Monday, October 30, 2023

Controlling the Diagnostic Narrative

The need to control the narrative is not automatically a bad thing. If you fear that someone with power or influence is going to lie about you, say a police officer or a co-worker, you want to wrest the megaphone from them. Completely fair.

Yet I grew to be suspicious of people who did this automatically.  Usually this would be patients saying "No you can't talk to my mother/wife/counselor about this.  They're going to lie about me." It was something of a giveaway. 

It would occur with staff as well. I recall getting a call from a supervisor who had been talking with her equivalent at another agency about a case that two of us low-levels had been arguing about. "She was talking with the case manager there, and Diane says you told her that our hospital doesn't trust her agency." Long story short, Diane had deleted both the emails and phone messages pertinent to the discussion. Ah, the dog ate her homework.  Funny how that happens. I thought that my supervisor would recognise that this was practically an admission that she was wrong, but no such luck. She was clearly defaulting to the idea that those two women were right and I was trying to make excuses and cover something up.  I told her I would forward her the email chain and invited her to come down and at least listen to my voicemails.  I told her I would go to the trouble of redacting all the patient information from the email chain so she could forward it to the other agency.  "No, you don't have to do that.  Diane already told her what was in them." (Emphasis mine.) So now I'm thinking I really might be screwed on this one, as I didn't see a clear defense unless we went to a very formal dispute and they were required to pony up with real information.  But I hesitated, because I knew my supervisor, and I knew she was going to resent all the extra work she would have to do on that, and in the end would more likely remember that I had put her through that, than that I had been clearly, crushingly, drinking-blood-from-their-skulls vindicated.

If I didn't mistrust that agency before, I sure did now.  Not that I would ever say it.

So you learn to be suspicious of people who destroy the evidence that quickly. I can get it on voicemails, as they stack up and it is tedious to zip forward to the newest ones if you have a dozen stored. But emails?  No cost. And if they went and also deleted them a further time from trash, quite automatically and as a matter of course, I am very cautious around that person.  They are trusting in their ability to command the floor and manipulate the situation. ("No, David, that's not fair.  Some people just like deleting things off the first page because it makes it easier..."  Yeah, right.)

Here's one that I doubt is really new, but I suspect is more common these days: whoever gets to declare the diagnostic information and have it stick, at least in part, wields a lot of power.  I noticed it because of the generational difference in accepting autism diagnoses.  I come from a generation that rejects such things. How dare you say... As they reject the idea that they have done anything wrong, any purported explanation is rejected out of hand.  They are not unable to put themselves in someone else's shoes, others are just wrong. They are not absolutist in their attribution of fault at 100%-0%, others are just wrong. They are not obsessed with unimportat details, others are sloppy.  If you live like this for decades, you will of course collect some confirming information because Jimmy really was sloppy in record keeping ten years ago.  So there. 

But we now have the opposite problem, young people actively seeking diagnoses to excuse bad behavior. They aren't jerks or insensitive or rude when they don't consider your needs, they have autism, and others should make accommodation for them, or at a minimum, cut them an enormous amount of slack.

Whoever gets in first has power.  It's like whichever partner gets to the courthouse first gets to take out the restraining order on the other. A lie goes halfway around the world before truth can get its boots on.

There ain't no justice, eh?

5 comments:

Korora said...

About using personal issues to excuse bad behavior:
1. I have Asperger's myself. And using that as an excuse... Is the self-justification attempt really worth it? Especially since...

2. ...I am reminded of something Chesterton wrote in Orthodoxy: "I have listened to scientific men (and there are still scientific men not opposed to democracy) saying that if we give the poor healthier conditions vice and wrong will disappear. I have listened to them with a horrible attention, with a hideous fascination. For it was like watching a man energetically sawing from the tree the branch he is sitting on. If these happy democrats could prove their case, they would strike democracy dead. If the poor are thus utterly demoralized, it may or may not be practical to raise them. But it is certainly quite practical to disfranchise them. If the man with a bad bedroom cannot give a good vote, then the first and swiftest deduction is that he shall give NO vote. The governing class may not unreasonably say: 'It may take us some time to reform his bedroom. But if he is the brute you say, it will take him very little time to ruin our country. Therefore we will take your hint and not give him the chance.' ... So it is when the ordinary Socialist, with a beaming face, proves that the poor, after their smashing [i.e., "smashing-up"] experiences, cannot be really trustworthy. At any moment the rich may say, 'Very well, then, we won't trust them,' and bang the door in his face."

Assistant Village Idiot said...

That is a great quote and a great thought. If you want to write it up as a blog-post and send it to me, I will post it with proper credit. (wymanhome at comcast) You have been a remarkably creative thinker here.

Grim said...

I note that the present moment runs the other way from Chesterton's fear. What I hear people saying is not that the poor/damaged can't be trusted to make decisions, but that only they can be so trusted. Everyone else has been privileged in one way or another that prevents them from being the one with a stake in the issue. Those who suffer most and most directly are the most legitimate speakers on this view; only their view should guide us all.

This is an outgrowth of Rawls' doctrine that differential rules are acceptable only insofar as they are structured to the advantage of the least advantaged, for those interested in the philosophy as well as the psychology. Yet there is a loss in it of the idea that reasoning is done best when it is dispassionate: Kant was big on that, but it seems to have dropped out in favor of endorsing passions.

For the Greeks, of course, 'passion' was something one suffers from; it was a bad thing that happens to you, and in which you are passive (thus 'passion'). Our contemporaries seem to view passion as an active part of themselves, even their truest nature and most authentic expression.

Assistant Village Idiot said...

I sometimes think that my passions are my most authentic expression, and it worries me.

Korora said...

I was just wondering whether the people who use their disability as an excuse are really thinking the implications through.