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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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13 min read

There’s more to manifesting, here’s its philosophical backstory

Beyond the so-called sensible, a hidden strand of Western spiritual thought reemerges.

Daniel is an advertising strategist turned vicar-in-training.

Against a purple glittery background, a orange notelet reads: 'what you seek is seeking you.'
Maia I on Unsplash.

I’m slightly late to the party, but you may have heard that the Cambridge 2024 Word of the Year was ‘Manifest’. Essentially, ‘To Manifest’,  according to our friends at Cambridge, is  ‘to imagine achieving something you want, in the belief that doing so will make it more likely to happen’. For many people, ‘manifesting’ belongs in the eye-browraising intellectual funfair of New Age spirituality and self-help gurus and charlatans whose books belong in the second-hand boxes outside shops on the high street of dilapidated coastal towns selling crystals.

If you’re a Gen Xer and elder Millennial, you’ll probably have heard of Rhonda Byrne’s The Secret, a 2006 self-help hit. She claimed to teach readers the secret to prosperity, self-realisation, and fulfilling your heart’s desires. Visualise the object of your desire in your mind, use the innate concentrative energy of your cognition, and, through the scientific Law of Attraction, the Universe (yes, the capital ‘U’, Universe)  will deliver unto you those things which you have brought into your mind because ‘like attracts like’. It shares a very similar perspective to a book written a hundred years prior in 1910 called The Science of Getting Rich by William Wattles which, again, claimed that through ‘creative thought’ you could achieve financial success. By ‘creative thought’ Wattle didn’t mean coming up with a growth strategy for your personal finances - he meant, like Bryne, that there was a psychical force in the Universe that you could tap into with your mind which could manifest, in reality, your thoughts and desires.

Again, if you’re a child of sensible society, you probably would have dismissed all of this as pseudoscientific New Age wishful thinking intended to make bad authors rich. Or, if you were more generous, you might have said that these were helpful psychological practices like ‘focusing on your goals’ encoded in woo-hoo New Age language. It belongs in the weird corner of society. And so, you might be somewhat baffled to find it breaking through into mainstream society - so much so that a sensible institution, like Cambridge University, would highlight it as a groundswell trend in the twenty-first century. 

But is this really a surprise? What has sensible society given us? For many, it’s been the managed and catastrophic decline into societal disillusionment, a generation of broken promises, and the feeling of being feudal serfs under the dominion of national banks and billionaires while we medicate ourselves to death with algorithmically-driven AI slop in the spiritual vacuum of a fragmented and polarised society. The fact that the Oxford Dictionary's Word of the Year was ‘brainrot' makes this all the more ironic and sad. And so is it any wonder that people are looking beyond the sensible towards the magical, the mystical, and the Esoteric? And I’m using the word ‘sensible’ in both ways. People are looking beyond the status quo of what is acceptable and accepted knowledge, but they are also looking to things that are beyond their senses.

Human consciousness can manifest thoughts into reality through metaphysical practices like concentration and visualisation. For New Thought thinkers, this was connected with loftier aims than getting rich or manifesting a pay-rise at work.

I’m definitely not alone in this diagnosis. It’s the thesis behind Rod Dreher’s new book Living in Wonder and Justin Brierley’s The Surprising Rebirth of Belief in God tracks prominent thought-leaders turning to God and mysticism. Even Wunderman Thompson, a leading advertising agency, highlighted the $3.7 trillion dollar neo-spirituality and wellness industry in their ever quotable report on the ‘Age of Re-Enchantment’. To be honest, even this recent trend of authors proclaiming the ‘spiritual turn’ is a bit late to the game. Back in 1999, the sociologist Peter Berger argued forcefully that the latter decades of the twentieth century saw the radical ‘desecularization of the world’. 

