I seemed an unlikely candidate for addiction. I excelled academically, behaved well in class and participated in numerous extracurricular activities.

Inside, though, I was suffering from loneliness, anxiety and sensory overload. The same traits that made me “gifted” in academics left me clueless with people.

That’s why, when my health teacher said that peer pressure could push you to take drugs, what I heard instead was: “Drugs will make you cool.” As someone who felt like an outcast, this made psychoactive substances catnip.

They focus on four risky traits: sensation-seeking, impulsiveness, anxiety sensitivity and hopelessness.

Importantly, most at-risk kids can be spotted early. For example, in preschool I was given a diagnosis of attention deficit/hyperactivity disorder (A.D.H.D.), which increases illegal drug addiction risk by a factor of three. My difficulty regulating emotions and oversensitivity attracted bullies. Then, isolation led to despair.

A child who begins using drugs out of a sense of hopelessness — like me, for instance — has a quite different goal than one who seeks thrills.

Three of the four personality traits identified by Preventure are linked to mental health issues, a critical risk factor for addiction. Impulsiveness, for instance, is common among people with A.D.H.D., while hopelessness is often a precursor to depression. Anxiety sensitivity, which means being overly aware and frightened of physical signs of anxiety, is linked to panic disorder.

Source: The 4 Traits That Put Kids at Risk for Addiction – The New York Times

Addiction vs. Dependence, Interventions, Rehab

Much of the advice given by treatment groups and programs ignores what the data says in a similar way that anti-vaccination or climate skeptic websites ignore science. The addictions field is neither adequately regulated nor effectively overseen. There are no federal standards for counseling practices or rehab programs. In many states, becoming an addiction counselor doesn’t require a high school degree or any standardized training. “There’s nothing professional about it, and it’s not evidence-based,” said Dr. Mark Willenbring, the former director of treatment research at the National Institute on Alcohol Abuse and Alcoholism, who now runs a clinic that treats addictions.

Consequently, families are often given guidance that bears no resemblance to what the research evidence shows — and patients are commonly subjected to treatment that is known to do harm. People who are treated as experts firmly proclaim that they know what they are doing, but often turn out to base their care entirely on their own personal and clinical experience, not data.

In the past, researchers believed addiction just meant that someone needed a substance to function without suffering withdrawal. But now medical experts such as the National Institute on Drug Abuse define addiction as compulsive drug use that continues regardless of negative consequences.

That’s different from just depending on a daily dose. The latter is called physiological dependence; it affects almost anyone who takes opioids daily long term. “Physiological dependence is the normal response to regular dosages of many medications, whether opioids or others. It also happens with beta blockers for high blood pressure,” said Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse. Although many chronic pain patients are physically dependent on opioids, few develop the life-threatening compulsive pattern of drug use that signifies addiction.

When opioid addiction occurs, it is rarely someone’s only mental health problem.

Addressing these underlying issues is usually essential to successful treatment – but unfortunately, many treatment programs are just not equipped to do so, despite claiming otherwise.

“Interventions are almost always destructive, and sometimes, they destroy families.”

“The pure tough love approach does not seem particularly effective and is sometimes quite cruel and potentially counterproductive,” Compton said.

Jail is not treatment. Prisons and jails tend to be neither safe nor drug-free — and interaction with the criminal system, even with drug courts, often restricts access to the best treatment while sometimes punishing relapse more severely than the original offense.

Consequently, do not try to use legal consequences as a way to help people you love, and if possible, bail them out if they get arrested for drug crimes. This doesn’t mean you shouldn’t hold them accountable, but do so in ways that are less likely to lead to lifelong problems. Meaningful employment is an important factor in recovery — and few things are more harmful to the chances of getting a good job than having a criminal record.

Because opioid addiction rarely exists by itself, experts recommend starting any search for treatment with a complete psychiatric evaluation by an independent psychiatrist who is not affiliated with a particular treatment program.

For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question

In the U.K., researchers looked at data from more than 150,000 people treated for opioid addiction from 2005 to 2009 and found that those on buprenorphine or methadone had half the death rate compared with those who engaged in any type of abstinence-oriented treatment.

“Rehab kills people”

Shame and punishment do not work: These tend to drive relapse, rather than recovery.

Families and loved ones can improve the odds for people with addiction by helping motivate them to get treatment; seeking evidence-based care; keeping naloxone on hand; and treating addicted people with the empathy, support and respect they’d offer if they faced any other life-threatening medical problem.

Source: What Science Says To Do If Your Loved One Has An Opioid Addiction | FiveThirtyEight

In other words, if pain medications are making your life genuinely better and improving your ability to love and work, what you are experiencing if you have withdrawal symptoms is dependence, not addiction.

“Even patients themselves confuse addiction and dependence and feel guilty about it and feel like something is wrong with them,” says Richard Saitz, professor and chair of community health sciences at Boston University. “They are often treated as if something is wrong with them, when there’s nothing wrong at all. All of that ends up leading to actions or policies or guidelines that are really misguided and address the wrong thing.”

Early definitions of addiction often did indeed see it as being identical to dependence, in part because physical withdrawal symptoms can be objectively measured and researchers were trying to minimize subjectivity.

“It is clear that any harm that might occur because of the pejorative connotation of addiction would be completely outweighed by the tremendous harm that is now being done to patients who have needed medication withheld because their doctors believe they are addicted simply because they are dependent.”

An accurate conception of addiction also has implications for the fate of children exposed to drugs in the womb. During the crack era, stigma against “addicted” babies did real harm: Teachers, parents and medical professionals viewed so-called “crack babies” as doomed to be either helpless invalids or psychotic criminals. Of course, babies can’t get addicted, since a helpless infant cannot pursue drugs despite consequences and doesn’t even know if what he craves is drugs or a diaper change. But at least one study found that the derogatory labeling produced more punitive responses from adults and lowered their expectations of the children—in itself a harmful outcome.

In fact, much of the damage initially attributed to crack exposure in babies turned out to be associated with stress and poverty—and could be ameliorated by a loving, stable home.

Addiction is not dependence, and dependence is not necessarily a problem.

Until America understands that, needless suffering will continue.

Source: You Can Rely on Drugs Without Being an Addict – VICE

12 Steps, The Troubled Teen Industry, and Tough Love

The myth is that 12-step programs and their associated treatment industry thrive simply because Americans love them. In fact, both are substantially built on and maintained by force.

Coercion into the 12 Steps comes from five main sources: criminal courts, family courts and family services, health care systems, families and employers.

So even by dated and conservative estimates, hundreds of thousands of Americans per year are forced into AA and 12-step-oriented treatment. Yet a steady stream of legal decisions confirms that such court-ordered treatment is illegal.

Every Federal Circuit Court (federal appeals court) and state supreme court that has ruled on such coercion has declared that the 12 Steps are religious in nature, and that it violates a parolee’s or probationer’s First Amendment rights for a court to require AA attendance when the 12-step philosophy violates the individual’s belief system.

Perhaps you didn’t believe that in a major American city in 2016, a court—nay, a drug court—could force people into AA against their belief system, with no sense that this was illegal, inappropriate, or ignorant of other options?

In fact, it remains standard practice.

We must realize that the American 12-step-treatment monolith, thought to be so facilitative and appealing to millions of people—and I have often lamented its cultural dominance—couldn’t operate to anything like its current extent without constant threats of denial or withdrawal of legal freedom, of custody of children, of licensure or employment, of medical care, of family support.

In the meantime, drinking problems, drug addiction and drug deaths in America continue to grow unabated, with our only response being more of the same.

Source: American Gulag: The Five Ways Hundreds of Thousands of People Are Coerced Into Rehab and AA | TheInfluence

Island View — which housed more than 100 children at a time, aged 13-17, and charged parents at least $10,000 a month — caused lasting damage to its students, a dozen of them told HuffPost. Former residents said the staff tormented and abused them — pitting teens against each other, physically restraining them, secluding them, medicating them with high doses of powerful antipsychotics and forcing them to sit without speaking for hours or days at a time.

But there’s little evidence that “tough love” techniques such as isolation and humiliation actually work. And the basic setup of residential treatment facilities lends itself to abuse, critics of the industry argue.

“If you have an institution where you have vulnerable people, abuses of power will almost always occur unless you have really strong safeguards against them —especially if you have vulnerable people who can’t contact the outside world,” said Maia Szalavitz, a journalist who wrote a book, Help at Any Cost, about the troubled-teen industry. “That in itself is a recipe for abuse.”

Despite this record of abuse — which journalists have been writing about for decades — parents upset by their children’s treatment at facilities like Island View often have just one option: lawsuits. “It’s one of the most horrendous things,” said Thomas Burton, a Utah attorney who has helped parents sue the centers. “The state isn’t going to prosecute these RTCs, and local law enforcement agencies aren’t going to impair the enormous amounts of money being brought into local communities. I mean enormous amounts of money — they’re cash cows. So where else can [parents] turn?”

Even solitary confinement — which President Barack Obama has banned for juveniles in federal prison — is permitted at many private treatment centers.

Island View and similar facilities demand one thing from students: absolute compliance.

Compliant children were rewarded with special privileges, like trips outside the facility. Noncompliant children were punished with physical restraint and isolation. They were all expected to participate in group “therapy” sessions that required them to complain about and attack each other. Many of them were medicated with high-dose antipsychotics.

Demands for compliance began the moment students arrived at Island View. Staff strip-searched new students.

“Long-term treatment facilities are like … a jail without having done anything illegal,” said 25-year-old Michelle Lemcke, who attended Island View in 2006.

Pysically restraining students and pitting them against each other weren’t the only ways Island View staff had to enforce compliance.

Island View’s resident handbook forbids “any form of sexual acting out … including note writing.” So when Graeber passed a note to a boy in her class one day — and locked eyes with him — she was immediately sent to the Yellow Zone.

Students in the Yellow Zone had to sit silently in a white plastic lawn chair at a desk in a hallway for hours — or days.

Graeber and others said they were often given the maximum sentence: 72 hours of isolation and silence.

“These kids were being used as damn lab rats,” he said. “Poor kids are falling asleep in class, getting in trouble, and they’re always so thirsty — mouths super dry. … All they did was pass pills. But if a kid was sick or throwing up from the medication, they wouldn’t do much else but give you a Sprite and watch you.”

