The Problem with Deficit-based Psychology
Why the world still gets neurodivergence wrong.
The misunderstanding didn’t start with malice. It started with theory.
Many people—both within and outside the field—don’t fully realize how much of what we treat as settled psychological science is, in fact, interpretive theory. These frameworks were originally designed to help categorize and manage observable behavior, not to explain the underlying architecture of cognition. But over time, their practical utility has been mistaken for explanatory depth. What began as provisional tools for navigating complexity have gradually been institutionalized as truth.
This has consequences. Because when your foundation is misaligned—not structurally false, but fundamentally incomplete—every framework built on top of it inherits that distortion. The result isn’t immediate collapse. It’s a slow, systemic warping of understanding. And the weight of that distortion falls hardest on the people being interpreted.
Behavior ≠ Cognition
Perhaps the most damning evidence against deficit-based pathology is the field-wide, rarely questioned assumption that clustering observable behaviors into diagnostic categories constitutes scientific understanding.
This approach is useful as an intermediate tool for organizing traits—but it is not intended to be permanent or representative of objective truth. And it is not science. It is operational theory—a method of managing symptoms without understanding their source. These behavioral clusters, still central to modern diagnostic criteria, reflect pattern recognition without structural insight. They tell us what deviates, but not what drives the deviation.
As a result, the public—and much of the field—has internalized a fundamental error: the belief that what someone does is a reliable reflection of how they think.
It isn’t.
To be explicitly clear: this isn’t to say all of psychology is blind to these limitations. There are researchers and practitioners actively questioning traditional frameworks—working to move beyond deficit-based models and toward more biologically-informed, neurodiversity-affirming approaches. But these efforts remain the exception, not the norm. And without structural redefinition, even well-intentioned work risks being absorbed into the same outdated systems it seeks to reform.
The Theory Trap
Attempts to justify these behavioral frameworks through scientific language often reveal an uncomfortable truth: psychological pathology is not actually rooted in science—it is rooted in theory.
At best, it occupies a single step of the scientific process: hypothesis formation. But it rarely progresses beyond that. Theories that do become grounded in consistent, replicable mechanisms tend to migrate out of psychology entirely. They become medicine, biology, or neurology—fields defined by testable, physiological structure.
Operational definitions were never meant to bear this weight.
They were introduced as tools—to make abstract traits measurable for research and clinical purposes. But over time, their utility was mistaken for explanatory power. What began as a means of communication became a substitute for understanding, leading to rigid diagnostic categories that mask the very complexity they were designed to observe.
What remains in psychology is often a flexible, interpretive infrastructure built more on precedent than principle. It adjusts just enough to remain useful, but rarely reevaluates its foundation. This is how autism gets defined by checklists instead of cognition. How attention becomes hyperactivity. How trauma gets pathologized as personality.
Psychology’s Identity Crisis
This is, in part, why neuropsychology exists. It represents an attempt to bridge the gap between theoretical psychology and measurable cognitive function—between interpretive narrative and empirical structure.
It also explains the institutional separation between diagnosticians and therapists: one is tasked with identifying patterns, the other with navigating them. Yet despite these distinctions, psychology as a field continues to yearn for scientific legitimacy it hasn’t structurally earned.
Part of the reason these systems persist is practical. Diagnostic categories serve administrative and institutional functions: they provide shared language for clinicians, justify treatment plans for insurance providers, and enable large-scale research protocols.
But pragmatic necessity doesn’t equal conceptual validity—and when the operational becomes the ontological, we lose sight of the difference.
It borrows the language of neuroscience, cloaks itself in clinical formality, and appeals to data that often emerge only after the fact—retrofit to justify frameworks that were never scientifically grounded to begin with.
And when the stakes are low, that might be forgivable. But when the stakes are people—especially people already vulnerable to misjudgment—interpretation without structure becomes harm disguised as help.
A World Misled
The result is that nearly everyone has been taught the wrong idea.
Society has absorbed a diagnostic vocabulary that equates behavior with identity. We assume someone who struggles to speak must lack understanding. That someone who appears “unmotivated” must lack will. That observable difference is cognitive defect.
This confusion infiltrates schools, workplaces, families, therapy rooms. It turns divergence into pathology and diversity into deficit.
And for those of us who live in that space—whose inner structures don’t conform to external expectations—it is disorienting, dehumanizing, and exhausting.