Clearly, cultural trends don’t happen in a matter of years, but take place over decades, even centuries and it seems that we’re finally seeing the mainlining of a previously hidden strand of Western spiritual thought into wider society. So much so that your children and neighbours are searching for ‘manifesting’ on Google and YouTube as a genuine intellectual query. 

Where does this all come from? Ideas don’t spring up from nowhere. They have a history, and the philosophical ideas underneath manifesting weren’t just made-up in the last minute of human history. They in fact go back to an incredibly rich and developed, and once respected, tradition of thought that we’re only getting to grips with again  in recent decades. 

Historical roots of manifesting

The modern concept of ‘manifesting’ finds its root in the New Thought movement of the nineteenth century that shared many themes with the earlier American Transcendentalists. While Transcendentalism emphasised the unity of nature, humanity, and God, New Thought took this further, focusing on the mind’s power to shape reality.

Both movements emerged as a response to the perceived spiritual emptiness of Enlightenment-era materialism, seeking to reignite our connection to the metaphysical. 

Central to New Thought was the belief that the human mind is not merely a passive observer but an active force in the universe - capable of influencing both spiritual and material realms through concentration and intention. Human consciousness shapes reality in the fullest sense. In other words, Human consciousness can manifest thoughts into reality through metaphysical practices like concentration and visualisation. For New Thought thinkers, this was connected with loftier aims than getting rich or manifesting a pay-rise at work. It was about sparking a spiritual revival, attaining a unified theory of everything, and ultimately, salvation. 

“Consciousness shapes reality.” On one level, this is obviously true. You need consciousness to design buildings and cathedrals and strategic operation models to run companies. Even the placebo effect - something that continues to baffle medical professionals - shows that mental states can have tangible effects on the physical world.

For those who pray, this idea feels almost intuitive. Your silent thoughts reach into the metaphysical realm. How else does God hear your prayers? But where prayer is directed towards a personal God, manifesting envisions tapping into a universal force, drawing power through sheer concentration. It’s less about thanksgiving and more about metaphysical technique - what you might call a kind of ‘science of prayer’. (For what it’s worth, if you’ve ever seen a ‘Christian Science’ bookshop, this is what they’re getting at.) 

The New Thought movement is what the scholar Catherine Albanese calls a metaphysical religion of nineteenth century America. It went against the major Protestant revivalist movements at the time, as well as the mainstream scientific community. They rejected Christian notions about God as a sovereign being who gives salvation to the individual through the sacrifice of Jesus Christ, but rather saw Him as the metaphysical font of life and universal forces. And they rejected the scientific community for ignoring the spiritual and intuitive aspects of nature. It fell somewhere in-between. Much like other disciplines that we might call ‘pseudo-scientific’ or ‘pseudo-religious’ like Astrology, Alchemy, and Magic. 

Behind the New Thought movement 

The rabbit hole goes deeper. The New Thought and Transcendental movements didn’t just spring up from nowhere either. It is a child of what recent scholars and intellectual historians have begun to call the ‘Western Esoteric Tradition’. In this bucket, you have the familiar traditions of Astrology, Alchemy, and Magic (what some people call the ‘occult sciences’) as well as lesser known ideas like Theosophy, Theurgy, Anthroposophy, Mesmerism, Animal Magnetism and Hermeticism. Western Esotericism is a philosophical and spiritual strand that draws on ideas that go as far back as early Antiquity from certain interpretations of the ideas of Plato and a mysterious Egyptian magical figure, ‘Hermes Trismegistus’, who is said to have written a book called the Corpus Hermetica which lays down many of those philosophical assumptions held by the Transcendentalists - The unity of the world, the Law of Correspondence, and the centrality of the Human Mind as a unique mediator.  The ‘‘Law of Correspondence,’ is particularly interesting. It suggests that everything in existence—from the human mind to the stars—operates in a symphony of interconnected harmony - there is a resonance, a ‘sympathy’ up and down the universe. This idea continues to underpin contemporary practices like visualization, meditation, and even astrology.

