The Master's Tools: Why Affirming Care Can’t Exist in a System Built to Control
Autism, Power, and the Political Economy of Mental Health
Autistic therapists challenge systems built to control, not care. True healing requires dismantling capitalist structures and creating affirming, collective spaces where neurodivergent people are free to exist as they are.
Introduction
I recently came across Bridgette Hamstead’s article on LinkedIn, Why We Need More Autistic Therapists and Neurodivergent Mental Health Providers, and was struck by how clearly it articulated a vision of care rooted in lived experience, solidarity, and affirmation. Many within the neurodivergent community—particularly adults and professionals—have found LinkedIn to be one of the few remaining social platforms where such ideas can be shared and discussed with a measure of seriousness and respect. As other platforms become increasingly hostile, LinkedIn has become a space where those of us navigating life as neurodivergent individuals can engage in thoughtful dialogue about the systems we’re entangled in. Hamstead’s vision—that of a future where autistic and neurodivergent therapists are not only included in the mental health field but are actively shaping it—is compelling and necessary. Yet, as much as I resonate with this vision, I find myself confronting the uncomfortable reality that it remains unattainable within systems designed to uphold control, compliance, and capital. The mental health system, like so many others under capitalism, was not built to nurture or liberate neurodivergent people; it was built to manage us.
Framing my thinking within the Power Threat Meaning Framework, I find it impossible to ignore the fundamental misalignment between traditional therapy models and the needs of neurodivergent people. PTMF asks us to consider different questions than those posed by clinical diagnosis. Instead of, “What is wrong with you?” PTMF invites us to ask, “What has happened to you?” “How did it affect you?” “What meaning does this have for you?” and “What is your response?” These are questions rooted in the recognition of systemic power, of trauma, of meaning-making within contexts often defined by exclusion and oppression. Yet traditional therapy, shaped by the medical model, denies these questions in favour of individualised pathology. It treats our distress as personal dysfunction rather than the predictable result of living in a world that refuses to accommodate, let alone value, our existence. This approach serves a purpose—not our healing, but our regulation into something more acceptable to the dominant order.
From a Marxist perspective, this makes perfect sense. Under capitalism, mental health is not about collective liberation; it is about restoring the individual to productivity. The goal is not to understand or challenge the conditions that produce distress but to return the worker—neurodivergent or otherwise—to functionality within a system that demands constant output. Care becomes compliance, healing becomes conformity, and therapists are trained not to question the structure itself but to guide individuals back into its fold. In this context, the inclusion of neurodivergent therapists is not only unlikely—it is threatening. It challenges the very foundations of a system that depends on the suppression of difference to maintain the illusion of normalcy.
The Power Behind the Pathology
Autism has long been framed not as a valid and natural variation of human cognition, but as a deficit, a disorder, something fundamentally ‘wrong’ with the individual. This framing is not a neutral or objective assessment—it is a reflection of the values, fears, and priorities of the dominant neurotypical culture. The pathologisation of autistic ways of being serves a clear social function: it allows systems of power to control difference, enforce conformity, and suppress behaviours that challenge normative assumptions about communication, productivity, and social engagement. Within the PTMF, we can see that this deficit-based view of autism is not just misguided but actively harmful. PTMF asks us to consider distress and difference not as evidence of pathology, but as meaningful responses to power, to threat, and to the social contexts in which individuals find themselves. When autistic traits are labelled as symptoms of a disorder, this recoding of difference as dysfunction legitimises interventions that serve not the individual, but the systems around them.
Non-conformity in a neurotypical society is often experienced as threatening—not because it causes harm, but because it disrupts the smooth functioning of environments built around narrow expectations. Autistic people often communicate differently, process sensory input in unique ways, and engage with the world through patterns of thought and behaviour that resist standardisation. Rather than seeing this as a valuable perspective, the dominant culture frames it as a problem to be managed. This is where the power behind the pathology becomes evident. Interventions commonly imposed on autistic individuals—such as social skills training, behaviour modification therapies, enforced eye contact, the suppression of stimming, and masking of true emotional states—are not acts of support. They are techniques of control. These approaches aim to make autistic people less visibly autistic, more acceptable to neurotypical norms, and ultimately, more compliant within systems that prize uniformity over authenticity.
Such interventions reflect the needs of institutions—schools, workplaces, and clinical environments—more than the needs of autistic people themselves. They are designed to reduce ‘disruption’, to facilitate productivity, to avoid the discomfort neurotypical people may feel when confronted with difference. From the PTMF perspective, these interventions are a response to the perceived threat posed by autistic people’s refusal—whether conscious or not—to perform normative behaviours. In framing this refusal as disorder, systems are able to justify coercive treatments under the guise of care. The logic is insidious: if autism is inherently disordered, then attempts to suppress or alter autistic traits are framed as benevolent, even necessary. But in reality, these interventions often cause profound harm—fueling internalised shame, anxiety, and burnout, as individuals are forced to abandon their natural ways of being in favour of performative compliance.
