Read my latest story, "A Tale of Two Birthdays", at 52|250.

Earlier this month, the New York Times covered a proposed changed to the Diagnostic and Statistical Manual of Mental Disorders (DSM) which would eliminate Asperger‘s as a separate diagnosis making it, instead, part of a category of autistic spectrum disorders. To me, the categories used by psychiatrists are of little interest. (I do, however, realize that there are some for whom it matters very much, and I in no way wish to denigrate them or their needs). The DSM, by its very nature, reflects reality as seen by psychiatrists not as seen by the people it’s supposed to categorize. That is to say, I have very little use for it myself, though I recognize that this proposed change would make it much harder for curebies to tell Aspies that they don’t really count as autistic, and that’s certainly something to be happy about.

Still, I’m not going to dodge the questions this proposed change raises about the difference between Asperger’s and autism. Ultimately, I see the former as a subset of the latter and will identify as one or the other or both depending on the context. Certainly, my response to stress is recognizably autistic, but my approach to and use of language seems to have more things in common with other Aspies’ than with non-Aspie autistics. It’s not either/or. It’s not both/and. And wanting to preserve the Asperger’s identity is not necessarily about wanting to maintain privilege or subscribing to some sort of notion of superiority-through-higher-functioning.

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The title of Sara Tracey’s And After This contains two ultimately unsolvable mysteries that add to a sense of loss and suspended grief created by the use of ashes (which are not cremated remains or something holy but, rather, the more everyday ash of cigarettes), the description of the mother after surgery, and the desire to visit the cemetery.

The most obvious mystery is what exactly “this” refers to. If we read the title also as the first line of the poem (And After This / I have nothing holy to say) then “this” indicates what is said in the poem, the last holy words of a human remembering the pain of growing wings and describing the surface of potentially spiritual actions. “This” could also refer to something prior: the mother’s surgery (and recovery or death), a diagnosis that has created awareness of the need for “a headstone meant for me”, or anything really. That this cannot be nailed down with any precision or certainty reflects the irretrievability of the past and thus supports the need to grieve for it.

If the title is not read as if it were the first line of the poem, one may also ask: after this what? Such uncertainty about the future reflects the liminality of states of bereavement and grief. It is in the context of this liminality, too, that the final lines become a sign of hope, though other interpretations remain valid. “I will remember / how it hurt to grow wings” is about recalling in the midst of one painful liminal state how a similar state has allowed one to grow in the past. Using wings as a symbol for this is by no means original, but that is necessary in such a short poem, as using something like horns or a tail would require several more verses to serve the purpose of reclamation.

After seeing previews that led me to believe the show would either be intriguing or awful and exploitative in its appropriation of the experience of madness or mental illness/injury, I went ahead and watched the premier of Mental last night. I have decided against continuing to watch, though not for the reasons I expected. I don’t have the experience to say whether the portrayal of schizophrenia in the episode was realistic, but it did seem to keep to a minimum the number of scenes which would provide an opportunity for more callus viewers to enjoy the show as an opportunity to gawk at “freaks” (though some of the graphic visions shown are dramatically awkward and demeaning).

Indeed, the show’s positives largely flow from the new director and main character, Dr. Jack Gallagher, treating patients as whole human beings. He uses empathy instead of resorting to tranquilizers when a new patient, Vincent Martin, is having a severe paranoid delusion. He invites patients to sit in on diagnostic meetings and allows them some choice in how they are medicated. He takes a small group out to dance so that they can enjoy themselves instead of only becoming “productive” through routine. He respects individuals’ creativity. This may not seem radical, and perhaps is not in TV-land, but in real life, those deemed mentally ill often struggle to be seen as whole people. By setting the show up to be a bit too much like House-in-a-mental-hospital, the real daring of the show has been obscured.

The show also included some indication of the problems of dealing with pharmaceutical companies, which will probably be dealt with in more detail in upcoming episodes.

Unfortunately, Mental has major gender issues. While I do wonder why, once again, the main brilliant and iconoclastic character must be male, that isn’t the biggest problem. The main case in this episode was that of a schizophrenic man who had stopped taking his meds because he wanted to regain his ability to draw. The show, then, revolved around the story of a mad male artist and the doctor’s efforts to allow him to create and to get the female relative who was serving as his caretaker to give him that chance. It was painted as a big deal that Vincent was willing, if necessary, to sacrifice his artistic talent to be with his niece and nephew, but we never saw what their mother sacrificed to raise them (or to take care of him, for that matter). 

It would have a been much less cliché story had the genders been reversed. To make matters worse, the teaser for the next episode showed a hysterical pregnancy. Maybe Mental will get better, but I don’t see any reason to give it another chance.

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If you felt caged and demeaned and telling people that you felt that way didn’t do a thing to change it, how would you react? If you ran out of ways to try to change that situation? If you felt hopeless? I think most people, regardless of whether their neurology is typical or labeled disordered, would answer that they would lash out (if they were being honest). This was my first thought as I read this tragic (for all involved) story by Ann Bauer in Salon.

Autism, being the marked case, gets blamed when something goes wrong. Similar lashing out from a neurotypical young man who could not be diagnosed with anything would not be blamed on his neurotypicality. The Stanford prison experiments screened participants so that only “normal” volunteers could be included, but you hardly ever hear anyone referring to them as the “dark side of normalcy” (only of the human psyche). (Given the tendency of well-known groups like Autism Speaks to portray the spectrum in negative terms, I have a very difficult time understanding why Ms. Bauer seems to think that discussing a “dark side” to autism is somehow transgressive.)

But what is the actual relationship between Andrew Bauer’s violence and his autism? Living in a society that does not have appropriate spaces for you makes it likelier that you will feel caged and humiliated. Autistic individuals, barring extensive educational interventions, typically have fewer tools to allow them to protest treatments that make them feel this way.

This leads to frustration which, intensified, can lead to violence. In some cases, it is internalized and leads to depression or self-harm too.

ETA: Lisa Jo Rudy also discusses this article on examiner.com

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