An engraving of  shows a standing mesmerist pointing to a sitting patient, with lines drawn between the,
A practitioner of mesmerism using animal magnetism on a woman who responds with convulsions. Credit: Wellcome Library, London.

We might think that all these ideas of Western Esotericism have always been fringe. Again - for non-sensible people. The reality is that these ideas have played a profoundly influential role in the history of Western thought. Isaac Newton was not only a scientist and a Christian, but he was an obsessive Alchemist. Friedrich Hegel, probably the most influential philosopher of the nineteenth century, was a keen reader of the Heterodox Christian Mystic, Jakob Boehme - a monumental figure in Western Esotericism - even calling him the First German Philosopher. His ideas about the progress of history and the self-realisation of the World Soul find their origins not in Enlightenment philosophy but in Western Esotericism mediated through the Romantics. In fact, many of the Romantic Movements that ebbed and flowed since the 1790s to the contemporary world drew deep inspiration from the Western Esoteric tradition. They represented intellectual movements that rejected Enlightenment and Orthodox Christian thought and sought to retrieve spiritual and metaphysical insights from other ancient sources. 

Esotericism has also deeply influenced modern art, shaping the work of some of the most celebrated artists in the last two centuries. Claude Debussy was deeply influenced by the late nineteenth-century Parisian esoteric revival and spent many Wednesday evenings in salons discussing sacred geometry and the Tarot, while W.B. Yeats, the famous Irish poet, was an initiate of the Theosophical society. Perhaps most notably, Kandinsky, was deeply impressed by esoteric spiritualism. His book Concerning the Spiritual in Art argues that colors and shapes are not merely aesthetic tools but bear profound metaphysical significance. For Kandinsky, abstract art was a rejection of materialism and a reawakening of humanity’s spiritual potential.

In fact, the idea that the artist plays a central role in spiritual awakening was common to some esoteric movements. Josephin Péladan, a prominent figure in the French Occult Revival, wrote: 

“Artist, thou art priest: Art is the great mystery; and if your attempt turns out to be a masterwork, a divine ray descends as on an altar. Oh real presence of the divinity resplendent under these supreme names: Vinci, Raphael, Michelangelo, Beethoven, and Wagner. Artist, thou art king; art is the real kingdom.” 

The artist is the beating spiritual heart of the human community. Again, does this sound familiar? 

You could say that Western Esotericism, particularly in the last 200 years, represents a powerful counter-movement that sincerely and powerfully raged against spiritual death, meaninglessness, and the phenomena of disenchantment. 

We often like to tell the story of Western philosophical and religious thought in the last 250 years as two sides locked in mortal combat. On one hand, you have the traditional Christian worldview. God is real, miracles exist, and the universe is alive with prayer and worship and open to the supernatural. Meanwhile, you have the new bulwark of Enlightenment secular atheism laying siege to the Christian world, stitching up the world into a closed system of pure science and evacuating society of the miraculous, the sacred, and the supernatural. 

In response, Christians developed their own response to modernity and presented a way through the meaninglessness brought about by the Nietzschian death of God - theologians demonstrated how Christianity could meet the existential hunger felt by every individual heart. Meanwhile, the Evangelicals sent out missionaries to the ends of the earth with storming success such that today, China is set to become the most populous Christian nation in the world, and the Pentecostals spread like wildfire infusing almost every Christian denomination in the world with a sense of personal miraculous encounter with the Holy Spirit of God in a mundane world. At the same time, the atheist and New Atheist philosophers continued to mock and polemicise religion as the source of all violence and dangerous superstitions. But their arguments are fading into obscurity and persuasiveness as some of the key advocates of that early twenty-first century movement are changing their minds. 

