Disability in speculative fiction

 I'm not at Worldcon in Glasgow. However, I get constant social media updates of what's happening there, courtesy of Sara L. Uckelman (of Ellipsis Imprints, who will publish my debut novel Cogwheel Souls in English! Yay!) For instance, she's been at a panel discussing disability and disability erasure in specfic. This got my mind going - first I wrote some long replies on Facebook, and then I thought enough thoughts about the subject for a whole blog post. 

1. The magical cure and the medical perspective

There's this specfic trope of the magical cure - either a piece of literal magic or amazing technology that can turn the previously disabled character normal again. Off the top of my head, the examples I come to think of are superhero stories - discussions around this in the DC comics when Barbara Gordon was still in her wheelchair, Felicity in the TV show Arrow (a different character but clearly inspired by Barbara in the comics), and some of examples from the MCU movies - the first Doctor Strange movie, Ghost from Antman and the Wasp. So I'll go with these examples since they were the first to pop up in my head, but there are far more out there. 

Now. From a mainstream, medical perspective, it's great if a disabled character can get a medical cure for their tragic impairment. And then, you've got your social justice conscious writers who see how this is problematic. I won't (obvs) try to recap all of the reasons why the medical model is problematic in a blog post, but there's tons written for anyone seriously interested. In extreme brief:

a) Aiming for a thoroughly "healthy" and non-disabled society will be a never-finished Sisyphus job. The bar for what counts as healthy enough constantly rises and you'll always have people deemed "problematic" due to their "defects". Also, when a disability-free society is an outspoken goal, no one is quite free to go against the flow. It might not be illegal to, e.g., not avail yourself of all techniques available for having children as healthy as possible, but expectations from medical professionals, what's default in a medical setting vs an active choice, and social pressure from everyone around you can be strong enough.

b) You will end up with a society in many ways more homogeneous than ours, which isn't a good thing. Some people might wanna say that they only strive to eradicate chronic illnesses and disabilities but not neurodivergencies that provide society with different perspectives and different ways of doing things etc. There are some philosophers who want to place a few conditions, like "high-functioning autism" (an itself problematic term, rejected by many autism advocates) in a the neurodivergence box, while still placing tons of other conditions in the box for disabilities to be eradicated. But because of the dynamics described in a), you'll likely have fewer and fewer conditions in the first box and more and more in the second over time.

c) Finally, the ubiquity of the medical perspective on disability makes it significantly harder for disabled people to fight for equal rights. Here in Sweden, disabled people are legally entitled to getting the assistance they need to live a normal life - with job, studies, their own flat, and so on. For some people, that means they require an assistant constantly by their side, so several employees with a rotating schedule, on public expanses (you'd have to be super rich to pay several employees out of pocket). However, legal entitlements on paper is one thing, what people get granted in practice is, unfortunately, quite another. Right-wing politicians (whether they call themselves "right-wing" or go by "social democrats") who constantly cut down on both taxes and public expenses will order the relevant clerks to make increasingly circumscribed judgments of what their clients actually need, with the wholly predictable result that disabled people are increasingly pushed out of jobs, schools, and overall public life. Adults end up living with their parents, who care for them until said parents die themselves. We're seeing the beginning of a new era of institutionalization.
There's no logical contradiction between embracing a mostly medical model, and yet argue that people should get all the assistance etc they need until we, hopefully, find a cure for their impairments. However, when people think of disability as something inherent and inherently tragic, something inside people's bodies and minds, it's much more difficult in practice to make them realize that withdrawing assistance and similar are political decisions, and to see disabled people as oppressed and discriminated against. The medical model helps, in practice, to cover up political injustices by presenting disabled suffering as a tragic but natural result of inherent impairments. 

Magical cure stories tend to implicitly rely on the audience accepting a largely medical perspective on disability, and therefore cheer for characters who seek a way to erase their tragic condition and become healthy and normal. However, subverting this trope is often easier said than done.

2. The implications of truly magical cures

I'm mad and neurodivergent but able-bodied. No one, whether embracing the medical model or not, thinks my body is inherently tragic. However, imagine that I came across a wizard who gave me the following choice: either you can continue as before, or I can wave my magic wand and make you as fast as Usain Bolt and with the stamina of Kelvin Kiptum. That's it, that's your choice. You can't trade it for something more altruistic, or some different thing that serves your own interests. It's just this offer, which you can take or leave.
I'd probably go yeah sure! Cool! I'd take the offer. 

Thus, the fact that you do not hate your body as is, the fact that you're perfectly fine with it as is, doesn't imply that you wouldn't accept an offer to make it more powerful. However, if I wrote a story about a wheelchair user who was offered "walkability" (is that a real word? Never mind, you all understand what I mean), and accepted the offer, it's probably impossible in practice to give the audience the same impression as when I accepted increased speed and stamina. Because regardless of how non-oppressive the fantasy setting where this takes place is, the audience still live in an ableist world, and this will inevitably inform their reading. Even though accepting the offer of walkability doesn't logically imply that the wheelchair user's life was tragic before it, anymore than accepting increased speed and stamina implies that it's tragic not to be an olympic level athlete, that's how it's gonna be perceived by most. 

Now I was talking about how the audience will perceive things due to them living in an ableist society. However, it's often hard for creators, too, not to insert their own ableism into stories, even if they try to write something social justice informed. Take, for instance, the movie Gattaca. It clearly tries to deal with disability-oppression in a eugenics-obsessed society. Yet, at the end of the movie (spoiler alert), the character who's disabled according to our standards, the audience's standards, brutally commits suicide because he can't stand it anymore, whereas a character who actually seems more oppressed within the universe of the movie but does not come off as disabled to the audience bravely soldiers on. Left a really bad taste in my mouth, that ending. Ok, societal oppression is bad and all that, but still possible to fight, unless you're in a wheelchair like Jude Law's character - he's gotta top himself at the end. Better off dead, that one.
Okay, that was a bit of a tangent, since Gattaca is about a society obsessed with birthing "perfect" babies, not about curing adult disabled people. So back to the magical cure discussion.

In most cases, it's probably better to just stay away from magical cures altogether in your writing. But if you wanna write something with literal and versatile magic or magic-level tech, the best thing is probably to have characters play around with it and change their bodies in a variety of ways (instead of everyone going uniformly "normal"). Like in Michael Moorcock's Dancers at the end of Time trilogy (part of his Eternal Champion series, but much lighter and more whimsical in tone than the others). You've got some people changing sex back and forth, some changing into monsters or looking like non-human animals, you've got this scientist character who's got a hunchback and a club foot and walks with a cane because he thinks it's a cool science look, and so on. I think that works better than specifically having the person who's disabled by real-world standards confronted with a magical cure and then go "no! I won't take it! Because I accept myself as is!" while it's treated as a non-issue for everyone else.

3. Good and bad reasons to reject being cured

In a society with medical treatments that do not exist in the real world, but it's still not on the unlimited, can-do-anything-level we see in Moorcock's Dancers, there are several legit reasons for characters to reject being cured. 

