Neurodiversity and the Myth of Moral Decline
How to spot reactionary critiques of medicalisation
Something I’ve often pointed out in my critiques of certain forms of neurodiversity, anti-psychiatry, and critical psychiatry is that not all resistance to medicalisation is progressive. While I’ve defend or proposed many forms of resistance coming from the left, many others come from reactionary, conservative, or even far right perspectives.
Today I’m concerned with a specific kind of reactionary critique of medicalisation and diagnostic expansion, where these are challenged because they are seen as symptoms and in some cases causes of moral or cultural decline. In these cases, further specific arguments are also typically given (e.g. about the validity of diagnostic constructs, etc.). But in contrast to critiques from the left, the underlying normative motivation for the conservative, and increasingly for the far right, is about declinism (although versions can occasionally be found on the religious left).
The most general kind of narrative I have in mind is, to give a secular example, the idea that the kids today are all mollycoddled and need to toughen up – the kind of thing you often see in conservative papers, but which has a long Christian history prior to secularisation. The at least implicit commitment here is to the belief that there has been moral decline, or fall, from a more virtuous past. Further to the right, fascists also adhere to more extreme versions of such narratives, for instance, the Nazi notion that that people with mental disabilities are causing cultural and moral degeneration by reproducing, and therefore need to be eliminated.
In the past few years I’ve seen a lot of this in right wing media, in response to the mass expansion of neurodivergent identification and psychiatric diagnoses. Consider the Christian conservative journalist Peter Hitchens, writing in the hard right Daily Mail in 2022:
“having grown used to a society which offers some sort of cure for almost every ill, we very much want to believe the astonishing claims of doctors and drug companies that they have unlocked the mysteries of the mind with biochemistry. We readily accept the claim we can regain contentment by swallowing a couple of capsules. The taking of mind-altering drugs is now actually a protected characteristic of our society known as ‘Neurodiversity’.”
Hitchens, it seems, is against neurodiversity being a protected characteristic in part because he thinks this is itself a symptom of how society has changed, a form of decline that ultimately makes us less virtuous due to an “unhealthy obsession” with trying to avoid suffering. Of course, there are many good reasons to be critical of pharmaceutical companies and the medical model. But for the conservative, the underlying issue is that life is just hard, and people are not born equal, so it is wrong to try to tamper with that with things like accessibility or medications.
Something I always find interesting about these narratives – and which makes me sceptical about them – is how they manifest in every generation, but each time the those preaching them think that their time is the first time this has happened. A very brief history will suffice.
Consider an example from a decade before Hitchens’ article, from the critic of psychiatry James Davies, who as I’ve argued before is essentially critiquing both psychiatry and neoliberalism from a conservative Christian perspective. In his 2013 book Cracked he wrote:
“Are we […] replacing traditional philosophical and religious ways of managing and understanding distress, which once saw meaning and opportunity in many forms of suffering, with a starker technological view [?] Is psychiatry’s essentially negative view of suffering, in other words, yet another manifestation of a wider cultural obsession with using emotional anaesthetics – pills, alcohol, retail therapy, escapist activities – as the principal consumables for managing emotional distress?”
As I cover in my previous post, for Davies, psychiatry is bad because he associates it with secularisation, a negative (unchristian) view of suffering, and thus, in his view, moral decline. Instead, he wishes we could face the harshness of reality and use it to grow and develop virtues, helping our culture recover to its full glory rather than sinking further into what he sees as godless escapism. And because he sees neoliberalism as enabling this decline even further, his golden age seems to have been the 1970s, Fordist era, which – like many on the right today – he seems to think we should organise to return to.
This, in short, why conservatives, not to mention more the far right today, now focus so much on the expansion of psychiatric diagnoses: they see them as helping more and more of us escape our problems, by letting us believe we are ill or disabled. Yet curiously, such claims about medicalisation are not new, even if the current focus is more often on psychosocial and developmental disabilities than it has previously been.
In fact, if we go back to Davies’ own golden age, the 1970s, we see a similar analysis from the conservative Catholic priest, Ivan Illich, in his 1975 book Limits to Medicine. Illich wrote that:
“Man's consciously lived fragility, individuality and relatedness make the experience of pain, of sickness and of death an integral part of his life. The ability to cope with this trio autonomously is fundamental to his health. As he becomes dependent on the management of his intimacy [though medical intervention], he renounces his autonomy and his health must decline.”
For Illich, modern medicine itself is making the people of the 1970s unwell, already bringing cultural decline by then. His vision of health is one where we embrace and overcome sickness as part of life, not something we should try to escape. He believed this would help us become more healthy, more virtuous, instead of helping us run away from problems by curing them. So, it turns out that going back to the 1970s won’t help: we were already, for Illich, in decline.
When, then, is this purported golden age of virtue if not the twentieth century? It is the nineteenth century? Or perhaps the eighteenth?
Unfortunately, it turns out, people were saying similar things even back then. According to the eighteenth-century philosopher Jean-Jacques Rousseau, for instance, the people of his time were already well into medicalised moral decline. In 1762 he opined that
“I do not know what the doctors cure us of, but I know this: they infect us with very deadly diseases, cowardice, timidity, credulity, the fear of death. What matter if they make the dead walk, we have no need of corpses; they fail to give us men, and it is men we need”
Yes, that’s right. Rousseau – whose own golden age was basically pre-civilization – thought that medicine was back then was bad not just because it was often ineffective and harmful (even though these were genuine problems he was concerned with). His worry was about medicine that correctly diagnosed illnesses and allowed people to “walk” again. He was against even medicine that worked, because he thought that medicine, through doctors, brought moral and cultural decline, specifically in relation to cowardice that stifled manly courage.
Perhaps all these people are correct, and we really have been in moral decline in every generation since medicine began. Or perhaps they are just conservatives who are against medicine because they fear change, and then react to this by embracing the most widely available and reactionary myth around.