So, what now?
This is not a call to abandon psychology. It is a call to confront its limits—and to rebuild from the inside out.
We need cognitive models grounded in structure, not symptoms. We need to separate theory from truth, interpretation from mechanism. We need to restore the distinction between what a person does and how a person thinks.
Only then can we begin to see each other clearly.
And for those of us who’ve spent a lifetime being misread: clarity isn’t just helpful. It’s freedom.
It’s in that spirit that I offer my own Monotropic Expansion model. It is, at its core, a theory—a rigorous one, rooted in lived experience, logical structure, and years of recursive insight. But it doesn’t pretend to be something it’s not. It doesn’t wear the cloak of scientific finality.
What it does offer, explicitly, is a structural lens for understanding cognition from the inside out—one that re-centers attention flow, recursive processing, and internally motivated meaning-making as the foundation, not the byproduct, of divergence. It directly challenges the assumption that behavior must be the entry point to understanding, and instead proposes that structure precedes symptom. That cognition is not defined by how it manifests externally, but by how it coheres internally.
A Mirror, Not a Dismissal
Again, to be clear, this is not a dismissal of psychology—it’s a clarification. Psychology, as we practice it today, is a theoretical discipline. A collection of models and frameworks that aim to interpret behavior and guide care. At its best, it provides pragmatic tools for navigating human complexity. But that usefulness doesn’t make it science. And it doesn’t need to be.
What it needs is honesty about its nature.
Calling psychology theoretical isn’t an insult—it’s a mirror. A reminder that value doesn’t come from claiming certainty, but from the willingness to keep asking better questions.
I want to be fully transparent: I don’t have formal, high-level education in psychology. My background is rooted in lived experience, cognitive modeling, and a kind of relentless pattern analysis that comes with being autistic, monotropic, and unwilling to let flawed structures stand unchallenged. That doesn’t make me right by default. But it doesn’t make me wrong either.
So to those working within the field—researchers, therapists, clinicians, and diagnosticians—I invite you to engage with this. Challenge me. Broaden my perspective if I’ve missed something. Tell me if I’m speaking to something real—or if I’ve misunderstood the scope, the stakes, or the structure. I’m not looking for debate. I’m looking for clarity. For growth. For models that can withstand the weight of lived experience and the rigor of interdisciplinary insight.
All I ask is that you meet me where I’m coming from: in good faith, with respect for the intelligence and perspective I bring, and with an openness to rethinking what we think we know.
Return to the Root
In the end, this is a call for structural integrity. Not just in psychology, but in how we build understanding at all.
We’ve spent decades refining systems that grew from misalignment—systems that privilege appearance over architecture, symptoms over structure, and external agreement over internal coherence. These systems persist not because they’re right, but because they’re familiar. They’re easy to teach. Easy to bill. Easy to cite.
But if the foundation is warped, refinement only reinforces the distortion.
To move forward, we have to be willing to return to the root—to ask what cognition actually is, before asking how to categorize it. That means accepting that some of our most institutionalized models may not be wrong in the details, but in their very framing.
If we can do that, we open the door to something better. Something more human. Something more honest.
And that’s what I’m trying to build—not a replacement for psychology, but a contribution to the part of it that’s still willing to evolve. ∞
It’s statistics as proof, but the nuances of human behavior can’t be explained by numbers. We aren’t cells on a spreadsheet.
I can see I'm just going to have to work my way through reading your entire stack, Michael, with the slowness and purpose it deserves. You've distilled down and presented what I believe to be the truth of the psychology-science illusion, a pretending at absolute truth. I'm a psychotherapist and psych assessor, with a particular interest in neurodiversity and some experience in research (though not in the neurodiversity field). If am keen to contribute where I can. For now, I will simply say that your critique of the field (and your acknowledgement of where current diagnostic frameworks are useful, albeit limited and blunt) appears pretty sound to me.
As an aside, I much prefer using the PDM (Psychodynamic Diagnostic Manual) to the DSM for my assessment work, because it includes (where possible) internal experience as more or less the core defining feature of a given diagnosis. There are also plenty of 'UNKNOWN' entries where the internal experience or contributing maturational patterns are not well understood. I shall have to remind myself what it has to say about autism when I am next in my office ... probably not a lot, but I still find an honest admission of "we don't really know that yet" more compelling than a behavioural label.