David Gray-Hammond cross-posted a post from DGH Neurodivergent Consultancy David Gray-HammondDec 1 · David Gray-Hammond I am quite proud of this piece of work and excited to share it with all of you! Toward An Ecosystemic Model Of Distress Rethinking Mental Health Beyond The Medical Gaze David Gray-Hammond Dec 1   READ IN APP   For more than a century, Western models of mental health have been shaped by a reductive idea; distress lives inside the individual. Mental illness has been framed as a disruption of brain chemistry (despite being debunked); pathology is located within neural tissue; a disordered mind is imagined as a malfunctioning organ. This biomedical gaze has become the dominant grammar of suffering, legible to institutions, politically convenient, and profitable to administer. Yet it has never fully described the reality of how distress takes shape in human lives. Across my work, whether writing about Autistic burnout as a crisis of connection, monotropism, addiction and recovery, psychosis, neuroqueering, or the relational roots of wellbeing, I return to the same foundational insight; human beings exist within ecosystems. Our experiences, behaviours, vulnerabilities, and trajectories of distress cannot be isolated from the sensory, relational, institutional, and political environments we inhabit. We are permeable creatures responding to worlds in motion. To rely solely on medicalised models is to confuse one tree for an entire forest. An ecosystemic model of distress offers a different way forward. It draws on neurodivergence-competent practice, disability justice, critical psychiatry, and the lived truths of communities who have been pathologised for generations. It refuses to treat distress as an internal failure and instead situates it within the interdependent networks of environment, relationship, culture, and power. The Chaotic Self, a concept I have defined throughout my work, sits at the heart of this shift. It explains why any model of mental health that ignores context will fail, and why a model that honours context has the potential to transform practice, policy, and human lives. The Chaotic Self: A Foundation for an Ecosystemic Model The Chaotic Self begins with a simple premise: the Self is never static. It is always becoming, always reorganising, always responding to the relational, sensory, emotional, and political & systemic landscapes it moves through. Every moment, every sound, every relationship, every threat, every joy, reshapes the Self, altering its trajectory. This is not chaos in the colloquial sense of disorder. It is chaos in the scientific sense; a system exquisitely sensitive to initial conditions and ongoing inputs. A small change in environment can shift the entire direction of a life. A moment of connection can stabilise the Self; a flash of coercion can destabilise it. If the Self is in constant flux, shaped by everything around it, then distress is not an isolated “malfunction”. Distress is a meaningful response to an ecosystem that has become unliveable, incoherent, or overwhelming. This alone should destabilise the foundations of the medical model. A model that insists distress is generated only inside the brain is already at odds with the lived structure of the human mind. Local Environment: The Sensory and Material Ecology of Distress To understand distress ecosystemically, we begin with the most intimate environment; the immediate sensory world. For Autistic and otherwise neurodivergent people, sensory environments are not neutral backdrops. They are living forces that shape cognition, regulation, attention, and behaviour. A single fluorescent light can erode executive functioning; the hum of a crowded waiting room can chip away at self-regulation; an inaccessible workplace can drain cognitive capacity long before “symptoms” emerge. Environmental toxicity, noise, lighting, temperature, unpredictability, creates fertile ground for distress, not because the person is inherently fragile, but because the environment is misaligned with their bodymind. Material conditions deepen this ecology. Poverty, food insecurity, housing instability, unsafe neighbourhoods, and limited access to transport all create chronic stress. These are “stressors” in the sense of structural determinants of mental health. Austerity and precarity physically alter nervous systems. The medical model treats these conditions as background complications. An ecosystemic model treats them as central causal mechanisms. Personal Relationships: Co-Regulation, Misattunement, and the Relational Roots of Suffering Humans regulate together. Co-regulation, our nervous systems tuning to one another, is not an optional extra; it is foundational to how distress forms and resolves. When relationships are safe, attuned, and reciprocal, distress softens. When relationships are coercive, confusing, invalidating, or characterised by neuronormative expectations, distress intensifies. This relational aspect underpins everything from the double empathy problem to Autistic burnout. Burnout, as I argue, is not simply exhaustion. It is a collapse of relational, sensory, and cognitive synchrony; a crisis of connection between the Autistic person and their ecosystem. The medical model often reduces relational ruptures to “interpersonal problems”. In practice, these ruptures are often consequences of systemic misunderstanding, structural ableism, or environments designed around neurotypical norms. Relationships generate distress not because the individual is disordered, but because the relational field is misattuned. The Unseen Influence: How Third-Party Relationships Shape Distress Much of what harms us takes place in rooms we never enter. A child feels the emotional fallout of tension between teachers. An employee experiences the instability produced by conflict between managers. A disabled adult bears the consequences of miscommunication between social services and healthcare providers. A family is strained by decisions made between professionals in closed meetings. Communities are impacted by political alliances that shape policy long before it reaches them. These