First, they might do so because they don't want to reject an aspect of their identity. This was brought up by ethnologist and crip scholar Christine Bylund when we briefly discussed the matter, and now I've been thinking some more about it ... To some extent, people are simply different with regards to how and what they identify with. People may be more or less prone to see themselves as integrated "bodyminds" vs seeing themselves as minds with bodies, for example. People differ in how much of their mental lives they see as integral parts of their personalities, and what seems a bit more external to them, perhaps simultaneously external and undesirable. I think we'd have differences in identification, and thus differences in how much and what people would be willing to change about themselves, even in an oppressive-free utopia.
However, in an ableist society like ours, disability is a political identity too. This is a big difference between the scenario in which I gladly accept increased speed and stamina, and a wheelchair user accepting an offer of walkability. Increased speed and stamina might get me fame and money that I've never dreamt of before, but I'd remain in the political category of "able-bodied" throughout, whereas a wheelchair user who acquires walkability goes from disabled to normate. For some people, that might be a welcome change, climb the social ladder to a better life, whereas others would reject as grotesque the idea of magicking your way into a politically privileged group. 

In any case, I think a story about a character who lives in an ableist society and gets a chance at a magical cure should deal with how they'll move from one political group to another if they take it. Not pretend like it's a completely isolated, individual choice about either getting cured or "accepting yourself". 

But do it in a better way than DC did with Barbara Gordon! 

Barbara Gordon used to be Batgirl. Then the Joker shot her through the stomach, bullet hurt her spine, and she ended up in a wheelchair. She went on superheroing as the computer wiz Oracle. Occasionally, writers felt the need to address why she remained in the chair despite living in this extremely high-tech superhero world. On the one hand, the DC consensus (if I understand things correctly) was that she provided good disability rep, so better keep the chair, but on the other hand, they should provide some in-universe justification too.
I've got an old nineties comic written by Grant Morrison where the issue comes up in dialogue. Babs says that she'd be happy to have her spine cured if someone invented a way for the nerves to grow back, but she doesn't want a cyborg solution - she just don't wanna be a cyborg, is all. That's a perfectly fine motivation! She'd lived most of her life walking (running, jumping, climbing, she was quite the acrobat), so makes sense that she'd have a preference for getting all that back, but it's also fine for her to just not wanna be a cyborg. 

However, most writers did a different explanation, which I think became the canonical one: Babs thought it would be unfair to all the other wheelchair users out there to accept the cyborg solution. She'd only accept it once it was available to the general public (so probably never in the USA, where she lived). So this is a sort of political motivation, but one that doesn't reject the medical perspective at all, and furthermore, it's ridiculous! Babs regularly used all kinds of amazing tech unavailable to most people - she even used to travel back and forth between Earth and the Justice League space station, in the League's teleportation machine! Apparently, this wasn't unfair to everyone else who could only dream of doing such things, but walking via cyborg gizmo would be.

They should either have stuck with the "I just don't want to be a cyborg" motivation, or given her a political motivation centred around disability activism, rather than some nebulous "fairness considerations" that apparently apply only to walking tech but no other tech. Finally, they should have given her a wider variety of chairs.
I get that she wanted to use a regular, manual wheelchair to get around most of the time. Asking why she'd use her arms to get around rather than drive something electric is like asking why Batman walks with his legs instead of driving everywhere in some vehicle. But she should have other options, like more mech warrior like options, for situations like when she's in the space satellite and it gets attacked by enemies for the umpteenth time. Sometimes, in the old comics I read, she almost came across as a lone luddite among enthusiastic tech bros. It's one thing not to give the disabled character tons of tech that erases their disability. It's quite another to give them less tech than their able-bodied but still non-powered counterparts, like Batman, because the disabled person must be "representative" in what they use.
Anyway. All of this is moot now since, after a few decades, DC cured her anyway and had her return to being Batgirl. 

The easiest version of "disabled character rejects an offered cure" to execute well is probably to abstain from perfect, magical cures, and instead have treatments that come with both pros and cons. They may be fantastical by real-world standards, but nevertheless involve pain, arduous rehabs or some other type of cost. A character can weigh the pros and cons and decide it's not worth it - and maybe do so against the expectations of other people who assume that they'd obviously want to be cured, and that any price should be worth paying. 

This was something Marvel's first Doctor Strange movie did pretty well, I think. The movie has been divisive since Strange starts out absolutely desperate to be cured. Still, we've seen that his entire identity revolves around his job (and the fame and money it's brought), so it's plausible that a career-ending disability would render him desperate. His girlfriend calls him out, too, and says look, you gotta get on with life and find some other job to do! She's proven right in the end, though not quite in the way she thought; she figured he could be a teacher at med school, and instead he became a sorcerer. Still, though. He did find another job, eventually, that he could do with his disability. He chose not to cure himself via magic since this would require constant concentration to uphold, and leave him with less magic for other, more important things. So, it's a thoroughly fantastical movie, but it's a fine and realistic ending in that the main character realizes that
a) contrary to what he thought right after his accident, his disability isn't the end of the world, and
b) now when he knows of a way to cure it, it's actually not worth it, there are better things to use his resources for.
It's only too bad that Marvel completely forgot about his disability in later movies, but I guess this is as good as it gets in the MCU. 

Also, if you're thinking of cures in terms of pros and cons, then there will be cases where it is best to be cured, and it's not ableist to say so. I saw this bizarre discussion about the character Ghost, also from the MCU, where one person insisted that portraying her as desperate for a cure for her condition was ableist. But her fantastical condition, besides giving her superpowers, is extremely painful and actively killing her. She's only in her early twenties, but we're told she'll be dead in a couple of months unless she finds a cure. Her wanting a cure is no more ableist than when a young person dying in cancer tries every treatment the medical profession has to offer because they want to live.

Concluding lines

This is something writers should think about, and put some mental effort into. Not just throw out that old magical cure trope - nor simply reverse it and think you're being progressive because you did it the other way around!

Cosmic comfort

"Cosmic horror" is a recognized genre. I'm thinking there's also an opposite genre, or perhaps more of a trope than full genre but still -- cosmic comfort. (So, I'm still struggling to coin new fictional trope names -- see "grimdark preach" and "hot fair slut", that I mentioned in my Poor Things review, for previous efforts.)

 If cosmic horror is showing the universe to be cold, uncaring, evil, incomprehensible, maddening -- one or several of the above -- cosmic comfort shows everything to be kinda nice and safe at the end of the day. It doesn't count as cosmic comfort unless the story goes into cosmic stuff -- I'm not thinking of cozy stories exclusively concerned with earthly matters here. Moreover, I think cosmic comfort can be divided into two sub-genres or sub-tropes: first, it might show a cosmos ruled by nice guys. Semi-nice, at least, not evil, and perfectly comprehensible and relatable. Second, it might show a cosmos ruled by assholes, but they're weak enough for humans to defeat.

Gaiman's and Pratchett's Good Omens is cosmic comfort of the first kind. The antichrist is born, but he's a super sweet little kid! Couldn't hurt a fly! There's an angel and a demon but they're both so very nice and become the best of friends! There's some vague apocalypse threat in the background but what with everyone being so sweet and nice, it's easily averted in the end. (Btw -- that joke with the guy who can't get near a computer without wrecking it should really have been scrapped when they turned the book into a TV show. It made sense back when the book was written, when computers were far less user-friendly, and people often worried about the possibility of completely wrecking the machine if they as much as looked at it wrong. It makes no sense today.)
And it's not just this Pratchett collaboration. The Sandman is much darker than Good Omens, but still contains its fair share of cosmic comfort. The Endless are said to be inscrutable and ageless and quite different from humans, but they're shown to have completely human psychologies. They may be immortal and powerful sort-of-deities but don't you worry, they're not scary or inscrutable in the slightest, they're just like us! Dream is recognizable as a brooding goth boy, Death is recognizable as an annoyingly cheery kind of person -- this was really a big improvement in the TV show, btw, for I couldn't stand the comic book version. I'm not personally comforted by the idea of dying and being greeted by this manic pixie death goddess harping on about Mary Poppins and shit, and sprouting fake-profound statements like "you get what everyone gets: a life-time" to dead babies, but lots of other people love the character and she's clearly supposed to have this comforting role. 

