Leftist history repeating itself: on the notion that adhd is caused by capitalism
“Hegel remarks somewhere that all great world-historic facts and personages appear, so to speak, twice. He forgot to add: the first time as tragedy, the second time as farce.”
— Karl Marx, “The Eighteenth Brumaire of Louis Bonaparte”
i've recently read some stuff suggesting that adhd is a product of capitalism, implying it wouldn't exist in a theoretical post-capitalist society. In particular, the finger is pointed at the pervasiveness of mass media / social media / advertising / marketing within capitalist societies (or at least, within ‘actually existing capitalism’). As someone who was diagnosed with adhd (and autism) last year, at the age of 47, i'd like to make some comments about this.
i spent the first half of my childhood in a suburb right on the edge of the Naarm/Melbourne metropolitan area, and the second half in rural Victoria. By ‘rural Victoria’ i don't mean in a town in regional Victoria: i mean in a farming community where the nearest ‘town’ was a village with a post office, a pub, and a primary school (of around 50 pupils total). To go to high school, i had to catch the only bus, which came past at the same time each morning, through 20+ kilometres / 13+ miles of farmland. There were two television stations available: one commercial, one the national broadcaster. There were two radio stations available, both AM: one commercial, one the national broadcaster. (Well, towards the end of high school, a commercial FM station began broadcasting.) i didn't have a computer until my first year of high school, and never had any network access, e.g. to BBSes via dial-up. There wasn't that much mass media and associated advertising to engage with - certainly no social media - and regardless, i wasn't interested in most of what was on television anyway, and barely listened to radio.
There is debate around the extent to which ‘adult-onset’ adhd occurs, but at the moment, an assessment of childhood behaviours is required as part of a psychiatric diagnosis of adhd - which is not an easy diagnosis to get here in Australia, as even getting the necessary referral from a GP can be difficult. And despite all the preceding, i've been given an adhd diagnosis, one which has allowed me to start taking meds for it - GPs cannot prescribe adhd meds without authorisation from a psychiatrist - and those meds have been having a significant positive impact on my daily life.
The ‘adhd’ diagnosis is clearly a social construct, and one developed by the psychiatric profession within capitalist societies. The same goes for the ‘autism’ diagnosis. But the comorbidity between these two diagnoses is significant; getting a diagnosis of one means there's a reasonable chance one might be diagnosable with the other, and there are a number of commonalities between the two (which makes differential diagnosis more complex/difficult).
What i believe is going on is that there are various underlying forms of neurodivergence. As things like adhd and autism are explored in greater detail - and, as, shock horror, health professionals and researchers actually start to listen to the lived experiences of adults with these diagnoses, instead of just assuming/asserting that we can't speak for ourselves - the classificatory processes are changing. And as i apparently keep needing to say: _the signifier is not the signified_. Changing the labelling of something doesn't inherently mean that the ‘something’ itself has changed. “A rose by any other name would smell as sweet”[a].
It's true that how societies function can, and does, have various impacts on those of us who are neurodivergent[b]. Various aspects of capitalist society penalise us for not having minds that meet capitalist society's requirements. For example, people with adhd can need more variety than workplaces are willing or able to offer, and people with autism need more stability than workplaces are willing or able to offer[c]. Being neurodivergent in such ways isn't necessarily inherently a disability, though it certainly can be so for a number of people. The problem is that we can be ‘dis-abled’ by being forced - due to lack of various forms of capital[d] - to work in ways that fundamentally aren't how we work. And we are forced to ‘prove’ that our challenges in meeting requirements aren't just us being ‘slackers’, and/or that we just don't have ‘the right attitude’. Some of us have spent many years destroying our physical and mental health as we've tried to ‘do better’, and feeling crap about ourselves for not being able to do so. In the same way that many queer and tgd people have to deal with many years of being told that being queer and/or tgd is always a choice, that one can choose to be otherwise.
Which brings me to the topic of leftist history repeating itself, whether as tragedy or farce or otherwise.
i recently remarked that, contrary to what a number of Anglosphere leftists seem to think, leftism does not automatically imply overall support of human diversity in sexuality and gender[e]. Both statist and anarchist leftists have historically regarded e.g. homosexuality as a product of capitalism, an illness resulting from bourgeois society. At best, the position was often that, although homosexual behaviour shouldn't be criminalised, it was ‘unhealthy’ and should be ‘treated’ and ‘cured’ (because post-capitalist society would be more ‘humane’). And this sort of position is certainly not dead: cf. e.g. the current position of the KKE in Greece[f], and of course the historical position of the CCP in China up until relatively recently:
Adult, consensual and non-commercial homosexuality has been legal in China since 1997, when the national penal code was revised. Homosexuality was removed from the Chinese Society of Psychiatry's list of mental illnesses in 2001
(Of course, there are ‘no true Wee Free Man’ arguments that can be made about whether these positions are ‘really leftist’, which is the dogmatist's time-honoured ‘resolution’, since it neatly avoids spending time and/or energy analysing what internal dynamics might lead to such a position.)
