Why bother? Given the breadth of diagnostic classes these days, there's a good chance you can find a practitioner[0] willing to make a diagnosis. That said, aside from getting funding for treatment or acceptance of accommodations, receiving a label of disordered often does not help, but does add harmful stigmatization. The OP's son seems normal, functioning, and isn't harming anyone. On the other hand, the diagnosing practitioner may need to be tested for Overpathologization Disorder[0].
Our daughter was diagnosed with dyscalculia, and the diagnosis was very helpful, both for us and for her. She was really struggling with maths and felt like she must just be stupid. The diagnosis helped her to understand that it's just a very concrete thing that she has that affects one aspect of her functioning, and doesn't mean that she's dumb, or lazy, or whatever other story she had ended up telling herself. We are homeschooling her, and it also helped us to understand what was going on for her, and to adapt how we teach her appropriately.
> That said, aside from getting funding for treatment or acceptance of accommodations...
Both of those can also be life-changing, but you make them sound like trivial details. They are not.
It sounds like the diagnosis marked a point of positive transformation. Before the diagnosis, your daughter attributed her math challenges to global stupidity and laziness. After the diagnosis, she attributed it to a specific difficulty with math. That reframing does sound healthy and helpful. It also sounds like the diagnosis helped you accept the situation and adapt your teaching modality.
Certainly, funding for treatment and acceptance of accommodation can make a life-changing difference. That in part motivates many caring and concerned practitioners to widen diagnostic criteria, so that more people can access benefits. I can see how I came across as trivializing those benefits. Quite the contrary, though, I meant to express that yes, diagnostic labels can bring positive results, and we need to weigh those against the negative results, especially when other options exist.
Some things can lead to benefits, without themselves being beneficial.
In psychology, diagnosis is sometimes like that. It can lead to treatment, accommodation, and funding, but the diagnosis on its own may not be beneficial, may cause harm through stigma, and may not be necessary to access the benefits.
The alternative: when possible, provide the benefits without labeling the person as disordered.
Exactly! Some things can be bad or good for certain people in certain contexts, and such things should categorically be avoided. In a similar vein when I see people discussing hydration online I point out that the only way to guarantee not drowning is to not be near or consume water. While some may complain about “thirst” they ignore their lungs’ “thirst” for oxygen! Why bother?
That in itself disproves your point though. That’s talking about a specific characteristic: mislabeling. It is really the symptom of someone talking about something they don’t know enough about to be talking about it.
Some people say ADHD for example is overdiagnosed. Perhaps that is true so college kids can get drugs or kids can be calmed down, but it is like saying people who don’t always wear glasses don’t need them and shouldn’t bother.
Because knowing about the presence of a condition is better than not. Depending on the severity, untreated ADHD during the years of life where a child begins to establish good study habits, management of the condition, and other tools that work for them, can lead to issue down the road and into adulthood. We have the ability to address conditions like dyscalcula with little interventions to help the student be successful.
Just because something is imperfect doesn’t mean it should disregarded completely if the benefits (academic, social, and career success) outweigh the drawbacks of being untreated. The stigma argument is just FUD and letting that take over decision making for the well-being of a child is a bad path to go down.
There are often, unknown to the parent, invisible scars that the child with a non-neurotypical condition will carry for the of their life after having found out about a condition they’ve had since birth and was not addressed during the most critical time of their life when early treatment could have greatly reduced the harm caused by this disorder.
I agree that knowing about something, and accepting it, is better than the alternative. Does that mean we need to diagnose it as a disorder? For instance, I have an introverted personality, and I accept that, even though I didn't receive a diagnosis of introverted. On a more serious note, I have friends who I know and accept as gay, but I don't consider them disordered. The diagnostic and statistics manual used to include gay as a disorder; removing it as a disorder reduced the stigma, and I don't think it reduced the societal or self-acceptance of gay people. Quite the opposite. So like you I love self-knowledge; I only take issue with "diagnosis" as the way to gain it.