Time to go off on a tangent before I move on: When I was young, there was Sandman merch you could buy, including an ankh necklace with "you get what everyone gets: a life-time" engraved. But this isn't a profound statement! It's fucking stupid! Imagine that I discover that other people at my job are paid twice or thrice as much as me. Angrily, I ask my boss why they get so much more money, and he just looks me in the eye and solemnly says: "You get what everyone gets: a salary". This isn't a profound answer! This is just him dodging the question and being an asshole!
Also, back when I was young (i.e., ages ago), when someone wanted to flatter me they'd say I looked just like Death. I always felt torn about this because yeah, I get it's supposed to be a huge compliment from goth to goth but I hated the character so much.
Fortunately, that stupid "you get what everyone gets" line wasn't in the TV show, big improvement on Death all around. 

Back to topic. All urban fantasy stories where there's heaven and hell and perhaps a whole host of gods but everyone is kinda okay, no one is truly evil, fall into cosmic comfort.

Then there are also those stories where Satan is evil and God is a dick but good news -- somehow, mere mortals are capable of taking them on and winning, so we don't need to worry about them too much. You can beat them if only you're manly enough (Preacher) or street-smart enough (Hellblazer) or, um, believe sufficiently hard in academic freedom, I guess (His Dark Materials, though I've only watched the TV show, not read the books). Writers start by painting this really bleak picture of the universe -- it's ruled by assholes, both from above and from below! -- and then back-pedal on the bleakness by showing that, at the end of the day, humans can beat the gods. 

Of all the stories I've mentioned, I enjoyed the Sandman comics overall despite some problems (Death, but not only Death), I've enjoyed the Sandman TV show so far, I read Preacher as it was published and really enjoyed it, Hellblazer has obviously been really uneven during it's super long run but I like lots of it too ... So I'm not hating on all of the above. (His Dark Materials, though, was a pretty-looking show but got increasingly stupid as it went on and was pretty much unbearably stupid by the end.) But I still dislike cosmic comfort as a trope. In my personal opinion, cosmic comfort always detracts a bit from the story. But your mileage may vary.

In any case, it really should be a recognized trope! Cosmic horror, and its opposite, cosmic comfort. 

One more musing, courtesy of my husband: When I discussed this with him he said "cosmic comfort -- or, as you might also call it, religion." First I protested and said yeah ok I get what you're saying, religions exist to comfort people about the cosmos, but I'm talking fictional tropes here, which is a different thing ... but then I realized this is an interesting point. Because stories like Preacher and His Dark Materials try really hard to be anti religion. So it's interesting that they still end up giving people these comforting messages about the cosmos.

The two genders: Scary and scared

 Lately, my social media feed has been dominated by these man vs bear memes. Would you rather be alone in the forest with a man or a bear? Often, the situation is quite under-described. There are bears in the forests where I live, but despite lots of hiking I never see any; they keep to themselves. In general, I'm neither afraid of random bears nor random hikers regardless of the latter's gender. However, the memes sometimes ask whether you'd rather meet a man or a bear when alone in the forest. If a bear walked towards me on the trail, that would be hella weird bear behaviour and I'd be scared. And some posters explicitly say that the bear might be dangerous, might attack and maul them, but even so - that's nothing compared to what you'd expect ... uh ... some random hiker dude to do to you? What the fuck, people. 

I discussed this with a couple of American colleagues the other day (colleagues who belong to the same gender as me - by which I mean the scared one, see further below for explanation). Lots of women have been victims of rape and physical assault. These are, sadly, common crimes. But in the overwhelming majority of cases, the perpetrator was the woman's partner or another man she knows. Stranger rape is rare. As a matter of fact, men are much more likely than women to be victims of violence from strangers. (Of course, statistics can vary over time and between countries, but this is a really strong pattern in Sweden, the US, and many other places.) Thus, if these constant violence warnings were based on actual risks, men would be told to stay at home so they don't get hurt, whereas women would be told to stay single.
But the warnings are not based on facts. They're based on traditional gender roles (which makes it highly ironic that so many feminists share these memes). Men are supposed to be strong and invulnerable and not have to worry about being victimized, while women are supposed to be little damsels in perpetual distress. And, of course, women aren't supposed to be out and about so much. Your place is in the kitchen, ladies! Not out in public. Or the woods. 

The man vs bear thing is the latest, but not the only viral thing of this kind. I remember how this thing went around social media a few years ago, where women wrote of what they would do if all men got a curfew or all men got locked up somewhere. Women then proceeded to list perfectly normal stuff that I already do without a second thought. 

Now, stranger rape does happen. If someone is extremely scared of unknown men because they or someone close to them have been through this, it would be a real dick move to rub statistics in their face and say it's nothing to worry about. It's like serious car crashes that maim or kill people; they're not very common, but it would be a real dick move to rub statistics in the face of someone who had been hurt in a crash. The big difference is that no one expects everyone to be terrified of cars. No one asks me "wow, you have a car? That you drive in? Aren't you scared that you'll get hurt or die? No matter how well you drive, you never know when you'll meet a drunk in a two-ton jeep who comes driving full speed at the wrong side of the road, and then it's game over! I really don't understand how you dare." 

But people do ask these really absurd questions re stranger rape. For instance, I once had to go from the bus station to my then-house via a pitch dark forest path and I didn't have a light with me. I thought well, worst case scenario is that I get lost, which is gonna suck, because then I'll have to freeze my arse off waiting for sunrise, when I'll find my way again. But I can probably find my way home by what little moon light there is and by feeling my way along. And I did.
When I mentioned this to some other people later, I was asked whether I wasn't scared of being attacked.
Let's unpack this, shall we? It's a little path. Through the forest. That a couple of people a day takes. So this would-be rapist hides behind a tree, for hours or days even, freezing his balls off, on the off chance that a lone woman will walk by? That's the scenario you think it makes sense to worry about?
I was even asked, once, whether I'm not scared of taking long walks alone on the frozen sea in the winter. It's the sea! Which is, famously, quite flat! I can see for kilometers that there's no one coming to attack me! Am I supposed to worry about the possibility that some rapist has donned an isolating snowsuit, buried himself in a small mound of snow, breathing through a straw, on the off chance that a lone woman will walk by?
When I worry about demons hiding in mirrors, then I'm "insane" and should "take my meds", but worrying about arctic snow-burrowing rapists is apparently quite normal and sane. 

You can't talk about how all women spend their lives in constant fear of stranger rape, you can't keep asking women who don't do so why they're not more afraid and how dare they, without creating a norm. When we talk like this, we're not just describing a state of affairs that already exists, we contribute to making women unnecessarily afraid, and making women needlessly restrict their lives. 

