Have We Turned Personality Into Diagnosis?

Summary

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Podcast Summary: The Opinions – "Always Late? TikTok Thinks You Have A.D.H.D."

Host: Nadja (The New York Times Opinion)
Guests: Tressie McMillan Cottam (Sociologist & NYT Opinion Columnist), Mary H. K. Choi (Author)
Date: August 5, 2026

Overview of the Episode

This episode explores the rising culture of self-diagnosing ADHD—and neurodivergence more broadly—through social media platforms like TikTok. The conversation delves deeply into how diagnostic labels can be both liberating and limiting, how pandemic-era isolation and algorithms accelerated the “neurodivergence” discourse, and the cultural and personal implications of embracing or resisting diagnostic labels.

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Key Discussion Points & Insights

1. The Rise of Self-Diagnosis and Diagnostic Labels ([01:21-04:47])

• Introductory statistics:
  • 25% of American adults suspect they have undiagnosed ADHD, but only 6% are formally diagnosed.
  • Self-diagnosis and social media trends are growing rapidly.
• Mary HK Choi’s Journey:
  • Diagnosed with ADHD first, then autism, both as an adult.
  • Her lifetime feeling of "miscalibration" between self and society, intense masking, and eventual relief and grief upon diagnosis.
• Quote:
  • "It was a complete OS update...Not only do I feel so profoundly affirmed...but then there was so much grief."
    — Mary HK Choi [05:53]

2. How Diagnosis Changes Self-Perception ([05:53-08:00])

• Mary describes an "update" to understanding herself and grieves missed opportunities or misplaced hopes.
• Recognition that patterns/behaviors (like time blindness) are not moral failings but part of her neurotype.
• Diagnosis brought surrender and peace—fewer “background tabs” open in her mind.

3. The Function, Power, and Pitfalls of Labels ([08:00-11:40])

• Tressie (Sociologist): Labels help groups make sense of "normalcy" and identity, but also create constraints and hierarchies.
• Quote:
  • "Any kind of sorting lends itself to moral judgments, to hierarchy, can become just another boundary or binary that traps people..."
    — Tressie McMillan Cottam [08:27]
• The current moment is unprecedented in how widely and quickly people expand personal identity labels.

4. Defining "Neurodivergence" ([11:40-12:51])

• Mary: Neurodivergence is not a binary nor medical term, but an umbrella—a "beautiful sort of queering term" that acknowledges diverse brains outside the norm.
• Neurodivergence resists straightforward categorization and productively disrupts binaries.

5. The Pandemic’s Role and Social Media’s Influence ([12:51-17:38])

• Adult ADHD diagnoses spiked dramatically during/after pandemic onset in line with algorithm-driven, personalized social media content.
• Isolation fueled self-evaluation and comparison.
• Algorithms began serving mental health content regardless of user intention, altering perceptions of “normal.”
• Quote:
  • "The way we manage that [social rupture] is by going online... the algorithm was pushing the idea that it was normal..."
    — Tressie McMillan Cottam [15:18]
• Social media often disseminates inaccurate information: 52% of top ADHD videos and 41% of autism videos are medically inaccurate.

6. Generational Savvy—and Where Self-Labeling Meets Meme Culture ([17:38-21:48])

• Mary and Tressie note that younger generations, though immersed in diagnostic meme culture, often distinguish internet shorthand from serious self-concept.
• Quote:
  • “I do wonder sometimes if we assign too much credulity to them... I think that we might get a much more nuanced sort of take on it…”
    — Mary HK Choi [18:39]

7. Labels as Permission Structures—and Their Limits ([21:48-26:42])

• Mary describes how diagnosis sometimes led to stultifying symptom hyper-focus—“the hamster wheel of positive feedback” about self-knowledge rather than direct feeling.
• Both guests liken viral symptom lists to horoscopes or palm reading: relatable but potentially shallow.
• Quote:
  • “It can be both really rewarding because it labels a feeling that you haven't yet finished feeling, but so broad that there's no risk in it asking you to do anything."
    — Tressie McMillan Cottam [25:48]

8. The Human Condition and Diagnostic Creep ([26:16-27:54])

• Pandemic anxiety "earned" rather than pathological, but labeling may distract from sitting with the discomfort of ambiguity.
• Quote:
  • "There is a tremendous incentive and satisfaction in naming a thing. Because it feels solved... There's a kind of gavel thwack in being like, oh, that's an ADHD behavior."
    — Mary HK Choi [27:10–27:12]

9. Diagnostic Labels in Family and Early Education ([27:54-32:00])

• Nadja shares personal family resistance to diagnosis; her mother feared it would limit her growth.
• Tressie emphasizes the importance of developmental flexibility for children—not prematurely pathologizing natural variation.
• Rigid milestones and increased structure have raised the stakes of ADHD or autism labels for kids.