Then she was placed in a Yellow Zone variation called “Individual Focus” — which included sleeping in a brightly lit hallway — for more than two weeks. As an additional punishment, Graeber said she was not allowed to speak for 58 days.

Parents sometimes forget that “troubled teen is not a diagnosis,” said Szalavitz, the journalist who wrote the book on the industry. “If your kid has behavior issues, generally the first thing to do is get a psychiatric evaluation — somebody who is independent, not an educational consultant, no affiliation with any industry — and figure out what the heck is going on.”

Moreover, the rote compliance these places demand is not a useful coping strategy for life outside an institution, Burnim said. “You can teach them to be compliant in an institution because they get the reward of … getting out,” he explained, “but once they get out, it’s the same old problem, and they haven’t learned how to better manage their condition.”

But the gold standard for treating most disturbed children is giving parents the support and services they need to keep their kids with them. There is a “virtual national consensus among people in the mental health field that children with mental health difficulties and behavioral problems should be treated at home,” Burnim said.

Source: The Troubled-Teen Industry Has Been A Disaster For Decades. And It’s Still Not Fixed

However, I’ll also deeply regret that people in the program persuaded me to give “tough love” a try.

The tougher I became, the worse Wyatt and I fought and more sneaky he became. He lied, stole, bullied and badgered me. And I was consistently guided to hold my boundaries, to kick him out of my home before I let him call the shots.

There’s a reward/shame element to the 12­-step philosophy. You get a chip when you do well. You start from square one when you “relapse.” After his anti­-extended care outburst, Wyatt was promptly bumped down a level and his phone privileges were taken away. In retrospect, this seems like nothing but pure punishment.

I have two very close friends whose sons died of heroin overdoses. When we talk, it’s often about our pain and anger over the rehab racket. And it was one of them who first told me about a different type of approach, known as “harm reduction,” that opened a bright new door for Wyatt and me.

“Harm Reduction means taking control—of your use of drugs or alcohol, of the damage that use does to you, of the harm your use causes others, and how you live your life,” write Patt Denning, Jeannie Little and Adina Glickman in Over the Influence.

According to this philosophy, abstinence is not required to be the goal—moderation, a reduction, or simply safer use are also seen as valuable positive outcomes. Importantly, individuals are encouraged to set their own goals, rather than having them imposed by others.

Substance use disorders don’t have to be viewed as lifelong diseases. And within this framework, many therapies, such as Cognitive Behavior Therapy (CBT) or Dialectical Behavior Therapy, process groups and individual counseling can be utilized. It does not hold that someone experiencing drug-­related problems must hit “rock bottom”—quite the contrary.

After a couple of sessions with a harm reduction counselor, Wyatt agreed to go to a SMART Recovery rehab in California. SMART Recovery support groups are abstinence-­based, but they recognize that not everyone walks in the door with an abstinence goal, and everyone is welcome. They don’t require the use of terms such as “addict” or “alcoholic”—in fact, these are discouraged. The overarching philosophy is one of empowerment and the use of scientifically proven tools.

When Wyatt returned home he continued to see his therapist. One day he described his cravings to me, and how marijuana helped them. I was still in abstinence­-only mode, but then a light switched on: If he found that using cannabis could help his PTSD and keep him off other, potentially much more harmful stuff, so be it.

I was very reluctant at first. But I considered a dear friend of mine who has acute lymphoid leukemia, and who treats her pain and nausea with cannabis. I decided I had nothing to lose.

It works. For Wyatt, it alleviates the anxiety and panic he experiences and assuages most (if not all) of his cravings for dex.

Last week, Wyatt commented that it had been a full year that he had not been in a hospital, in jail, on probation or in a rehab—the first full year since 2009.

I am certain that had I continued on the “tough love” path, he’d be dead or in jail. I am also certain that in addition to the trauma of my parents’ deaths, there was considerable additional trauma as a result of the application of certain Al-Anon principles.

I no longer attend Al-Anon. I wish I could comfortably and honestly share in meetings about the benefits of marijuana, but I can’t. My friend whose son died has told me she’d have been more than willing to let her son smoke some marijuana to keep him alive. She feels she has learned too late about harm reduction.

I can no longer tolerate the sobs of a parent who has tossed their child on the street in the name of “tough love” and “hitting rock bottom.”

I now know that there’s a better way.

Source: How I Learned That “Tough Love” Was Failing My Son—And Found Something So Much Better | TheInfluence

Fully buying into the program requires desperation, in other words, and to “help” addicts get to that desperate point is to help them recover: “From this perspective,” writes Szalavitz, “the more punitively addicts are treated, the more likely they will be to recover; the lower they are made to fall, the more likely they will be to wake up and quit.”

Szalavitz explains that this is a totally pseudoscientific concept — the founders of A.A. embraced it as dogma but were not in a position to test it scientifically. And even they realized, on some level, that “hitting bottom” was it was a bunk idea, simply because some A.A. members would recover before thoroughly screwing up their lives. A.A. had to introduce the conceptual trick of “high bottoms” — some people hit “bottom” at a relatively high point, in other words — to account for this.

“Misinterpreted ideas taken from 12-step-based rehabs are integrated with the criminal justice system and are part of the belief system that quietly upholds current policies. They are deeply embedded … in nearly every public and private system that addresses addiction.” Specifically, 12-step programs “are now a required curriculum in at least 80% of American addiction treatment programs.” And since many people get referred to these addiction programs via court orders, countless vulnerable people are shuttled into programs that embrace a totally false, harmful view of what addiction is. In many cases, drug-court advocates argue against treatment and in favor of harsh punishment, simply because it fits into the 12-step, “bottoming out” framework — a bare prison cell certainly feels more like “hitting bottom” than a treatment program.

Forcing patients to hit bottom had results that were, in retrospect, predictable: It gave rise to “attack therapy” in programs like Synanon, launched in 1958, where “the idea was to demolish the ego, using intimate secrets people revealed to find their weak spots and try to obliterate the ‘character defects’ believed to be found in all people with addiction.”

But what is clear is that these ideas all fly in the face of what the literature shouts at us about treating addiction: that it’s best done by providing addicts with empathy, support, and healthy social networks — not by snatching these vital lifelines from them.

But throughout her book, Szalavitz argues, and argues compellingly, that when it comes to “hitting bottom” and so many of the other pseudoscientific approaches to fighting addiction, the actual goal — or part of it, at least — has always been to marginalize the addict, to set them apart and humiliate them. There’s a deep impulse to draw a clear, bold line between us, the healthy people, and them, the addicts. What clearer way to emphasize that divide than to cast them down into a rock-bottom pit, away from the rest ofus?

Source: The Tragic Myth of Addicts ‘Hitting Rock Bottom’ — Science of Us

I think that 12-step programs are fabulous self help. I think they can be absolutely wonderful as support groups. My issue with 12-step programs is that 80 percent of addiction treatment in this country consists primarily of indoctrinating people into 12-step programs, and no other medical care in the United States is like that. The data shows that cognitive behavioral therapy and motivational enhancement therapy are equally effective, and they have none of the issues around surrendering to a higher power, or prayer or confession.

I think that one of the problems with the primary 12-step approach that we’ve seen in addiction treatment is that because the 12 steps involve moral issues, it makes people think that addiction is a sin and not a disease. The only treatment in medicine that involves prayer, restitution and confession is for addiction. That fact makes people think that addiction is a sin, rather than a medical problem. I think that if we want to destigmatize addiction, we need to get the 12 steps out of professional treatment and put them where they belong — as self-help.

Source: ‘Unbroken Brain’ Explains Why ‘Tough’ Treatment Doesn’t Help Drug Addicts

Cannabis and Harm Reduction

Using data on all prescriptions filled by Medicare Part D enrollees from 2010 to 2013, we found that the use of prescription drugs for which marijuana could serve as a clinical alternative fell significantly, once a medical marijuana law was implemented. National overall reductions in Medicare program and enrollee spending when states implemented medical marijuana laws were estimated to be $165.2 million per year in 2013. The availability of medical marijuana has a significant effect on prescribing patterns and spending in Medicare Part D.

Source: Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D

The researchers found that in states with medical marijuana laws on the books, the number of prescriptions dropped for drugs to treat anxiety, depression, nausea, pain, psychosis, seizures, sleep disorders and spasticity. Those are all conditions for which marijuana is sometimes recommended.

If the trend bears out, it could have other public health ramifications. In states that legalized medical uses of marijuana, painkiller prescriptions dropped — on average, the study found, by about 1,800 daily doses filled each year per doctor. That tracks with other research on the subject.

Marijuana is unlike other drugs, such as opioids, overdoses of which can be fatal, said Deepak D’Souza, a professor of psychiatry at Yale School of Medicine, who has researched marijuana. “That doesn’t happen with marijuana,” he added.

Source: After Medical Marijuana Legalized, Medicare Prescriptions Drop For Many Drugs : Shots – Health News : NPR

A 2002 review of seven separate studies involving 7,934 drivers reported, “Crash culpability studies have failed to demonstrate that drivers with cannabinoids in the blood are significantly more likely than drug-free drivers to be culpable in road crashes.” This result is likely because subject under the influence of marijuana are aware of their impairment and compensate for it accordingly, such as by slowing down and by focusing their attention when they know a response will be required. This reaction is just the opposite of that exhibited by drivers under the influence of alcohol, who tend to drive in a more risky manner proportional to their intoxication.

Today, a large body of research exists exploring the impact of marijuana on psychomotor skills and actual driving performance. This research consists of driving simulator studies, on-road performance studies, crash culpability studies, and summary reviews of the existing evidence. To date, the result of this research is fairly consistent: Marijuana has a measurable yet relatively mild effect on psychomotor skills, yet it does not appear to play a significant role in vehicle crashes, particularly when compared to alcohol. Below is a summary of some of the existing data.

The results to date of crash culpability studies have failed to demonstrate that drivers with cannabinoids in the blood are significantly more likely than drug-free drivers to be culpable in road crashes.

“Cannabis leads to a more cautious style of driving, but it has a negative impact on decision time and trajectory. However, this in itself does not mean that drivers under the influence of cannabis represent a traffic safety risk. … Cannabis alone, particularly in low doses, has little effect on the skills involved in automobile driving.”

