Although Eugene Bleuler thought that schizophrenia was caused by an unknown organic cause, he nonetheless attempted to understand the psychological conflict that triggered the latent disease. One of the fundamental symptoms of schizophrenia from his point of view was autism, by which he meant a withdrawal from reality into an inner, self-absorbed phantasy world.
Rather than withdrawing from participation in the outside world, Leo Kanner described 11 children that had always had such extreme autistic aloneness (see previous post). Hans Asperger also saw autistic children as shutting off relations between the self and the outside world from the start.
Attempts to understand the social intelligibility of events in the family that led to childhood autism tended to be seen as indicating poor parenting as the cause, which was seen as stigmatising to parents. This led to a paradigm shift from such psychogenic theories to a neurodevelopmental perspective, which meant that autism became seen as a brain disorder (see eg. Youtube video clip of interview with Michael Rutter). Autism and intellectual disability became understood as commonly coexisting.
Although Asperger regarded autistic children as having difficulties at home and school, he argued that they should be valued and their idiosyncratic way of dealing with the world could make them "the salt of the earth" (see previous post). The online world further encouraged self-advocacy and the development of the neurodiversity movement, making autism with ADHD the principal diagnoses of neurodivergence.
Neurodiversity fundamentally means the need for society to adapt to people’s personal differences, which I think does make sense. It’s understandable that people want to gain any advantage they can from others adapting to their idiosyncrasies. With the spread of the original diagnosis of autism from children to adults, adult psychiatrists, at least, in the NHS, have probably always generally been cautious about this development, which has meant that neurodiversity services, including the diagnosis of autism and ADHD, have become separated into a specialist service, run by those that have this special interest, with vast waiting lists (see eg. previous post). Nonetheless advocacy groups tend to be supported and reinforced by institutional psychiatry (see eg. another previous post). The diagnosis of autism no longer generally needs to be made before the age of 30 months, as originally, and the link between autism and intellectual disability has essentially been lost (see yet another previous post).
Advocacy groups have nonetheless valued seeing autism as a neurodevelopmental problem, meaning that they tend to understand themselves as having a different kind of brain. This neurodevelopmental understanding has been reinforced by the neuro-turn in cultural thinking in general. Brain scans have created the impression that we can see how our brains work (see eg. previous post). Brain overclaim in everyday life is widespread (see eg. another previous post).
The trouble is that it does not really make sense to see people as having different kinds of brain. It isn't the brain that determines what people think, feel and do, although of course it mediates such cognition, emotion and behaviour. Unlike bodily disorders, there is no brain abnormality that causes people to be autistic. It is important to try and understand why people withdraw into themselves, but such theories can never be proven as such in naturalistic terms. It was never right for parents to be blamed, as such, for causing autism. Creating a biomedical myth was never the way to counter such concerns and has led to an unsustainable situation about neurodiversity in mental health services and popular culture in general.
