Neurodiversity is a buzzword that, sooner or later, you will hear in the counseling room. How will you respond to a counselee who tells you that they are “neurodivergent”?
As biblical counselors, we counsel the whole Word of God to the whole person. The language of neurodiversity imports theological, anthropological, and ethical assumptions that run counter to Scripture, and the medical terminology associated with neurodiversity confuses rather than clarifies the physical and neurological issues involved. We need to help our counselees think biblically about this topic.
Let’s begin by defining what we’re talking about.
What Is Neurodiversity?
The term “neurodiversity” was coined by sociologist Judy Singer to describe how each person’s nervous system—including the brain—develops and functions differently, affecting how we sense the world around us and influencing how we think, feel, and act. She first used the term in a seminal 1998 paper entitled Odd People In: The Birth of Community amongst People on the Autistic Spectrum.Thomas Armstrong, “The Myth of the Normal Brain: Embracing Neurodiversity,” AMA Journal of Ethics, accessed February 19, 2024, https://journalofethics.ama-assn.org/article/myth-normal-brain-embracing-neurodiversity/2015-04. Singer wrote, “For me, the key significance of the ‘Autistic Spectrum’ lies in its call for and anticipation of a politics of Neurological Diversity, or what I want to call ‘Neurodiversity.’ The ‘Neurologically Different’ represents a new addition to the familiar political categories of class/gender/race and will augment the insights of the social model of disability.” After the concept gained widespread use, she stated that she purposely chose a political term (“diversity”) and joined it with a scientific term (“neuroscience”) to name what she hoped would be “the last great identity politics movement to come out of the 20th century.”John Harris, “The mother of neurodiversity: how Judy Singer changed the world,” The Guardian, July 5, 2023, accessed May 24, 2024, https://www.theguardian.com/world/2023/jul/05/the-mother-of-neurodiversity-how-judy-singer-changed-the-world.
From this origin as a political construct designed to create a new point of intersectionality,Singer says, “I came up with the word ‘Neurodiversity’… to add a necessary new category to what is now called ‘Intersectionality.’”Judy Singer, “Neurodiversity: It’s politics, not science! … or … It’s the name of a social justice movement, not a diagnosis,” Reflections on Neurodiversity (website), accessed May 24, 2024, https://neurodiversity2.blogspot.com/2021/02/neurodiversity-its-political-not.html. the term hit a nerve among those in the autistic community, where individuals often experience:
- Legitimate physical problemsSee Dale Johnson and Daniel Berger, “Thinking Biblically About Autism,” Truth in Love 409, April 10, 2023, https://biblicalcounseling.com/resource-library/podcast-episodes/thinking-biblically-about-autism/.
- Social and relational deficits
- Frequent co-occurrence of developmental and intellectual disabilitiesCenters for Disease Control and Prevention, “Autism Spectrum Disorder (ASD): Diagnostic Criteria,” accessed February 19, 2024, https://www.cdc.gov/ncbddd/autism/hcp-dsm.html.
- Misunderstanding by the general public
Together those experiences present great obstacles for those with autism to establish and maintain healthy relationships.However, there is an increasing consensus that autism is overdiagnosed. See Eric Fombonne, “Editorial: Is autism overdiagnosed?” Journal of Child Psychology and Psychiatry 64:5 (2023), 711–714, and John Mac Ghlionn, “Doctor who helped broaden autism spectrum ‘very sorry’ for over-diagnosis,” New York Post, April 24, 2023, accessed May 24, 2024, https://nypost.com/2023/04/24/doctor-who-broadened-autism-spectrum-sorry-for-over-diagnosis/. Similarly, families and caretakers can feel isolated, “grieving the loss of ‘normal,’” and “at their wit’s end.”Pamela Gannon, “Autism Spectrum Disorder (ASD): Essential Background Knowledge and Helpful Biblical Principles,” in The Christian Counselor’s Medical Desk Reference 2nd Edition, ed. Charles D. Hodges Jr. (Greensboro, NC: New Growth Press, 2023), 136.
Many people can identify with such difficulties. After Singer’s 1998 paper and with the growth of internet chat forums, the term quickly expanded beyond the autistic community into “fields such as disability studies, special education, higher education, business, counseling, and medicine,”Armstrong, “The Myth of the Normal Brain.” and now entered widespread use in the culture at large.