1. There is no evidence that consumption of cannabis alone increases the risk of culpability for traffic crash fatalities or injuries for which hospitalization occurs, and may reduce those risks.

In contrast to the compensatory behavior exhibited by subjects under marijuana treatment, subjects who have received alcohol tend to drive in a more risky manner. Both substances impair performance; however, the more cautious behavior of subjects who have received marijuana decreases the impact of the drug on performance, whereas the opposite holds true for alcohol.”

Evidence from the present and previous studies strongly suggests that alcohol encourages risky driving whereas THC encourages greater caution, at least in experiments. Another way THC seems to differ qualitatively from many other drugs is that the formers users seem better able to compensate for its adverse effects while driving under the influence.”

Source: Marijuana and Driving: A Review of the Scientific Evidence – NORML.org – Working to Reform Marijuana Laws

The reduced rate of opioid-related fatalities translated into about 1,700 fewer deaths in 2010 alone. The researchers suggest several possible explanations for this effect. “Patients with chronic noncancer pain who would have otherwise initiated opioid analgesics may choose medical cannabis instead,” Bachhuber et al. write. “In addition, patients already receiving opioid analgesics who start medical cannabis treatment may experience improved analgesia and decrease their opioid dose, thus potentially decreasing their dose-dependent risk of overdose. Finally, if medical cannabis laws lead to decreases in polypharmacy—particularly with benzodiazepines—in people taking opioid analgesics, overdose risk would be decreased.”

That last possibility could be more significant than you might think, since opioid-related deaths typically involve mixtures with other drugs, with benzodiazepines playing a substantial and increasing role. Bradford and Bradford found that medical marijuana laws were associated with decreases in prescriptions for drugs used to treat anxiety and sleep disorders. Benzodiazepines are commonly used for both purposes.

“We find fairly strong evidence…that states providing legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medications,” Powell et al. write. “We provide complementary evidence that dispensary provisions also reduced deaths due to opioid overdoses….Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.” Like Bachhuber et al., they found that the longer medical marijuana was legally available, the bigger the apparent benefit.

Source: Medical Marijuana Replaces More Dangerous Drugs – Reason.com

Cannabis is the least harmful way for we humans to cope with the burdens of sentience, senescence, and mortality. Cannabis is popular in STEAM cultures, at least the ones I’ve inhabited. It is part of the process of living, creating, and coping. I think the neurodivergent have long used it to regulate and cope in a world that does not accommodate. If your neurodivergence is accompanied by tics, seizures, paresthesia, fasciculations, panic, anxiety, or self-harming stimming, as but a few examples, then cannabis is a tool and ally. There are as many human operating systems as there are humans. The endocannabinoid system is a useful interface to our operating systems for which we have a natural, easy-to-grow key. All humans and their mammalian kin share this interface and this plant. We plucky prometheans figured out how to decarboxylate with fire.

Because, the drug war. The drug war preys on and abuses the different and the powerless. It puts neurodivergent kids in pipelines to prisons and foster systems where the incentives are to drug minds into compliance so that bodies can be more conveniently warehoused and souls more conveniently iced. The great many of us using cannabis to medicate and regulate are under constant threat of violence, humiliation, and confinement  in inhumane jails and prisons. The drug war’s perverse notions of addiction, addicts, and coping limit our vocabulary, stifle our empathy, and harm us all. The drug war, zero tolerance, and compliance culture are enemies of neurodiversity. Cannabis is a friend and a lever for change.

Source: On cannabis and neurodiversity

“The Silk Road website was in many respects the most responsible such marketplace in history, and consciously and deliberately included recognized harm reduction measures, including access to physician counseling,” he wrote. “Transactions on the Silk Road website were significantly safer than traditional illegal drug purchases and included quality control and accountability features” that kept purchasers “substantially safer” than regular drug purchases.

Many reformers, myself included, have long been highlighting the forward-thinking benefits of Silk Road and the ways it began to slowly revolutionize drug sales around the world. For instance, it provided a platform that could allow indigenous growers and cultivators around the world to sell directly to the consumer, potentially reducing cartel participation and violence… None of the transactions on Silk Road, for instance, resulted in women drug buyers being sexually assaulted or forced to trade sex for drugs, as is common in street-level drug transactions. Nor did any Silk Road transactions result in anyone having a gun pulled on them at the moment of purchase.

In his declaration, Caudevilla testifies that the site “espoused a harm reduction ethos which was reflected in the individual buyer-seller transactions on the site and in the community created on the site’s forums.” That community “enabled some site participants to reduce, if not entirely eliminate, their drug use.”

Caudevilla participated on the Silk Road forums for seven months and states that he “never came across even a single report of a Silk Road-related drug overdose.” Ulbricht’s lawyers point to the lack of such a “report” as a telling fact, although one wonders which section a user who had overdosed was expected to post in.

Source: Ulbricht’s lawyer: Silk Road was “the most responsible” drug market in history | Ars Technica

Supervised Injection

The more we degrade and ostracize people who inject drugs, the harder it is for them either to quit using their painkiller or to use it in a less risky way. When marginalized drug users walk through the doors of a supervised injection facility, the medical staff often become the only people in their lives who believe in them.

SIF staff may administer naloxone to stop clients from dying, but it is the human connections they forge that may give their clients the will to live.

Source: Supervised Injection Facilities Save Money and Lives: My Research Shows They’d Work for San Francisco | TheInfluence

 

The problems presented by injection drug use are legion, but creative solutions exist. One is the provision of safe drug-use rooms. Cities as far-flung as Vancouver, British Columbia, and Paris and Berlin have opened safe, well-lit rooms where addicts can get clean needles and other equipment without fear of incarceration. In New York State, Ithaca and Manhattan are considering similar initiatives. Such facilities can also connect addicts to needed services like preventive testing, acute care and treatment for addiction.

Safe drug-use rooms are typically designed to help keep addicts out of the hospital, but they could work for addicts within hospitals. A safe place to inject for addicted patients in the hospital could reduce conflict with staff, protect patients and providers from dirty needles and other drug hazards, and enable patients to receive respectful, high-quality care when back in their hospital beds. Safe drug-use rooms could also offer treatment for addiction, a step often neglected in hospitals.

The creation of these rooms for hospitalized addicts won’t be easy. There will be legal liability concerns, and hospitals must safeguard against the risk of overdose or unseemly behavior. It will be worthwhile to tackle these issues if it enables the provision of compassionate care for at-risk patients whose treatment would otherwise be endangered by conflict with providers.

Source: Let Opioid Users Inject in Hospitals – The New York Times

More

Identity First

“People-first” language is meant to divide, it is meant to demean, it is meant to dehumanize, it is meant to pathologize, and yet, it is meant, as I said before, to make its users feel good. In that way it is ultimately destructive because it covers up the crimes.

Only when people get to choose their own labels will we get anywhere toward building an equitable culture.

Source: Using “Correct Language” And “People First” by Ira David Socol — Bowllan’s Blog

I’m autistic, not a person with autism. Autistic is my identity.

Identity first language is common among social model advocates. When hanging out in social model and neurodiversity communities, identity first is usually a better default than person first.

There’s a language gap between self-advocates and the institutions that claim to represent them. There’s a gap between parents and their #ActuallyAutistic and disabled kids. There’s a generational gap in the disability movement. This is confusing for those trying to be allies. The articles below offer perspective and advice on identity first and person first language from self-advocates.

But please realise this: when autistic adults offer their experiences or insight, consider listening. We do not speak for your child, but we’re not really all that different from them. Telling us we’re “not autistic enough” insults us and trivialises the hardships many of us have endured. Hardships that, yes, may be very different from what your child might experience, but hardships nevertheless. I’ve earned the right to label myself as autistic. It explains everything. It is not all that I am, but it defines so much of who I am.

And that is why, for me at least, the identify label comes first. That I’m still a person should be obvious.

Source: Dear Autism Parent | The Misadventures of Mama Pineapple

When you excise a core defining feature of a person’s identity from their living, breathing self, you sort of objectify them a bit. And you make that core defining feature optional. Because it can be safely removed, and they’re still a person. Right? Well, a person, yes — but not the sort of person they know themselves to be. And not the sort of person you can truly get to know. Because you’ve denied one of the main characteristics of their nature, out of an intention to be … compassionate? Dunno. Or maybe sensitive?

Whatever the original intention, the effect is just a bit dehumanizing. And a lot of us don’t like it.

So, if you’re into PFL – person-first language – please reconsider before you use it regarding autism. Cancer is one thing. Plaque psoriasis is another. Autism… well, that’s in a league all its own. And I wouldn’t leave that domain for all the money (or well-intended compassion) in the world.

Source: The cognitive dissonance of “person-first” references to #autistic people – Happy, Healthy Autist

Though person-first language is designed to promote respect, the concept is based on the idea that disability is something negative, something that you shouldn’t want to see. After all, no one tells me that I should call myself a person with femaleness or a person with Jewishness. I’m a Jewish woman. No one questions that. Yet when I dare to call myself a disabled person, it seems the whole world turns upside down. That’s because gender and religion are seen as neutral, if not positive, characteristics. The idea of separating the disability from the person stems from the idea that disability is something you should want to have separated from you, like a rotten tooth that needs to be pulled out.

Disability is only negative because society makes it so. For sure, there are negative aspects of my disability. (For the sake of simplicity, I’m focusing solely on my physical disability, which is both the most visible and the most integrated into my being.) Chronic pain and fatigue are no picnic. But for the most part, my disability is just another thread in the tapestry of my life. Pull it and the whole thing might unravel. Pull it and you might get an ugly hole where something beautiful once was.

Identity-first language is founded upon the idea of the social model of disability. In a nutshell, the social model says that though our impairments (our diagnostic, medical conditions) may limit us in some ways, it is the inaccessibility of society that actually disables us and renders us unable to function. The most basic example is wheelchair accessibility. If I am using my wheelchair and I can’t go to a restaurant because it doesn’t have a ramp, am I disabled by my cerebral palsy or am I disabled by the inaccessibility of the restaurant?