10. Accommodations vs. Self-Compassion—What’s the Real Gift? ([32:00-38:02])

• Mary reflects on “ingenious” strategies she developed pre-diagnosis, and the profound solace in self-compassion post-diagnosis.
• The “boon or the salve” of diagnosis isn’t drugs or external validation but internal kindness.
• Quote:
  • “The only perk… is… with this behavioral diagnosis… all I can actually do is give myself more time, more patience, exponential amounts of compassion and kindness.”
    — Mary HK Choi [34:00 approx.]
• Tressie reframes the label as an externalized “permission structure” to prioritize self-kindness, emphasizing that the need for diagnosis reflects cultural rather than personal deficits.

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Notable Quotes & Memorable Moments

• On the double-edged sword of labels:
  "It is not an indictment of the people who do it. It is an indictment of our culture that gives people so few options to find themselves in a healthy way..."
  — Tressie McMillan Cottam [36:02]
• On naming vs. feeling:
  "There is a difference between understanding your feelings and feeling your feelings."
  — Tressie McMillan Cottam [23:26]
• On the core value of diagnosis:
  "All I can actually do is give myself more time, more patience, exponential amounts of compassion and kindness."
  — Mary HK Choi [34:00 approx.]

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Timestamps for Important Segments

| Segment Description | Timestamp | |----------------------------------|--------------| | Statistics on ADHD prevalence and self-diagnosis rise | 00:54–01:21 | | Mary HK Choi’s diagnostic journey | 02:19–05:49 | | The meaning and impact of labels | 08:00–11:40 | | Defining neurodivergence | 11:40–12:51 | | Pandemic, algorithms, and the self-diagnosis boom | 12:51–17:38 | | Generational dynamics & meme language | 17:38–21:48 | | Performance vs. processing of feelings | 21:48–26:42 | | On childhood diagnosis and developmental flexibility | 27:54–32:00 | | The true “boon” of diagnosis—self-compassion | 34:00–36:02 |

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Tone and Conversation Style

• Warm, candid, gently humorous, and deeply thoughtful.
• All participants blend personal anecdote with social analysis.
• The conversation relaxes into both seriousness and accessible asides, with moments of laughter (“I do have a favorite spoon” [25:31]) highlighting the everyday absurdities of seeking identity through broad online criteria.

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Final Thoughts

Through insightful personal stories and sociological context, this episode offers a nuanced reflection on the complexity of labels, the effects of the pandemic and social media, and the ultimately human need for permission to treat oneself with patience and understanding. It resists easy binaries—between self-diagnosis and formal diagnosis, or between liberation and limitation—favoring a more ambiguous and honest grappling with identity, suffering, and the modern search for meaning.

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Transcript

[Tressi McMillan Cottam]

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[Tressi McMillan Cottam]

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[Nadja]

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[Jonica]

There's an aspect to this where I

[Tressi McMillan Cottam]

think the list of things like, oh, you have a. Do you not like loud sounds? Do you have a favorite spoon? That one got me recently. I do have a favorite spoon, as it turned out, and I do only eat out of favorite spoon.

[Jonica]

Thank you. And I'm like, if this is the diagnostic criteria, right,

[Nadja]

A quarter of American adults suspect that they have undiagnosed ADHD, but only 6% have a formal diagnosis. So what's going on?

[Mary HK Choi]

Tell me you have ADHD without telling me you have adhd. I'll go first.

[Tressi McMillan Cottam]

Put a finger down. If you leave things half open, like

[Progressive Insurance Advertiser]

cabinets, drawers or doors,

[Mary HK Choi]

I will procrastinate

[Nadja]

an assignment for like two weeks, but then somehow get it done in two hours. And if any of these sound like

[Tressi McMillan Cottam]

you, you probably have ADHD too.

[Nadja]

With self diagnosis on the rise, I started to wonder, when is a diagnosis liberating and when is it limiting and what compels us to label ourselves at all? I spoke with opinion columnist and sociologist Tressi McMillan Cottam and author Mary HK Choi, who has written about being diagnosed with autism and adhd. Tressy Mary, thank you so much for being here with me today.

[Mary HK Choi]

Thank you for having me.

[Tressi McMillan Cottam]

It's a real pleasure. Nadia.

[Nadja]

We're going to be talking about neurodivergence and diagnostic labels like ADHD and autism. And what interests me in that conversation is these systems that we use to understand ourselves and how they change our self perception and sometimes our lives. So Mary, you. You were diagnosed with ADHD and then with autism, both as an adult. And I was wondering if you could start our conversation by telling us a little bit about your journey to those diagnoses and what they allowed you to understand about yourself that you maybe didn't have words for before.

