"Oughtism" - Rethinking Autism, Diagnosis, & Systemic Responses in Practice
Notes de l’épisode
In this episode of The Systemic Way, we are joined by Dr Mairi Evans, Systemic Therapist, Social Worker and Clinical Director in the NHS, to explore autism, neurodivergence and the stories that shape how people are understood within families, services and wider society.
Drawing on her doctoral research with mothers of autistic girls, Mairi explores the “aha moments” that can emerge through the diagnostic journey, and what changes once a diagnosis is given. We discuss the history and social construction of autism, the limitations of stereotypical and gendered understandings, and the difference between observed autism and the lived experience of being autistic.
Mairi introduces the idea of “Oughtism” to explore the pressures placed on autistic people and their families to behave in particular ways. Through examples from family life, she considers how dominant ideas about what families “should” look like can create additional pressures, and how systemic therapists can help families develop their own ways of being together.
The conversation also explores the relationship between autism and ADHD, the limitations of linear ideas of the spectrum, the double bind created by diagnosis and service systems, and the importance of holding both neurodivergence and the wider family context in mind.
Throughout, Mairi brings together social constructionism, CMM and systemic thinking with a strong focus on lived experience. She argues for a shift away from seeing neurodivergence as specialist territory and towards making neuroinclusion “everybody’s business”.
We also consider what this might mean for systemic family therapy, including how curiosity, neuro-informed not-knowing, hypothesising and attention to family relationships can become part of everyday practice.
A conversation about diagnosis, language, family life, service design and the possibilities for a more neuroinclusive systemic practice.
Dr Mairi Evans is a Systemic Therapist and Social Worker with experience of working in social care, child and adolescent mental health, adult mental health, neurodevelopmental services and senior management in the NHS. Mairi has a professional doctorate in systemic practice, in which she focused on the diagnostic experience of autism for the mothers of autistic girls. Taking a social constructionist perspective and adopting the Co-ordinated Management of Meaning as a lens Mairi has explored the balance and relationship between co-constructed narratives (stories told) and lived experience (stories lived) for autistic people, their families and helping professionals. She has worked to connect theory to practice across health and social care organisations in order to promote connections, improve services and to reduce barriers to healthcare for autistic people and their families.
As a Clinical Director in the NHS, Mairi has an interest in stories for change in wider NHS systems and the relationship between research narratives, commissioning decision makers, service providers and the individuals that seek support.
Publications:
- Oughtism and Oughtistic Narratives in the Lives of Autistic People and their Families (gvsu.edu)
- Autism and Systemic Practice – Autism and Intersectionality: Implications for Systemic and Relational Psychotherapeutic Practice and Research (systemicautism.com)
- How do Mothers of Autistic Girls Perceive and Experience the Potential Affordances and Constraints of Diagnosis for their Daughters? (Thesis, University of Bedfordshire)
- The “Aha Moment”: Exploring autism narratives as told by the mothers of autistic girls (Murmurations: Journal of Transformative Systemic Practice)