If that restaurant has a ramp, I am able to function perfectly within that situation. I am able to go in, sit at a table, order my food, eat it, and pay, just like everyone else. My wheelchair is not the problem. The inaccessibility of the restaurant is. Saying that I am disabled more accurately highlights the complex biosocial reality of disability. I am not merely a person existing with a label; I am constantly disabled and enabled by the interplay of my body and the environment.

Source: I am Disabled: On Identity-First Versus People-First Language

Taking a cue from the radical Deaf community, ANI members began to refer to themselves as “Autistic” instead of saying that they were people with autism. “Saying ‘person with autism’ suggests that autism is something bad—so bad that it isn’t even consistent with being a person,” Sinclair observed. “We talk about left-handed people, not ‘people with left-handed- ness,’ and about athletic or musical people, not about ‘people with athleticism’ or ‘people with musicality’ . . . It is only when someone has decided that the characteristic being referred to is negative that suddenly people want to separate it from the person.”

Source: The Dawn of Autistic Space – Excerpt from NeuroTribes – Wrong Planet

In the case of “People First” language for those with disabilities , what we have is not belief in linguistic emancipation, but a desire to “change something” in order to make educators feel responsive. Special education services haven’t changed much at all in the past 40 or 50 years – we use the same deficit model, we use the same types of assessment, we still flail around with school-generated solutions which foster dependence – but we can see we have “evolved,” no retards, no cripples, no morons, hey “we’ve changed since the bad old days.”

But disability remains a social identity. To work from Tom Shakespeare, it is the intersection of ability and the social structure. There is no such thing as a legitimate way to define “normal.” After all, if there were, the bizarre global minority of humans without black hair and brown eyes would be considered freaks. So, society defines certain people as outside of normal, and they do that with words.

For some groups, the hyphenation strategy is reached, be it “Scotch-Irish” or “African-American” or even “Student-Athlete,” but for others, where a real belief in pathology remains, we keep the “person with” structure. A student with the swine flu. A student with cancer. A student with a learning disability.” We don’t hyphenate any of those because we do not accept them as cultural identities, rather, we view them as illnesses.

So call me “dyslexic,” and call me “multi-attentioned” (or something), but stop pathologizing me. I don’t “have” these things, I “am” these things, because your society has made it that way.

I believe that we have to challenge accepted strategies and ideas. And whether you call it “Normalism” or “Disablism” we need to understand how narrative impacts cultural belief. If we convert horrid prejudices into pleasant sounding phrases, we diffuse those prejudices as an issue. So, since you treat me as if I am “retarded,” please don’t hide behind your nonsensical, “Student with Learning Disabilities.” That language might make you feel better, but it does nothing for me.

As long as you consider one way of doing things “normal,” you will demean me and treat me as less than fully human. What I was trying to say in this post –in a way which would provoke conversation – was that the very concept of “accommodation” is so very wrong, because it is based in disablism – the belief that I and others are not, and will never get to be, “normal,” unless “you” cure me by making me like you.

“People-first” language is meant to divide, it is meant to demean, it is meant to dehumanize, it is meant to pathologize, and yet, it is meant, as I said before, to make its users feel good. In that way it is ultimately destructive because it covers up the crimes.

Only when people get to choose their own labels will we get anywhere toward building an equitable culture.

Source: Using “Correct Language” And “People First” by Ira David Socol — Bowllan’s Blog

When ABA proponents tell parents that only several hours a day of relentless compliance training can “make us fit for society”, they are not seeing a person. They are seeing a problem, a defect. Yet they insist on Person First Language.

When we are abused, and murdered, the perpetrators don’t think we are “much more than autism”. They use Person First Language and forget our humanity.

Or maybe they are trying to beat, stab, suffocate or shoot “the autism” out of us.

When the media blame us for our own murders, by pointing out how “tragic” and “pitiful” our lives are, they use Person First Language to point out how non-persons we are. This is dehumanization.

When the media and some “experts” speculate that a mass murderer might be Autistic, they use Person First Language to say autism makes people evil. To them, that’s all we are.

Person First Language is not about “seeing a person before the diagnosis”, or about “seeing much more than the diagnosis”.

Person First Language is about putting as much distance between the person and “the autism”. It is the opposite of acceptance.

It is like a contest to see how many ways one can talk about Autistics without using the word “Autistic”.

This is how Person First Language proponents refer to us:

“Person with autism”

“Person has autism”

“Person on the autism spectrum”

“Person with a diagnosis of autism spectrum disorder”

Each time, they come up with a longer description that starts with “person” and ends with “autism”.

It would be much more inclusive, and respectful of our voices, to simply say “Autistic”. It is simple and direct. It does not waste words, it is easily understood. More importantly, it is the most accurate description of who we are.

Source: The Gymnastics of Person First Language • Ollibean

In that wave of claiming who we are, from our perspective—in our proclaiming of what it is actually like to live as an autistic individual—many autistic self-advocates have embraced the word ‘autistic.’ In this way, we are not running from the degradation and falsehoods, but proudly proclaiming: “I am autistic.” It may seem counter intuitive. But indeed, the act of accepting the word “autistic,” in and of itself, makes something once untouchable—now held. For you see autism is not a disease—though many think it so, or at maximum treat autism like a plague to be eradicated.

The issue we take, in most circles of Aspergerians and Auties, is with the trials and tribulations parents face and share publicly in raising such “anomalies” (children with autism). Interestingly enough, if you listen with intent, you will note that the autistic parents of autistic children aren’t complaining publicly about the woes of being a parent of a child with autism. We aren’t declaring how hard it is to be a parent of a child with autism. Nor are we seeking sympathy. We understand what our child is experiencing. We understand the torment of living in a world, where you not only feel like you don’t belong, but are told from the authorities that be (parents included) that your condition, your being, your very existence has “affected” everyone around you.

I am defined by autism because I want to be, because by embracing my autism I am embracing myself fully. I cannot separate the way my brain works from the rest of me. I leave it up to my son about how he wants to define himself. I will never tell him how to perceive autism. I imagine his perception will be ever-changing.

I have not and will not proclaim my family was affected by my son’s autism; nor will I say my son is affected by the trials that come with autism. There is not some outside boogeyman disease, illness, or even condition making our life hard. Life is just hard, sometimes

Source: “Affected” by Autism – Everyday Aspie

When you use person-first language, you are literally separating me from my identity, deliberately distancing me from an integral aspect to who I am. It feels like someone is dissecting me.

There’s this idea that we’re given more respect if we separate our disability or disabilities  from our personhood, that the more distance we place between ourselves and our disability, the more respect we’re given. This very idea is rooted in ableism.

Also important to note is that whether I’m called a Disabled person or a person with a disability, I am treated with the same level of disrespect.

When people continue to separate our disabilities from our personhood, they aren’t thinking about how our disabilities impact our personhood and how its viewed by others.

My friend Eb on Twitter worded it best, people shouldn’t need to use person-first language in order to be reminded that we’re human beings deserving of respect and rights and that we also have other identities.

I think that when people insist on saying “but you’re a person first!” and that people don’t acknowledge my disability first, that can lead to accommodations being an afterthought. When folks continue to separate my disabilities from my personhood, they aren’t thinking about what accommodations I need because they’re too busy trying to NOT think about my disabilities.

Source: 8 Reasons I Prefer Identity-First Language | Journey of IsaJennie

I don’t have autism. I am autistic.

That’s a thing I’ve been saying forfuckingever. And yet people keep insisting on pointedly saying that I and others “have autism”, are “individuals who happen to have autism”, are “living with autism”, or the ever popular “are individuals who just happen to have autism”.

Those are a lot of words just to deny a fundamental part of who I am, huh? It’s like people think if they wedge enough words between their identifier noun and the word autism, they’ll pry the condition off of us.

I know that y’all are taught person first language, and many communities prefer it and I support that. But the purpose of person-first language is to respect the person you are describing. Ask them what they prefer. I, and many MANY other autistic people, prefer to be called autistic, not “living with autism” or “having autism” or “an individual who happens to have an intimate neurological understanding from living with autism” or whatever.

Source: Radical Neurodivergence Speaking: I don’t have autism. I am autistic.

I don’t have autism. I am autistic. This is important to me. It also doesn’t mean that I “see myself as a disability first and a person second,” whatever that is supposed to mean. In my eyes, I’m Julia. Just Julia.

I cannot separate out which parts of me brain are wired because baby I was born this way and which parts of my brain should be marked off as AUTISM. Nor do I particularly care, to be honest.

Being autistic fundamentally shapes how I perceive and interact with the world, with a million cascading and subtle consequences. I would not be the same Julia I am now without whatever parts of my brain can be marked as AUTISTIC (and that’s bad science in the first place, the brain is a whole lot more complicated and subtle than that, we know that there isn’t one gene or one wiring variation that leads to autism).

I am not flattered when you say that I don’t really see you as autistic or it’s just a label.

Because what you mean is that “I don’t really see you as Bad right now,” and while I am incredibly grateful for that safety, I am also furious that autistic means Bad at all in the first place and that I feel I have anything to be grateful for in that entire situation.

It is, indeed, just a label. One without nearly the neutrality of, say, Campbell’s Chicken Soup. All your wishing in the world won’t change that, and taking away the words I have for my experience just hurts me so you can feel a little more enlightened.

Source: Dear “Autism Parents”, | Just Stimming…

“Autistic”, or “with-Autism”? I had to decide this for myself quite some time ago, after a great deal of thought, since there are positives and negatives to both methods. Finally, it boiled down to one factor: communication. What does each say to the listener? What does each say to me? And to what effect?

There are basically three groups who would, sensibly, prefer person-first language for autism. First, those who want to appear to care. Person-first language implies that you don’t blame the person-with-autism for being they way he is. That you are presupposing that the autism made him do it – whatever it is – and everyone should cut him slack. However, it also implies that he will so certainly fail to behave acceptably that you want to get out in front of his failure and forgive him in advance. Person-first language protects this group from having to internalize the idea that people can be radically different, while still deserving complete acceptance as they are. Or it’s simply a shorthand for “you’re damaged and inferior, but we forgive you.”

Second, there is group that believes that autism is something you catch. Like a virus. Or that it’s the result of an accident that suddenly injured you. They believe that it is simply a matter of time and effort before you are relieved of your autism, and that you will be just like you are now – just with all the problems removed and the nice parts remaining. This perspective is generally the result of failing to accept that your child is not just a poor substitute for the “real” child you believe you deserve. Person-first language protects this group from reality.