[Mary HK Choi]

Yeah, totally. I mean, this happened in my early 40s, which is to say that like, you know, I do think that there was this suspicion my whole life that something was, I mean, not like amiss, but like in my 30s, at some point I was like, I don't get invited to weddings. And I was like, what is that? And I was just like. And then it was like the dual thing of, like, and I don't want to go to any weddings. And so I was just like, okay, that's a thing. And I sort of like, set that aside. But there were these, like, kind of schisms or these things that I really believe that like, held me apart from other people. And I didn't really know what that was, but boy, was I working really, really hard to make sure to mask those qualities. And so some of that is just kind of like people pleasing or just like this almost like preternatural sort of receptivity to what I think you will do. And so, you know, that made for a lot of, like, really ill advised, long monogamous relationships. It made for, like. Cause there's a lot of safety in that just being, like, we're together. I'm using this other person as a human shield. It's gonna be fine. So that sort of thing. But at a certain point, like, more specifically, when my dad got sick and he passed away, there was just such a torrential sort of like, seismic reorganization of my thinking. And so I was like, not only is it weird that I can't seem to reconcile how death works, and I'm sure this is not like a unique proposition, but, you know, because no one significant in my life previously had died before, which is also incredibly rare to, you know what a gift like to be in your 40s before you suffer that kind of, like, grievous loss. But when he died, I was so caught up in masking, and what that looked like was, okay, well, my mother is closer to my dad. She's known him longer, so she gets to be this, this. This degree of sadness. And then my brother, because he's the masculine child, like, and he has sons, like, he. He gets degree for his father this amount. And I just kept crunching on this, like, in this, like, really, like, recursive way, like, how do I figure out with these two data sets how I'm supposed to feel? And then I was like, were you

[Nadja]

figuring out how you were supposed to feel or were you figuring out how much you were allowed to express? Was it internal or was it about external expectations?

[Mary HK Choi]

I mean, I wish it was just external expectations. The fact that it was entirely internal is the. Is the thing that I found so disquieting where I was just like, fam. Like, you just want to know for yourself how much you are allowed to miss this person. And then I was just like, okay, something's weird. And at that point, I started looking into, as one does, social media. So I immediately went to an authority, aka TikTok, and then from there, I sought actual diagnostic assessment. Yeah.

[Nadja]

What came first for you? Your diagnosis for autism or for adhd?

[Mary HK Choi]

I was assessed for ADHD first by a psychiatrist, and then afterwards I was formally assessed for autism, but they were having a two for sale. So, like, I got assessed for ADHD at the same time. And so ADHD first around five years ago, and autism was about, like, three and a half years ago.

[Nadja]

And how did that retroactively change your understanding of your life?

[Mary HK Choi]

I mean, it was a complete OS update. I mean, not even an OS update. It's not like, you know, going from one to another. It's like, you know, like Sequoia from Panther. It was just like I was like, oh, my God. Like, not only do I feel so profoundly affirmed in the fact that, like, I knew it was weird that I had time blindness, I knew it was weird that I have absolutely no sense of direction, like, to the point where I can get lost on my way home to a home I've lived in for 20 years. Like, if there's any sort of aberration in, like, I could meet you once, and if you got a haircut, by the next time I saw you, I would know you got a haircut. Like, I can tell from a person from behind. Like, my pattern recognition is, like, really, really potent. The way I store information is really specific. The way I even tell a story is very peripatetic. It's very nonlinear. And it also answered a lot for, like, why I didn't feel close to a lot of people and why, when I was with a lot of people, even though I'd known them for such a long time, where I felt completely closed off and exhausted. And so that was, like, really helpful. It explained so much for me, and it, you know, affirmed so much for me. But then there was also so much grief. You know, I think there was, like, a childlike belief in my heart that, like, befriending people or keeping friendships would become easier or that, like, my sense of direction would improve. When I'm, like, a grownup, meanwhile, I'm in my 40s, you know, and so there is a lot of grieving those hopes in certain ways. But that's also really beautiful because there is so much, like, surrender and there's so much sort of, like, peace and that kind of reconciliation. At least like, you know, at least those like CPU aren't being eaten up by all the tabs being open for all the things I'm waiting on to get better.

[Nadja]

That's really interesting and I think touches on sort of one of the central questions I have as we think this through together, which is like, in what ways can a diagnosis be liberating, and in what ways is it limiting? And Tressy, you're a sociologist. How do you. You think about labels and the ways in which they limit us, how they liberate us, how we use them to categorize ourselves and each other?

