Tuesday 31 January 2023

Masked, Alone, and in the Dark

Today's post is by Nuria Gardia, a Mental Health Master’s student at University of Birmingham with a newly discovered passion for Philosophy. Her interests lay in the intersection between philosophy and psychology to better understand how the mind “overcomes” trauma and the relationships between mind-body and self-world. Specifically, how trauma affects human experience and thus, human reality. 

This is part of a series of posts by students of the Philosophy and Ethics of Mental Health and Wellbeing module at the Institute for Mental Health. They share some of their views on key topics discussed in the module.

Nuria Gardia

Autistic women navigate a world made by-and-for neurotypicals within a society that ignores their strengths (Russell et al. 2019), and wrongfully denies their capacity as knowers (Catala et al. 2021), by underdiagnosing them and excluding them from research (D'Mello et al. 2022).

Moreover, without a diagnosis, autistic women are wrongly deprived vital knowledge, that could help them comprehend their social experiences (Fricker 2007, chapter 7) and be socially understood. Whilst, also denied access to social support (Stagg and Belcher 2019).

Thus, inspired by Catala (2021), and guided by Laing's Divided Self, I propose that masking is imposed by a socially MAD world (Mandy 2019).

Currently, autism remains a misconceptualised term imbued with wrongful assumptions, which society maintains. Classified a disorder to characterise its associated social interaction, communication, and behavioural difficulties. Autism’s diagnostic criteria focus solely on its related deficits. Hence, autism is perceived negatively, and society discriminates, marginalises, and negatively impacts autistic individuals and their mental health (Catala 2021). 

Yet, autistic strengths, such as passion, creativity, and great expertise in areas of interest, are dismissed. Moreover, one could postulate, that autistics display socially normative behaviours, such as honesty and trustworthiness, which neurotypicals do not (often) display. However, society interprets them as not conforming to social norms, and feels threatened.

Emphasising that this assumed threat is due to the lack of understanding surrounding autistic individuals, specifically women and their gender-specific characteristics. I suggest autistic women-led research and consider autism as gender biased at all possible spheres. Conceptually, society associates autism with males and excludes autistic women from research (D'Mello et al. 2022). 

Medically, diagnostic criteria is based on male traits. Also, psychosocially, autistic women display different, not-medically-considered, behavioural traits. Thus, it raises ethical and moral considerations and epistemic injustice at testimonial levels (Fricker 2007, chapter 1). Their word is not considered valuable for research or clinically trustworthy for no logical reason –just their gender. However, it also accounts current underdiagnosis rates (Gessi et al. 2021).

In line, underdiagnosis raises epistemic injustice at hermeneutical levels. Without a diagnosis, autistic women do not receive diagnostic or community-service-level autism-related information. Which is extremely valuable and helps autistic women comprehend the complexities within their social worlds. 

Thus, autistic women can view diagnosis as bearer of valuable knowledge, reducing, among others, undeserved feelings of disconnection, inadequacy, oddity, shame, and self-blame. Conversely, a lack of knowledge raises ethical concerns at individual levels, with the self-stigmatisation of misunderstood thought processes and sensory and behavioural self-identified differences. Also, at societal levels, misguided assumptions enhance and exacerbate the stigmatisation surrounding autism.

Furthermore, non-diagnosis also leads to social injustice. Without a diagnosis, there is no access to community-based services or access to extra support. Thus, many autistic women are socially conditioned into masking, hiding their true selves to form a socially expected version of themselves, at a high cost. However, over time social masks get tired and violate demarcating boundaries, impeding diagnoses. 

Socially Masked by Ainara Gardia

Concluding,  ethically and morally, difficulties or differences are not equal to deficits. Thus, diagnostic criteria should be modified to include autistic difficulties as much as their strengths. Also, informed by autistic women-led research to account for their gender-characteristic differences. 

Thus, I propose that masking, imposed by a socially MAD world, makes the urgent plea for epistemic growth.

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