‘I will never love anyone like that again’: cognitive behavioural therapy and the pathologisation and medicalisation of ordinary experiences

Ratnayake, Sahanika

doi:10.1136/medhum-2021-012210

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…This would be particularly important to clinicians without extensive autism knowledge. There are potential risks though situating autistic burnout within the psychiatric nosology, with similarity to the pathologisation of depression (Ratnayake, 2022). Further research is needed with sensitivity to the most beneficial approaches to supporting autistic adults.…”

Section: Discussionmentioning

confidence: 99%

Towards the measurement of autistic burnout

Arnold

Higgins

Weise

et al. 2023

Autism

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Studies are emerging documenting the experience of fatigue, exhaustion and loss of functioning that has long been described by autistic adults as autistic burnout. New assessment tools are needed to enable identification and diagnosis. Here, we sought to identify factors associated with severity, develop an autistic burnout assessment and test the prepublication AASPIRE Autistic Burnout Measure tool. A co-produced survey of 141 autistic adults with experience of autistic burnout (98% above cut-off for depression) was subjected to exploratory factor analysis and scale reduction to identify a grouping of Autistic Burnout Severity Items. Autistic Burnout Severity Items showed strong overall internal consistency and acceptable internal consistency across four factors. Masking and depression were associated with the Autistic Burnout Severity Items, once variation in alexithymia, interoception, repetitive behaviours, sensory sensitivities and autism severity had been adjusted for. There is some suggestion that the Autistic Burnout Measure may not be as robust as the Autistic Burnout Severity Items, particularly as it showed a significant relationship with depression but not masking. Our findings alongside recent literature highlight a core phenomenon, comprising exhaustion, withdrawal and cognitive overload, associated with stressors potentially unique to autistic people. Further disambiguation from autistic shutdown and other conditions is needed in work towards the measurement of autistic burnout. Lay abstract Autistic burnout has been talked about by autistic adults for some time on blogs and in social media. Now, research describes fatigue, exhaustion and other related symptoms experienced by autistic people. We need new ways to help identify autistic burnout. In this study, we tested a new questionnaire called the AASPIRE Autistic Burnout Measure, and we investigated things that are linked to worse autistic burnout. We also trialled a group of Autistic Burnout Severity Items that we made. Working with an autistic researcher, we made the Autistic Burnout Severity Items based on published definitions of autistic burnout. Autistic adults ( n = 141) who had experienced autistic burnout completed an online survey. We found that autistic burnout was connected to masking and depression. The Autistic Burnout Measure tool was associated with depression but not with masking. It was not very accurate in telling apart participants who were currently experiencing burnout versus those who were reporting on their past experience. The Autistic Burnout Severity Items might have problems with subscales adding together to measure autistic burnout. More work is needed on how to measure autistic burnout. Our research and other recent studies show autistic people experience a combination of exhaustion, withdrawal and problems with their concentration and thinking. Burnout seems to be linked to the stress experienced by autistic people in their daily lives. We need more research to understand the difference between autistic burnout and other conditions and experiences. We need to develop assessment tools that can help identify this burnout.

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Section: Discussionmentioning

confidence: 99%

Towards the measurement of autistic burnout

Arnold

Higgins

Weise

et al. 2023

Autism

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“…Ratnayake 31 employs a critical discourse analysis (CDA) to critique the conceptual and theoretical framework of CBT. Using an abductive logic of inquiry, he begins from a given, stated assumption that the medicalisation of ordinary human distress is a feature of modern mental health services.…”

Section: The Conceptual Framework Of Cbt: a Critical Discourse Analysismentioning

confidence: 99%

Unravelling the Dominance: An Exploration of the Relationship Between the Medicalisation of Ordinary Mental Distress, the Primacy of Cognitive Behavioural Therapy, and the Influence of Neoliberal Ideology in the UK Mental Health Economy

Rowland

2024

MRAJ

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This article explores the predominant status of Cognitive Behavioural Therapy within the UK mental health sector, and critiques its alignment with the concept of individual responsibility within neoliberal ideology and the tendency towards the medicalisation of mental distress. Drawing from the field of critical psychology, which historically questions the medicalised approach to mental health within the field of psychiatry, this analysis extends into cognitive psychology's clinical applications and questions the scientific underpinnings and widespread acceptance of cognitive behavioural therapy as the prevailing clinical method. Through a critical literature review and evaluation of existing research, the article reports potential biases and methodological flaws identified by researchers, drawing conclusions that its efficacy has been exaggerated and its scientific credibility might be partly constructed. Furthermore, by reviewing research into the qualitative dimensions of the conceptual framework and discursive practices of cognitive behavioural therapy, the author describes how its dominance could be perpetuating individualistic and pathologizing approaches to mental distress. These approaches contribute to the broader medicalisation trends observed in contemporary mental health practices, which both reflect and reinforce the ideological role of individualism in late modern capitalism.

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Impulse, Movement, and Collision: Productive Space at the Confluence of Sociology and Psychotherapy

Davidson

2023

Clinical Sociology: Research and Practice

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‘I will never love anyone like that again’: cognitive behavioural therapy and the pathologisation and medicalisation of ordinary experiences

Cited by 6 publications

References 31 publications

Towards the measurement of autistic burnout

Towards the measurement of autistic burnout

Unravelling the Dominance: An Exploration of the Relationship Between the Medicalisation of Ordinary Mental Distress, the Primacy of Cognitive Behavioural Therapy, and the Influence of Neoliberal Ideology in the UK Mental Health Economy

Impulse, Movement, and Collision: Productive Space at the Confluence of Sociology and Psychotherapy

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