[Tressi McMillan Cottam]

Well, the, you know, the basic definition we give to people when they're like sociology is they like social work is that, you know, sociology is quite literally the study of groups and societies. And so when it comes to labels, it's one of the ways that we sort ourselves into our groups and we determine what's normal, which all I hear in a lot of what Mary has said is a misunderstood miscalibration between her internal state and what is considered normal or normative. But as a sociologist, for me, everything happens in a context. And I think labels maybe do their best work their most, what we might call, like, functional work, positive work, pro social work, when they help us figure out ourselves in a way that gives us a better way. Yes, to talk about ourselves, to talk to ourselves, to recalibrate our expectations for ourselves. You know, the flip side, however, of a label is that any kind of sorting lends itself to moral judgments, to hierarchy, can become just another boundary or binary that traps people in a group that does not feel normal to them. And those things can change over the time. And I think one of the things that we are experiencing is just like a moment of, like, rapid change in how people identify themselves and how many people feel empowered to identify and sort themselves. These are things that are still actually pretty new in the long Duray of history. And we're just in an era where I think we are renegotiating which labels are available to us and kind of expanding the repertoire. And the good side is, for a lot of people, that it's going to be empowering. It is going to help them make sense of their world if done uncritically, though I do think it will do the opposite too. It is going to make more people feel left out or out of step with what is expected to them and can create more anxieties about what are the right ways to act and think and feel, when really the answer is there isn't a right way to think or act and feel. But everything to my mind always has a little bit of both.

[Nadja]

Yeah, I want to pivot and dig in specifically on the label neurodivergence because I've, I have been hearing it so much more recently and was interested when I was looking up the origin of the term. It was introduced in the late 90s by an autism rights activist, but really gained steam during the pandemic. Like if you do a Google trend search on the word neurodivergence in 2020, it just takes off and we are right now in peak neurodivergence as I understand it. And maybe, Mary, I'll ask you to give your definition to. But as I understand it, neurodivergence is not a medical term. It's an umbrella term that can hold lots of different diagnoses and ways of being that differ from the norm that just says an umbrella term for this person's brain is a little bit different from the sort of normative brain as we think of it. Is that how you would define it? How would you define it?

[Mary HK Choi]

So neurodivergence, as I understand it, as I experience it, is also just basically like, it introduces this not, you know, especially specifically with autism, that it's not like a gradient. You know, it's not like you go from low support needs to like high support needs and that's that. It's like, you know, there is this saying in the autism circles where it's like, if you've met one autistic person, you've met one autistic person. And so the profile is very much this three dimensional sort of constellation where it's not this like left to right with like, you know, like extremity or anything like that. So neurodivergence, I think, is. It is this like beautiful sort of like queering term where it's just basically like it's not a binary. And so that to me is really, really helpful. So it's just like kind of for me, a launching pad and being like, okay, well this is the baseline information I have. And then from there I can add the colors to the tapestry of my own mental stuff. Like, you know, it's just, it's a, it's a beginning place, you might call it. Yes. And in improv,

[Nadja]

looking at the data, something happened around the time of the pandemic, but it's not clear why or what exactly. There's a Canadian study out of British Columbia that found that the rate at which adults were diagnosed with ADHD more than doubled during the pandemic, and then starting in the summer of 2021, nearly quadrupled from the pre pandemic rates. And I'm just curious, Jesse, what was happening around the time of the pandemic that we both started talking about neurodivergence online and saw started seeing this increase in adults being diagnosed with adhd?

[Tressi McMillan Cottam]

Yeah, the spike in adults, the start of that trend of adults being diagnosed with ADHD lags and mirrors the same sort of pattern that we saw happen with children. And I think actually those two things are related. So these type of, like, cultural transformations always happen within a context. And so it is not a surprise to me that during COVID what we really mean is during COVID shutdowns, right? The social isolation, the social distancing, everything that came with that, you know, horribly fraught period between Covid becoming a global phenomenon and the first vaccine, everything about that moment isolated us in the real world, cut us off from our social systems, broke us from our routines, and then funneled almost all of our energies, our performance of ourself, our connection with other people, through the Internet. Right. We're working on zoom. We're doing zoom school. Right. At the time, there were lots of studies about, like, Instagram face and Zoom face during this moment, because we were watching ourselves, some of us for the first time at that, with that kind of concentrated focus. And it. And it skewed our perception of how we looked. And so you see an uptick in interest in things like cosmetic surgery and face filters. I think the same thing is happening with the idea of our mental health, which is that a social rupture produces a lot of anxiety. The way we manage that is by going online. And one of the things that had happened by the time we were all going online in 2020 that had not been true even four or five years earlier, is that the algorithm made the Internet feel personalized and delivered then these ideas to you. Not because you had been up thinking last night like, hey, is my, you know, is my hyper focus maybe an indication that I could use some, you know, medical intervention?