Types of Neurodiversity
According to ExceptionalIndividuals.com, there are many ways in which an individual can be neurodivergent, including:
- ADHD
- Aspergers
- Autism
- Developmental Language Disorder
- Dyscalculia
- Dysgraphia
- Dyslexia
- Dyspraxia
- Hyperlexia
- Irlen Syndrome
- OCD
- Synesthesia
- Tourette’s Syndrome
Biblical counselors may encounter such a non-exhaustive list of psychological diagnoses in the counseling room under the umbrella of neurodiversity. Even anxiety, bipolar depression, and posttraumatic stress disorder are also described as neurodiverse, along with many types of developmental and intellectual challenges.
A Critical Evaluation of Neurodiversity
The people you will meet in the counseling room are unlikely to be aware of Judy Singer and the critical theory roots of the term that they have bought into. So, I’d like to consider and evaluate definitions from two popular websites that appear in web search results.
First, Cleveland Clinic defines neurodiversity rather cautiously:
“Neurodivergent is a nonmedical term that describes people whose brains develop or work differently for some reason. This means the person has different strengths and struggles from people whose brains develop or work more typically. While some people who are neurodivergent have medical conditions, it also happens to people where a medical condition or diagnosis hasn’t been identified.”Cleveland Clinic, “Neurodivergent,” accessed February 16, 2024, https://my.clevelandclinic.org/health/symptoms/23154-neurodivergent.
Next, Harvard Health Publishing provides a much more ideological definition:
“Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.”Nicole Baumer, MD, Med, and Julia Frueh, MD, “What is neurodiversity?” Harvard Health Publishing, November 23, 2021, accessed February 16, 2024, https://health.harvard.edu/blog/what-is-neurodiversity-202111232645.
These descriptions differ in approach but agree in several important ways. Here are some observations:
1. Neurodiversity is not a medical condition
Neither definition claims neurodiversity as a medical condition. Cleveland Clinic notes that some neurodivergent individuals have medical conditions, but, according to a plain reading of both definitions, a medical condition is not necessary for someone to be considered neurodivergent.
2. However, neurodiversity is portrayed as a medical condition, using clinical terms
Cleveland Clinic acknowledges that there is a “typical” way in which “brains develop or work,” and neurodivergent people deviate from that norm or standard. This may be due to a medical condition, whether identified and diagnosed or not.
While they state that the term is nonmedical, the clinical language of their definition gives the sense that it is a condition, whether medical or psychiatric, that “happens” to people. As a culture, we are so accustomed to thinking of behavior in medical terms that we can easily fail to recognize when a label—whether “neurodivergent” or a disorder listed in the DSM—is a tautology, a different term given to a set of behaviors which doesn’t explain anything.Dale Johnson and Daniel Berger, “Schizophrenic Unicorn,” Truth in Love 466, May 20, 2024, https://biblicalcounseling.com/resource-library/podcast-episodes/schizophrenic-unicorn/ The functional result of Cleveland Clinic’s clinical description is victimization: “for some reason,” people are affected by this thing called “neurodiversity,” and the hope they have is that perhaps someday there will be a medical explanation.
Meanwhile, “Harvard Health” writes about neurodiversity—in an article by two MDs, no less—“in the context of Autism spectrum disorder (ASD) as well as other neurological or developmental conditions.” They admit, “While it is primarily a social justice movement, neurodiversity research and education are increasingly important in how clinicians view and address certain disabilities and neurological conditions.” Even while bluntly stating the movement’s origin in intersectionality, the authors provide a respectable veneer of clinical language.
The tendenz speaks for itself; as Marshall McLuhan famously put it, “The medium is the message.” Medical professionals writing for a medical website using medical terminology in the context of disorders, conditions, diagnoses, and treatment options gives a strong impression that this is a clinical subject.
3. There are no uniform criteria to define or diagnose neurodiversity
If we take Harvard Health at face value, neurodiversity simply describes the reality that everyone is different. In describing everyone, this definition diagnoses no one.
Cleveland Clinic asserts that neurodivergence is a divergence from a norm without defining what the norm is. In other words, these two definitions serve to illustrate how little agreement exists among experts regarding what neurodiversity actually is apart from a broad-stroke description of the simple idea that everyone has a varying brain development.See Patrick Dwyer, “The Neurodiversity Approach(es): What Are They and What Do They Mean for Researchers?” Human Development 2022 May, 66(2):73-92, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261839/.
As a tautological, nondiagnosable label, we must recognize that the seeming usefulness of the term does not reside in its explanatory capacity but in its political function.