Finally, of course, there are those who, for their own practical reasons, prefer to preserve the illusion that autism can be removed from a person like a stain, leaving a pristine child ready to please his parents and join mainstream society invisibly. Some of these people have created images of themselves as beacons of hope with many books and speeches and postings, some as cutting edge researchers into a cure or the cause, some as major movers-and-shakers in the industry who may – any day now – slay the dragon. Person-first language preserves the delusion these people succeed within.

In all these cases, person-first language is used to hide the truth. And in none of these constructs is the autistic actually the primary beneficiary of the charade. Person-first language used as a default by anyone but the autistic himself is always selfish.

And always demeaning. The overwhelming message of “person-with-autism” is always “we wish we could really remove the autism from you, because it’s offensive, and we’re sure you’d be more acceptable without it.” Of course, it can’t be removed. At least not in the near future. So, until then, the autistic is stuck with his unacceptableness, no matter how kind and apologetic the label appears to others.

When you use person-first language, you create and then highlight a failing, a disappointment, a limitation. When I declare myself as an autistic, I acknowledge my difference as an acceptable part of my self-identification at the outset, and challenge you to do so too.

Source: Autism First (Again) – Turtle moon

I would argue that “person with autism” risks misrepresenting the nature of the condition. It implies that autism is an attachment, like a torn ligament or a brain tumour, which can be isolated and removed without otherwise affecting the individual, when to my mind autism is intrinsic to the person’s identity.

Another flashpoint is the word ‘suffering’. One of the surest ways to raise the hackles of the autism community is to write or say that somebody “suffers from” autism or Asperger’s syndrome. I’ve read and heard two examples of this in the last fortnight alone. There are two conflicting responses here: on the one hand it’s insulting to people who get by reasonably well although they have some form of autism, and yet on the other there are autistic people who quite evidently do suffer, and we shouldn’t shy from saying so. The key point, I think, is that while they may suffer from depression, from isolation, from short attention spans or from an inability to express themselves, saying they “suffer from autism” is aggravating to people who have worked hard to overcome the more debilitating aspects of the condition. It also puts a too simplistic gloss on the way people experience autism, since a strong adherence to routine can be comforting, and even rewarding, in the right context.

Source: Autistic Dad: On Language

Though it is common for medical and cure-focused communities to refer to an autistic person as a person with autism, such references are not the lingo of the greater whole of the Autistic Community.

In a nutshell, saying a person has autism may imply that the person is defective or that there is an inherent problem or sickness within the person. It also implies that autism can somehow be separated from the person.

Being a deaf person, as well as a member of the Deaf community, I prefer to be referred to as Deaf. This is preferable to me rather than the terms “hearing impaired” or “person who has deafness.” I don’t have deafness, I am deaf. For me, it is the same with autism. I don’t have autism, I am autistic. Since I do not view my deafness and autism as negatives, I use language that puts me in the direct light of both autism and deafness.

Source: Aspitude!: Autism-first Language

Saying “person with autism” suggests that the autism can be separated from the person.  But this is not the case.  I can be separated from things that are not part of me, and I am still be the same person.  I am usually a “person with a purple shirt,” but I could also be a “person with a blue shirt” one day, and a “person with a yellow shirt” the next day, and I would still be the same person, because my clothing is not part of me.  But autismis part of me.  Autism is hard-wired into the ways my brain works.  I am autistic because I cannot be separated from how my brain works.

Saying “person with autism” suggests that even if autism is part of the person, it isn’t a very important part.

Yet autism goes deeper than culture and learned belief systems.  It affects how we relate to others and how we find places in society.  It even affects how we relate to our own bodies.  If I did not have an autistic brain, the person that I am would not exist.  I am autistic because autism is an essential feature of me as a person.

Saying “person with autism” suggests that autism is something bad–so bad that is isn’t even consistent with being a person.

It is only when someone has decided that the characteristic being referred to is negative that suddenly people want to separate it from the person.  I know that autism is not a terrible thing, and that it does not make me any less a person.  If other people have trouble remembering that autism doesn’t make me any less a person, then that’s their problem, not mine.  Let them find a way to remind themselves that I’m a person, without trying to define an essential feature of my personhood as something bad.  I am autistic because I accept and value myself the way I am.

Source: Why I dislike “person first” language by Jim Sinclair – Journals – CafeMom

In the autism community, many self-advocates and their allies prefer terminology such as “Autistic,” “Autistic person,” or “Autistic individual” because we understand autism as an inherent part of an individual’s identity — the same way one refers to “Muslims,” “African-Americans,” “Lesbian/Gay/Bisexual/Transgender/Queer,” “Chinese,” “gifted,” “athletic,” or “Jewish.” On the other hand, many parents of Autistic people and professionals who work with Autistic people prefer terminology such as “person with autism,” “people with autism,” or “individual with ASD” because they do not consider autism to be part of an individual’s identity and do not want their children to be identified or referred to as “Autistic.” They want “person-first language,” that puts “person” before any identifier such as “autism,” in order to emphasize the humanity of their children.

Because when people say “person with autism,” it does have an attitudinal nuance. It suggests that the person can be separated from autism, which simply isn’t true. It is impossible to separate a person from autism, just as it is impossible to separate a person from the color of his or her skin.

Autism, however, is not a disease. It is a neurological, developmental condition; it is considered a disorder, and it is disabling in many and varied ways. It is lifelong. It does not harm or kill of its own accord. It is an edifying and meaningful component of a person’s identity, and it defines the ways in which an individual experiences and understands the world around him or her. It is all-pervasive.

Person-first language opponents believe the best way to do this is by recognizing and edifying the person’s identity as an Autistic person as opposed to shunting an essential part of the person’s identity to the side in favor of political correctness.

It is impossible to affirm the value and worth of an Autistic person without recognizing his or her identity as an Autistic person. Referring to me as “a person with autism,” or “an individual with ASD” demeans who I am because it denies who I am.

When we say “person with autism,” we say that it is unfortunate and an accident that a person is Autistic. We affirm that the person has value and worth, and that autism is entirely separate from what gives him or her value and worth. In fact, we are saying that autism is detrimental to value and worth as a person, which is why we separate the condition with the word “with” or “has.” Ultimately, what we are saying when we say “person with autism” is that the person would be better off if not Autistic, and that it would have been better if he or she had been born typical. We suppress the individual’s identity as an Autistic person because we are saying that autism is something inherently bad like a disease.

Yet, when we say “Autistic person,” we recognize, affirm, and validate an individual’s identity as an Autistic person. We recognize the value and worth of that individual as an Autistic person — that being Autistic is not a condition absolutely irreconcilable with regarding people as inherently valuable and worth something. We affirm the individual’s potential to grow and mature, to overcome challenges and disability, and to live a meaningful life as an Autistic. Ultimately, we are accepting that the individual is different from non-Autistic people–and that that’s not a tragedy, and we are showing that we are not afraid or ashamed to recognize that difference.

Source: Autistic Hoya: The Significance of Semantics: Person-First Language: Why It Matters

“Autistic” is another marker of identity. It is not inherently good, nor is it inherently bad. There may be aspects or consequences of my identity as an Autistic that are advantageous, useful, beneficial, or pleasant, and there may be aspects or consequences of my identity as an Autistic that are disadvantangeous, useless, detrimental, or unpleasant. But I am Autistic.

These are not qualities or conditions that I have. They are part of who I am. Being Autistic does not subtract from my value, worth, and dignity as a person. Being Autistic does not diminish the other aspects of my identity. Being Autistic is not giving up on myself or limiting myself or surrendering to some debilitating monster or putting myself down. Being Autistic is like being anything else.

Person-first language is a form of hypocrisy. Its strongest advocates are non-disabled parents and professionals, very well-meaning people who love their friends and family members and students deeply and who want to do right by them by treating them as human beings. But if a fairly large number of us to whom this type of language refers find it objectionable, why are we told “Well I respect your opinion, but I think person-first language is more respectful.”

Why is it culturally appropriate and typical to accept race, religion, and nationality as markers of identity that ought to be designated with proper adjectives that (in English) precede the noun “individual” or “person” and not those that fall under the category that we call “ability?” Is it a reflection of a secret fear of the non-disabled of people who are not like them, or is it a reflection of the inhibiting fear of offending one of us? As most of us prefer to identify with proper-adjective language (disabled or Autistic), using this language is highly unlike to offend. Asking me, “So you have autism?” will almost always produce a wince and a cringe. An identity is not something that I have. It is who I am.

Source: Autistic Hoya: Identity and Hypocrisy: A Second Argument Against Person-First Language

Language around disability is complicated and there is currently no universally accepted term. Even the terms that are considered most acceptable like people with disabilities (in North America) and disabled people (in the UK) are not universally accepted by people in those locations. In order to be respectful it is usually inoffensive to default to the most acceptable term based on your location. However, if a person expresses an alternate preference, it is extremely rude and disrespectful to insist that they conform to the dominant preference. Best practice would be to utilize the term that the individual prefers.

Source: Could You Please Stop Insisting that People Have to Use Person First Language | crippledscholar

The golden rule of disability language has been that the person should come first in phrasing, preceding the condition that disables them. For example, people who have diabetes aren’t “diabetics” in respectful usage but instead are “people with diabetes.” But developmental conditions and those related to the brain are a trickier territory. With a nod to Francis Crick, if your brain is you and you are your brain (with some guidance from your endocrine system and your environmental inputs), then how appropriate or even rational is it to separate the person and the condition? Many people want to say “person with autism,” but to a lot of autistic activists, that phrasing is silly, like saying “Person with Brain.” For them, autism and brain and themselves are all one and the same. Autistic activist Jim Sinclair wrote in 1999 about instead using “identity first” language. The Autistic Self Advocacy Network also features an essay by autistic activist Lydia Brown, elaborating the concept. That doesn’t mean, of course, that every autistic person prefers that phrasing, and it’s always best to go with what any individual with a condition expresses as their preference.

Source: 7 Things You Need To Learn About Autism

For anyone who has been around Autistic communities, or is Autistic themselves, one of the first things they may notice is the different ways in which we are referred to. Some will  say, “has autism/person with autism/people with autism”, whilst others will say, “is [an] Autistic/Autistic person/Autistics”.