[Jonica]

No.

[Tressi McMillan Cottam]

You were sitting there shopping or watching the CDC announcement on TikTok and Instagram, and the algorithm decided to expose you to the idea that, hey, if you do these five things, you may have ADHD or ADHDers be like and normies be like this. Right. That whole framing, the algorithm was pushing the idea that it was normal and changing people's expectation at a time when people were extremely anxious about everything and did not have a lot of ways to figure out what was normal, what the options were. And we just had so much more time to do the self assessment, to obsess with ourselves in a way that usually work and commuting and school and everything would have distracted us from. So I think Covid is a very, very big part of the story about adults seeking, if not a formal diagnosis, a medical label that would have some sort of coherence in a time of great upheaval.

[Nadja]

I mean, I want to make clear that like a medical diagnosis of any kind, especially mental health diagnosis, is important. It can be life saving. It can allow access to treatment, to medication, to accommodations that people need. And I want to make a separation between talking about that and sort of talking about a phenomenon that we're observing online because I think that what you're talking about is very true, Tressy, that there's these social media videos that throw around medical terms without necessarily being medically sound. There's a study that showed that 52% of the top performing ADHD videos and 41% of the autism videos contain inaccurate medical information. I collected a few just because I was curious. According to social media, these are symptoms of autism. Liking the sound of a hairdryer, feeling tired after socializing, having very strong opinions, looking up the menu at a restaurant before going to it heavily, researching a product before buying it, having a high pain tolerance, having a huge compassion for suffering, having only one or two close friends instead of many close friends. I just, I feel like there's, it's, it's, it's within the capacity of the algorithm to want to tell us about ourselves and it is changing how we think think about ourselves. And to me that's really interesting.

[Mary HK Choi]

I do wonder though, you know, like, you know how like Gen Alpha and everyone's worried about their Internet consuming habits and the manosphere and this, that and the other. And like, you know how Gen Alpha doesn't know Juice WRLD is dead? You know, like all of these different things.

[Nadja]

Wait, I don't know about this. What is Juice wrld?

[Mary HK Choi]

Oh, I don't know what it is

[Nadja]

and I don't know he's a rapper,

[Mary HK Choi]

but he appears in different sort of like video game based places where it doesn't make a difference to them if he's alive or dead because they still have access to like his avatar or his, you know, skin or whatever.

[Tressi McMillan Cottam]

I don't think that I know anything about this, by the way, Nadja, so it's okay.

[Nadja]

I'm grateful to you for bringing me more Online. Thank you, Mary.

[Mary HK Choi]

No, I just say this to say, but if you were to actually talk to these kids and be like, how much do you believe this? Or how seriously do you take this? They know.

[Tressi McMillan Cottam]

So savvy. Yep.

[Mary HK Choi]

And so I do think there's.

[Tressi McMillan Cottam]

However, yes, the parents are a little too incredulous, but, yeah, the kids actually are pretty much aware of the. The concept.

[Mary HK Choi]

So I question, like, for anyone who's even written, like, autistic or like, oh, my God, that's me. Like, I do wonder sometimes if we assign too much credulity to him, to them, and if we were to ask them, do you actually seriously consider yourself to be autistic? I think that we might get a much more nuanced sort of take on it or a much larger conversation rather than lol. I love blow dryers.

[Tressi McMillan Cottam]

So therefore I'm autistic. And I. That's my instinct too, Mary. Not just generationally, but I think there is a difference between the shorthand that develops in, like, Internet speak. You know, there's a language of the Internet that lends itself to identifying, self identifying, because that is the way you speak back to the algorithm. Right. This is the communication method, by the way I identify. The things that I allow to capture my attention is my interaction with the algorithm. And it gives me some sense of that, that the algorithm is accurate. Right. Because it is responding to the things that I have inputted, I've input, even though that may not necessarily be true anymore, that lends itself to, yeah, maybe taking on labels that don't in any way shape how you actually see yourself or the decisions you make in your life. But we aren't exactly clear on the line between, you know, fun shorthand and the way the concept creep of these terms can take up resonance in your mind, even if you do not think that they have done so. My friends have been joking with me for quite some time. For the record that I am neurodivergent or neurospicy, as my friend Jonica likes to say. Shout out to Jonica, who does have an official diagnosis, which is very hard for women, which is shout out to Mary. Almost impossible for black women, which my friend Jonica is. And so we have talked very openly about this and her journey of getting a medical diagnosis. And every step along the way, she has come back wanting to report to me that she is pretty sure that I too, am on the spectrum.