4. Neurodiverse language carries political baggage
While maintaining a convincing pretense of medical expertise, the Harvard Health authors incredibly do not attempt to couch the language of their formal definition in clinical terminology.With a significant exception: The denial that neurodiverse differences are “deficits.” The word “deficit” is found throughout the DSM-5 criteria for autism: “To meet diagnostic criteria for ASD according to DSM-5, a child must have persistent deficits in each of three areas of social communication and interaction (A) plus at least two of four types of restricted, repetitive behaviors (B).” This is followed by a list of behaviors, many of which begin with, “Deficits in…” Harvard Health’s definition is intentionally pushing against the language of the DSM-5 and the association of neurodivergence (i.e., autism) with a deficit or “wrong” way of thinking, learning, or behaving. See DSM-5, 299.00 Autism Spectrum Disorder. They state an incontestable fact (that people experience and interact with the world in different ways) and draw an ethical conclusion from it (that there is no right or wrong way to think or behave). Bolstered by the prestige of Harvard and two MDs, the certainty of this non-medical ethical conclusion is breathtaking.
There are assumptions behind this conclusion. Singer, who as we’ve seen created the term, wrote a blog post entitled, “Neurodiversity: It’s politics, not science! … or … It’s the name of a social justice movement, not a diagnosis.”Judy Singer, “Neurodiversity: It’s politics, not science!” There she argues for the political basis of the neurodiverse identifier and describes the intersectional theory underlying the movement: “Neurological minorities… have been discriminated against… disempowered, and devalued.”Ibid. Harvard has similar underlying philosophical commitments, saying, “the suffering [of autistic people] may result from the barriers imposed by societal norms, causing social exclusion and inequity,” and quoting Singer regarding “equality and inclusion.”Baumer and Frueh, “What is neurodiversity?”
Thomas Armstrong explains, “The word itself was first used by autism rights advocate[s]… to articulate the needs of people with autism who did not want to be defined by a disability label but wished to be seen instead as neurologically different.”Armstrong, “The Myth of the Normal Brain.”
In this context, the idea of neurodiversity helps raise awareness of the challenges faced by autistic people and their families. At the same time, it “normalizes” their experience by challenging the very concept of normalcy.See Judy Singer, “Quotations from my work,” Reflections on Neurodiversity (website), accessed February 19, 2024, https://neurodiversity2.blogspot.com/p/selected-quotations.html. If neurological function and social interaction is on a spectrum, then there is no “normal,” and therefore—importantly—no “abnormal,” no “weird,” no “disabled,” no “deficit,” and no “standard.”
This leads to two emphases, which both reveal the function of the term as a sociopolitical advocacy label:
- Accommodation for disability. On the one hand, autism advocates want to raise awareness of the unique challenges they face (this is in line with Cleveland Clinic’s definition). This might include recognition as having a disability, equal opportunity access to funds and resources, workplace and educational accommodations, and more.
- Acceptance as normal. On the other hand, autism advocates want to emphasize that everyone is different, everyone is unique, and everyone is an individual (this is in line with Harvard Health’s definition). This type of awareness can encourage warmhearted sympathy and extra effort on the part of others towards those regarded as “different” or “outsiders,” and aims to change negative views of a neurodivergent person’s challenges into positive views of their strengths.Jenna Fletcher, “What to know about the relationship between bipolar disorder (BD) and neurodiversity,” Medical News Today (website), June 30, 2022, https://www.medicalnewstoday.com/articles/bipolar-neurodivergent. Yet it can also excuse harmful or toxic behaviors (see the last half of Harvard Health’s definition) by normalizing them.
The draw for each emphasis is obvious. Those who face hardships appreciate anything that eases their suffering. At the same time, those who are viewed as different (i.e., odd, awkward, etc.) desire acceptance and normalcy.
The trouble is that in order to receive special accommodation, one must be special. Yet if that very “specialness” is normalized, there are no grounds for special treatment. This explains the difficulty in defining neurodiversity.
The simplicity of the term makes it memorable, and the ambiguity of the term (and lack of medically diagnosable criteria) enables it to be applied broadly, especially in fields that tend to value diversity, equity, and inclusion (DEI).
This means that without being a minority (e.g., BIPOC) or claiming a sexually deviant status (e.g., LGBTQIA+), just about anyone can self-identify as neurodivergent and receive something of the perceived cultural cachet that comes with having a “diverse” identifier.
We need to be careful here. As counselors, we may have counselees who come into the counseling room with a full adoption of the concept of neurodiversity. It is important for us counselors to recognize that neurodiversity conflates legitimate physical weaknesses (i,e., autism) with psychological diagnoses that do not have any biological markers. At the same time, our counselees may also have various physical weaknesses, which is why we need to be familiar with the definition and context of neurodiversity and then consider how we will respond with love and truth to such psychologized counselees.
How will we respond? Will we be dismissive and condescending? Will we be accepting and obliging? Or will we sit back and listen (Proverbs 18:13), dig in and learn (Proverbs 18:15), and seek to apply the living and active Word of God in such a way that the counselee’s true needs are biblically exposed (Hebrews 4:12)?