These descriptions cover two broad categories of language: identity-first language, and “person-first” language. In my blog (and outside of it), I pretty much entirely refer to myself as “Autistic”, rather than a “person with autism”. Some people wonder why I choose to “label” myself. These people have probably been taught most of their lives that person-first language is the correct way, and that anything otherwise is inherently disrespectful. This could not be further from the truth. I and many other Autistic advocates, particularly those who support the neurodiversity paradigm, use identify-first language. In fact, I, for one, see person-first language as disrespectful, demeaning, and ableist.

Something that I see a lot of well-meaning non-autistic folks say to their Autistic children, siblings, relatives, or friends, is “you are more than autism”, or, “you are not autism, you are still yourself”, or, “don’t let autism define who you are”. Many of these same people insist on using person-first language, because they deem it somehow superior.

Despite that these people mean well, and want the best for their children, these quotes, and “person-first language” are ultimately harmful and damaging: damaging to the child’s self-esteem, giving them the pressure to be “more than autism”, whatever that even means. It is also damaging to the rest of the Autistic community, implying that autism makes a person less. “Person-first language” was not created by Autistics to begin with.

The first claim, that Autism can be separated from the individual, is complete nonsense. Autism is the way our brains are wired. Autism shapes our perception, the way we see the world, as well as how we think and feel. A lot who talk about “curing” autism seem to forget that doing so would completely change who we are as human beings. We would no longer be the same person. Autism is SUCH an integral part of who we are, and to take it away, to take our minds and how we think away, would make us lose our personhood. Back when I used to hate who I was (again, because of people sending a subliminal message that autism is a bad thing), I thought back on what my life would be like if I was non-autistic. I realized that I would not be the same person at all. Sure, I may not have had some of the bad experiences I’ve had, but I would also not love the things I love, believe the things I believe, and I also would not have many of the skills and talents I possess; at least not to the same level. I would be a completely different, foreign person. I wouldn’t even recognize myself.

As many Autistic individuals have experienced, when I stopped hiding myself – when I no longer concealed the fact that I’m Autistic, and when I embraced that part of my identity, that is when I suddenly became a lot more confident in my abilities. I started to like myself, recognizing my strengths, while working on my shortcomings.

If an Autistic person asks me to use person-first language, I will respect their wishes and do so for them. However, we shouldn’t be teaching Autistic kids to distance themselves from their autism. We shouldn’t be telling them they’re “more than autism”. We should be telling them that they’re Autistic, and teach them to be proud of their identity and neurology, and celebrate who they are.

Source: Actually, I Do Let Autism Define Me: Identity-First Language – The Autistinquisitor

The neurodiversity approach has important implications when it comes to language. A lot of people (typically neurotypical people who are helping or caring for autistic people) support ‘person-first language’ to describe autism. This means referring to someone as a person before stating their disability, a “person with autism”.

You might have noticed that I do not use person-first language. What I use is called ‘identity-first language’. This means referring to autism as an aspect of someone’s identity, an “autistic person”.

People who support person-first language say that no-one should be defined by their disability, that they are a person before they are anything else. It sounds like a noble aim, and they generally have good intentions. The trouble is, the very idea that person-first language is necessary comes as a result of the medical model of disability. It’s bad to define a person by their disability if you think a disability is inherently a bad thing.

Identity-first language accepts that neurological differences and impairments are not inherently positive or negative, they are just aspects of a person’s identity. You wouldn’t dream of saying “a person with homosexuality”, would you? Because that implies that being gay is negative, as well as something that could even theoretically be separated from the person.

The neurodiversity approach says that being autistic is comporable to being gay. It’s an identity, and a natural and value-neutral aspect of human variation. And autistic people should be accepted and accommodated in the same way as gay people. If there are problems associated with being autistic (or being gay), like finding it difficult to communicate (or finding it difficult to get married) – those problems should be accommodated by society.

When you use person-first language, you are saying “Being autistic is entirely and inherently negative”, and “Being autistic makes you less of a person”, and “I have to be reminded that autistic people are human”. Please stop saying those things to us.

Source: Neurodiversity, language, and the social model | autisticality

See also,

Interaction Badges

Chapter 11 of NeuroTribes, In Autistic Space, mentions interaction badges (also called color communication badges). These are used at autistic conferences and are showing up at tech, sci-fi, fantasy, comic, and fandom cons. I’ve never been to a conference that uses them, but I rarely go to conferences because they induce extreme sensory overwhelm.

Cons are overwhelming sensory spaces–often with no places to escape. Adjusting to them takes time. During that adjustment, social and verbal interaction are beyond me. I’m busy managing a flood. Interaction badges would help quiet edge walkers like myself. I’d love to see WordCamps and the Automattic Grand Meetup try them.

Interaction badges are also handy for classrooms, coworking spaces, and other collaborative environments where zone workers need to be left alone to maintain high memory flow states.

Interaction badges can also be a tools for neurodivergent and disabled students to fend off the unwanted objectification and privacy violation of inspiration porn.

The quotes and resources below discuss the origin, use, and benefits of interaction badges.

They also devised an ingeniously low-tech solution to a complex problem. Even highly verbal autistic adults occasionally struggle with processing and producing speech, particularly in the chaotic and generally overwhelming atmosphere of a conference. By providing attendees with name-tag holders and pieces of paper that were red on one side and yellow on the other, they enabled Autistics to communicate their needs and desires without having to articulate them in the pressure of the moment.

Silberman, Steve (2015-08-25). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (p. 448). Penguin Publishing Group. Kindle Edition.

Color Communication Badges are an accommodation to support social interaction for people with a variety of disabilities and communication needs. Color communication badges were first developed by Autism Network International, and popularized by the Autistic community in Autistic spaces and conferences.

Color Communication Badges offer those who use them an opportunity to communicate explicitly the degree to which they want to participate in new social interactions and with who. They offer a universally designed way of making a conference, university, event or other space more accessible to those who may not find typical nonverbal social cues accessible. Many non-disabled people report that this system also benefits them too.

Source: Color Communication Badges | Autistic Self Advocacy Network

Color Communication Badges are a system which were first developed in Autistic spaces and conferences. They help people tell everyone who can see their badge about their communication preferences.

A color communication badge is a name tag holder that can pin or clip onto clothing. In the name tag holder there are three cards: one green card that says “GREEN”, one yellow card that says “YELLOW”, and one red card that says “RED.”

The card that is currently visible is the active card; the other two are hidden behind the first one, accessible to the person if they should need them.

Showing a green badge means that the person is actively seeking communication; they have trouble initiating conversations, but want to be approached by people who are interested in talking.

Showing a yellow badge means that the person only wants to talk to people they recognize, not by strangers or people they only know from the Internet. The badge-wearer might approach strangers to talk, and that is okay; the approached people are welcome to talk back to them in that case. But unless you have already met the person face-to-face, you should not approach them to talk.

Showing a red badge means that the person probably does not want to talk to anyone, or only wants to talk to a few people. The person might approach others to talk, and that is okay; the approached people are welcome to talk back GREEN YELLOW RED to them in that case. But unless you have been told already by the badge-wearer that you are on their “red list”, you should not approach them to talk.

Color communication badges are a good aid because they allow people to express their current communication preference quickly, nonverbally, and simply – people can change what card is showing if their preference changes. They are a good way to prevent situations where someone is caught in a social situation they do not want to be in, or situations where someone wants to talk but can’t initiate.

Source: Color Communication Badges

At this conference, not only did we use these communication badges pictured above, but we actually had the opportunity to meet Jim Sinclair, the inventor of these badges.

During the part of the conference in which Jim Sinclair gave us a history of Autism Network International (ANI)—which they were a co-founder of—they talked to us about the establishment of this particular piece of assistive technology.  Basically, it was a simple idea that seemed to fit a need and quickly became very popular among many autistic spaces for it’s practicality and ease of use.

The Curb-Cutter Effect is when something to fit a specific need is found to create convenience in a broader area than intended.  Curb cuts allowing for wheelchair accessibility to sidewalks proved to also be convenient to anyone who may have trouble with steps or even simply a mother with a baby stroller or maybe a child with a wagon.  This is a desirable outcome with disability rights advocacy as creating convenience for non-disabled people often makes the assistive technology easier to advocate for.

In this sense, these colored communication badges could serve that Curb-Cutter effect.  Not only would this be perfectly acceptable for non-disabled people to use for convenience, but would also help to increase their effectiveness and convenience for those of us who need them.

Source: Autieble Sam

I found that interaction badges make a huge difference with autistic access. People take them seriously and you can use them to have no one initiate interaction with you, or only people you’d told in advance can do so. I found them helpful the one time I was overloaded and couldn’t deal with people, and also found the green badges helpful for knowing I had permission to talk to people.

The orange star is to give people permission to ask if they may touch you, for example for people who like to be hugged and would like people to ask for permission to hug them. Without this star no one should even ask to touch you, let alone hug.

I really enjoyed my experience at Autscape and I’ve already registered to go back this year. I especially enjoyed the sensory room and the ‘sparklies in the dark’ group stimming outside after dark. It was wonderful to be in clearly autistic space where stimming and being explicit and direct were the norm and celebrated. I’m looking forwards to going again this year 🙂

Source: A photograph (description below) of my interaction…

A lot of people are, understandably, quite concerned about the heavy social demands of being in a large group for several days. There is no requirement to socialise at all, and there will be no implicit or explicit disapproval of those who choose not to interact with others. There is coloured badge system for indicating whether you would like to socialise or not.

  • No initiation – Red – Please do not initiate any interaction with me.
  • Prior Permission – Yellow – Please do not initiate unless I have already given you permission to approach me on a yellow badge.
  • Please initiate – Green – I would like to socialise, but I have difficulty initiating. Please initiate with me.
  • Neutral – White (or no badge) – I am able to regulate my own interaction.

People who do not wish to be in any photographs or video may wear a black circle.

Important: It is not necessary to use any badge at all. If you are okay with approaching others, and with others approaching you (even if you do not wish to interact, but are comfortable saying so), then there is no need to use a coloured badge. If green is used as a default for everyone who wishes to interact, whether they can initiate or not, then it is less meaningful for those who have difficulty initiating and rely on others to approach them.