Another example from an online discussion: It started with a woman writing about how some guy groped her in the metro. She didn't protest, and felt bad about not doing so afterwards. She wanted to initiate a discussion about the problematic psychological obstacles that prevent many people from simply going "Hey! Get your hand off my arse! Fuck off!"
In so many ways, people in general and women in particular are socialized into being nice and polite and people-pleasers. We're socialized into giving people the benefit of the doubt rather than getting pissed off ("maybe his hand just happened to brush on ..."). Children are often taught, from a young age, that it's wrong to protest against being hugged even if they feel uncomfortable, they should put up with all kinds of unwanted physical affection - but even if said unwanted affection isn't sexual at all, it merely comes from adults who think the kid is so cute, this type of socialization often spills over and makes it harder to object against unwanted sexual touching too.
These are real and important problems to discuss. However, another woman complained that men can't understand how scared you become when groped, and how impossible it is to just tell someone off "but maybe if we compared being groped to having someone threaten you with a knife, men might understand what it's like".
Okay. If someone pulls a knife at you, they might seriously hurt or even kill you. Depending on the details of the case, the safest course of action might be to be as quiet and passive as possible so as not to further provoke the knife-wielder. Your life is on the line!
Now, which message do we send if we say that being groped in the metro is like being threatened with a knife? That it's not only psychologically difficult to protest, but dangerous to do so. You'd better do nothing when you're groped.
Ten-thousand dollar question: Who gains if women believe that they shouldn't protest when someone gropes them in the metro? Is it
a) women?
or
b) metro gropers?

Moreover, whereas some men feel bad about being painted with this broad more-dangerous-than-a-bear-brush, others love this meme and happily share it around. Love it in a kind of ... iffy way. 

It's possible to have empathy and compassion with people you respect and consider your equals when they're going through a rough time. This is an important part of friendship and other close relationships! But it's also possible to pity people and offer your help in a condescending way; here, let me, who's so much more powerful than you and so much better off, gracefully lend you a hand. Here, you poor little creature, you don't need to cry anymore! Your betters have to come rescue you.
I think most people who consider themselves feminists and committed to social justice recognize how problematic it can be when white wealthy influencers travel to some poor country to, say, build a school or what-not - they might not know much about building houses, but these poor things should be grateful for any help they get. Cue selfies with little African children, look at this poor little child, how sad his life is! Fortunately, I'm here to make things better. Smile for the camera, kid! I wish more people cared about these poor, unfortunate souls as much as I do.
Sometimes, when men talk about how much they pity women and how important it is that men help women, there's a similar vibe.

I've seen people share a post by some man who says that it's wrong for men to feel insulted when women say they prefer to meet the bear. Instead, strong, powerful men like himself must listen to those poor, scared little women when they speak about their plight. Men must appreciate how terribly hard it is to be a weak, helpless woman. For instance, he remembers this time when he was simply walking down the street, minding his own business, and spotted a woman further ahead. She realized that a man walked on the same street as her, and he could tell from her body language that she became terrified! As a strong, powerful man, his mere presence suffices to scare every woman within a hundred meter radius absolutely shitless!
He's pretty much like the Old Testament God, whose mere presence is enough to make mortals tremble. Not his comparison, it's mine, but it struck me while reading this post. Of course, he writes that it's horrible that women are so scared of men, they shouldn't have to be - it's hard to be a god, as the Strugatsky brothers said. Nevertheless, the post goes on, in the patriarchal world in which we live, it's only natural that women react like this to any man who appears in their vicinity. It's up to men to change this! (Up to God to be a benevolent God, a protective God rather than a smiting one.)
No matter how hard it is to be a god, I can't help suspecting that it also feels a little bit awesome to think of yourself as this strong and powerful, and think of those others, of women, as constantly scared and helpless and in need of protection.
(Now I imagine a male reader angrily asking whether I wouldn't want someone to save me if someone attacked me? Of course I would. I'd prefer not to be attacked in the first place, but if I am, I prefer to be saved over not being saved. But surely that holds for you too, imaginary male reader. You would also prefer not to be attacked in the first place, but if you are, you would prefer to be saved over not being saved. As I said in the beginning, you're even at a higher risk than me! None of this implies that you'd like other people to have a constant condescending protective attitude.)

Finally, as a non-binary colleague pointed out when we discussed this: man vs bear and similar discourse assumes a strict gender binary. Of course, some people who post about these things try to be trans-inclusive: they'll talk about how women and non-binary people would rather meet a bear than a man, or even more narrowly about how cis men pose a danger to everyone else. But that's still a strict binary!

There are only two genders, do you hear? You're ether scary or scared.

 

Poor Things is the best feel-good movie ever

I saw Yorgos Lanthimos' "Poor Things" in the theater. I hesitated to do so because although I've really enjoyed the Lobster and the Favourite, I thought - based on some reviews I had read - that Poor Things would make heavy use of the known trope "Born Sexy Yesterday", and another one I like to call "Hot Fair Slut". Unfortunately, I'm not a famous media personality with enough clout to coin new trope names, so "Hot Fair Slut" is as unlikely to catch on as "Grimdark Preach" which I keep pushing in discussions both online and AFK as soon as I get a chance. 

People tend to think that only stories written by authors who see themselves as fighting for good (whether that be leftist social justice values or conservative Christianity or something else) ever get preachy. But there are many dark stories where the author shouts at you through a megaphone "did you think the world was just and filled with honestly good people? You're wrong! And I'm here to tell you how wrong you are!" Cue plotlines about how naïve goody-two-shoes come to see the error of their ways and reform and turn cynical like you ought to.
We need a name for this phenomenon, and my suggestion is Grimdark Preach.

Anyway. Back to Poor Things and the tropes I worried would appear in it! 

Born Sexy Yesterday: A sexy woman is either literally born/created very recently, or she's lived for longer but in a different world (fairyland, different planet, etc.), making her a newcomer among us. Because she doesn't know shit about our world, and have no basis for comparison, she's super impressed by the first dude she comes across and falls for him. Mr. Average gets the woman of his dreams, because she fails to realize that he is average! 

Hot Fair Slut: You know how misogynists rant about "Stacys"? (TBF, they might have come up with a new name by the time I write this blogpost - I don't keep up with their antiques.) A "Stacy" is a hot slut whose greatest crime isn't sleeping around per se, but the fact that she doesn't want to sleep with the men who complain about her. When a woman sleeps around already, it's just not fair that she won't sleep with everyone!
Of course, in real life, it's pretty uncommon to fancy precisely every person you come across, or even every person of a certain gender. Whether you're strictly demisexual or happily promiscuous, it's certainly more common to have some kind of preferences, be sexually attracted to some people and not to others. But since this is unfair in the eyes of misogynistic entitled men, we see plenty of fictional women without these pesky preferences. Hot, slutty women who'll happily sleep with any man they come across. See, for instance, the planet Risa in Star Trek. TBF, they pay lip-service to Risa being a gender-neutral sexy paradise where female crew members can fuck around as much as the men, and where the inhabitants are happily horny and not the least bit exploited. But there's still an overall emphasis of "any man can go there and get a hot babe - no man will be rejected, nor hit on by older or uglier women". Which always makes the place feel kinda iffy. And there are far worse examples than this in fiction.

Some stuff I had read about Poor Things made me worry that it would feature both BSY and HFS. But I was wrong.

On to the actual plot of the movie. Spoilers ahead. And, like, all the trigger warnings for people who need them, I guess.

Godwin "God" Baxter is a mad scientist, like his father before him. He was also his father's guinea pig - his dad used to operate on him, take out organs just to see which are necessary for survival, and overall, God looks more like a traditional movie version of Frankenstein's monster than Frankenstein himself. He's disfigured and castrated and only survives by hooking himself up to various machines of his own invention, but can't bring himself to condemn his father - you see, it was for the good of science! 