This two-strand narrative—of Secular Disenchanted Nature governed by science versus Christian Enchanted Creation under a Trinitarian God—has shaped much of Western thought. Yet this framework is now undergoing a significant renovation. A third strand has always existed, though it has often been overlooked: the strand of Enchanted Nature. This perspective holds that humans have access to the supernatural and an open-ended universe outside of any religious and Christian frame, and this access is governed by ancient philosophies and ideas that are becoming more and more plausible in contemporary society - ergo MANIFEST. 

So what? 

If you’re a child of sceptical modernity and raised on the New Atheists, contemporary society must feel like a whiplash. It’s becoming more and more implausible to maintain a materialistic and rational worldview and the closed universe. Respectable thought-leaders are turning to faith and your friends, children, and colleagues are looking at you as if you're the weird one who lives in a little Reddit-atheist lock-in universe. It is becoming socially more and more difficult to maintain this without either being wilfully blind or being accused of imposing an quasi-imperialist vision of Western Scientism against the reality that most people in the world actually believe and live in. 

Christian thinkers and leaders ignore this at their peril. To dismiss the Esoteric based on books like The Secret would be like dismissing Christianity based on Instagram memes. When you walk past one of those crystal shops, or overhear a colleague comparing star charts, you’re in-fact encountering a millenia old intellectual tradition which taps into perennial human longings for cosmic connections. Sneering at this misses the point entirely. After all, Christians believe in a divine-human Messiah who reigns above angels and archangels who conquered demons and turns his ear to the whispered prayers of broken hearts on dark cold nights. What do you mean that ‘manifesting’ is ‘unscientific’? If you want to critique manifesting or astrology, you’ll need arguments rooted in your own rich tradition—not borrowed Enlightenment dismissals, the same ones once aimed at Christianity itself.

Christians should also recognise that Western Esotericism shares more-or-less common aims. Both seek to renew society, spread wisdom, and heal souls. But this doesn’t mean the two can coexist uncritically. Christianity no longer exists in a vacuum. It is in a marketplace of ideas and Christians need to discern what makes Christianity uniquely special and ensure that it doesn’t adopt ideas that can dilute its integrity. 

The word manifest reveals more than a passing trend—it taps into a deep human longing.

History reminds us that Christianity and esotericism have long had a complex and entangled history. Renaissance Catholic Christians first re-introduced Hermetic ideas and Kabbalah back into the Western mind, and it was nineteenth century Protestant Christians who tried to encode Christianity into the wider frameworks of Esoteric thought and injected society with the panoply of sects and secret societies. Would it surprise you that some of the leading Occultists back then, like Eliphas Levi, were motivated to promote Jesus Christ? Maybe you’re a Christian artist and that quote above from Péladan was disconcerting precisely because of how closely it matches your intuitions. This history is both a caution and invitation: to understand the spiritual landscape more deeply and engage more thoughtfully. 

The real challenge isn’t opening minds to the supernatural - that’s already happening. The task now is to show why the longing for cosmic connection finds its true answer in the person of Jesus Christ. And in a world captivated by openness, that’s no easy task. And it's far more attractive to tell people to be more ‘open-minded’ than to be ‘close-minded’. 

The word manifest reveals more than a passing trend—it taps into a deep human longing. Beneath the vision boards and affirmations, beyond the social media buzzwords, lies a shared ache for transcendence—a yearning to live in a world that feels alive, meaningful, and connected. It’s the search for something more.

We’re not just bystanders to this cultural moment; we’re participants in a profound shift. This is an invitation to move beyond easy skepticism or condescension. What we’re witnessing isn’t a flash-in-the-pan phenomenon but a continuation of a timeless quest to find order, purpose, and connection in a universe that so often feels fragmented. 

But let’s be honest: this is a competitive and crowded marketplace of ideas. Ancient philosophies, mystical practices, and modern interpretations are converging in a swirl of cosmic vibrations, personal empowerment, and spiritual techniques. And while that diversity is exciting, it’s also disorienting. The challenge for all of us, no matter our background or beliefs, is to discern what’s authentic, what’s helpful, and what’s merely noise.

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