Dr Benjamin Janaway @drjanaway Psychiatrist, Writer and Science Communicator. Working on a novel. Widely published. Media enquiries via DM. RTs usually endorsements. Future Silver Fox. Sep. 25, 2019 6 min read

Hey Piers, so I read your column. I appreciate that you have spent the time to review what autism is, and explained it in a way many can understand. I also appreciate that you have showed concern for Greta, and appreciated how much of a problem climate change is.

But.

Lets expand on a few things, and I will reference your words as we go.

1) Autism is a neurodevelopmental condition, where people with it can express a range of behaviours that society would, for the most part, consider atypical. Aside from that, it is a very individual condition

2) You mention that she has previously been depressed. Depression is not a permanent state in all cases, and recovery is possible. Although we do take into account appearance in helping diagnose it, unless you do a full psychiatric evaluation this is speculation.

3) Whereas I agree that being in the public limelight is difficult, Greta has the autonomy and capacity to make this decision. Autism does not, by existence, remove this. As much as I applaud your concern, it may be misplaced. And certainly not worth a headline.

4) You mention that she came over as 'extremely vulnerable, emotionally unstable and possibly psychologically damaged by her year of campaigning.' Unless you are a psychiatrist talking to her, this is speculation. Being in front of large crowd could look very much the same.

5) You cite, in reference to Greta's message, that it makes her 'entire generation think they are about to die.' I do believe this is hyperbole, and you are dramatizing and mischaracterising her words. I may be wrong about this, but most young people are aware of the science.

6) You 'agree with her' on climate change, this I applaud and I thank you for speaking openly on this stance. The climate change deniers continue to hold on to pseudoscientific nonsense to justify either personal or political interest.

7) 'she wants fellow teenagers to share that fear and pain.' This is an inference, not an objective analysis. It makes for punchy journalism, but continues to be hyperbole. The pain and fear is already there, Teenagers already know about climate change

8) 'it would be hard for even her most ardent supporters to argue that greta doesn't currently have an intense preoccupation.... or display one sided verbosity.' Here you are making her opinion and actions a symptom of her autism. It is not for me to say if this is true, or you.

Regardless of the debateable veracity of this statement, you cannot so easily ascribe passionate pursuance of a goal to a condition, or as could be as could be implied by your words, being unwell. People with autism have beliefs and interests, they do not have to be pathology.

9) You state that people with 'Aspergers (autism) have feelings like pain and fear.... but often experience them more intensely.' This can be true, but says nothing about an individual. I once again state that unless you are a psychiatrist, this is stereotyping, a form of stigma.

10) 'over-the-top thespian histrionics.' I respect that this is an expert area for you, but to assess her facial expressions and statements as histrionic requires them to be self-referential to a fault, which they are not. Her statements attract attention based on merit.

11) You reference a number of her previous symptoms ver batim, which I can imagine was an attempt to paint a picture of illness. What you have missed is recovery, autonomy and progress. You cannot reference one in isolation.

12) 'if she was my daughter, id want to protect her now, not keep throwing her to the wolves.' There are a few points here, the first is I agree from a fundamental standpoint of wellness, I don't want her to be hurt. But, the assertions are a little unfounded.

a) you continue on the assumption that her current work is making her unwell, without objective analysis or the expertise to claim this
b) you would imply (and correct me,) that her parents are using her. It would seem to me that Gretas autonomy and intelligence suggest otherwise

c) If I am correct in interpreting your words, you would be suggesting that they are abusing her. From my experience, parents of people with autism know them best, love them deeply and understand them much more than anyone else. Also, they are supported by doctors and...

other health staff who would raise the alarm if any concerns. Is it not possible that Greta wants this, or if she doesn't want the attention, has made the decision to go ahead as she sees the issue as pressing? Would you be saying the same if she wasn't autistic?

13) This is the crux of the point, we need to stop considering greta as different, or vulnerable, due to a diagnosis and place stereotypes, well meaning or otherwise, on her as an evaluative measure of her work.

And as much as this column seems to try to strike a balance between concern and support and criticism, I worry that your interpretation has been marred by the need to make the article more histrionic (to use your own words,) rather than a call to action to protect a woman.

Having worked (and still working,) with people with autism, I can say that the stereotypes do not define the individual, that autonomy, intelligence and bravery are not limited by genetics in the same sense, and that Greta exemplifies the best qualities of a human...

not a human with autism, not a human with ocd or depression, but a human. That's how we should think. If we begin to ascribe actions or beliefs purely to illness, we risk undermining and stigmatising the valid contribution of many humans to society.

My concern is, although your column shows some empathy, is that it plays into the conspiratorial dogma of her political opponents, who wish to undermine the severity of her arguments by judging her as less than a person, or her parents as less so.

This technique (essentially virtue ethics or fundamental attribution error,) is one used when the opponents primary argument is flawed, so they change the goalposts or interpret information incorrectly to shift the narrative and opinion to their own ends

I.e, who would disagree that she should be protected? Who would vouch for parental abuse? Who would hurt a vulnerable child? Although the answers are obvious, these are not the questions on the table, but distractions without significant evidence to back their assertion.

For me, and I could be wrong, I will finish with this. Continue with the empathy, but realise the limits of your expertise, the impact these limits and your motivations have on your analysis, the role of stigma (subtle or direct,) and the impact of your words.

PS

1) Capacity is always assumed to present. To suggest otherwise requires assessment. Capacity is decision, time and context specific.
2) I do not regard autism or its behaviours as anything less than that of a person and their expression, the societal view concerns me little.

Feel free to correct me on any of the points made. If I have misunderstood, I apologise and will retract any statements without question.

I have reached the limit of what I can proffer with any confidence, so if anybody else wishes to expand on any of these points and discuss them, I would encourage it. But be respectful, Greta is a human, not a political or journalistic fascination.

And if anyone with Autism feels like I have mischaracterised or made a mistake, I am always happy to be educated. I will not pretend to share the experience, but will do my best to understand it.

And one last thing, change that damn headline. If you are going for empathy, then it undermines it.


You can follow @drjanaway.



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