This is not care. It is management. And it serves to obscure the real sources of distress that many autistic people experience—not their autism, but the constant pressure to fit into a world that refuses to accommodate them. The narrative of pathology shifts responsibility away from oppressive systems and onto the individual, insisting that it is the autistic person who must change, who must adapt, who must be fixed. This is the essence of power operating through pathology: it disguises control as help, and conformity as healing. Within this context, the demand for neurodivergent-led, affirming care is not simply a call for inclusion—it is a direct challenge to the systems that have long used the language of disorder to silence, marginalise, and erase.
The Political Economy of Mental Health
Within a Marxist framework, the mental health system must be understood not as an impartial or benevolent force, but as part of what Louis Althusser identified as the ideological state apparatus—institutions that exist to uphold the dominant social order and reproduce the conditions necessary for capitalism to function. Mental health care, far from being a neutral service aimed at individual well-being, operates to enforce norms, discipline behaviour, and ensure that individuals remain productive members of the labour force. Under capitalism, health itself is not defined by holistic well-being or self-actualisation, but by one’s ability to participate in wage labour. The ‘healthy’ individual is the one who can work, who can perform efficiently, and who does not disrupt the smooth functioning of capitalist enterprise. Those who cannot meet these expectations—due to cognitive, emotional, or sensory differences—are not seen as diverse or in need of accommodation, but as disordered, defective, and in need of correction.
In this context, neurodivergent people, and autistic people in particular, represent a challenge to the model of the ideal worker. The ideal worker is punctual, compliant, sociable on demand, able to process information in linear and time-bound ways, and capable of self-regulation under pressure. Many autistic people struggle with or outright reject these expectations—not due to lack of will or capability, but because our neurology does not lend itself to the rhythms and demands of capitalist labour. Instead of questioning whether the model of work is humane or sustainable, systems turn their gaze on the individual, diagnosing and pathologising non-conformity. This serves to naturalise the existing economic order, positioning it as unchangeable whilst casting those who cannot conform as inherently flawed. Therapists, in this schema, often function as gatekeepers of normalcy, tasked with guiding individuals back into acceptable patterns of behaviour—not for their liberation, but for their reintegration into the systems of production and control.
Therapy thus becomes a means of social regulation, not emancipation. It is no coincidence that the rise of behavioural therapies, such as Applied Behaviour Analysis (ABA), and the expansion of pharmaceutical interventions for neurodivergent individuals have coincided with the commodification of mental health itself. Autism, in particular, has become a site of intense industrial activity—entire sectors now exist around its diagnosis, ‘treatment’, and management. From therapy clinics to pharmaceutical companies to educational consulting firms, the ‘autism industry’ is driven by capital accumulation, not by a genuine concern for the well-being of autistic people. ABA, for instance, is marketed as a means of preparing autistic children for participation in normative society, with little regard for the trauma and long-term harm it causes. Similarly, pharmaceutical interventions are often used to suppress behaviours deemed inconvenient or undesirable, without addressing the underlying social and environmental causes of distress.
These industries do not exist in isolation—they are woven into the fabric of capitalism, which seeks to monetise all aspects of life, including difference and distress. The treatment of autism becomes another avenue for profit, and in the process, the voices and needs of autistic people themselves are marginalised. Our existence is framed as a problem to be solved, a market to be tapped, a deviation to be corrected—all in service of maintaining a social order that cannot accommodate us as we are. True well-being, in this framework, is impossible, because it would require a fundamental transformation of the conditions under which we live and labour. It would require the dismantling of systems that see our value only in terms of economic output and seek to erase or exploit anything that cannot be easily assimilated into the capitalist machine.
Neurodivergent Therapists: A Threat to the System
Hamstead’s vision is powerful not only because it offers hope to neurodivergent people seeking affirming care, but because it fundamentally challenges the power structures embedded within the mental health system. The presence of autistic and neurodivergent therapists disrupts the status quo by resisting the pathologisation of difference and offering solidarity in place of surveillance. These therapists do not view their neurodivergent clients as broken or in need of correction; they understand, from lived experience, that distress is often rooted in systemic oppression, not individual failing. Their very existence calls into question the legitimacy of a system that claims authority over how people should think, feel, and behave. To practise from a neurodiversity-affirming stance is to refuse the logic of control that underpins traditional therapy—and that refusal is threatening to a system that relies on maintaining control, extracting profit, and defining what is ‘normal.’
The system cannot easily accommodate neurodivergent therapists because doing so would require relinquishing not only control, but also the right to define reality itself. Within both clinical and institutional settings, neurotypical norms are positioned as the default, the objective standard against which all others are measured. To allow neurodivergent therapists to operate openly, without being forced to mask or conform, would undermine the assumed neutrality of these standards. It would expose the constructed nature of ‘professionalism,’ ‘competence,’ and even ‘mental health’ itself—terms that are deeply rooted in cultural and economic expectations rather than universal truths. Through the lens of the PTMF, we can see how meanings are attached to neurodivergent professionals in ways that maintain power hierarchies. They are often seen as incompetent, emotionally unstable, biased, or unprofessional—not because of any actual shortcoming, but because their presence threatens the authority of those who benefit from the current order. Their insight is dismissed, their experiences minimised, and their contributions undervalued, all in service of preserving the illusion that only neurotypical minds are fit to determine what constitutes health and care.