[Jonica]

And I'll tell you what I told Jonica.

[Tressi McMillan Cottam]

Jonica, girl, I don't have time for a new way to understand myself. Right.

[Jonica]

Like, I don't discount that it may be absolutely true. I'm saying I do not have the bandwidth at this time to figure it all out.

[Tressi McMillan Cottam]

I've gotten this far. I'm just gonna ride it out. But I do think there are a lot of people who are in that sort of mushy middle. Well, you know, it might be fun. It might even be a little clarifying the way your horoscope might be. Some days you don't believe in it, but hey, that is really timely today. I do need to pay attention to my deadlines a day if I want to attribute it to Mercury retrograde in a quick joke to my friends in group chat. Fine. But that doesn't necessarily signify that I have changed how I think about myself. I would be really interested in parsing out the difference between our shorthand driven by Internet speak and the real changes for people who find either self diagnosis or community or self identifying as neurodivergent really impacted their everyday life.

[Nadja]

Yeah, I was reading one of your substacks, Mary, the one called why I quit Therapy. And I know this is just your experience, but you were saying that to some degree the diagnoses had also like, caused you to sort of hyper focus on symptoms in a way that had felt like perhaps you needed to take a step back from it. And I'm curious if you can talk a bit about that.

[Mary HK Choi]

Yeah, I mean, there's an aspect to it that is incredibly stultifying. And there is a aspect to it. To your point, trustee, what you were talking about the pandemic and isolation where, you know, people talk about dissociation all the time. Right. And like, sometimes I really do be like, jettisoning out of my body, being like leaving that body for dead, where it's like, it's just me and my brain now. Like, it's all pure cognition. And like, for me, talk therapy, even something like cognitive behavioral therapy, like, it got to a point. And I also did like 12 step. I've taken my own inventory. Like all of these things where I'm just like, by God, like, how much more do I need to parse the like, sort of like effluvia of my own personhood? I don't think I need to be in therapy to identify how I'm feeling. You know, alexithymia, which is an inability to really recognize emotions within yourself or feelings within yourself, is an aspect of autism that I do also have. And so I was just like, you know, I think that time is better spent for me, really sitting down and like sitting with a thing that I suspect to be sadness without curing it, labeling it, understanding it, you know, routing it back to some sort of childhood phenomenon or something that happened to me and just being like, apparently you're sad.

[Tressi McMillan Cottam]

Yeah, I think that is so important. I do think this. I've been thinking about this a lot. I've been working on this memoir that in part deals with why the psychologicalization of the culture did not in any way empower me to better understand or to make better decisions in my family unit. That there is a difference between understanding your feelings and feeling your feelings. And understanding can have so much positive feedback attached to it, right? Your therapist gives you an atta girl. Your friends tell me, ooh, girl, what did you figure out today? And you get to unpack it with them over a little martini or you know, know whatever your thing is, right? You've got this new and exciting story to put on, you know, the grammar and TikTok. And it's really hard to come up with new content ideas. So that's great, right?

[Jonica]

There's just a lot of positive feedback

[Tressi McMillan Cottam]

loops to understanding your feelings. I think a lot about the trend, especially among adults, especially during this time of COVID which I just think is a social rupture. And anything that accelerated during that time deserves like our critical eye, not because it's necessarily bad, but let's just think it through. And it happening during that moment gives me some pause to think about how much of this is about people avoiding the feelings. Right. And getting into the hamster wheel of the positive feedback of performing, how well they understand their feelings. And I do think that matters because we're not exactly sure how much of things like this, you know, the list she just gave me, it reminds me of, you know, you go to the, you know, the state fair and there's somebody there who'll read your palm, you know, as a palm reader or something. And you know, they look you up and down and they're like, you have major decisions, decisions in your life and you need to resolve things with your mother. And you're like, then you go home, you think about it, you're like, well, I'm a 40 year old woman.

[Jonica]

What 40 year old woman doesn't have major things in her life and needs to have a serious talk with her mother, right? So there's an aspect to this where

[Tressi McMillan Cottam]

I think the list of things like, oh, you have a. Do you not like loud sounds? Do you have a favorite spoon? That one got me recently I do have a favorite spoon, as it turned out. And I do only eat out of balloon.

[Nadja]

I also have a favorite spoon.

[Jonica]

Thank you. And I'm like, yeah, me too. If this is the diagnostic criteria, Right.

[Tressi McMillan Cottam]

It can be both really rewarding because it labels a feeling that you haven't yet finished feeling, but so broad that there's no risk in it asking you to do anything. Right.

[Jonica]

Because what am I supposed to do

[Tressi McMillan Cottam]

about my favorite spoon?