You make a good point about the benefits of receiving treatment. I personally have received training in social skills, goal setting, relaxation exercises, and realistic thinking. I learned those skills to overcome specific challenges. I had some anxiety, like every normal person does, so I learned a skill for that. I had trouble dating, so I learned skills for that. I felt overwhelmed, so I learned goal setting for that. I thought I was stupid, so I learned realistic thinking to avoid overgeneralizing and labeling. Throughout that process, I brought my challenges to a psychologist, and the psychologist taught me skills. That approach offers a way to help people without diagnosis, by suggesting treatments for specific challenges.
Can we keep the early treatment and drop the diagnosis?
There are people who genuinely struggle with these things because their brains literally don’t work the same as everyone else. I have ADHD and struggle to be on time to things and god forbid even early. Getting a diagnosis was a life saver because at least I don’t beat myself up for not trying harder.
A diagnosis isn’t a “label”, but understanding of how someone works. It is like being diagnosed with myopia: it explains why your kid can’t keep up in school because they literally can’t see the chalkboard (me, had glasses before finishing 1st grade).
So, no we can’t drop the diagnosis. Chances are you may have something too and not realize it. Does that make you less human? No. It just means you think a little different.
Assuming you grew up in a loving home with stability, in theory you learn life skills as a kid that you don’t need training as an adult for. However, most people don’t have loving parents that stay together, love each other, and can teach you every skill. Some don’t know they have a brain that is different, and need specialized training that works with them. Because of childhood trauma and ADHD, I have had to learn other techniques to handle my life and executive dysfunction. Finally approaching 40 I’m starting to put it together.
So no, we can’t discard the diagnosis. It isn’t a label or problem, but an explanation and scientifically proven reason for the problematic behaviors seen.
Nice initiative. Particularly for civilians doing daily activities, biking and walking seem like the best forms of transportation. They enhance personal happiness, increase community connections, make streets safer, and promote beautiful surroundings.
Thank you for the kind words! I would agree — and I think there are some more fundamental approaches, like housing density paired with in-fill of retail and shops, that can make that more accessible from the ground up. Literally!
Your suggestion of housing density with retail and shops fits the description of my current neighborhood. I love it so much that I changed careers to find ways to support more of this kind of community.
Good. If we want cleaner air and quieter cities, we have several alternatives to gasoline cars. I imagine a graph of CO₂ production goes a bit like this:
Walk -
Bike -
Train ------
Electric Car ------------
Gasoline Car ------------------------------
On the one hand, it seems silly to debate electric cars versus trains while we have gasoline cars on the streets. On the other hand, I like that we focus our news on the low emitters, so gasoline cars drop out of popular culture. To change a paradigm, it helps to speak with assurance from the new one.
The article seems to be looking at marginal CO2 production, so that's what I'll look at. To be precise, let's consider this situation: you want to go from your present position at point A to some other point B. There's a nice road from A to B, which is suitable for walking, biking, and driving. There's also a train track beside the road with stations at A and B. You already own and regularly use a bike, an ICE car, and an EV.
The question then is if you take a trip from A to B, which choice from {walk, bike, train, ICE, EV} will result in the lowest change in total atmospheric CO2 from the time you leave A to the time you arrive in B?
Let's first just look at walking vs biking. Perhaps surprisingly you will actually produce more CO2 walking. Here's a site [1] with some example calculations. Their example is a trip of 3.2 km, with a walking speed of 4.8 km/hr and a biking speed of 12.8 km/hr.
Walking would take 40 minutes and burn 167 kCal, but just being at rest for 40 minutes would burn 56 kCal so we should count walking as costing 111 kCal.
Biking would be 15 minutes and burn 70 kCal, but just being at rest for 15 minutes would burn 21 kCal so we should biking as costing 49 kCal.
We produce about 0.7 kg of CO2 per 2000 kCal, so that gives 0.03885 kg CO2 for walking and 0.01715 kg CO2 for biking.
But wait...should any of that actually be included? The C in the CO2 we exhale comes from the C in the food we eat. For plants we eat they get it from atmospheric CO2. For animals we eat they get it from the food they eat, and so on with it also ultimately coming from plants that get it from CO2 in the atmosphere.
That's just contributing to fluctuations in atmospheric CO2 levels, not to an increase over time in CO2 levels. The question asked above probably should have not been about the lowest change in total atmospheric CO2 over the time of the trip but about the lowest change in the amount of CO2 in the atmosphere that had not recently been in the atmosphere before the trip.