This dismissal of neurodivergent labour ties directly into a Marxist critique of capitalism. Under capitalist logics, labour is valued not for its humanity, but for its utility—specifically, its capacity to generate profit. The labour power of neurodivergent people is consistently undervalued or excluded altogether because it does not easily conform to the commodified, standardised frameworks of productivity that capitalism demands. Neurodivergent therapists often work in ways that are more relational, more flexible, and less focused on replicable outcomes—qualities that resist quantification and thus cannot be neatly packaged for profit. Their care cannot be easily scaled, marketed, or extracted for surplus value. Moreover, their insistence on centring client autonomy, self-definition, and authenticity threatens the mechanisms of control that underpin much of the mental health industry. In this sense, neurodivergent therapists are not only marginalised workers—they are, by their very presence and praxis, a form of quiet rebellion against the system itself. Their vision of care is not one that can be co-opted without losing its integrity, and for that reason, it remains outside the bounds of what capitalist mental health systems are willing to accept.
Toward Liberation: Collective Care, Not Compliance
True healing for neurodivergent people cannot occur within systems that commodify care, enforce conformity, and uphold hierarchies of power. It requires a fundamental shift—a liberation of care from the grip of capital, and a centring of lived experience over professional gatekeeping. The dominant mental health model privileges credentials, standardisation, and authority over the knowledge that comes from lived struggle, from community, and from solidarity. For neurodivergent individuals, especially those who have been pathologised and excluded, healing is not found in compliance with systems that harmed us, but in spaces where our differences are not only accepted, but celebrated. It is in the quiet, often unrecognised practices of community-led care, peer support, and mutual aid that we find resistance to the commodification of mental health. These spaces operate outside—or in defiance—of capitalist logics, prioritising relational connection, reciprocity, and the recognition of each person’s inherent worth.
The PTMF offers a way to reframe our experiences, not as individual dysfunction, but as understandable and meaningful responses to power. It asks us to see distress not as a symptom to be treated in isolation, but as rooted in the conditions of our lives—conditions shaped by marginalisation, violence, exclusion, and exploitation. Within this framework, the goal is not to make us more palatable to the dominant culture, but to support our survival, our agency, and our right to exist as we are. Similarly, from a Marxist perspective, health care—including mental health care—must be understood as a public good, not a commodity to be bought, sold, or rationed according to profitability. When care becomes a market, those of us who do not generate profit or conform to normative expectations are left without meaningful support. The drive for efficiency, standardisation, and cost-effectiveness erodes the possibility of care that is slow, relational, and responsive to difference.
To move toward liberation, we must dismantle the systems that commodify and control, and in their place, build networks of support that honour neurodivergent lives. This means not only advocating for neurodivergent therapists and affirming care models, but also recognising that true support often comes from outside institutional spaces—from each other, from communities that understand the violence of conformity and the radical potential of difference. It means rejecting the notion that healing is about fixing individuals, and instead understanding it as a collective process of survival, resistance, and flourishing. In doing so, we create the conditions not just for coping, but for thriving—for imagining and building a world where care is not conditional on compliance, and where every person’s way of being is met with dignity, respect, and solidarity.
Final thoughts …
Hamstead’s article presents a clear and compelling premise: that the inclusion of autistic and neurodivergent therapists in the mental health field is essential for creating care that is truly affirming, accessible, and effective. This is not a call for tokenistic representation, but for a fundamental shift in how mental health is conceptualised and practised—a shift away from conformity and towards authenticity, from pathologisation towards solidarity. It is a vision where neurodivergent people are not merely the subjects of care, but its architects, shaping therapeutic spaces that honour lived experience and resist the erasure of difference. This vision resonates deeply with those of us who have been failed by systems that do not see us, that insist we must change to fit into a world built without us in mind.
Yet, for all its clarity and urgency, this vision cannot be realised within the confines of capitalism. The current mental health system is not broken—it is functioning exactly as designed, serving the interests of capital, not community. Its purpose is to regulate, to control, to ensure that individuals can be rendered productive in service of economic gain. In such a system, care is commodified, difference is pathologised, and those who resist are marginalised. The tools of this system—licensing boards, clinical hierarchies, standardised models of care—are the master’s tools, and they cannot dismantle the master’s house. They are designed to preserve the very structures that prevent neurodivergent liberation.
Real change cannot come from reform alone. It must come from dismantling the systems that profit from our distress, that seek to mould us into compliant, productive subjects. It must come from building alternatives rooted in collective care, mutual aid, and the affirmation of all ways of being. Hamstead’s vision remains vital—not as a blueprint for integration into existing structures, but as a rallying cry to imagine and create new ones entirely. It is not enough to ask for a seat at the table when the table itself was built to exclude us. We must instead ask: what kind of world do we want to build, and how can we support one another in bringing it into being?