He teaches physiology and medicine at a university in a bizarre steampunky version of Victorian London, and hires bullied student (he's noticeably poorer than his classmates) Max McCandles to be his assistant. God explains that he cares for Bella, a young woman recovering after serious brain damage, and he needs Max to observe and make notes of her progress. 

Bella is played by stunning Emma Stone, but immediately deconstructs the whole Born Sexy Yesterday trope for us viewers by not only doing baby stuff traditionally considered sexy in grown women (such as vaguely toddlerish speech and body language, looking at you Leeloo from the Fifth Element - I hate the Fifth Element so much - and tons of other fictional examples), but also throwing food around and pissing on the floor. 

Eventually Max suspects that there's more to Bella than God has told him, and demands to know the truth. Okay, says God, fine! It's actually a real sunshine story.
You see, he stumbled upon this heavily pregnant woman who had committed suicide via drowning. He brought her home and noticed that there remained some electricity in her brain, meaning she was revivable. But he decided against it, because if she wanted to die, he should respect her autonomy. However! The baby's brain was alive and well, so he decided to stick the baby brain in the adult body and make a brand new creature instead.

God is such an interesting character because he does have a conscience and he does try to do the right thing and be ethical. But given his background, he's not (generously put) very good at it. 

This is a fantastical movie in many ways. You gotta accept that biology works differently from real life. (See Bella's entire creation.) Bella's mental development - I guess because of her adult body - goes much faster than that of a real baby. But she remains weird by regular societal standards. It's also a really weird situation, where Max and Bella hardly ever leave the mad scientist's house. God gets the idea that Max and Bella should get married and live with him forever, and they both agree. He draws up a contract that will legally bind them to do that, but then Bella runs away with Duncan the lawyer (a fun and over-the-top-sleazy Mark Ruffalo) who falls for her Born Sexy Yesterday charms (she's stopped throwing food on people and pissing herself at this point). 

They travel around in amazingly bizarre steampunk-versions of European cities. Bella is, initially, thrilled by seeing the world and having lots of sex. However, their relationship soon begins to unravel. Bella isn't some loyal puppy-dog like Leeloo (I hate that movie so much! ). She fucks other people. She tries to punch a screaming baby. She dances and talks in embarrassing ways. She gives away Duncan's gambling money in a fit of compassion after seeing poor people for the first time. Eventually, when they're starving in Paris, she gets a job at a brothel. At this point, it's revealed that Bella does have preferences - she thinks that much (though not all) of the brothel sex sucks. Nevertheless, for various reasons, she decides to stick it out.
Even though Bella, in her typical hyper-rational way, explains to Duncan that her new job is good for their relationship, since she appreciates sex with Duncan more when she's got those crappy sexual experiences to compare it with, Duncan gets super upset and leaves. And then he comes back again and wails beneath her balcony that she's the love of his life and he wants her back. This previously irredeemable fuckboy even wants to marry her! However, at this point, Bella has concluded that (in her words) an unconventional and experimental woman like herself would need an open-minded and forgiving husband, and Duncan is none of that. Goodbye!

So, so much happens in this movie. I'm not gonna recount the entire plot or spoil everything. It's got marvelous visuals, it's frequently laugh-out-funny, but it's also, at heart, a genuine feel-good movie.

Bella, God and Max form a kind dysfunctional family, where God the father figure seems to do his best, but given his own horribly traumatic childhood, he can't help but passing on lots of shit to his "children".
However, he does realize, towards the end of his life, that his own father had been terrible. And Bella calls him out on how he's, well, played God with his creations. And then, after many morbid and bizarre twists and turns, we're finally treated to some sort of reconciliation and a happy ending. (Except for that poor goat! If you've seen the movie, you know what I mean. The goat did not deserve his fate)

I rarely like feelgood stuff. It often feels too soppy, and like serious problems are too easily glossed over. For instance, I enjoyed the over-the-top craziness of "Everything, Everywhere, All at once", but really felt that way about the ending - the mum-daughter relationship seemed terrible, but in the end we kinda gloss over how bad it is.
Poor Things, on the other hand, takes everything up to eleven and beyond, including the relationship problems. There's no shying away from how grotesque God and Bella's "family" is, and yet - at the end of the day, they're still family.

Best feel-good movie ever!

John Z. Sadler's Vice and Psychiatric Diagnosis

 My impression is that people who are neither moral philosophers nor psychiatrists or psychologists tend to think that there's a sharp line between "vice" and "psychiatric disorders" - or, colloquially, between the bad and the mad (note, I don't know of any empirical research that investigates this very matter, this is really just my impression). My impression is also that people are quick to assume that there's a limit to how bad someone can be without also being mad. But perhaps not the other way around. 

Philosophers who work on moral responsibility and moral agency tend to assume this as well. I think all this drawing of lines and placing people in neat boxes is a fundamentally misguided way of looking at moral responsibility, but it's nevertheless the common and traditional way. Neurotypical people are morally responsible agents. Psychiatric and neuropsychiatric diagnoses, on the other hand, frequently undermine moral responsibility, and place people in the "exempted" box. Some philosophers like to divide moral responsibility into different subkinds, and play around with what kind of responsibility you can have with this or that diagnosis, even as you're exempted from the other kinds. 

The moral landscape would certainly be a neater place to navigate if there really were sharp lines between the mad and the bad. Sharp lines out there, so to speak, in nature - but alas, there aren't. And that's the main topic for Sadler's book. 

More than half of the book is taken up by a loooong journey through time, and also, to some extent, through different cultures and different parts of the globe. People have struggled with the mad-bad distinction everywhere and for ages. And they still do! We still don't have a scientifically and philosophically well-grounded theory! This isn't because the mad-bad border is hard to find, and our science and/or philosophy isn't sufficiently well developed yet. It's because there isn't a sharp border. Sure, lots of people may be categorized as purely mad, or as purely bad (though as the reader of the book will see, the latter has, in modern times, been more controversial), but we'll remain stuck with a big grey area.
Sometimes, this grey area has given rise to "vice-laden" DSM diagnoses, like Conduct Disorder, Oppositional Defiant Disorder or Anti-Social Personality Disorder. Sadler calls these "vice-laden", because the diagnostic criteria is moralizing in a way that the criteria for, say, Schizophrenia or Major Depression are not. At other times, after discussions and debates, behaviours remain "just bad" rather than "bad and mad": Intolerant Personality Disorder, Behavioural Addictions (apart from gambling) such as addiction to sex, shopping, or social media, Political Apathy Disorder, and Paraphilic Rapism never made it into any diagnostic manuals. Sadler, only half-jokingly, suggests that White-Collar Antisocial Disorder, or, as we might call it, the Bernie Maddoff syndrome, could be a psychiatric diagnosis - why should only criminals from the lower social classes be pathologized? 

Way too many moral philosophers assume that the business of coming up with psychiatric diagnoses and applying them to individuals is a much harder science than it actually is. If someone has a bona fide diagnosis which includes descriptions of moral vices and vicious behaviour, it goes to show that it's not the person's fault, and they can't be morally responsible. If there's no diagnosis that covers their character traits and behaviour, they are responsible and blameworthy. Or so many philosophers seem to think.
Some people also like to appeal to neurological findings - people with this or that diagnosis have different brains! But every mental difference must have some corresponding brain difference - regardless of which mind-body theory we subscribe to, regardless of whether the mind is identical to the brain or if it supervenes on what happens in the brain or even if we're fancy old-fashioned dualists who think it's just correlation, it follows that every mental difference has some corresponding brain difference. You can't just point to "a brain difference" as evidence of undermined moral responsibility. Nor can you point to "a brain difference" as evidence that people with this or that diagnosis can't help their vices, unlike undiagnosed vicious people.
In our world, you can have Oppositional Defiant Disorder, but not White-Collar Antisocial Disorder. In a nearby possible world, in which human psychology works exactly the same, but psychiatry had a somewhat different development, it's the other way around. 