How to count the train is also unclear. The most straightforward way would be to figure the energy the train has to expend for the trip and divide it by the number of passengers, then attribute to each passenger the CO2 from producing that energy.
But the train is still going to make that trip regardless of whether or not you decide to take it. One could argue that for this comparison we should be looking at how much additional energy the train uses if you are on it compared to if you are not. That's going to be very small, and the corresponding CO2 is going to be very small even if the train gets it energy from fossil fuels.
You can get a situation where if you have a dirty activity and a clean activity you only actually come out ahead if enough people switch to the clean activity so that the dirty activity can end.
This is something to watch out for. It can lead to cases where the rational behavior is to advocate for the discontinuation of something on environmental grounds but to personally continue to do/use that thing until regulation or economics make it stop. Some people mistake that for hypocrisy but it is not.
If the train is an electric train and it has a clean source of electricity it might be down near walking and biking.
Similar for the EV. If it has a clean electricity source, it too might be down there near walking and biking. If we are including exhaled CO2 it could actually be lower if it has 100% green electricity because your kCal burn rate in the car should be the same as your at rest burn rate.
The ICE car is going to be way up there.
In summary I think then it would be bike and walk very low or even zero, ICE car very high, EV anywhere between walk/bike and maybe 80% of ICE car depending on its electric source, and train somewhere between EV and walk/bike again depending on electric source (assuming EV train).
Thanks for the thorough analysis. In British Columbia, and specifically where I live, much of our electricity comes from hydro electric, we have suitable pathways-with-boulevards for walking, and the streets have segregated or low traffic bike lanes. That leave us with an almost idyllic situation for walking, biking, and EVs. Not only does that support a reduction in my CO2 production, but also it support my personal well-being with neighbors, exposure to nature, and exercise.
Unlike those in public high school, students who aren't serious about medical school won't have earned the entrance grades. So at least in first year, most students will have a serious attitude. Are you suggesting that someone will bust their ass for four years, only to start slacking once in medical school? Or that medical school entrance grades don't require serious study?
I can see what you mean about the halfway point. Maybe undergrad came easily, and at the halfway point, the student realizes that medical school simply isn't a good fit, or it's more work than they thought it would be. So they drop out. This is probably a good thing, to prevent people becoming doctors who don't have the chops or the attitude for it. Unfortunately, the school does lose some money on a candidate they ought to have filtered out in the interview.
Happily it's an empirical question, and we can circle back in a few years to see if the drop out rate increased or not. Maybe the drop out rate increases at first, and then the entrance interview becomes more stringent.
One way to have skin in the game is to pay a considerable sum of money to join medical school. This reminds me of the Commitment and Consistency chapter in Cialdini's book Influence. In part it says we stick with things more after we exert effort and especially so after public effort. With free tuition we take away some of the skin in the game, but students will still have to expend considerable effort to achieve high enough grades. That probably fosters commitment (and might explain why people with scholarships still tend to value school). In any case, we already have doctors whose parents paid for school, so even when free schooling does reduce commitment (and it probably will sometimes), at least this evens the playing field.
I like this because it encourages affluent people to adopt electric vehicles. If we want to live in cities with clean air, quiet streets, and fewer gasoline stations, then it makes sense to encourage electric vehicle adoption. Many people look to the wealthy as role models, and many wealthy people seek status, so this seems like a win.
This kinda glosses over the entire history of BYD cars though.
BYD started very low, selling cheap EVs or hybrids like the BYD F3, then slowly creeped up to being a mainstream brand (a la Toyota) in China, and is now moving towards the even higher end with cars like Yangwang U8.
I guess my point is, it always seemed to me that their plan was to release products like the U9. It's just that they were doing it bottom-up.
I find this useful on myself and with others. It gives an approach when someone (or my own mind) says, "None of this is my fault, so I shouldn't have to change."
From the article:
> In effect, our client is operating from a justice model... pleading their case before a court, [so] the party ultimately found guilty will... change.
> The challenge is that [life] is not a courtroom... the guilty party is usually neither present nor inclined to alter their behavior... [and so] the client will remain helpless.
