Article
Comment
Leading
Politics
7 min read

Leaders wanted for these testing times

We need leadership that is famous for fifteen miles not fifteen minutes.

Elizabeth Wainwright is a writer, coach and walking guide. She's a former district councillor and has a background in international development.

A deflated looking woman stands aside from a protest rally, holding a small doll of herself that reads Recall Knope'.
Local leadership: Leslie Knope serving Pawnee, Indiana.

We are in a year of elections – locally, nationally, and in the US, and I have been wondering whether it’s true that we get the leaders we deserve, whether political leadership has always felt this way – this detached, divisive, even dangerous? More about ambition than integrity, about individuals more than our common life? Where might we find leaders that can take us into an increasingly hard to navigate, uncertain world?  

I find myself thinking back to local leadership and difficult conversations I was involved in as a district councillor. These were often conversations about priorities, and money – mainly, the fact that there wasn’t enough of it, and what there was continued to be pared back and back until only the absolute essentials were covered. Many council tax bills have recently gone up, usually with an explanation of the reason for the rise. Local authorities in Scotland recently voted for a council tax freeze but only after the promise of funding from the Scottish government to make up the shortfall. During my time on the council, we would write letter after letter to government ministers seeking clarity about grants or cuts. When extra funding was announced we were pitted against other councils to bid for meagre pots of money, taking time away from officers who were already stretched too thin. Each councillor, each officer, each member of the community we served had their own idea about how to approach budgeting and spending. Sometimes those ideas aligned, but often they did not. Councils are in an impossible situation.  

And yet decisions made at this level impact us all. National leaders might set the direction, but local leaders steward and implement and envision and listen – they are close to the people they serve, their decisions impact us all day-to-day: councils are responsible for things like children’s services, highways, housing people, parks and pools, and lots more

The people who have played the biggest role in my life have been the people that made me feel valued, seen, heard, capable. 

Conversations about how to fund local authorities are difficult at any time, but especially so now, with crises coming from every angle – cost of living, climate change, ongoing post-covid recovery, austerity, and so on. To be a leader now – nationally yes, but especially locally, means making sure that essential services keep functioning despite lack of funding or clarity from government, and whilst also tackling climate change and all the other pieces of our fragmenting world. To be a leader now who shows vision and humanity and care despite the seemingly cynical and hurting spirit of the age – is, I think, a test of the meaning of leadership. This test of leadership doesn’t just face local and national government though. It faces all of us right now as we contemplate an unknowable future.  

Essayist Ralph Waldo Emerson believed that “our chief want is someone who will inspire us to be what we know we could be”, and we are all capable of helping others be what they can be – whether a neighbour, a colleague, a community, a team, an organisation, others we come into contact with; we can all lead. Author, poet, and civil rights activist Maya Angelou said that “people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” The people who have played the biggest role in my life have been the people that made me feel valued, seen, heard, capable. They have seen who I am, and who I could be, and they walk with me as I move in that direction. I think the best leaders do this too.  

It is not glamourous, but, like a lighthouse that shines by just staying where it is, it calls people, lights the way, watches, serves, guides. 

In contrast, the worst leaders seem to cling to traditional ideas of power, to control more than setting people free, to achieving their goals through any means necessary. I think of authoritarian regimes that rig elections and limit freedoms, and corporations that pursue profit at the expense of employees and the environment, and political campaigns that prioritise controlling the narrative over informing people. These embody warped leadership traits. And these warped ideas of leadership are given airtime, they fuel our news and our social media feeds and our anxiety. They make us angry, but they can also disempower us and close off the possibility that there is another kind of leadership, one more aligned with the Old English root of the word ‘leader’, meaning ‘one who guides and brings forth’. There are, though, places we can look that point to that other kind of leadership – to something more beautiful.  

One place is my own doorstep. Here, there are people that see a need and organise people to fill it – whether hunger, loneliness, lovelessness, this is a kind of roll-up-your-sleeves leadership, the kind that is famous for fifteen miles not fifteen minutes. It is not glamourous, but, like a lighthouse that shines by just staying where it is, it calls people, lights the way, watches, serves, guides. 

I try to hold on to the fact that we do not need to wait for national elections to call forth the kind of leaders we want. 