A Biblical Anthropology of Neurodiversity
Albert Mohler provides a helpful starting point. Addressing a listener’s question about neurodiversity on The Briefing, he said,
“…a term like neurodiversity is not without ideological commitments, or it is not without a certain agenda. The agenda here is to suggest that many things that might be described in positive or negative terms should be taken out of a positive or negative context, and simply put into the context of diversity.”Albert Mohler, The Briefing, February 16, 2024, https://albertmohler.com/2024/02/16/briefing-2-16-24.
This is a crucial observation. When we look at physical symptoms or personality quirks and judge them as morally wrong, we lack not only compassion but also an appreciation for the Master Artist at work. Mohler goes on to say that the idea of neurodiversity can be a very healthy way of looking at many differences between people to identify and affirm the image of God—the imago dei—in each person.
As Christians, we seek to affirm the image of God in everyone, even those who are different from us in some way. After all, the body of Christ is composed of people with different functions, gifts, and abilities (Romans 12:4–8; 1 Corinthians 12:4–11), who come from many different backgrounds (Revelation 5:9; 7:9) and demographics (Galatians 3:28).
Physical weaknesses—including neurological disorders that can affect the brain—are a reality of human existence after the fall.Medically identifiable neurological disorders include Acute Spinal Cord Injury, Alzheimer’s Disease, Amyotrophic Lateral Sclerosis (ALS), Ataxia, Bell’s Palsy, Brain Tumors, Cerebral Aneurysm, Epilepsy and Seizures, Guillain-Barré Syndrome, Head Injury, Hydrocephalus, Lumbar Disk Disease (Herniated Disk), Meningitis, Multiple Sclerosis, Muscular Dystrophy, Neurocutaneous Syndromes, Parkinson’s Disease, and Stroke (Brain Attack). Johns Hopkins Medicine, “Neurological Disorders,” accessed May 25, 2024, https://www.hopkinsmedicine.org/health/conditions-and-diseases/neurological-disorders. But the Bible is clear that the way he made us does not cause us to sin (James 1:13–15). We can do right no matter what situation, circumstance, or condition we face (1 Corinthians 10:13). In fact, God uses our weaknesses to display his power and show us his grace (2 Corinthians 12:9).
To those who suffer in some way because of physical weakness, we want to display compassion and honor them as they experience very real and very difficult physical trials (Romans 15:1, Psalm 82:3–4). If someone is simply different from us, we want to appreciate the variety and, well, diversity of God’s good design.
But we must be careful in the way we talk about these things. The politically loaded word diversity may not be the most helpful. Mohler’s comment about the “agenda” to “simply put [negative and positive things] into the context of diversity” gets to the heart of the issue: How we talk about moral issues and the image of God in people matters.
When we are dealing with physical weaknesses, our evaluation of individuals should move from the categories of defective or sinful (John 9:1–3) into the category of God’s good purposes in creation and providence.
However, when anything that the Bible describes as sin is removed from positive and negative moral categories of right and wrong and placed into a vague concept of neurodiversity in which “there is no one ‘right’ way of thinking, learning, and behaving,”Baumer and Frueh, “What is neurodiversity?” then this is at odds with the biblical witness.
What then does Scripture tell us about thinking, learning, and behaving—ultimately, being—different?
The answer must begin with the word holy. To be holy is to be set apart, which, in one sense, means to be different.
The apostle Peter puts it this way:
“Therefore, preparing your minds for action, and being sober-minded, set your hope fully on the grace that will be brought to you at the revelation of Jesus Christ. As obedient children, do not be conformed to the passions of your former ignorance, but as he who called you is holy, you also be holy in all your conduct, since it is written, ‘You shall be holy, for I am holy.’” (1 Peter 1:13–16)
The problem Peter identifies is that humans are “conformed” to the passions or desires that come naturally to us when we are ignorant of the Gospel. In other words, apart from encountering Christ, our minds aren’t different! To appropriate the terminology, we are “neurotypical” in that we conform to the norm. And what is that norm? Our own desires.
Rather than following our sinful desires—“the passions of [our] former ignorance”—God calls us to be conformed to a different norm: Himself. “You shall be holy, for I am holy” (1 Peter 1:16).
The only way for us to live this way is to be born again (1 Peter 1:3). The revelation of Jesus Christ provides that new birth, enabling us to be holy in our behavior (“in all your conduct,” 1 Peter 1:15).
In this way the Gospel is the basis for every single person—whether they would self-identify as “neurotypical or neurodivergent”—to have hope for growth and change.
