HThere’s a phrase I often hear in the office, especially from adults who received a late diagnosis: “Suddenly, everything made sense.” In recent weeks, it was said by an Olympic champion. Chloe Kim, the American snowboarder with three Olympic halfpipe medals, said she recently discovered she has ADHD. “For years I struggled, but when I finally opened up to my doctor, it was like everything suddenly clicked into place.” He explained that he lives off lists, cell phone alarms and fixed routines, and that in the halfpipe you can’t be distracted in the air. The news reached the Portuguese press a few days ago.
Before thinking about the phrase, it is worth saying where it was said. Kim disclosed the diagnosis as part of a paid partnership with the pharmaceutical company that sells the medicine he takes, announced in a statement at the end of August. None of this makes your suffering any less true, nor the relief any less real. But remember that a diagnosis, when it enters the public space, rarely circulates alone: it carries with it interests, treatments and a certain illusory promise that, once the name is found, the rest will be resolved. In the European Union, advertising of prescription-only medicines to the public is prohibited. In the United States, it is permitted.
Relief deserves to be taken seriously. Many neurodivergent adults have spent their lives being told that they are distracted, lazy, disorganized, or strange. They constructed explanations about themselves based on these other people’s words, and almost always overwhelming explanations. A well-made diagnosis can dispel part of this accusation. What was previously read as a character flaw now has a different meaning. For someone who has spent years and years blaming themselves, this is not insignificant.
Freud often used a word to describe the way the psyche deals with time: Nachträglichkeit, which is usually translated as “a posteriori” or “only afterwards”. Old experiences and memory traces are remodeled later, when a new experience or a new phase of life gives them another meaning and another effectiveness. Diagnosis in adults is reminiscent of this movement. School grades, last-minute assignments, the feeling of always being one step behind: none of this happened any other way, but the memory you have of them changes its meaning and weight. This is why the phrase “everything fell into place” is so common. Whoever says it is discovering something new about an old thing and, at the same time, rewriting history itself. There is, however, a difference: in Freud, this work is mainly unconscious and often focuses on childhood experiences; in diagnosis, it is a conscious word, coming from outside, that reorganizes the past. It’s an analogy, and it’s worth reading it as such.
This is where the work begins, however.
A rewrite can free you or it can close you too quickly. When all the pieces fit together, the temptation is to stop looking at them. The ADHD goes on to explain the difficulty in starting tasks, but also the anger with the father, the relationship that ended, the fear of failing. Some of these things will, in fact, be related to how attention works. Others ask for another reflection. A name that explains everything stops helping us think.
There is also a second, more subtle movement. In “Mass Psychology and Analysis of the Self”, from 1921, Freud described a form of identification that can arise from the perception of a common quality with another person, without that person being the object of sexual drives. The more important this common quality is, he wrote, the more successful this partial identification can be, and can thus be the origin of a new bond. This is what is happening today in the communities that form around a diagnosis, on social networks and beyond. They have a lot of good: they break isolation and give words to those who didn’t have them. But Freud called it, precisely, a partial identification: it is based on a single quality. When a person starts to recognize himself above all for himself, the rest of him risks being left without a place.
High-level competitive sport offers a rare example here. For years, Chloe Kim has been described as a prodigy, capable of maneuvers that require absolute precision in the air. After all, what seemed like a natural gift also had behind it a permanent effort of organization. This says a lot about what many neurodivergent people do every day without anyone seeing: they compensate, they adapt, they “put up with it”. There is enormous intelligence and strength in this effort. However, there is also a brutal tiredness. It is often when this effort stops arriving – in a job change, the birth of a child, the end of a career – that the person seeks help and the diagnosis appears.
The diagnosis can open the door to a space where this tiredness can finally be expressed and elaborated: the psychotherapeutic space. It can also be the moment when someone, relieved, decides that they already know everything there is to know about themselves. The difference between one thing and another is not in the name, in the diagnosis, but in what is done with it.
At the clinic, what interests me most after a diagnosis is the following question: now, what do you want to do with this? For some, it is authorization to ask for help without shame. For others, it is the possibility of talking to those who are experiencing the same thing. For many, it is the beginning of a conversation about what was left unsaid during the years when the explanation was different. It was with this in mind that we created, at Mentanalysis, online therapeutic groups for neurodivergent adults: a place where common quality serves to create a bond, without anyone being reduced to it, and where we think together about what the diagnosis explains and what it leaves unexplained. The name gives ground. The path remains to be done.
Declaration of interests: the author is the clinical director of Mentanalysis, which has the online therapeutic groups for neurodivergent adults referred to in this text.