Another place is the gospel, where again and again Jesus turned traditional ideas of leadership upside down. He taught that it must serve, not be served; that it can be great through humility not self-importance. He criticised religious leaders for seeking prestige and personal gain. And Jesus did not just teach this stuff, he lived it – he washed the feet of his disciples, he empowered them rather than wielded authority over them. He lived as a shepherd that leads and tends his flock with his love. He laid down his life for his friends, for all of us. And this I think is where leadership starts to look a lot like love. Jesus showed how true leadership that transforms individuals and communities, that heals division and brings people together, is led and motivated by love, not power. He taught that leadership without love is hollow and even harmful. He showed that leadership, and the love that fuels it, guides and inspires and cares for people. We need these kinds of leaders now more than ever. My own experience tells me that hard conversations become easier to navigate when care, humility, and listening are present.  

In the UK, many of us are trying to get the measure of Rishi Sunak and Kier Starmer. An Ipsos poll in February explored how the public view these and other political leaders – a significant number were unclear about what they both stood for, but Starmer was ahead of Sunak in various leadership traits including experience, capability, strength. I want to know what other traits we’re seeking and demanding of our leaders nationally, locally and in ourselves. On the council I served on, I saw elected councillors asleep in meetings, ill-prepared, voted in because people did not think their vote or questions or care made a difference. On some level at least we do get the leaders we deserve – those we are prepared to be curious about, and call out, or encourage, or demand more of; more than just the ability to stay awake during meetings, more than just capability and strength, but also aliveness, care, compassion, humility, love.  

We need to demand more of our national leaders, especially now. But I try to hold on to the fact that we do not need to wait for national elections to call forth the kind of leaders we want. We can call them forth in ourselves, in each other, in our communities – these are the leaders that impact us closely, every day. I think of some of the best leaders I have known: theirs was a leadership of passion more than position, invested in people more than prestige, offering both humility and vision – a combination that feels hard to find in our current political landscape. They call to mind what writer and aviator Antoine de Saint-Exupéry said, that: “if you want to build a ship, don’t drum up the men to gather wood, divide the work, and give orders. Instead, teach them to yearn for the vast and endless sea.” Good leaders will help us see and navigate this endless ocean, these present storms – cost of living, conflict, division, ecological and economic unravelling. They remind us, like the gospel does, that the ship is a means to an end – one of new horizons, of togetherness, of love for this beautiful wide world. 

Review
Books
Care
Comment
Psychology
7 min read

We don’t have an over-diagnosis problem, we have a society problem

Suzanne O’Sullivan's question is timely
A visualised glass head shows a swirl of pink across the face.
Maxim Berg on Unsplash.

Rates of diagnoses for autism and ADHD are at an all-time high, whilst NHS funding remains in a perpetual state of squeeze. In this context, consultant neurologist Suzanne O’Sullivan, in her recent book The Age of Diagnosis, asks a timely question: can getting a diagnosis sometimes do more harm than good? Her concern is that many of these apparent “diagnoses” are not so much wrong as superfluous; in her view, they risk harming a person’s sense of wellbeing by encouraging self-imposed limitations or prompting them to pursue treatments that may not be justified. 

There are elements of O-Sullivan’s argument that I am not qualified to assess. For example, I cannot look at the research into preventative treatments for localised and non-metastatic cancers and tell you what proportion of those treatments is unnecessary. However, even from my lay-person’s perspective, it does seem that if the removal of a tumour brings peace of mind to a patient, however benign that tumour might be, then O’Sullivan may be oversimplifying the situation when she proposes that such surgery is an unnecessary medical intervention.  

But O’Sullivan devotes a large proportion of the book to the topics of autism and ADHD – and on this I am less of a lay person. She is one of many people who are proposing that these are being over diagnosed due to parental pressure and social contagion. Her particular concern is that a diagnosis might become a self-fulfilling prophecy, limiting one’s opportunities in life: “Some will take the diagnosis to mean that they can’t do certain things, so they won’t even try.” Notably, O’Sullivan persists with this argument even though the one autistic person whom she interviewed for the book actually told her the opposite: getting a diagnosis had helped her interviewee, Poppy, to re-frame a number of the difficulties that she was facing in life and realise they were not her fault.  

Poppy’s narrative is one with which we are very familiar at the Centre for Autism and Theology, where our team of neurodiverse researchers have conducted many, many interviews with people of all neurotypes across multiple research projects. Time and time again we hear the same thing: getting a diagnosis is what helps many neurodivergent people make sense of their lives and to ask for the help that they need. As theologian Grant Macaskill said in a recent podcast:  

“A label, potentially, is something that can help you to thrive rather than simply label the fact that you're not thriving in some way.” 

Perhaps it is helpful to remember how these diagnoses come about, because neurodivergence cannot be identified by any objective means such as by a blood test or CT scan. At present the only way to get a diagnosis is to have one’s lifestyle, behaviours and preferences analysed by clinicians during an intrusive and often patronising process of self-disclosure. 