Leftists have a long history of taking the approach: “I regard this as a social ill. As a social ill, it exists because of capitalism.” One example i've regularly encountered over the last few decades, and still regularly encounter, is leftists who apparently believe that markets - and thus, presumably, trade in general - didn't exist prior to capitalism. lolwut. And historic leftist attitudes towards queerness are another example of this, despite being based on reactionary ideologies taken as a given: “Yes, we all agree that homosexuality is a problem, the issue is the appropriate approach to dealing with it.”
And now the same phenomenon seems to be occurring around adhd. The two main positions around adhd in particular in this context[g] seem to be:
- “Adhd doesn't actually exist, it's purely a creation of big pharma to sell unnecessary pharmaceuticals.” Not to put too fine a point on it: Oh fuck off. i have spent so many years in talk therapy, being given analyses and perspectives intended to ‘manage’ or ‘resolve’ various issues, and working hard to put them into practice - only for them to have far less impact than a single dose of lisdexamphetamine. (Having the ‘noise’ in one's head suddenly fade into the background, and to suddenly be far less distracted by various sensory inputs, is an amazing experience.) Yes, big pharma is even more outrageously rent-seeking than other corporate sectors already are, but that doesn't mean their products are necessarily snake oil.
- “Adhd exists, but it's a product of capitalist society, and even if drugs can somewhat ameliorate it, it's a problem that can only be eliminated by eliminating capitalism.” An underlying issue here is leftism's iron grip on ‘tabula rasa’ theories of the self, where the self is basically entirely the result of social conditions, with the possibility of other factors (e.g. Dunbar's number[h]) being dismissed a priori. In the Anglosphere, the main exception is the typical left position of “born this way” in regards to sexual orientation; but on the other hand, even amongst tgd-supportive leftists, there's the idea that no aspect of gender is possibly rooted in biology[i]. And the ‘tabula rasa’ assertion seems to be in action in this position on adhd.
Rather than accepting the framing of adhd as a social problem needing to be ‘solved’, and reflexively implying or claiming that getting rid of capitalism will do so, i suggest a leftist position around adhd should be along the lines of:
“Human beings are diverse, and human neurologies are no exception. Capitalism prefers homogenisation over diversity in order to minimise costs, and doesn't support diversity unless forced to by other factors. This results in a particular group of neurodivergent people being pathologised, and in need of ‘correction’, rather than being accepted as just another instance of human diversity, and treated with respect.”
PostScript. After reading this post, a friend pointed me to the following piece, which i substantially agree with:
This topic is complex, and although - as this post hopefully suggests - i overall lean more towards the ‘social model’ of neurodivergent disability rather than the ‘medical model’, a fundamental point i wish to make is: leftists need to listen to the diversity of lived experiences of those of us with things like adhd and autism, to not pick and choose who amongst us are used as ‘data points’, nor arrogantly presume to ‘explain’ why we are we are the way we are. “Nothing about us without us.”
To quote from a previous post:
To me, it's incredibly arrogant for anyone, regardless of where they are on the political compass, to claim that:
• they ... know what ‘natural’ human psychology is ‘really’ like
PostPostScript. Apparently someone noticed some of the characteristics of what we now call ‘adhd’ back in 1775:
In Weikard's book, he describes a “lack of attention” disorder commonly known as attention deficit hyperactivity disorder or ADHD. He provides many details that closely match the disorder we currently know, and many of Weikard's observations hold up to modern scrutiny. Weikard characterizes the disorder as distractible by anything even a person's own imagination, taking more effort to complete tasks, flighty, careless, work has many errors, and generally disorganized. He hints at impulsivity though he does not explicitly say it. This matches the DSM-V's diagnostic criteria of inattention and hints at the hyperactivity and impulsivity criteria.
[a] Cf. e.g. these posts of mine from a couple of years ago:
[b] ‘Neurodivergent’, not ‘neurodiverse’. A group (e.g. a community) is ‘neurodiverse’, an individual is ‘neurodivergent’.
[c] Why yes, having these two mutually contradictory tendencies within myself is challenging, and their combined presence has strong ‘explanatory power’ for a number of aspects of my life so far.
[d] By “various forms of capital”, i'm referring to the types of capital described by Pierre Bourdieu:
Bourdieu introduced the notion of capital, defined as sums of particular assets put to productive use. For Bourdieu, such assets could take various forms, habitually referring to several principal forms of capital: economic, symbolic, cultural and social.
[g] Both positions can be (and are) accompanied by the “adhd is overdiagnosed” position. My experiences, and learning about the experiences of others with adhd, is that the situation is much more complex than that: i believe it's both overdiagnosed and underdiagnosed. There certainly seems to be overdiagnosis coming from a place of “this person needs to be medicated so that they are ‘sufficiently’ well-behaved according to subjective external standards”. But it's also increasingly recognised that those of us who are women are significantly underdiagnosed because how it manifests for us does not fit the ‘hyperactive boy’ stereotype that even many health professionals still believe characterise adhd.