Late bloomers, early maturers, outdoor children, visual thinkers and dreamers - neoliberal society wrongly problematises the behaviour of these children. Child and adolescent psychiatrist and APH researcher Hilgo Bruining believes things can and should be different, as he explains in an extensive interview with Medisch Contact.
Hilgo Bruining is a man with a mission: care for children with developmental disorders must become fair and sustainable. Because, according to the Amsterdam-based child and adolescent psychiatrist, it is now too fragmented, arbitrary and the exchange of information is simply poor, he states in an interview with Medisch Contact (in Dutch). He wrote a book about it: Donutpsychiatrie (in Dutch), in which he links ecological thinking, the disastrous influence of neoliberalism and the problems in his profession.
Central statement: ‘We have a society in which children have to perform, regardless of whether that makes them thrive. We need a society where children can flourish regardless of their achievements or contributions.'
He takes the title of his book from an idea, or perhaps better, a visual model, of British economist Kate Raworth. Disappointed by her profession's focus on growth, expansion and the laws of the market, she began to consider the issue of how growth comes at the expense of a livable planet, but also causes inequality. Thus, she devised the donut model, where the donut reflects the livable space between social livelihoods on the inside and planetary boundaries on the outside. It became a famous model because it shows, in an appealing way, that we need to strike a balance between fighting social insecurity and preventing the earth from collapsing under our ecological footprint.
Concepts like autism and ADHD need thorough revision
Donut model
In his workspace at the Amsterdam UMC, location AMC, Bruining enthusiastically talks about how he saw important analogies with youth care and child psychiatry. 'We too tend to focus very much on growth. And by that I mean that performance and outcome are actually leading in how we judge and look at children and focus on the deviation from the norm. And that this is at the expense of what children actually need. My contention is that we judge children's development too much instead of feeling a duty to provide the right conditions for development. With the donut model, we guard the balance between aptitude and basic conditions on the inside and the ceiling of care and educational opportunities on the outside. In between lies the sweet spot, the donut itself, for optimal and sustainable flourishing. In my profession, we recognise the importance of environment and context in this, but have limited ability to give them a place in concepts like autism and ADHD. These once made sense to streamline science, but are now in need of thorough revision.
Read the full article with Hilgo Bruining on Medisch Contact (in Dutch)