I sometimes only use the first few steps, and have found them useful when acting as a friend, manager, or colleague.
That doesn't sound fair to me either. The subset of people who have benefitted from polluting won't have to foot the clean-up bill. So those who want lush, temperate, and healthy surroundings may have to take charge, even though it isn't fair. I certainly feel grumpy about those who benefit from polluting, when others have to deal with the effect. It would be nice if they were more responsible, so we didn't have to figure this all out. I gave up on that happening, and instead have started to change my own part in this. It's a shift from the justice model to the effectiveness model.
I feel convinced to participate in climate change in my work. I don't know whether we can reverse it or whether tech will solve it, but I do believe in its importance, and I want to understand it. I have incorporated all of this change into my worldview by finding ways to improve morale in the community, and recently, by switching careers from software development into sustainable innovation.
> Once upon a time there was a field called Personality Psychology, which concerned itself with normal-range individual differences between people, as distinct from dysfunction-inducing extremes classified as psychopathologies. Over the last 40 years, however, mental health diagnostic categories have broadened markedly, making the range of what we used to think of as "normal" much narrower. Diversity has become disorder. Although intended to broaden the availability of mental health services to more people, there is no evidence that this trend has contributed to improvements in population mental health - indeed, the opposite seems to be true.
Edit: clarified that this quotes the video description.
> Although intended to broaden the availability of mental health services to more people, there is no evidence that this trend has contributed to improvements in population mental health - indeed, the opposite seems to be true.
Greater awareness with more accessible treatment means the reported number of cases of X go up.
The video argues that yes, greater awareness has happened, and also, we have widened our pathological categories to include normal functioning. First we invented autism (etc), then we widened the definition(s).
Widening the disorder criteria seems to cause more harm than good. We could already improve ourselves without identifying as disordered. And we usually do better when we identify as normal, healthy humans.
Fortunately, we can recognize the absurdity of the widening criteria and opt-in to identifying as normal, like most people are.
> We can already improve ourselves without identifying as disordered.
The purpose of the "disorder" is to group common pathologies and their respective treatments (methods to improve).
Let's take high functioning autism as an example of a "expanding disorder". The "treatment" for high functioning autism is largely behavioural. Preparing for known stressful events, methods to stay focused on a task you don't like, practicing identifying and displaying emotions appropriately, etc.
> We could already improve ourselves without identifying as disordered.
Many people with high functioning autism don't see it as a disorder and view it as a "different thinking style".
We can (and I think should) "embrace" that, but that does nothing to improve difficulties such as dealing with a new situation, making friends, communicating with their boss, etc.
Similarly I've heard "everyone says that have trouble focusing, you don't have adhd".
Whether you have adhd or not, the ways to improve your behaviour are the same. Methods to stay organized, prepare your environment to focus, prioritizing, etc. apply regardless of whether "you really have adhd or not"
Thanks for the comment. It looks like we mostly agree.
> The purpose of the "disorder" is to group common pathologies and their respective treatments (methods to improve).
So nice to see this expressed. Classification helps when it lets us find effective treatment approaches. We do want to give people effective tools to face life difficulties.
That said, a problem happens when a classification has many different presentations. Person A with high functioning autism might need help staying focused on disliked tasks. Person B with high functioning autism might have trouble expressing emotions (but do fine with disliked tasks). As the classification widens, so does the range of presentations, and that increases the risk of treating people like B for difficulties that they don't have.
We can remove that risk if we treat the difficulty directly. Instead of `person -> classification -> difficulties -> treatments` we go `person -> difficulty -> treatment`. Simply match difficulties to treatments directly.
"Lots of people have difficulty staying focused on tasks they don't like. These things tend to help... "
> Many people with high functioning autism don't see it as a disorder and view it as a "different thinking style".
It's just so nice to see that. Happily, the DSM may remove high functioning autism, at least in part. Good! We did the same with homosexuality in 1973. The classification was the stigma.
It looks like we agree that classifications can help, if it points to effective treatment. I like to point out that wide categories obscure effective treatments and also introduce stigma. By dropping the classification, we can focus on the person, their real difficulties, and to normalizing their human experience.
[0]: http://www.psychologysalon.com/2012/01/overpathologization-d...