Source: Autscape: Autistic needs

I’ve wished, pretty much since I learned about them, that the rest of the world would implement Color Communication Badges, especially for events like conferences where so much emphasis of the benefit is placed on the face-to-face connections: in other words, the socializing – that thing I can’t do. My dear friend, Nightengale, made a wonderful argument in her most recent post about why we need to introduce the badges into schools. Because what we expect people to want isn’t necessarily the same as what they do want, and the first step in advocacy is ask-vocacy: ask the person.

That got me thinking about the benefit of implementing Color Communication Badges in my classroom, not just for my students but for myself as well. There’s pretty much nothing a student can do in my classroom that will bother me, or prevent learning from happening, but there are 4 little words that can throw off an entire lesson or even an entire day:

“Do you have a minute?”

The unwritten answer to this question, of course, is “yes.” I work very hard to be flexible and accessible for collaboration. It’s worked. It’s worked a little too well, to the point where people think it’s okay to interrupt me in the middle of lessons. But the fact remains that, a lot of the time, I don’t have a minute. I’m with a student or group; I’m mentally (sometimes physically) organizing the next lesson; or I’m taking a much needed breather so I can be “on” again in a minute.

The problem is, once I’ve explained that, no, now is not a good time (because it would be rude to just ignore you) I’ve already lost that focus so I might as well recoup my losses and go down the rabbit hole on whatever you wanted “a minute” about. Maybe it will be useful. So I have acquired a reputation of being always accessible that is actually counterproductive to the way my brain works.

Source: Teaching and Learning With Disabilities: Do You Have a Minute?

As an autistic person, I can think of lots of reason why this child might have preferred to be sitting alone. His other option might have been sitting with bullies, which was my only other option at his age. Of course, the adults didn’t see the kids talking to me as bullies. They saw them as nice. Nice people peppering me with questions about why I did all the things I did differently than everyone else, from my food, my wardrobe and my vocabulary. Alone was certainly preferable to that, and if this child is being bullied, that should be addressed.

But there are other reasons for a person, any person but most specifically, an autistic person, to seek solitude. Perhaps the only choices of people to talk with have such vastly different interests there would be no topic of conversation. Perhaps the sound of others chewing food is distressing. Perhaps one just needs some time to recharge and think, without having to process language and social cues.

Karla Fisher has a great visual she uses for IEP advocacy called “Our breaks are not like NT breaks.” She points out that, for an autistic person, lunch and recess can be the most stressful times of the day.

On a regular basis at work, I hear about children who are alone at lunch and recess, from their worried parents. I always ask the child what they like to do at those times. Sometimes I hear stories of wanting to play but being excluded. Often I hear stories of not being able to find someone who wants to play or do similar things. And then I hear about the child who prefers to spend recess looking for rocks – alone. It always seems I am the first person to have ever asked the question.

The autistic community has a solution for this, for autistic events. They are Color Communication Badges. With green displayed, the message is to approach. With yellow, only known people are welcomed. With red displayed, the wearer is to be left alone except in direst emergency. This makes it easy at autistic events, to know if a person sitting alone would relish or loathe company.

Why don’t we have something like that at schools? Color badges or seat markers or perhaps a choice chart the child can use in class before recess.

Source: I (,) Object – Nightengale of Samarkand

See also,

Inspiration Porn, Growth Mindset, and Deficit Ideology

Navigating ableist systems built on the deficit and medical models is a full time job for my neurodivergent family. We must be case workers constantly pushing back against deficit ideology and promoting instead the social model and structural ideology.

There have been many attempts to dress up deficit ideology, to put new clothes on the same old systems. In education, grit and growth mindset are currently popular. These deficit model veneers, like the self-esteem movement veneers before them, ignore the structural problems of school and society and instead blame kids and families, putting the burden of change on them instead of our systems and institutions. Broken systems cannot be fixed by telling kids to have a good attitude, as explained in Growth Mindset and Structural Ideology and DSISD Growth Mindset.

Disabled folks also face deficit ideology. The deficit and medical models are ableist gauntlets. Like students, we are told to get a good attitude, that we just need the right mindset. Instead of the growth mindset served students, the deficit ideology veneers applied to disability are inspiration porn and the supercrip narrative.

The statement “the only disability in life is a bad attitude” puts the responsibility for our oppression squarely at the feet, prosthetic or otherwise, of people with disabilities. It’s victim blaming. It says that we have complete control of the way disability impacts our lives. To that, I have one thing to say. Get stuffed.

By far the most disabling thing in my life is the physical environment. It dictates what I can and can’t do every day. But if Hamilton is to be believed, I should just be able to smile at an inaccessible entrance to a building long enough and it will magically turn into a ramp. I can make accessible toilets appear where none existed before, simply by radiating a positive attitude. I can simply turn that frown upside down in the face of a flight of stairs with no lift in sight. Problem solved, right?

Source: We’re not here for your inspiration – ABC News (Australian Broadcasting Corporation)

We are all too aware of the risk of being filmed for someone’s feel-good story (or for someone to mock, but that could be another post). We already face enormous pressure to not ask for help – to be the “supercrip” and “overcome” our disabilities – and the risk of being a viral story is yet another reason we might avoid asking for help when we need it.

Source: How the Media and Society Objectify Disabled People | Paginated Thoughts

Inspiration porn makes us feel that everything is going to be OK. That’s possible only if we stop being distracted by pretty stories and have the tough conversations.

Source: inspiration Porn Further Disables the Disabled | Al Jazeera America

Growth mindset and inspiration porn are pretty stories. Pretty, useless stories that bikeshed the deficit model, never changing anything, always blaming down.

The excerpts below discuss inspiration porn from the point of view of disability self-advocates and the social model.

Inspiration porn is a term used to describe society’s tendency to reduce people with disabilities to objects of inspiration. You’ve all seen the memes, “the only disability in life is a bad attitude.” Or a picture of a small child running on prosthetic legs accompanied by the caption “what’s your excuse?” These images make the people viewing them feel great, but often they take images of people with disabilities simply living their daily lives and make them extraordinary. But at what cost?

I’ve been the subject of inspiration porn. One of my earliest “inspiration porn” memories is from my primary school days. There was a prize giving at the end of each year. Without fail every year I would get an award for overcoming obstacles or perseverance. It was never explicitly stated what exactly I was overcoming, but I knew they were referring to my disability.

Everybody around me seemed thrilled. Everybody except me. While everybody around me was feeling inspired by the tenacious little disabled girl with a “can do” attitude, I wanted to run out of the building and hide. The awards emphasized my difference, and all I wanted was to be the same. They seemed to benefit those giving the award more than me.

Source: How to Avoid ‘Inspiration Porn’ When Talking About Disability | The Mighty

When people with disabilities being genuinely included in friendships is an item that makes the news, we as a society assume that isolation, exclusion, and loneliness is not only the norm, but the natural outcome for people with disabilities. Furthermore, praising non-disabled people for merely being with us implies that we are not deserving of friendship, or not worth spending time with in the absence of money, volunteer hours, or “feel good” attention from social media outlets. The fact that someone may just want to be with a disabled person for the sole purpose of eating lunch seems to be too much for the media to handle. Disturbingly, the photo is accompanied by hashtags such as #volunteerism. Volunteerism? It is obvious that our world remains in a terribly backward place if spending time with a person with a disability is considered an act of charity. They should try #ableism, if the writers are seeking greater accuracy.

Just because I have a disability does not mean being with me is community service. I am a person worth getting to know, and anyone who considers eating lunch with me an act of charity to be documented on Reddit is not a friend. Unfortunately, our culture often trains non-disabled children to view those with disabilities exclusively in the context of volunteerism and charity. Thus, inspiration porn like this news story is born.

Inclusion should not be shocking. Friendship should not be newsworthy, and no one should assume that the only company a wheelchair user will have is the result of an act of laudable compassion. One article even suggested that the football players were helping a “less fortunate man”. Not only does it imply that people with disabilities must have a lesser quality of life, it implies that the only friendships we will ever have will exist because someone feels sorry for us.

Source: The Squeaky Wheelchair: I’m Not Your Fodder For A Feel Good Story: People With Disabilities & The Assumption That Friendship Is Charity

We, disabled people, see these types of things spread like wildfire, time and time again:

– A disabled person does something that a non-disabled person does, which often plays into the “supercrip” media model of disability

– A non-disabled person treats a disabled person with kindness.

– A non-disabled person helps a disabled person (whether the disabled person asked for help or not).

The effects of these viral stories are quite damaging, even when one does not go to the most extreme consequences. Any one of us could be the next story by asking for help, or getting help even if we don’t want it. Since the conductor announcements of what train is approaching are hard to hear, a  blind person asks a subway stationmaster to help them get on the right train. An autistic person has a shutdown. Their friend helps them retreat to a quiet location without fanfare at the scene. A wheelchair user faces a curb cut, and they decide to complain to the city after finding another route. But a stranger rushes over anyway and helps get them over the curb cut. Someone could film any one of these situations and unleash the tidal wave of feel-good comments, shares, and news stories.

We are all too aware of the risk of being filmed for someone’s feel-good story (or for someone to mock, but that could be another post). We already face enormous pressure to not ask for help – to be the “supercrip” and “overcome” our disabilities – and the risk of being a viral story is yet another reason we might avoid asking for help when we need it.

Finally, we notice when we get objectified as inspiration porn. We feel objectified. It is toxic. Being objectified hurts our self-image and mental health. It erodes our ability to feel safe and like we can have even some privacy. It hampers our ability to set boundaries around privacy. It makes us feel like we have no control over our life and story. We notice, and it hurts in more ways than one.

Source: How the Media and Society Objectify Disabled People | Paginated Thoughts

Inspiration porn is an image of a person with a disability, often a kid, doing something completely ordinary – like playing, or talking, or running, or drawing a picture, or hitting a tennis ball – carrying a caption like “your excuse is invalid” or “before you quit, try”.

The statement “the only disability in life is a bad attitude” puts the responsibility for our oppression squarely at the feet, prosthetic or otherwise, of people with disabilities. It’s victim blaming. It says that we have complete control of the way disability impacts our lives. To that, I have one thing to say. Get stuffed.

