Asperger’s Hysteria


12/9/2012

They oughta know. The American Psychiatric Association, that is. They’re the experts. They’re the ones who decide who is sick and who is not, who gets treated for one illness instead of another, who gets committed to a mental institution, who gets reimbursed for ministering to the mentally ill and who does not. It’s an awesome power APA wields and understandably their actions receive a lot of attention. This has never been more true than it is today, as changes to the APA bible–the DSM–are poised to go into effect. Graced with the imprimatur of the APA, these changes will become dynamic actors in private practice offices, special ed programs, and psychiatric treatment facilities.

This is serious stuff. When the APA makes a pronouncement about the legitimacy of a diagnostic category, the mental health universe listens. Such is the case with Asperger’s Syndrome. Despite the collective wail of a community that has come to define itself by this diagnostic term, the APA ruled last week that Asperger’s simply does not exist. The APA’s governing committee decided to fold certain characteristics of the phantom condition into the larger family of autism spectrum disorders.

So, all those people who see in themselves some similarity to a defined group are suffering from hysteria, wishful thinking that leads them into a culturally induced delusion. The APA, instrument of science and objectivity, will set the situation right. With the DSM V and the elimination of Asperger’s from its pages, clarity will rule

Under the amorphous heading of autism spectrum disorders, clinicians and patrons will find a comfortable niche, one that will serve them better than the hysterical specificity of Asperger’s Syndrome. Prior to DSM V (due in May of 2013), a person diagnosed with Asperger’s Syndrome could use the term and be reasonably confident that a few clear ideas would be communicated. As someone with Asperger’s they likely demonstrate certain traits, among them: severe, life-long, social limitations; perseverance, or the tendency to pursue ideas and interests obsessively; abnormalities in spatial perception; a fondness for patterns; hypersensitivity to stimuli; I.Q generally in the normal or high-normal range.

Henceforth, with the DSM changes, people formerly diagnosed with Asperger’ will be free of this onerous specificity; they will no longer diagnostically fit into a narrowly defined subgroup of autism spectrum disorders. They will have been given the gift of inclusion. This will likely mean that when they speak about their diagnosis, they will be met with puzzlement. For autism, everyone knows, can be severely disabling and deny the autistic access to mainstream activities. By contrast, people who carry the illusory diagnosis of Asperger’s Syndrome very possibly are able to integrate, however awkwardly, into mainstream life. While certain characteristics might set them apart, they still have a good chance of leading productive, somewhat “normal” lives–though their successful social integration likely is predicated on hiding much that otherwise would stigmatize them.

Hiding, leading a closet life, can be draining. It’s hard to actively conceal a secret, to daily negotiate conflicts between innate character and societal expectations. Which is probably why so many high-function autistics enthusiastically accept the label of Asperger’s Syndrome. Finally, a label that approximately describes the way they are. A label that offers what most of them have never experienced: a sense of community. People with Asperger’s enjoy the comfort of knowing there are others in the world who are somewhat like them, others to whom they can relate, in an odd, limited fashion.

It’s a good thing we have the APA to free all these benighted people from their delusions. And we can, of course, rely on the soundness of the APA’s judgment, because they have such a long and legitimate history. A history which includes endorsement of frontal lobotomy and insulin shock therapy. A history which only twenty years ago included accepting Asperger’s Syndrome into its diagnostic manual

An honest and unjaundiced appraisal of the APA’s methodology would give the organization an accuracy rating that approximates the on-target performance of a blind-folded dart thrower. To describe the APA’s success rate as hit or miss would be kind, for there is much more deliberation in the APA’s process than mere chance would allow. When it comes to the APA, I don’t know if it’s arrogance, corrupt influence, or just plain ignorance that guides their judgment. Whatever the case, they seem to get it wrong as often as they get it right.

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