Creating Difference with Support Workers and Mentors in the Therapeutic Process

• A diagnosis in and of itself is a marker of difference between the wearer of the diagnosis and those people who do not have to wear that diagnosis.
• Some diagnoses are transitory whereas other diagnoses are permanent – markers of difference in transition as opposed to markers of permanent difference.
• DSM is the institutional record of legitimate differences in this domain and their dollar value.
• A difference not listed in DSM is not legitimate and of particular relevance it does not have a dollar value.
• The relationship between difference and inequality is important. The argument is that difference is naturally occurring in the human population, and inequality is the collective value imposed collectively upon that individual difference – individualism and collectivism become confused in this space, a mirror into the confusions of logic referred to in Russell and Whitehead’s Theory of Logical Types.
• The idea abroad that inequality is naturally occurring is incorrect and cannot be sustained philosophically or mathematically – Rawls refers to inequality in this way in A Theory of Justice – he was wrong notwithstanding the fact that the rest of his thesis is correct and stands the test of recent time.
• Difference is a mathematical-computational proposition central to the organisation of being human – recent scholarship in this domain makes a significant contribution to our understanding of difference in biological and social organisation and as such in therapeutic practice. (Soren Brier, Gordana Dodig Crnkovic)
• How difference (with a dollar value) transposed as inequality is managed in the therapeutic process is fundamental to how we think about ASD and manage this diagnosis and people with this diagnosis in the therapeutic setting – this most certainly applies to other non transitory diagnoses (Psychosis)
• The dollar value of difference made manifest by the DSM legitimises our interaction in the therapeutic process with people carrying the diagnosis and it legitimizes their therapeutic and other interaction with us.
• The nodal point in all of this is the intersection between, or perverse interface of, difference, inequality, therapeutic practice, and money. There may well be other lines of clinical, commercial, or political discourse that run themselves into and through or across this perverse interface face or into this nodal point.
• Notwithstanding such intellectual rhetoric, the point being made is simple – reversal, the inversion of inequality is at the heart of all things good in the management of the therapeutic process with clients diagnosed with ASD or similar.
• The task of the lead practitioner is to make such inversion manifest and real in the three-cornered relationship between a support worker, the client, and the therapist.
• This is not all smoke and mirrors – this is about having a robust analysis and understanding of inequality and how inequality is functionally present in the relationship between responsibility and authority in the therapeutic process between all of us – that there is no therapeutic process that does not peddle some version of the relationship between responsibility and authority.
• The inversion of inequality in the therapeutic process, is about the way in which responsibility and authority can be manipulated backwards, turned upside down, turned inside out, reverse engineered, so that all dissonance in relationship to inequality as authority and responsibility is dissolved into something that looks like nothing, a chimera – for the moment.
• In fact, what happens with such a therapeutic arrangement with support workers in place in the moment, is the dissolution of inequality back into naturally-occurring difference.
• Naturally occurring difference in that therapeutic moment seems to lose its dollar commercial value – just for a moment – producing incredible fluidity and dexterity that is cognitively clever, that is in fact collective cognition at its best.