So, let's admit that psychiatric diagnoses and the mad/bad distinction is a huge bloody quagmire. What are we supposed to do? Sadler ends his hefty brick of a book with no less than forty theses of what ought to be done, society-wise, in light of this realization. He very nicely divides these theses into stuff we could do immediately and more distant, long-term goals.
As I said, it's a huge book, and I can't even begin to do everything justice in a blog post. But an overarching theme of the forty final theses is to ditch the attempt to find a neat mad/bad divide. Psychiatry should admit and discuss more explicitly than has hitherto been the case how value-laden it is, and how value-laden it must be. An open discussion allows for scrutiny and criticism of underlying values, instead of implicit acceptance. Also, we shouldn't divide criminals into the bad who deserve punishment and the mad who should go to forensic psychiatry (though very few perpetrators of serious crimes do so in the USA, the insanity defense is rarely invoked and even more rarely successful). We should rehabilitate as many as possible so they can be released back into society, and permanently dangerous people should be kept in humane confinement. The mad/bad distinction is ultimately irrelevant.

This is obviously extremely controversial. I'm not sure what I ultimately think of this idea. Let's say I'm somewhat sympathetic, because Sadler is so very aware of all the problems and pitfalls that come with this suggestion, and discusses them at length.
Both psychiatry and criminal justice institutions in various countries and time periods have played thought police, and have locked people up under the guise of either punishment or treatment/rehabilitation because they have the "wrong" ideas, dare to challenge old social norms, and so on. This is a serious danger, though it exists even when psychiatry and criminal punishment are kept separate. The goal of any rehabilitative program must be people that aren't dangerous to others, not to turn everyone into "normal" people who think the "right" thoughts. 
Perhaps there is even a greater risk for abuse when the systems are kept separate - it's so easy to justify abuse of prisoners by painting them as evil and thus deserving of everything they get, and simultaneously justify abuse of psychiatric patients by painting them as so irrational and confused and utterly different from normal people that what would count as horrible violations of a normal person is okay, or at least not all that bad, when done to "those people". Also, no need to listen to any complaints they have, since they don't know what they're saying anyway.
Generally, Sadler shows so much more awareness of potential problems with treatment and rehabilitation than many philosophers who write about these matters. Way too many philosophers are acutely aware of how harmful punishment can be, while utterly oblivious to the horrors that often befall people after they have been declared incompetent and exempt from responsibility. 

Regardless of whether one agrees with Sadler's radical conclusions, everyone should agree about the importance of an open discussion about these matters. There's no dividing line between the mad and the bad "out there" for us to discover. And history shows how difficult it is to construct a non-arbitrary line. 

So, this is a positive review. I recommend the book to all philosophers working on these topics, and to everyone else who researches or is simply interested in psychiatry and criminal justice. Or more broadly human nature.

After the recommendation, a reservation: Sadler contrasts common "folk-psychological" explanations of behaviour in terms of beliefs and desires with proper scientific explanations. Then he compares this distinction to the distinction between Newtonian physics and later scientific theories like special relativity and quantum mechanics. Folk psychology and Newton work well in everyday life, but when there's lots at stake and we need to be extra careful, they sometimes need to be replaced with more detailed and complicated theories.
Now I'm in deep water here since I'm not an expert on physics. Nevertheless, all physical explanations seem to me, ultimately, the same kind of explanation. They're all purely causal, tell us what causes what. Now, purely causal explanations may or may not conflict with each other. A biological explanation in terms of cellular events, a biochemical in terms of molecules, and a physical that zooms in on atoms need not conflict, since they take place on different levels of explanation. But causal explanations can conflict with each other. I take it that Newtonian physics actually conflict sometimes with relativity and quantum mechanics. When it does, we may say that Newtonian physics is less detailed but still has its place in everyday contexts where it's sufficiently precise for the purpose at hand, whereas we might need more detailed theories in other contexts.
Reasons explanations, on the other hand, are a different kind of explanation to causal explanations. "Folk psychology" is a loose term, and may involve more than reasons, but insofar as reasons are what we focus on - reasons may justify or not, show that you're action was rational or not, show whether it was moral or not ... Reason explanations are a different kind of explanation. They differ from all causal explanations, whether these causes are understood within a psychological, sociological, neurological, or other framework.
If I explain why I did what I just did by referring to my reasons for doing it, while a bunch of empirical scientists who study me provide causal explanations, the difference isn't that I give a rough and sloppy explanation whereas their explanations are detailed. We're looking at my action from completely different angles.
However, I might over-interpret the point that Sadler wanted to make with his Newton-relativity-quantum comparison. It's possible he agrees with everything I write here, in which case it's more of a comment than a reservation.

Now, I'm gonna nitpick. 

Sadler discusses - and obviously, he's not alone in this, these discussions are common - whether to say, e.g., "I have schizophrenia" or "I'm schizophrenic". The "am" vs "have" debate, "people first" vs "identity" language. He contrasts how people often say "I am" with regards to psychiatric diagnoses, with the "I have" language we use for physical health problems like cancer or a broken bone. Then, he says that this isn't all that weird, considering how intertwined a psychiatric condition may be with one's personality. 
But
a) it's not true that we say "I have" about all physical health problems, it differs from condition to condition, and
b) it's also not true that "I am" language, generally, implies that something is an important part of who I am.
Obviously people don't say "I am cancer" because "cancer" is a noun, you can't say that unless you're the personification of cancer itself, some kind of disease god or other supernatural entity. Similarly, people don't say "I am schizophrenia" or "I am depression". Now, with cancer, people don't usually say "I'm cancerous" either, but there are other physical health problems where "I am" language is common. "I'm diabetic", "I'm HIV-positive", "I'm lactose-intolerant", etc. In English, we say "I have a cold", but in Swedish, we say "jag är förkyld" - roughly, "I'm over-chilled".
Also, if we look at features other than health problems, we habitually use "I am" language about tons of things that aren't important parts of our personalities or who we are. "I'm medium blond", "I'm 169 cm tall", "I'm a Star Trek fan", and so on. In both English and Swedish, people are this or that number of years old and they are hungry if they haven't eaten for some time, whereas in Spanish and French, people have their years and have hunger. Surely these are random language differences that don't matter for how speakers conceive of their ages and states of hunger in relation to their personalities and identities.
And yet, in mental health contexts, people suddenly make a big deal out of "I am" vs "I have", as if these expressions have all these linguistic implications. Well, I guess "I am" vs "I have" have strong linguistic implications in the specific context of mental health now, because so many people have made such a big deal out of it for so long. But why did this come up in the first place? Given that "I am" vs "I have" don't have any interesting implications in language in general?
I can only assume it's because lots of people think it's horrible-horrible-horrible-shameful to have a mental health condition, and therefore they suffer intense second-hand shame every time they hear someone openly say, e.g., "I'm schizophrenic". If you're gonna talk about it, could you at least try to distance yourself from that horrible condition as much as possible?
If this was a peer-reviewed paper rather than a blog post, the imaginary peer reviewer would have this to say:
"That doesn't make any sense. You claim that there's no interesting distinction between 'I am' language vs 'I have', outside of mental health contexts and the special norms that have been created there by people who 'make a big deal out of it'. But if you're right about this, saying 'I have schizophrenia' wouldn't have signaled more detachment than saying 'I'm schizophrenic' until these special mental health language norms were already in place."
Fair enough, imaginary peer reviewer.
Anyway, it's weird. This entire insistence on "have" over "am" in mental health contexts is hella weird, let's just leave it at that.