Despite the invidious nature of this diagnostic process, more and more people are willing to subject themselves to it. Philosopher Robert Chapman looks to late-stage capitalism for the explanation. Having a diagnosis means that one can take on what is known as the “sick role” in our societal structures. When one is in the “sick role” in any kind of culture, society, or organisation, one is given social permission to take less personal responsibility for one’s own well-being. For example, if I have the flu at home, then caring family members might bring me hot drinks, chicken soup or whatever else I might need, so that I don’t have to get out of bed. This makes sense when I am sick, but if I expected my family to do things like that for me all the time, then I would be called lazy and demanding! When a person is in the “sick role” to whatever degree (it doesn’t always entail being consigned to one’s bed) then the expectations on that person change accordingly.  

Chapman points out that the dynamics of late-stage capitalism have pushed more and more people into the “sick role” because our lifestyles are bad for our health in ways that are mostly out of our own control. In his 2023 book, Empire of Normality, he observes,  

“In the scientific literature more generally, for instance, modern artificial lighting has been associated with depression and other health conditions; excessive exposure to screen time has been associated with chronic overstimulation, mental health conditions, and cognitive disablement; and noise annoyance has been associated with a twofold increase in depression and anxiety, especially relating to noise pollution from aircraft, traffic, and industrial work.” 

Most of this we cannot escape, and on top of it all we live life at a frenetic pace where workers are expected to function like machines, often subordinating the needs and demands of the body. Thus, more and more people begin to experience disablement, where they simply cannot keep working, and they start to reach for medical diagnoses to explain why they cannot keep pace in an environment that is constantly thwarting their efforts to stay fit and well. From this arises the phenomenon of “shadow diagnoses” – this is where “milder” versions of existing conditions, including autism and ADHD, start to be diagnosed more commonly, because more and more people are feeling that they are unsuited to the cognitive, sensory and emotional demands of daily working life.  

When I read in O’Sullivan’s book that a lot more people are asking for diagnoses, what I hear is that a lot more people are asking for help.

O’Sullivan rightly observes that some real problems arise from this phenomenon of “shadow diagnoses”. It does create a scenario, for example, where autistic people who experience significant disability (e.g., those who have no perception of danger and therefore require 24-hour supervision to keep them safe) are in the same “queue” for support as those from whom being autistic doesn’t preclude living independently. 

But this is not a diagnosis problem so much as a society problem – health and social care resources are never limitless, and a process of prioritisation must always take place. If I cut my hand on a piece of broken glass and need to go to A&E for stiches, I might find myself in the same “queue” as a 7-year-old child who has done exactly the same thing. Like anyone, I would expect the staff to treat the child first, knowing that the same injury is likely to be causing a younger person much more distress. Autistic individuals are just as capable of recognising that others within the autism community may have needs that should take priority over their own.   

What O’Sullivan overlooks is that there are some equally big positives to “shadow diagnoses” – especially as our society runs on such strongly capitalist lines. When a large proportion of the population starts to experience the same disablement, it becomes economically worthwhile for employers or other authorities to address the problem. To put it another way: If we get a rise in “shadow diagnoses” then we also get a rise in “shadow treatments” – accommodations made in the workplace/society that mean everybody can thrive. As Macaskill puts it:  

“Accommodations then are not about accommodating something intrinsically negative; they're about accommodating something intrinsically different so that it doesn't have to be negative.” 

This can be seen already in many primary schools: where once it was the exception (and highly stigmatised) for a child to wear noise cancelling headphones, they are now routinely made available to all students, regardless of neurotype. This means not only that stigma is reduced for the one or two students who may be highly dependent on headphones, but it also means that many more children can benefit from a break from the deleterious effects of constant noise. 

When I read in O’Sullivan’s book that a lot more people are asking for diagnoses, what I hear is that a lot more people are asking for help. I suspect the rise in people identifying as neurodivergent reflects a latent cry of “Stop the world, I want to get off!” This is not to say that those coming forward are not autistic or do not have ADHD (or other neurodivergence) but simply that if our societies were gentler and more cohesive, fewer people with these conditions would need to reach for the “sick role” in order to get by.  

Perhaps counter-intuitively, if we want the number of people asking for the “sick role” to decrease, we actually need to be diagnosing more people! In this way, we push our capitalist society towards adopting “shadow-treatments” – adopting certain accommodations in our schools and workplaces as part of the norm. When this happens, there are benefits not only for neurodivergent people, but for everybody.

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