By far the most disabling thing in my life is the physical environment. It dictates what I can and can’t do every day. But if Hamilton is to be believed, I should just be able to smile at an inaccessible entrance to a building long enough and it will magically turn into a ramp. I can make accessible toilets appear where none existed before, simply by radiating a positive attitude. I can simply turn that frown upside down in the face of a flight of stairs with no lift in sight. Problem solved, right?

Inspiration porn shames people with disabilities. It says that if we fail to be happy, to smile and to live lives that make those around us feel good, it’s because we’re not trying hard enough. Our attitude is just not positive enough. It’s our fault. Not to mention what it means for people whose disabilities are not visible, like people with chronic or mental illness, who often battle the assumption that it’s all about attitude. And we’re not allowed to be angry and upset, because then we’d be “bad” disabled people. We wouldn’t be doing our very best to “overcome” our disabilities.

I suppose it doesn’t matter what inspiration porn says to us as people with disabilities. It’s not actually about us. Disability is complex. You can’t sum it up in a cute picture with a heart-warming quote.

So next time you’re tempted to share that picture of an adorable kid with a disability to make your Facebook friends feel good, just take a second to consider why you’re really clicking that button.

Source: We’re not here for your inspiration – ABC News (Australian Broadcasting Corporation)

In other words, inspoporn is a collection of overcomer, supercrip, and saintly helper stories. The common undercurrent to all types of inspiration porn, however, is the disabled person’s role in the story. Instead of being an individual character, fleshed out and made fully human and at least potentially relatable to the reader/viewer, the disabled person (or disabled people, if there’s a group) exists as a prop for the non-disabled person in the story. The disabled person’s existence serves as edification for the non-disabled people around them, or as a moral yardstick to measure whether the non-disabled people (the ones who are relatable as main characters to the presumed non-disabled only audience) are sufficiently good tolerant people who are minimally not shitty. This is not the same as being actively anti-ableist, by any stretch of the imagination.

Ari Ne’eman, Autistic Self Advocacy Network co-founder and president, describes the third category of inspoporn as Very Special Episode syndrome — where a disabled character is newly introduced for one or a few episodes of a long-running series (in a book or film, this could easily be adjusted to a single chapter, single scene, or background plot) to teach the main characters (of course not disabled themselves) a very important lesson about tolerance before going back to the institution or special needs school where they “really belong.”

Source: Autistic Hoya: Disabled people are not your feel-good back-pats.

“Inspiration porn” is any meme, video or feel-good article that sensationalizes people with disabilities. Browse social media long enough and you’ll inevitably find images of disabled children doing ordinary activities, like coloring or running, usually captioned with the now-infamous Scott Hamilton quote, “The only disability in life is a bad attitude.” The disability community rejects depictions like these, because according to activists, their only purpose is to make the non-disabled viewer feel good about themselves. Inspiration porn turns people with disabilities into mere objects, placing their physical differences on display and reassuring the viewer that “If these people can live with just one leg,” for example, “I can do so much more without a disability.”

We’re drawn to inspiration porn like this because it comforts us. The idea that anyone can be suddenly diagnosed with bone cancer or get into a car accident and break their spine is terrifying; it reminds us of our frailty and, ultimately, our mortality.

In other words, inspiration porn paints people with disabilities as nothing more than modern-day Tiny Tims—pitiable people who help us put our own problems into perspective while making us smile with their courageous outlook on life. The problem with this is twofold: It not only assumes that disability automatically equals hardship, a tragedy that must be overcome, but it also incorrectly assumes that disability can actually be overcome with a smile and a little bit of determination.

The reality is that disability is a social experience, not simply a medical impairment or disorder. While a person can be born with a congenital condition, like muscular dystrophy, for example, they aren’t truly disabled until they enter a world filled with stairs instead of elevators, or workplace discrimination that prevents them from getting a job. Civil rights legislation like the Americans With Disabilities Act of 1990 and the United Nations Convention on the Rights of Persons With Disabilities (which every major nation has ratified except for the U.S.) are crucial to the lives of people like Purdy and O’Neill. However charming their smiles are, they could never be enough to overcome the oppression that disabled people face.

Source: “Inspiration porn is not okay”: Disability activists are not impressed with feel-good Super Bowl ads – Salon.com

Many disability advocates have expressed disdain for being viewed as “inspirational” in popular media and reject the premise that this emotion adds any positive value to their status. This often used description associated with able-bodied individuals’ emotions in connection with accomplishments or just daily living of those with disabilities is seen by some in the community as separating, objectifying, condescending and regressive in terms of equality and inclusion.

Ask yourself: Who do you overly praise and overly compliment? You do that to children. The implication is that our accomplishments are somehow heroic and need to be reinforced, that we are not naturally motivated from within, from an organic developmental impulse that we all share.

Excessive compliments, like patting us on the back and saying, ‘Look at how brave you are’ or ‘How wonderful you are able to do this’ are based on a negative feeling about us. The assumption is that we in fact carry a negative feeling about ourselves. It is their negative emotion, their aversion, being masked by the apparently positive sentiment.

By over-complimenting us, one may think they are helping our mental health when in fact they are harming it. It makes me feel infantilized, angry and discounted, but stimulates my darker sense of humor as well. Sometimes veiled irony or biting humor is social strategies for subverting their assumed but incorrect assumptions about me.”

Source: Disability as Inspiration: Can Greater Exposure Overcome this Phenomenon?

At its core, inspiration porn demonstrates the need for a broader engagement with the social model of disability. People typically view disability through the medical model, in which diagnosed conditions present obstacles to be cured or overcome. But according the social model, while many people may have all kinds of medical conditions, people are disabled by the lack of accessibility in our society.

Inspiration porn makes us feel that everything is going to be OK. That’s possible only if we stop being distracted by pretty stories and have the tough conversations.

Source: Inspiration Porn Further Disables the Disabled | Al Jazeera America

When you define things in simple terms, you also imply that those who don’t beat their illness or disability are “losers.” Were they not as tough as the kids wearing the super hero costumes in the video? The ad begins with the line, “Sick doesn’t mean weak.” In the video, the word “defeat” flashes. Does that mean some kids “surrender?” Do we really want to suggest that children have that much control over their medical conditions? And at some point, don’t images of boxing and blowing things up conflict with ideas about health and healing?

In her 2015 book Malignant Metaphor: Confronting Cancer Myths, science writer Alanna Mitchell writes about why the battle metaphor isn’t helpful to cancer patients and their families (she also writes about why it’s not a great analogy for the latest clinical treatments). “A main concern is that when someone dies of cancer,” she writes, “the message that remains is that that person just hasn’t fought hard enough, was not a brave enough soldier against the ultimate foe, did not really want to win.”

Many children, like my son, have congenital disabilities or complex medical problems that can’t be defeated. Did they, or their parents, not try hard enough?

The way disability is viewed in our culture—as a deficit, failure, or something to be “overcome”—sets parents up to never feel good enough.

When your child has a disability, you start out trying to “fix it” through intensive therapy. Over time, you push back. You learn that “fighting” is not a good model for living. Instead of making the child change to fit the world, you want the world to change to fit your child—to accept your child as a full human being.

Source: Illness Isn’t a Battle · thewalrus.ca

ABC’s “Speechless,” a sitcom about a family with a son who has a disability, tackled why it’s often offensive to call people with disabilities “inspirational.” And it’s done so, so well.

“Inspiration porn” is a term used to describe a common tendency in which able-bodied people condescend to those with disabilities by suggesting they are brave or special just for living. Ray DiMeo, a character in “Speechless” who is the younger brother of a teen with cerebral palsy, explained it perfectly in Wednesday night’s episode:

“It’s a portrayal of people with disabilities as one-dimensional saints who only exist to warm the hearts and open the minds of able-bodied people,” he said.

To which his brother, JJ, who has cerebral palsy, hilariously adds: “I blame Tiny Tim.”

While these sorts of simplistic attitudes may seem harmless, if misguided, they can have real consequences in a world where disabilities are stigmatized. Research even shows stigma can lead to damaging health care consequences.

What’s more, these kinds of portrayals render the person who is disabled as a side character only revered for what they provide to others.

Source: ‘Speechless’ Just Schooled Everyone On Disability ‘Inspiration Porn’ | The Huffington Post

Media coverage of disability is often informed by some of our worst ideas about difference. Coverage of disability tends to be pornographic - not in the sense of sexual titillation (mostly), but focused on evoking feelings in the consumer, rather than authentically displaying the lived experience of the subject. In the disability rights community, we tend to critique suchrepresentations as “inspiration porn,” a phrase popularized by the late activist Stella Young.

There are at least three basic types of inspiration porn. In one, a disabled person does something normal - like dance to Lady Gaga - and the viewer feels inspired because the disabled person can do this normal thing. Look at them overcome their disability! the narrative goes. This framework cheapens real accomplishments and rarely considers the socially-constructed obstacles to broad success for people with disabilities.

In the second type, an abled person does some basic act of kindness - such as having lunch with an autistic kidisolated at school, stopping work to feed a disabled customer at a restaurant, or inviting a disabled teen on a date. The abled person is then celebrated for their goodness, with the disabled person turned into an object on which the able person acts. Again, structural issues leading to the need for abled intervention vanish.

In the third type, often distinguished as “tragedy porn,” a horrible situation involving a disabled person is displayed, sometimes with comments about overcoming or courage, with the goal of providing perspective on your own (presumably not as bad) troubles. Perspective can be good, but again, the disabled person’s experiences are being leveraged as a tool to make the viewer feel something.

Cuteness is a way of aestheticizing powerlessness.” Many disabled adults, especially those with Down syndrome and Little People, are treated as perpetually cute children.

Because disability is a part of humanity’s natural diversity, it needs to be part of the important conversations we’re having about inclusivity.

Disability as identity and disability pride may be familiar concepts within the disability rights community, but they’re still pretty radical for the ableist world as a whole.

Source: Don’t Turn My Son’s Lady Gaga Dancing Into Your Inspiration Porn

See also,

Neurodiversity Library

Steve Silberman discusses several of these in this interview at Five Books. See also his recommended reading list.

Follow the #ActuallyAutistic hashtag for perspective from actually autistic folks. Note that identity-first language is generally preferred in this community.