Saturday, September 16, 2017

The world of the 1990's

I am a bit of a sucker for buying second hand textbooks from the charity shops, you can usually pick up something that might not be the latest edition, but certainly costs you a lot less than the present edition would. I picked up a couple today on psychology.  I should have checked the publication dates of one of them a bit more carefully however. It is called "The Handbook of Clinical Adult Psychology, second edition" I will not embarras the editors by naming them. Its date of publication is 1994. I guess it only serves as a historical artefact showing the state of play at that time.  It is not irrelevant though, as a perusal of the index has not one mention of autism or asperger's syndrome anywhere. I was eventually diagnosed in 1999, but it shows you pretty much why I did not recieve a diagnosis in earlier adulthood, it just was not on the horizon of most clinical psychologists.

I was in fact diagnosed by a clinical psychologist not a psychiatrist, and that was at my own insistence at the time. For various reasons my GP had wanted to send me for psychiatric evaluation (being himself a part time psychiatric consultant) I managed to sidestep that by suggesting that I should be evaluated elsewhere for possible asperger's syndrome. The cynic in me suspects he only agreed to that to "humour me" figuring that eventually he would be able to slap a neat little psychosis on me by default (as you do). Turns out I struck lucky though, and the clinical psychologist who evaluated me, had been trained by Digby Tantum, who prior to his move "oop north" had been collecting street lamp numbers at Warwick University.

However to get back to the point, the text book shows that for the most part asperger's and autism was not even on the street map until the very end of the nineties.

In 2002 I met the man who had been largely responsible for getting asperger's syndrome in the the American Psychiatrist's Association's Diagnostic and Statistical Manual. editon four. I say met, but it was more like I confronted him. After he had given his presentation, he called me aside, and I expected he was going to give me a going over, for having interupted his presentation with my objections and questions, but instead we settled down to a long conversation about our respective viewpoints. I don't know if it was an education to him, but it was to me, especially so far as the workings of the DSM go.

DSMIV has come and gone since, and the guy is now in a minority, as asperger's syndrome did not make it to the next edition. I amongst many others submitted a paper to the consultation process and for whatever others might think about the outcome, I was pleased that it went the way I had wanted, and left poor Fred Volkmar (for it was he who I had conversed with in 2002) in the shade somewhat.  But you know that is psychiatric politics. Having this time had the privelege in 2014 to be a presenter myself for the UK launch of DSM talking about the impact of diagnosis on me.  Again co presenter Cathy Lord also mentioned the politics behind the scenes and why asperger's syndrome gets "grandfathered in" under the general heading of Autistic Spectrum Disorder.

Well fast forward back to 2017 and I have my doctorate as "academic without portfolio" now. One of those awkward autistic academics who are busy trying to make a mark on the landscape of autism.

I have recently written the first draft of an overview of "Autism in England" which includes a historical romp through the phenomenon, going back beyond Langdon Down, and back before Shakespeare was the Warwickshire Lad. (William not Tom I must remind people who can't remember anything before 1990) It is in part my answer to the vexed question of where the autistic person sits in all of this narrative, but here you go, the editor for this is none other than that guy I had a conversation with in 2002.

Some say that Nadesan was the first to get into print with the idea that autism became part of the psychiatric and psychological narrative as part of a historical necessity (not her words, mine) arising from the rise of particular professions and their focus. I know that I got there before her, I was in fact contemplating a book on that subject myself when I discovered that she was writing something on the same theme. I gave up.

Well anyway this text book I unearthed today, might not be of great value for the psychological landscape of today, but considered as a historical document, it is enlightening.

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