Neurodiversity in the Counseling Room
Yet the body is wasting away even as we grow spiritually (2 Corinthians 4:16). The counselor must recognize the unrelenting nature of the weight that some of these hardships place on counselees. Pamela Gannon notes in The Christian Counselor’s Medical Desk Reference that autistic people often experience “heightened or continuous sensory input… For example, an autistic person who puts on a jacket feels it the entire time he wears it, whereas a non-autistic person soon adapts.”Pamela Gannon, “Autism Spectrum Disorder,” 132. This heightened awareness can be pervasive, affecting the individual’s taste, hearing, smell, and vision. Add in difficulties in understanding nonverbal communication, humor, and sarcasm, plus a propensity to interpret conversation literally, and the autistic person can appear socially awkward and unloving, leading to miscommunication issues and social alienation.Ibid., 132–133.
Neurological problems can certainly influence the inner man, as can autoimmune issues, cancer treatment, medication taken for legitimate medical conditions, and much more. Always encourage your counselees to seek a physical examination and take their physical ailments seriously. However, each medical diagnosis must be evaluated biblically to avoid excusing sin. Biblical counselor Ed Welch provides four helpful principles in Blame It on the Brain for such an evaluation. First, brain injuries cannot cause a person to sin or prevent them from faithfulness. Second, each person has unique strengths and weaknesses. Third, heart issues can be exposed by physical and neurological issues. Fourth, sin can sometimes result in physical symptoms, and righteousness can sometimes result in improved health.Edward T. Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience (Phillipsburg, NJ: P&R Publishing, 1998), 49. Summary taken from Daniel Szczesniak, “A Review of Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience,” unpublished class paper for Reformed Baptist Seminary, October 19, 2023, 3.
For those whose physical perceptions, limitations, and differences create difficulties, Peter simply calls them to learn to rejoice. “In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials” (1 Peter 1:6). He is speaking of “various trials” (diversity!) faced by mixed congregations of Jews and GentilesWayne Grudem, 1 Peter, The Tyndale New Testament Commentaries (Grand Rapids, MI: Wm. B. Eerdmans: 1988), 38. See 1 Peter 1:1, which addresses “those who are elect exiles of the Dispersion in Pontus, Galatia, Cappadocia, Asia, and Bithynia.” (diversity again!) who are called to be demonstrably different from those around them (more diversity!). His solution does not pander to them, nor does it minimize or delegitimize their suffering. In fact, Peter’s solution elevates their suffering by setting it out as the mechanism by which hope is achieved: the grief of trials tests their faith in such a way that it results in praise, glory, and honor (1 Peter 1:7). Suffering is the process by which their faith is refined.
In other words, these individuals bear no blame for failure to perceive the world around them when God has removed their biological ability to experience the world rightly (John 9:1–3). In fact, the struggles that come from disabilities or differences are to their advantage (see James 1:2–4; Romans 5:3–5; 2 Corinthians 12:10). At the same time, even though we bear no blame for our physical condition, we are still accountable for our response to the truths of Scripture (1 Peter 1:10–12). Your counselee needs to know that no matter what difficulty they face, they are still called to love Jesus Christ. They must learn that in God’s wise providence, these very troubles are often the seed from which sanctification grows.
In these ways, your counselee is no different than anyone else. We are all exiles, strangers in a strange land (1 Peter 1:1), with a calling from God himself to be different (1 Peter 1:14–16). The greatest hardship we face is being bent and conformed to our own passions (1 Peter 1:14). We might think it would be easier if we could just see Jesus, but God has chosen that we should live and walk by faith and learn to love him without the aid of our physical perceptions (1 Peter 1:8). And most importantly, we all have the same hope, a new birth that comes through the resurrection of Jesus Christ from the dead (1 Peter 1:3). In this we can and must rejoice, even though we are grieved by our current situation (1 Peter 1:6).
Ultimately, the language of neurodiversity is more distracting than helpful. While it is right and good to recognize the unique strengths, weaknesses, and personalities of every person God has created, we must be wary of the unscriptural baggage and ideological commitments that the term can bring. If your counselee has been diagnosed with a physical condition, use concrete descriptions and accurate medical terminology rather than the ambiguous, sociopolitical label of neurodiversity.
When we hear someone describe themselves as neurodivergent, our task as biblical counselors is to help them evaluate that description through the lens of Scripture. Question and challenge the deterministic clinical language, help the counselee identify the assumptions that such terminology carries, bring those assumptions into contact with the Word of God, and call the counselee to be conformed to the image of Christ, as they learn to rejoice in the One who made them.