[Jonica]

I'm just gonna keep using my favorite spoon. And I think that trap keeps us

[Tressi McMillan Cottam]

from dealing with how much some of our anxiety is just earned. It is an earned, real response to anxious times.

[Jonica]

Right. Covid was anxiety producing. It was hard and it was challenging. And maybe, just maybe that's okay. Totally.

[Mary HK Choi]

But also, the human condition is really tough and it's hard.

[Jonica]

The Buddha came up with the whole thing. The Buddha said to us, right? Suffering. Attachment is suffering, Right? Yeah. This is the human condition.

[Tressi McMillan Cottam]

And I'm not sure that sometimes the way we treat the self labeling and the labeling of others helps us in that condition.

[Mary HK Choi]

I will say, though, that the other thing, too, kind of like, not to put a button on it, but it is. There is as a dopamine seeking brain and as all of us dopamine seeking people, whether like, that, that sort of thing is regulated or not, there is a tremendous incentive and satisfaction in naming a thing.

[Tressi McMillan Cottam]

Yeah.

[Mary HK Choi]

Because it feels solved.

[Tressi McMillan Cottam]

That's right.

[Mary HK Choi]

The taxonomy is great. Like, not only giving yourself agency to call yourself something, but to be like, and now I'm done. There's a kind of a gavel thwack in being like, oh, that's an ADHD behavior. That's an autistic behavior. Rather than, I am actively being challenged in this moment. I do not know if I have the resources to figure this out. I am so deeply, deeply isolated and uncomfortable. Rather than, I'm outy hd, slap it on the bio. Other people are like, yay, us too. It's like, you know, a chorus of minions. And then that is just like a different serotonin dopamine moment than just sitting with that horrible feeling of, like, absolute ambiguity.

[Nadja]

I want to go back and catch something from earlier because we were, we were talking about, oh, the young generation, they don't take these things so seriously. They can tell the difference between an autism video that is using the like, that is not medically sound. And they don't take it too seriously. But, you know, there's a. There's a survey from last year that shows that nearly a third of American adults And half of Gen Z adults report having self diagnosed themselves with a mental health condition because of stuff they saw on social media. I think it is really widespread. I mean, I've. I am susceptible to these videos. I think I have ADHD from. I cannot focus on a task for very long. I want to be thinking about lots of different things at once. And then when I meet my friends, I have friends who like, have many more symptoms than just the ones that I see on the Internet. And I'm like, you really need medication in order to function in a work, in a work office environment in a way that I do. And I understand your diagnosis as something different than something that I'm diagnosing myself with based on a couple traits on the Internet. And to me, I see those two things as separate. But for me, this feels really personal, this question, because it's something I've thought about my whole life. My family, my, my nuclear family. I would say absolutely none of us are neurotypical. But my French mother has always been very, very against the idea of any kind of mental health diagnoses. And especially when myself, yeah, especially when my sibling and I were younger and I think exhibiting behavior that could have lent itself to a mental health diagnosis and intervention. She really didn't want us to feel limited in our capacity to become our full selves by giving a single word to what we were. I mean, you, Tressi, when you're like, I resist this. I don't want to be labeled in this way by my friends, even though I see myself in so many of these descriptions. How do you think that through?

[Tressi McMillan Cottam]

That's a great question because I think some of what your mother. I really, my gut really leaned into your mother's perspective on this, which is that it could even be useful in some sense. But when a child is still developing, unless the behaviors are getting in the way of that development, development is not linear. I actually am not entirely sure it matters if a child can read aloud from the picture book at the end of kindergarten. And maybe it's okay if it doesn't happen to second grade. And that we used to have far more flexibility at the classroom level in schools for those determinations to be made right when there wasn't a whole bunch of standardized testing and teaching to a test a teacher could go, okay, Tressy, you read really well, but you cannot get the round item into the square hole. And yet you keep trying. That was a real thing that happened to me. I almost flunked kindergarten because I couldn't cut a piece of Paper in a straight line. This was an assessment for whatever reason,

[Jonica]

but I could read at the sixth

[Tressi McMillan Cottam]

grade level, and a teacher could assess that and go, okay, you're probably fine. It's going to shake out by high school.

[BetterHelp Advertiser]

Right.

[Tressi McMillan Cottam]

The idea that all of that flexibility has left our children's lives. Children's lives have become so structured that the stakes of the diagnosis seem really out of whack with the possible benefits for a lot of people and families. And so I think as an adult, what I was dealing with is that I come from that time when there was so much more flexibility for me to develop in my own way, and the milestones weren't so rigid. And I think that, you know, having come up with that worldview, I'm not really willing to give it up just yet. Something about it just didn't quite sit well with me. That is not to say that I reject it, however, again, from my friends, and that I won't necessarily reconsider. But that was my gut. I think my gut was much more like your mother's and Mary.