Finally, philosophers who read this book may find some little annoyances here and there, where Sadler's terminology doesn't align with ours. For instance, at one point, he talks about adherents of retributivism who are  "couching the concept in the context of utilitarian ethics".
This reads as somewhat philosophically confused. Utilitarianism is the view that an action (including the act of punishing a criminal) is right if it maximizes utility (traditionally understood as happiness) and wrong otherwise. "Desert" has no place in utilitarian theory, except, perhaps, as a derived and pragmatically used term. Utilitarians since Jeremy Bentham and onwards have focused on the role that punishment allegedly has in deterring criminals from re-offending and deterring potential criminals from offending in the first place (something Sadler also recounts in his book). Retributivism is a different theory, according to which criminals should be punished because they deserve it.
Now, it's possible to hold a mixed theory, according to which we have several different reasons for punishing criminals; they deserve to be punished, and it's great if we can deter people from crime. Stephen Morse and others have pointed out that real-life politicians often freely mix appeals to an alleged deterrence effect and appeals to desert when they argue for harsher punishments. Nevertheless, claiming that we have both deterrence reasons and retributivist reasons to punish criminals is very different from saying that deterrence is a reason for retributivism.

Still, this was a very minor nitpick. Overall, I recommend this book. Agree with Sadler or not, he does raise some really important questions.

On pushing yourself and ignoring self-care as a disabled person

 This is something I've discussed a lot with my friend and fellow scholar Christine Bylund. She's an ethnologist, I'm a philosopher. She's got cerebral palsy, and I'm mad. But we have some common experiences of having pushed ourselves hard to get where we are now, while other people blame us for doing so (yeah, yeah, you don't want to call this blame - but I don't care what you wanna call it. I say "blame" anyway). Other people will blame you for supposedly internalizing destructive societal norms about the importance of hard work and grit. Other people will tell you that you ought to let go of these norms, and get better at self-care. This is because other people erroneously believe that this is always possible to do without serious negative consequences. 

1. Deterioration of the welfare state

Many western European countries that used to have strong welfare states and where strong job security used to be the norm have changed drastically over the last decades. Sweden is one of those. 

Bylund's doctoral dissertation features interviews with three generations of disabled people; the oldies who grew up in institutions, the middle-aged ones who grew up in a time where they had rights and real possibilities to live normal lives, and the young ones who have seen their rights seriously eroded - not so much on paper as in practice.
Laws aren't magic. If an entire system and most of the people who work there habitually ignore legal rights and entitlements because cutting costs is considered more important, there may be nothing that the system's victims can do about it. Sometimes, initially dismissed disabled people eventually get what they're entitled to through lots of stubbornness, information gathering, and legal council. Still, at the end of the day, you're always at the mercy of the people in charge; unless they listen, you can't force money, accommodations or assistance out of them. 

Nowadays, if you don't have a job, you might not have any money at all. You might lose all of your income, and lose your home. You might lose everything - especially if you're chronically ill or disabled.
Perhaps people close to you have a little money with which they try to help as best they can. Perhaps you can survive by the good graces of your parents or romantic partner. But as any feminist from the last few centuries can tell you, being wholly financially dependent on another is not without problems, even if their money is enough for both of you.

There's this well-known phenomenon where people think, of various calamities, that it won't happen to them. No particular reason, they're just irrationally certain that they will remain lucky. In a similar vein, many people apparently believe that no serious calamities can possibly befall people they know, who are perceived as being sufficiently similar to them. Therefore, many normate scholars believe that chronically ill or disabled scholars whom they know and have lots in common with, cannot possibly lose everything. Subsequently, they can't grasp why those disabled people keep struggling and pushing themselves instead of doing proper self-care.
Well. Everyone who ever lost everything had people who knew them; people who thought that nothing this bad could possibly happen to someone they know. Didn't save them.

2. In my best interest

Before I got my current job, I spent years in a downward spiral of deteriorating mental health which I (eventually in vain) tried to compensate for by taking more and more pills, as I moved from one fixed-term job to another. This wasn't because I thought going on sick leave would be shameful because of internalized job norms and blablabla. In the late nineties, I was on sick leave for six months at one point. I've been on sick leave for a month or two later than that. But nowadays, going on sick leave for mental problems is risky. Försäkringskassan (the public health insurance agency) may hound you - you should get back to work soon! You've been on sick leave long enough now! Time to recover already! Time to get back! - so much that the stress makes you sicker. And what happens if you go on sick leave and only get sicker and sicker? Eventually, they might simply kick you out of the system. If you're in terrible shape and absolutely can't work at this point, well, too bad - you've lost everything (see above). 

However, thanks to how I continued to push myself, combined with some much-needed good luck (we always need luck too, it's never all about your own effort), I finally landed my current job. I finally got job security, financial security, a generally idyllic and far less stressful life. I could finally begin to recover. 

It sucks balls - big, stinking donkey balls - that society looks like this. But given the way things are, I did what was in my best interests. Don't blame me for pushing myself "too hard" - blame society. 

3. In capitalism's best interests?

Occasionally, I come across the following idea: By dropping out of school or the workforce, we somehow hurt capitalism (I should add that it's people who see hurting capitalism as a worthy goal who claim this, not liberals and conservatives who worry that capitalism might get hurt). If this were right, there would exist a tension between on the one hand looking after your own interests and push yourself so you don't lose your income and home, and on the other hand fighting capitalism by dropping out.

This is wrong. Single individuals can't hurt the system by dropping out of job/school.
When most or all workers in a company strikes, the company is hurt. If most or all Swedish citizens went on strike at the same time, the nation would be hurt. Whether this is a good idea for a revolution really depends on how the entire plan would look and what is supposed to come after, but there's no doubt that it would have drastic effects. But single individuals can't hurt capitalism as a system by dropping out - and I'm not saying this merely because everything a single person does (unless that person holds a powerful position) has negligible effects. 

People have argued that it's pointless to go vegan, or pointless to go by train instead of plane, since the consequences of a single person's choices are negligible. However, some people who make that argument go on to say that we should, instead, focus on voting for political parties with good environmental policies (animal welfare policies, etc.) and support the right organizations. But the consequences of individual votes and individual memberships are negligible too. For my own part, I'm of a more Kantian than consequentialist bend, so I don't fret over negligible consequences; there are also consequentialists who try to show that the right kind of "moral mathematics" support the importance of individual choices after all.
In any case, going vegan, taking the train, voting for decent political parties, etc., are all importantly different from dropping out of school/job. Whereas, for instance, going vegan means that the meat industry gets a little less money than if I had continued to buy meat, capitalism as a whole isn't even a little hurt when I drop out. The meat industry doesn't need vegans, but capitalism needs the poor, desperate and unemployed. 

First, demand for workers isn't constant, it varies over time. Employers prefer a scenario in which there are unemployed, poor, and desperate people they can hire straight away when they suddenly need more workers, to a scenario in which they must outbid the competition to increase their staff.
Second, it's advantegous for employers that people who already have a job are afraid to lose it - scared workers will work harder and complain less. In addition to their function as "spares", unemployed, poor, and desperate people also serve as cautionary tales: Look! This is what happens to people who claim they're too sick to work. Watch and learn. Watch, and struggle for another day.