third-party relationships act as invisible winds in the ecosystem. Their turbulence shapes wellbeing without ever being located in the individual. Traditional diagnostic frameworks cannot account for these forces because they fall outside the boundaries of the “patient”. An ecosystemic model understands that these broader relational patterns are active agents in the production of distress. Institutional, Political, and Economic Systems: The Deep Currents of Distress At the widest ring of the ecosystem are the institutional, political, and economic structures that govern daily life. These systems are lived environments that permeate every aspect of wellbeing. Institutional Ecosystems Healthcare, education, criminal justice, housing, social care; these systems shape mental health outcomes through: Availability of resources Accessibility Staff training Embedded ideology Biases and discriminatory practices Institutional violence and coercion Autistic adults waiting years for assessment, or ADHD services abruptly discharging people at age 25, are not experiencing “illness”. They are experiencing the predictable distress of institutional neglect. Political Ecosystems Political priorities decide whether communities thrive or collapse. Policies on welfare, immigration, disability rights, drug regulation, education, housing, and employment create conditions that either reduce or amplify distress. A society built on austerity will always produce burnout and breakdown. This is not a clinical issue; it is political architecture. Economic Ecosystems Precarity is its own form of slow violence. When people cannot afford stability, housing, transport, food, energy, their nervous systems remain in perpetual threat mode. The resulting distress is frequently medicalised, shifting responsibility from structural causes to individual pathology. This is convenient for governments. It is not accurate. Biology in Context: Vulnerability Without Reductionism None of this poeticises biology away. Bodies matter. Neurodevelopment, sensory profiles, genetic predispositions, and neurological differences influence vulnerability, reactivity, and resilience. But biology is not a sealed container. It is porous. It receives information from the environment, responds to relational dynamics, and adapts to structural conditions. Biological vulnerability does not mean biological determinism. The medical model collapses context into chemistry. The ecosystemic model situates chemistry within context. Distress as Feedback: The Nervous System as Ecological Witness In an ecosystemic framework, distress is not evidence of malfunction. It is a form of communication. When the ecosystem becomes unsustainable the bodymind raises alarm. Distress becomes ecological data. A person experiencing Autistic burnout is not “failing”. They are responding to unliveable demands. A person using substances to self-medicate is not “disordered”. They are mitigating relational or environmental pain. A person experiencing psychosis may be responding to trauma, community disintegration, or systemic violence. The medical model locates the problem in the person. The ecosystemic model locates the problem in the system. Healing as Ecosystem Repair If distress arises from ecosystems, healing must involve ecosystem repair. Environmental Repair Making sensory environments compatible with neurodivergent bodyminds. Rebuilding predictability. Ensuring basic material security. Relational Repair Strengthening co-regulation. Cultivating community belonging. Reducing neuronormative demands. Building neurodivergent cultural spaces. Institutional Repair Training professionals in neurodivergence-competent practice. Reforming coercive policies. Addressing wait times, service gaps, and systemic exclusion. Political Repair Investing in social safety nets. Ensuring disability justice. Addressing poverty as a public health emergency. Cultural Repair Combating stigma. Expanding narratives of neurodivergence beyond deficit. Honouring lived experience as epistemically valid. Under an ecosystemic model, healing becomes a collective responsibility, not an individual task. Why Ecosystemic Models Matter Now We are living through a crisis of mental health services, but the deeper crisis is conceptual. Systems built on medicalised assumptions will always blame the individual for what the ecosystem has produced. By shifting to an ecosystemic model: Distress becomes intelligible Interventions become humane Policy becomes grounded in reality Practice becomes collaborative People become more than diagnostic objects An ecosystemic model does not reject medicine; it contextualises it. It does not discard biology; it reframes it. It does not minimise suffering; it explains it. Most importantly, it returns agency and dignity to those whose distress has been medicalised into invisibility. It affirms that distress is not a personal defect but a relational, environmental, and political event. A More Honest Map of the Human Condition Human beings are ecological. The Chaotic Self expresses this; we are reshaped by every experience, every interaction, every environmental shift, every policy, every relationship, every systemic force. Distress is the nervous system bearing witness to the ecosystem. To build mental health systems that actually reduce suffering, we must build models that reflect the reality of human life; dynamic, relational, interdependent, and political. The ecosystemic model does this not by abandoning science, but by expanding it. It offers a map of distress that honours the body, the community, the environment, and the world we share. We have never lived as isolated brains. We are, and have always been, bodyminds within the context of our ecosystem. For more discussion and exploration, consider joining the NeuroHub Community. Join NeuroHub Don’t forget to check out the neurodivergent pride store! Neurodivergent Pride Store You can also support my work by buying me a coffee or subscribing. Buy David A Coffee DGH Neurodivergent Consultancy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. 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