[Nadja]

We're reaching the end of our time at Mary for, like, a hypothetical if. There was a. If we could imagine a world in which you never received a diagnosis, but Somehow in your 40s, a friend or a therapist suggests these behavioral interventions of, like, maybe you don't have to go to parties you don't want to go to, and maybe you can wear earplugs in loudspeakers. That's radical.

[Jonica]

Are you telling me, Nadja, I don't have to go to parties I don't want to go to?

[Nadja]

Only if you get diagnosed, Tressy, without a diagnosis, you have to go to the party.

[Tressi McMillan Cottam]

Well, this changes everything.

[Jonica]

Thank you very much. Okay.

[Mary HK Choi]

That's the hidden accommodation. Yeah, totally. No, I mean, like, it is true to your point. It's like, I understand the thinking behind that, too, and I agree. If you were to get a full behavioral diagnosis from a clinician and that affords you certain accommodations in school, who is to say if those accommodations, again, that largely are one size fits all, which is you get more test time or you get more this, or you have this remedial class with other kids, like, that is also not for you, and it could affect you in adverse ways that we absolutely do not know. And in my particular circumstance, because I wasn't diagnosed until later, it was edifying and clarifying to see all these really sort of meticulous and hilarious Rube Goldbergian ways that I had organized my life with the routines or the Systems and things like that. And a lot of those were ingenious and a lot of those actually do sort of point to my like acuity and faculties and other places where those skills outpace like an allistic person or like a non autistic person. And that I do derive a great deal of pleasure and esteem from. But really the only perk for, for self identifying or being formally assessed as an autistic person is because it is not a drug seeking behavior. Because unlike adhd, there is no amphetamine that I'm trying to get. With this behavioral diagnosis of, of self evaluating, all I can actually do is give myself more time, more patience, exponential amounts of compassion and kindness. You know, like there was a moment in which I was just like, you know, I'm woo woo. Like I do like inner family systems, I do inner child work, all this stuff. I'm just like, oh, my inner child has like very special needs. Like and I never got that until my 40s. Like I felt unloved, but even by my parents and so that it's not my parents fault entirely. Like that affords me more compassion for them. Like it's just like, oh, like I wasn't ruined by my parents immigrant experience and workaholism. It was a factor in the way that I received love and was like, and you know, again, it's hereditary symptoms. I'm just like, are you neurodivergent? Can I give you more compassion and understanding? And so really the only the boon or the salve of it was the fact that I was just like, okay, I can be less unkind and I can be less demanding of myself and I can be less perfectionistic or hard on everyone. And so for me that's been like an incredible gift that is so profound.

[Tressi McMillan Cottam]

That really is.

[Nadja]

Yeah, yeah. Trustee. I wanted to ask you, you as well, like, what is it about labels and the ways in which we label ourselves that that can be liberating?

[Tressi McMillan Cottam]

Oh for sure. I mean a label is a possible shortcut, yes to you know, foreclosed possibilities, thought terminating cliches. But it can also be a for you to give yourself a permission structure, which is what I kind of hear in Mary that feels so profound that for some of us how we are socialized, the repertoire of identities that we inherit from our families, from our communities may not have a costume in it for us. Right. And so maybe it takes something as medical sounding as a diagnosis to give ourselves the permission structure to be kind to ourselves. Maybe that's what it takes for some of us. Which I think is not an indictment of the people who do it. It is an indictment of our culture that gives people so few options to find themselves in a healthy way with reasonable risks that we would go through instead. This whole process, it is not easy to get a diagnosis. I'd even argue there are downsides to self identifying as such. Right. It can kind of come with a lot of judgment and it can come with jokes and things, though, that can diminish your experience. I think it is an indictment of a world that for some people, that feels more reasonable than just saying, maybe I'm gonna be kind to myself today. Maybe I'm gonna give myself more time to get where I need to be. Maybe I won't rush. Maybe I'm worth the extra steps in my process that it takes for me to get out of the door in the morning. I just find that really profound and not a process that necessarily needs the label, but that we have produced labels that engender that kind of permission structure says something about where we are, what we need, and the people who need it and who benefit from it.

[Jonica]

Yeah.

[Nadja]

That's beautiful. Well, thank you both so much for talking about this with me today. I really appreciate how much you've shared both of your intellect and of your personal experiences. It's been really wonderful to talk about it with both of you.

[Mary HK Choi]

Thank you for having us.

[Tressi McMillan Cottam]

This was a lot of fun. Thanks for having me.

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