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Self-diagnostic practices in adolescence

This week's post is by Floriane Brunet (Service de pédopsychiatrie, CH de Saint Nazaire) and Christophe Gauld (Service de Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant – Hospices Civils de Lyon). 


Floriane Brunet 
Christophe Gauld

Today, growing attention is being directed toward self-diagnostic practices among teenagers, a trend that may legitimately be related to the notions of childism and epistemic injustice within adolescent psychiatry. These two notions provide insight into the multiple processes through which adolescents’ testimonies are silenced within Western societies. Becoming aware of this systemic invisibilization of singular adolescent experiences, as well as of the continuum of violence directed toward them, calls for renewed forms of adult engagement. How does this bundle of domination shape the way clinicians listen to adolescents lived experiences? How can the reception of self-diagnostic practices at this age be reconsidered?

It was hypothesized that certain self-diagnostic practices may reverse knowledge and power dynamics within the traditional medical diagnostic framework. Adolescents consulting with an explicit request of this kind, presenting an already formulated diagnosis, place clinicians within a space of truth telling and demand transparency regarding the knowledge mobilized. In this situation, both individuals share, in relative symmetry, a common vocabulary and comparable terms for understanding what constitutes suffering. Epistemic justice may then be mobilized as a form of emancipation. This hypothesis opened the possibility of approaching such requests for care differently, restoring the interpersonal relationship as a central dimension of the caregiving dynamic, understood as a space of negotiation through which existence can be reclaimed.

At a time when mental health has become widely publicized, self-diagnostic practices may contribute to active responses to experiences of harm. These practices increasingly intersect with citizen claims of identification with the neurodiversity spectrum. Neurodiversity challenges diagnostic categories and may support transformations in societal representations of disorders, as well as in the organization of care and inclusion regarding difference and suffering. In this way, self-diagnostic practices may constitute a modality for managing distress through an autonomous engagement with inner suffering, whereas neurodiversity claims may function as collective strategies for managing disability, oriented toward the recognition of externally situated and publicly negotiated forms of impairment.

Both self-diagnostic practices and identifications with the neurodiversity spectrum may support a more detailed understanding of self-management of harm, as well as collective ways of responding to disability. Considering a parallel between self-diagnostic practices and neurodiversity claims requires clinicians, and more broadly social groups, to approach these practices with greater complexity. Moreover, self-diagnostic practices and neurodiversity claims may thus contribute to reversing the stigma associated with distress and disability, engaging individuals in an emancipatory appropriation of harm.

Reciprocal relational commitment are central in this process. Each person relies on the relationship itself, understood as a shared relational space grounded in reciprocity and respect, allowing difference to be recognized without pathologization while avoiding the trivialization of suffering. Maintaining a relational understanding of lived experience is essential, supporting an ethics of the subject and a society more attentive to experiences of distress and disability.

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