If you work or study, sure, you're a cog in the larger capitalist machine. But if you drop out, you're still a useful cog.

To sum up: Stop blaming disabled people for allegedly pushing themselves too hard. Blame society. Or better still; get politically active yourself and try to change things.

Review: Robert Chapman's Empire of Normality: Neurodiversity and Capitalism.

Everyone has problably witnessed, or even partaken in, debates over neuropsychiatric conditions like autism and ADHD, or common psychiatric conditions like depression and anxiety disorders. Why are so many people diagnosed these days? And then you get two camps who offer two radically different answers to that question.

First, you've got the camp who says that there's rampant over-diagnosis going on. People get diagnosed on really flimsy grounds these days. Does seven-year-old Timmy find it difficult to sit still in school? Slap an ADHD diagnosis on him, and fill him with stimulants! In the good old days, we knew that this was perfectly normal - lots of kids find school boring and have trouble sitting still, but nowadays, they all get diagnosed. Does little Lisa have trouble making friends? Is she, well, just too nerdy for her own good? Autism! No one is allowed to just be a little nerdy and a little weird these days, it's gotta be autism! Did Annie cry her eyes out after her boyfriend broke up with her? Depression! Bring on the SSRI pills! 

Then we've got the other camp, protesting that it's not all that easy. They point out, quite accurately, that most struggling kids and their parents, most suffering teenagers and twenty-somethings, has to suffer and suffer and fight and fight to get diagnosed. It often takes ages before someone can get access to medications and/or special accommodations. Much less accurately, they'll insist that just as many people struggled in the past, only then their struggles weren't recognized as legit by the mental health care system. Instead, the "pro diagnosis camp" claim, the kind of people who nowadays get diagnosed with ADHD/autism/depression/anxiety were labelled freaks, changelings, witches, or they would be locked away in institutions, or they would just go kill themselves.
This is plain false.
About 10% of US childrens are diagnosed with ADHD. Almost 3 % are diagnosed as being on the autism spectrum. Over 18 % of the US population are, at some point in their lives, diagnosed with depression. And these are just three common diagnoses - there are so many other psychiatric and neuropscyhiatric conditions. Of course, there's plenty of diagnostic overlap - you can't just add these numbers up. Nevertheless, the Johns Hopkins institute estimate that 26% of all Americans have one or more mental health conditions, and the WHO estimate that the same goes for 1 in 8 people worldwide. Thus, when the "pro diagnosis camp" claims that the same people who would have gotten diagnosed today, were labelled witches and burnt at the stake or institutionalized in horrible conditions or simply killed themselves in the past, this is blatantly false - it's not the case that 12-26% of the population regularly suffered these fates, until modern psychiatry came around to save us.

However, the idea that either there's rampant over-diagnosis and people are diagnosed and treated on the flimsiest grounds, or else the number of people with (neuro)psychiatric disabilities remain constant through time whether they get helped or not, is a false dichotomy. Chapman argues, in Empire of Normality, for a third option: present-day capitalist society keeps raising the bar for how productive, efficient, socially competent, focused, and overall how normal you gotta be to keep up. As the bar goes higher and higher, more and more people fall below it, which results in actual, serious suffering and struggles.

I've occasionally seen radical disability activists claim that disability as a concept didn't exist until the industrial revolution. This claim seems both weird on the face of it, and contradicts some historical research I'm acquainted with. Chapman makes the somewhat weaker and much more plausible claim that with the industrial revolution and arrival of modern medicine, the view on disability became much more streamlined. In pre-industrial society, people who would be considered disabled today could sometimes find themselves a niche on the farm where they got along just fine - for instance, a blind or deaf woman might still be able to do traditional female farm chores. Other people might be considered scary freaks or just plain useless - whereas some disabled people were seen in a positive light, as having a special connection to God, and subsequently getting an extra privileged treatment. In short, it varied wildly.
With the industrial revolution and the arrival of modern medicine - the latter of which, Chapman hastens to stress, did save countless lives and drastically improved the quality of life of many - the view on disability/normality became tightly connected to productivity in standard work conditions. If you weren't fit to work a normal job at a normal pace, you were broken and bad. 

Even today, many medical diagnoses, in particular within the psychiatric realm, are explicitly defined in terms of distress and dysfunction - and the latter, in turn, tied to your (in)ability to work a normal job and/or study in the normal educational system. If you can't do this, at least not without special help and special adjustments, you're deemed disordered or disabled. A natural consequence is that more and more people will be judged disordered or disabled as the demands go up, up, up. Thus, both these things can be true:
1. It's very difficult to get a (neuro)psychiatric diagnosis, and get access to medication, special accommodations and other kinds of help. You need to suffer and struggle quite seriously first.
2. Many, many people who get diagnosed today wouldn't have qualified for a diagnosis if they had been born fifty or a hundred years ago - they'd have been considered normal back then.

Now, popular media do sometimes publish optimistic articles about how employees with autism and ADHD might help companies increase their productivity. People who have trouble managing many jobs and many social contexts might find their special little niche in which they thrive and help their employer make more money. However, this will never apply to more than a small subgroup of all people with (neuro)psychiatric diagnoses. There will still be an ingroup of people deemed useful and productive by our capitalist society, and an outgroup deemed useless and costly, because they demand all this extra help and special accommodations and mental health care. To really change this ingroup-outgroup dynamic - rather than just move a few individuals from one group to the other - we must change society quite drastically.  

In a capitalist society obsessed with productivity and making more and more money, Chapman writes, there is an inherent tension:
On the one hand, the bar for how socially competent, cheery, stress-resilient, flexible, fast-thinking, hard-working, etc. etc. employees must be, keeps rising. This means that over time, fewer and fewer people manage to reach the bar, and thus fewer and fewer people are considered normal/neurotypical. More and more people are diagnosed with a neuropsychiatric disability because they fail to live up to society's demands, and/or diagnosed with a mental illness as the ever-increasing demands causes them to break down.
On the other hand, a fiercely competitive capitalist society can only afford a certain number of sick and disabled people, can only afford to let a certain number of people live on welfare, can only afford a certain number of employees to get special accommodations and a certain number of students extra help in school. 

So far, the neurodiversity movement has operated largely within a liberal, rights-based framework, and for some time, people made progress by insisting that neurodivergent people should be seen as a marginalized group that require equal rights. But nowadays, this progress seems to have, by and large, come to a stand-still. More and more parents of neurodivergent children as well as adults with (neuro)psychiatric diagnoses find that it gets increasingly difficult to get the special help and accommodations that you're legally entitled to on paper. Now, many people seem downright puzzled by this development. They seem to think it's just some large accident that this happens, and that it should be possible to correct without any large-scale changes to society.

No. This tension is built into our present-day capitalist system. It's built in both that more and more people qualify for diagnoses because they simply can't manage the normal school system or normal job market without all kinds of extra help, and that this extra help will be denied them, because there's a limit to how many ill or disabled people the system can afford. 

Chapman, unfortunately but understandably, doesn't give us a recipe for revolution towards the end. But step one is to, at least, recognize that this tension is built into capitalism. It's not something we can just fix by providing people with better information about various diagnoses and neurodiversity. Some kind of more thorough-going societal change must take place.

I recommend this book to anyone interested in issues of neurodiversity, psychiatry and capitalism.